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There is no indication of delay. In fact, the child is meeting expected developmental milestones. Recommending an evaluation is unnecessary and may cause unwarranted concern.

Imaginary friends and storytelling are common and healthy components of imaginative play at this age. They are not signs of a problem, nor are they typically linked to TV use.

While the child is developing well, the described skills fall within the normal range for a 4-year-old. Calling the child advanced would be inaccurate and could lead to unrealistic expectations.

Allergic conjunctivitis and allergic rhinitis are not caused by bacteria, so antibiotics offer no benefit. Using antibiotics unnecessarily increases the risk of resistance and exposes the child to unnecessary medication side effects. This statement shows the parent has misunderstood the teaching.

The child’s symptoms, itchy, watery eyes, sneezing, and clear rhinorrhea, are classic findings of allergic conjunctivitis and allergic rhinitis, not a viral infection. Viral infections usually involve redness, discomfort, and often systemic symptoms such as fever, malaise, or thicker nasal secretions.

Allergic conjunctivitis is not contagious, so notifying the daycare is not required. This response suggests the parent believes the condition may spread to others, which indicates misunderstanding of the teaching.

Imitation is more characteristic of the toddler stage (Autonomy vs. Shame and Doubt). While preschoolers may still imitate, it is not the primary defining behavior of their Eriksonian stage.

Taking apart a toy to understand how it works reflects curiosity and problem-solving more typical of the school-age child (Industry vs. Inferiority), who is focused on mastery and understanding how things function.

Building a model requires higher-level fine motor skills, sustained attention, and structured task completion, abilities more aligned with the school-age period rather than preschool development.

Critical thinking is incorrect because it requires logical evaluation, analysis, and objective reasoning—skills not yet developed in a 5-year-old. The child’s interpretation is based on imagination, not logic.

Concrete reasoning is incorrect because it belongs to the concrete operational stage (ages 7–11 years), when children begin to think logically about real, tangible objects. A child at this stage would understand the IV pole as a medical device, not as a monster. The child's interpretation is prelogical and imaginative, not concrete.

Egocentrism is incorrect because it refers to a child’s inability to see another person’s perspective, another feature of the preoperational stage. While a 5-year-old may still be egocentric, the behavior described—giving life-like qualities to an object—is specifically animism, not difficulty understanding viewpoints.

This is a form of regression is incorrect because regression involves reverting to behaviors from an earlier developmental stage (e.g., bedwetting or thumb-sucking) often triggered by stress or illness. Having an imaginary friend is a normal developmental behavior in preschoolers and is not considered regression.

Inclusion of imaginary friends may indicate lack of parental attention is incorrect because the presence of imaginary friends is not a sign of neglect or lack of attention. It is a normal aspect of imaginative play, even in children who receive adequate parental interaction and support.

She needs to seek psychiatric help for her daughter is incorrect because the presence of an imaginary friend in a preschooler is not pathological. Unless accompanied by other concerning behaviors (e.g., social withdrawal, aggression, developmental regression), it is considered a normal developmental phenomenon.

Concern with attractiveness is incorrect because this is more characteristic of the adolescent stage (Identity vs. Role Confusion), when children focus on body image, self-identity, and peer acceptance.

Wants to please parents is incorrect because preschool-aged children (ages 3–6) in Initiative vs. Guilt often seek parental approval. While school-aged children still value adult feedback, their primary focus shifts toward competence and peer recognition rather than parental approval alone.

Makes up games is incorrect because inventing games is typical of the preschool stage (Initiative vs. Guilt), when children engage in imaginative and symbolic play. School-aged children move toward structured play and rule-based activities, reflecting cognitive growth and industry development.

A BMI at or above the 90th percentile is generally considered overweight, not obese. Using the 90th percentile as a cutoff would overestimate the number of children classified as obese, potentially leading to unnecessary interventions. The 90th percentile does not align with established CDC guidelines for obesity screening in children.

A BMI at the 70th percentile is within the normal weight range for children of the same age and sex. Children in this percentile are not considered overweight or obese and typically do not require weight-related interventions beyond routine healthy lifestyle guidance. Labeling a child with a BMI at the 70th percentile as obese would be inaccurate and could contribute to unnecessary anxiety or inappropriate treatment.

A BMI between the 85th and 94th percentile is classified as overweight, not obese. This distinction is important because children who are overweight may benefit from preventive lifestyle interventions, whereas children at or above the 95th percentile may require more intensive assessment and management. Misclassifying overweight children as obese could lead to inappropriate labeling or interventions.

Video games and other stimulating electronic media before bedtime can interfere with sleep onset and quality by increasing arousal and exposure to blue light, which suppresses melatonin production. Encouraging gaming before bed is contrary to sleep hygiene recommendations for school-aged children.

Having electronic devices in the child’s bedroom increases the risk of excessive screen time, sleep disruption, and reduced physical activity. Devices should instead be located in shared family spaces to allow for monitoring and balanced use.

The American Academy of Pediatrics recommends no more than 1–2 hours of recreational screen time per day for school-aged children. Three hours exceeds this limit and does not align with evidence-based guidance on healthy media use.

Encouraging conformity to peers does not foster authentic self-esteem. Relying on external approval can undermine the development of self-worth and independence, which are critical during the school-age period.

Simply allowing the child to quit may temporarily reduce stress but does not build competence, skill mastery, or resilience, which are essential components of healthy self-esteem. School-age children benefit from support and encouragement to persist in activities where they can develop mastery and confidence.

While allowances may teach financial responsibility, they do not inherently promote self-esteem. Self-worth in school-aged children is more strongly influenced by skill mastery, achievement, social competence, and opportunities for meaningful contribution rather than monetary rewards.

Protein is essential for growth, muscle development, and tissue repair in school-aged children. Limiting it to one meal per day could lead to inadequate intake of essential amino acids and impair growth. Children should consume age-appropriate amounts of protein distributed across meals.

Milk is an important source of calcium, vitamin D, and protein, critical for bone development and growth during late childhood. Limiting milk unnecessarily could increase the risk of calcium deficiency and poor bone mineralization. Recommendations typically allow 2–3 servings of dairy per day.

While vegetables are important, school-aged children should consume a variety of vegetables daily, not just twice a week. Dark green leafy vegetables provide vitamins A, C, K, folate, and iron, which are crucial for overall health, immune function, and growth. Limiting consumption to twice a week is insufficient.