Preschool children gain about five pounds and grow two to three inches a year, they are much more stable. Physically, preschoolers are more robust and show tremendous improvement in their gross and fine motor skills. Preschoolers learn to ride a tricycle, skip, jump rope and even throw a ball over their head. Although preschool children are still in the preoperational stage of cognitive development, according to Piaget they are very intuitive in their thinking process. Preschoolers bring inanimate objects to life by having imaginary friends and engaging in pretend play. Piaget believes that pretend play is healthy because it allows the child to determine the difference between reality and fantasies. One of the main health concerns for patients in this age group is their nutrition. Preschoolers tend to be very picky eaters and find it difficult to eat a balanced diet. Eating balanced meals is very important in the preschool stage, so educate the caregiver about the need for their preschoolers to eat balanced meals and encourage them to make an effort to try different foods which will help promote health and safety issues with the child.