4-year Check-Up

(Children 48 – 60 Months Old)

You are now the proud parent of a preschooler. Your child should be able to help with simple day to day activities like fixing breakfast cereal, brushing teeth and dressing without help (shoe laces and buttons or zippers may require some assistance). Your child should know four colors, they should be talking well enough for strangers to understand everything they are saying, and they should be able to stand on one foot for 2-5 seconds.

Your child is becoming more independent each day, but still needs a great deal of supervision and direction. Your child is learning how to effect their environment to get what they want. This may lead to some conflicts, temper tantrums, and behavior problems. These interactions are to be expected, and it is our job as parents to teach children socially acceptable ways to make their point and to get what they want. There are a few simple rules to keep in mind when disciplining your child. Be consistent, children are more likely to mind when the rules are easy to understand and do not change from day to day or parent to parent. Do not make rules you are not willing to enforce every time they are broken. It is better to tolerate non-dangerous behaviors than to be inconsistent about enforcing rules. Don’t place your child in situations where they are likely to break rules (if you place your child in a room that has a lot of attractive toys that are not safe for 4 year olds, it is not reasonable to expect them not to try and play with them). Remember, to discipline means to teach, not to punish. Children should be given a few basic chores like setting the table, cleaning up their toys, and helping make the bed.

Car accidents, burns, poisonings, drownings, and other accidents cause more harm to children in this age group than infections and other medical problems. Even though some children are big enough to move out of a car seat by this age (over 40 lbs), a booster seat is recommended to assure proper positioning of the should strap on the safety belt. Some care seats convert easily to a booster; check your instruction manual to see if your car seat converts. For more information about care seats check out

Remember that the majority of the damage we do to our skin is done in the first 18 years of life; use SPF 30 or greater sunscreen every day, don’t forget to reapply the sunscreen every 2 hours when you’re out. Avoid direct sunlight as much as possible, especially between noon and 3 pm when the sun’s rays are the strongest. Where hats, sunglasses and light colored clothing, and use shade like tents and umbrellas when possible. This is a great time to begin swim lessons. There is no substitute for close supervision around water. Wear life jackets especially around the gulf and when boating. Get your child used to wearing a bicycle helmet every time they are on a bike. Make the rule “if your rear end is on the bike, the helmet is on your head”.

Kids in this age group love to learn. Make sure you read with your child every day. Practice letters, numbers, colors and shapes to prepare them for kindergarten. Books like “Where the Wild Things Are”, Disney’s “Princess Collection”, and the “Clifford” series are always enjoyed. If your child does not have a library card, now is a good time to get one. Work on sorting things by shape, color, number and size. Coloring, drawing and playing with clay or “Play dough” will help your child develop the strength and coordination they will need to begin writing. It is not too early to start learning to write letters, spell names and small words, and to begin learning phone numbers, addresses, days of the week and months of the year. Most children view these tasks as play time and fun rather than work, encourage them and tell them what a great job they are doing so they continue to look forward to learning.

The next scheduled check-up is when your child is 5 years old. Brush teeth and floss twice a day, and if your child has not seen a dentist you should schedule an appointment. Have a great year!

Your next appointment will be at 5 years old