I don't think it's nursery, it's middle class educational aspiration, league tables and constant comparison
When I was at school in the 60s/70s we played, drew, watched educational tv, carved balsa wood, made charts about our favourite colours and toys, took sweets to school, the naughty boys got sellotaped to their chairs, we laughed, wrote freestyle, got sent out in the snow, had lunch with beakers of water, knives and forks, china plates, meat and two veg.
At secondary in the 70s (and I went to grammar school) only the nerdy girls wanted 9 O'Levels. Most of us were happy with 5 or 6 and with 5 or 6 you cpuld go into teaching, nursing, work in a bank, get an entry level civil service job. If you were a bit better off you might have done cordon bleu cookery, flowers, secretarial course, or go to London to work in a posh estate agent.
My DC who were clever were expected to achieve. Set against that the fact that dd had undiagnosed adhd add undiagnosed because she was a high performer, had firm boundaries at home, two loving parents, etc. Anxiety and self harm and depressiin are often co-morbidities but many camhs nurses don't look beyond their noses other than to parent blame. Back in my day I'm quite sure dd would have been happy to do a secretarial course or cookery course. In today's world she felt she had to achieve her potential. Her neuro developmental disability needed to be diagnosed to allow her to do it. I can still hear the v experienced CAMHS nurse saying "well now mum, I think she's being to old at 17 to be diagnosed with ADHD. "Er no, not according to a consultant psychiatrist, privately appointed, may I discuss this with the CAMHS psychiatrist"? What would you be wanting to do that for mum?
CAMHS needs root and branch overhaul and until there are 4 x the qualified psychiatrists assessing our dc, its staff should not be allowed an opinion on what the problems are.