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Patient Education

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Milestones for 4-Year-Olds

Overview

Children usually progress in a natural, predictable sequence from one developmental milestone to the next. But each child grows and gains skills at their own pace. Some children may be advanced in one area, such as language. But they may be behind in another area, such as sensory and motor development.

Milestones usually are grouped into five major categories: physical growth, cognitive development, emotional and social development, language development, and sensory and motor development.

Physical growth and development

Most children by age 4:

  • Have gained about 4 lb (2 kg) and grown about 3 in. (8 cm) since their third birthday.

Go to www.cdc.gov/growthcharts to see the high and low percentiles for normal weight and growth.

Thinking and reasoning (cognitive development)

Most children by age 4:

  • Can say their first and last names.
  • Understand the concept of counting. They may know some numbers.
  • Better understand concepts of time.
  • Can name some colors.
  • Understand the difference between things that are the same and things that are different.
  • Are aware of their own gender and can identify the gender of others.
  • Understand that events are connected. But their interpretation may not always be logical. For example, a child may understand the logic that glass may break if hit with a rock. But a child may still throw the rock thinking that it won't break this time (magical thinking).
  • Know the difference between fantasy and reality. But they still play "pretend," which becomes increasingly inventive. They also may blur fantasy and reality when they are stressed or have extreme emotions. They may form new fears as a result of their active imaginations.

Emotional and social development

Most children by age 4:

  • View themselves as whole people, with a body, mind, and feelings.
  • Are aware that they can be hurt physically, which sometimes causes them to be very sensitive about their bodies.
  • Are interested in new experiences.
  • Cooperate with other children. And, with help, they can negotiate solutions to conflicts.
  • Switch between being demanding and cooperative.
  • Dress and undress themselves.
  • Pretend to be a mom or dad during play.
  • Are noticeably more independent.

Language development

Most children by age 4:

  • Use sentences of 5 to 6 words.
  • Speak clearly enough for strangers to understand them.
  • Can describe something that has happened to them.
  • Sing songs.
  • Tell a short story as well as recall parts of a story.

Sensory and motor development

Most children by age 4 can:

  • Stand on one foot.
  • Move forward and backward easily.
  • Go up and down stairs without holding on to anything for support.
  • Ride a tricycle or a bicycle with training wheels.
  • Throw a ball overhand and sometimes catch a bounced ball. They also can kick a ball forward.

By age 4, most children can use their hands and fingers (fine motor skills) to:

  • Build a tower of 10 blocks.
  • Draw a circle and squares.
  • Draw a person with 2 to 4 parts.
  • Use scissors.
  • Write some capital letters.

Credits

Current as of: October 24, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: October 24, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.