Four Year Old Well Child Check


Happy Birthday to your four-year-old! Your child is still in a period of slower growth. Offer a well-balanced diet, recognizing that your child has certain likes and dislikes and will not eat everything offered to him or her. Let your child control how much he/she eats and avoid encouraging your child to “clean your plate.” You may use a multivitamin. Use 1%, 1/2%, or skim milk. If your well water tests negative for fluoride, we will prescribe it.

Development and Behavior

The four-year-old child has become his or her own person- more independent and able to carry on a conversation. Rapid growth in language and motor skills help the four-year-old to progress in motor and social development. Your child has a clearer sense of self and behavior expectations. Gender-role identification, emergence of conscience, the capacity for collaborative play and the beginnings of mastery over impulsivity are seen at this age. Read. Read. Read.

By the age of four, most children understand some prepositions, can identify colors and common animals, can recite the alphabet, and a few can recognize letters. Four-year-olds can catch a large ball, skip and do a broad jump. Motor activities still appear “childlike” due to lack of refinement which is common at this age. Competence in sports or activities that require accuracy or careful timing and sequencing will not be seen for several years. Four-year-olds should be encouraged to dress themselves, except for tying shoes. 
Your child’s thinking is still magical and he/she has a unique point of reference. Your child has difficulty taking another’s point of view, cannot fully understand cause and effect, nor anticipate the consequences of their actions. Your child’s reasoning is based on seeing themselves as the center of things. You may experience imaginary friends or hear “tall tales.” This behavior is not to be interpreted as lying but should be seen as reflecting your child’s rich imagination.


Always place your child in a forward facing carseat in the back seat. Keep your child in his convertible seat until he outgrows the weight limit and then transition to a booster seat. Be a good role model and wear your seat belt. Never leave your child alone in the car. Never place your child in a seat with an airbag. Supervise all outside play and closely observe water play. Keep all medicines, vitamins, cleaning supplies, poisons and rearms locked away. Keep the poison control center number 1-800-848-6946 next to your phone. Remember, we no longer recommend Syrup of Ipecac or Activated Charcoal for poisoning.

Children love to explore the outdoors. Make it safer by fencing the yard and keeping children inside when lawn mowers or other machinery are used. Inside, check the stability of drawers, tall furniture and lamps. Make sure windows are closed or have screens that cannot be pushed out. Trampolines and gasoline motor vehicles are very dangerous and should not be used by children.

Health Maintenance and Shots

Today, your child will be screened for vision and hearing problems. The DTaP, Polio, Chicken Pox and MMR immunizations can be given today or at the 5 year old checkup. If your family is at risk for high cholesterol, blood may be taken to measure your child’s cholesterol profile. We recommend your child see a dentist for routine checkups.

Next Appointment

At 5 years your child will receive a checkup, and be measured for height, weight and blood pressure. Vaccination boosters for DTaP, Polio, Chicken Pox and MMR will be given at the 5 year old checkup if not given today. No laboratory studies are scheduled today. Yearly checkups are recommended throughout childhood. Call our office at any time if you have any questions or concerns.