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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.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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