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Developmental milestones record - 4 years

Definition

There are skills and growth markers expected in a typical 4-year-old child. These milestones are physical and mental developments considered normal for this age group.

Alternative Names

Normal childhood growth milestones - 4 years; Growth milestones for children - 4 years; Childhood growth milestones - 4 years

Information

All children develop a little differently. If you are concerned about your child's development, talk to your child's health care provider.

PHYSICAL AND MOTOR

During the fourth year, a child typically:

  • Gains weight at the rate of about 6 grams per day
  • Grows to a height that is double the length at birth
  • Shows improved balance
  • Hops on one foot without losing balance
  • Throws a ball overhand with coordination
  • Can cut out a picture using scissors
  • May not be able to tie shoelaces
  • May still wet the bed (normal)

SENSORY AND COGNITIVE

The typical 4-year-old:

  • Has a vocabulary of more than 1,000 words
  • Easily composes sentences of four or five words
  • Can use the past tense
  • Can count to four
  • Will ask the most questions of any age
  • May use words that aren't fully understood
  • May begin using vulgar terms, depending on their exposure
  • Learns and sings simple songs
  • Tries to be very independent
  • May show increased aggressive behavior
  • Talks about personal family matters to others
  • Commonly has imaginary playmates
  • Has an increased understanding of time
  • Is able to distinguish between two objects based on simple criteria such as size and weight
  • Lacks moral concepts of right and wrong
  • Is rebellious if expectations are excessive

PLAY

As the parent of a 4-year-old, you should:

  • Encourage and provide the necessary space for physical activity
  • Instruct the child on how to participate in, and follow the rules of sporting activities
  • Encourage play and sharing with other children
  • Encourage creative play
  • Teach children to do small chores, such as setting the table
  • Read together
  • Monitor both the time and content of television viewing (preferably less than 1.5 hours of TV, no more than 3 hours maximum)
  • Expose the child to different stimuli by visiting local areas of interest

References

Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 10.

Review Date: 11/3/2008
Reviewed By: Jennifer K. Mannheim, CPNP, private practice, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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