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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 puts together 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 words
- 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 tell the difference between two objects based on things like size and weight
- Lacks moral concepts of right and wrong
- Rebels if too much is expected of him or her
PLAY
As the parent of a 4-year-old, you should:
- Encourage and provide space for physical activity
- Show the child 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
- Limit television watching to 2 hours a day of quality programs
- 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.
Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children’s Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
