Developmental milestones record - 4 years
Definition
The typical 4-year-old child will demonstrate certain physical and mental skills. These skills are called developmental milestones.
Alternative Names
Normal childhood growth milestones - 4 years; Growth milestones for children - 4 years; Childhood growth milestones - 4 years; Well child - 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 (less than one quarter of an ounce) per day
- Weighs 40 pounds (18.14 kilograms) and is 40 inches (101.6 centimeters) tall
- Has 20/20 vision
- Sleeps 11 to 13 hours at night, most often without a daytime nap
- Grows to a height that is double the birth length
- Shows improved balance
- Hops on one foot without losing balance
- Throws a ball overhand with coordination
- Can cut out a picture using scissors
- May still wet the bed
SENSORY AND COGNITIVE
The typical 4-year-old:
- Has a vocabulary of more than 1,000 words
- Easily puts together sentences of 4 or 5 words
- Can use the past tense
- Can count to 4
- Will be curious and ask a lot of questions
- May use words they do not fully understand
- 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 them
PLAY
As the parent of a 4-year-old, you should:
- Encourage and provide space for physical activity.
- Show your child how to participate in and follow the rules of sporting activities.
- Encourage play and sharing with other children.
- Encourage creative play.
- Teach your child to do small chores, such as setting the table.
- Read together.
- Limit screen time (television and other media) to 2 hours a day of quality programs.
- Expose your child to different stimuli by visiting local areas of interest.
References
American Academy of Pediatrics website. Recommendations for preventive pediatric health care. www.aap.org/en-us/Documents/periodicity_schedule. Updated October 27, 2022. Accessed March 13, 2023.
American Academy of Pediatrics website. 2022 Recommendations for preventive pediatric health care. Pediatrics. 2022;150(1):e2022058044. PMID: 35921638 pubmed.ncbi.nlm.nih.gov/35921638/.
Carter RG, Feigelman S. The preschool years. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 24.
Marcdante KJ, Kliegman RM, Schuh AM. Normal development. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 7.