4 years


Vaccinations

MMR | Varivax | DTaP | IPV | Influenza

Development

These skills tend to be quite variable. But at this age the typical child:

  • Hops and jumps forward and can stand on one foot.
  • Climbs a ladder, rides a tricycle, walks on tiptoes.
  • Can build a tower of ten small blocks and can cut and paste.
  • May name three or four primary colors.
  • Counts from one to five and can sing a song.
  • Dresses and undresses with supervision except for laces and buttons.
  • Initiates make-believe and dressing-up play.
  • Has formed gender identification.
  • Copies a cross and a circle.
  • Draws a person with two or three parts.
  • Plays cooperatively and enjoys the companionship of other children.
  • Asks questions constantly
  • Tells stories about experiences either real or imaginary.

Safety

Injury prevention is proactive. Consider the following:

  • Children may appear more aware of danger but still require close supervision.
  • Select safe toys; avoid placing furniture with sharp edges in play areas.
  • Wear appropriate car safety restraints.
  • Teach children what to do in case of fire.
  • Supervise a child when riding a bike or playing near the street.
  • Lock up power tools, firearms, matches and poisons.
  • Use caution when serving hot liquids at meals.
  • Instruct children about behavior regarding strangers.
  • Advise children to use caution around strange animals.
  • When around water, children should be constantly watched by a responsible adult.

Parenting

These activities provide good examples for modeling important skills and encourage your child to grow in a healthy and happy way:

  • Encourage children to sleep in their own beds if this arrangement is feasible.
  • Provide opportunities for interaction with similar aged children.
  • Begin to assign small chores such as setting the table.
  • Praise a job well done.
  • Realize a child can make and keep an agreement.
  • Children are ready for simple board or card games.
  • Keep up with an established bedtime ritual.
  • Show interest in a child's daily activities at daycare or preschool.
  • Limit television viewing.
  • Encourage exploration and outings to new places.
  • Promote activities that make children "figure it out" for themselves.
  • Answer questions regarding sex honestly and at an age-appropriate level.
  • Encourage privacy for children when they are dressing, undressing or bathing.
  • Use correct terms for genitals.
  • It is normal for children to be interested in their own bodies as well as their playmate's.

Nutrition

Good nutrition is essential to a growing body. Tips include:

  • Serve balanced meals; avoid junk food and junk drinks.
  • Continue fluoride supplementation if necessary.
  • Create a pleasant atmosphere at mealtime with conversation about the day's activities as well as what's planned after the meal or the next day.
  • Offer small portions of food with the opportunity for seconds.

Behavior

Childhood behavior may go from one extreme to another. This age is no exception:

  • Reprimand privately.
  • Provide clear and appropriate limits.
  • Meaningless threats are ineffective; always follow through.
  • Establish a balance between a child's need for independence and the need for limits.
  • Do not talk down to a child or belittle a child.
  • Be consistent.

Health

Health maintenance is essential to a child's well-being.

  • Biannual dental visits ensure healthy teeth; promote dental hygiene.
  • By this age, 95 percent of children are bowel trained.
  • By this age, 90 percent of children are dry during the day and 75 percent are dry at night.

Resources

The following items may be useful:

  • Ames, Louise. Your Four Year Old. Delacorte, 1976.
  • Brazelton, Berry. Touchpoints: Your Child's Emotional and Behavioral Development. Addison Wesley, 1992.
  • Mitchell, Grace. A Very Practical Guide to Discipline With Young Children. Telshare Publ., Inc. MA, 1982.
  • Faber, Adele. How to Talk So Kids Will Listen, and Listen So Kids Will Talk
  • Pantell, James Fries. Taking Care of Your Child—A Parent's Guide to Medical Care
  • West, Richard. The Complete Guide to Childhood Ailments

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