Developmental Milestones Record – 4 Years
The typical 4-year-old child will demonstrate certain physical and mental skills. These skills are called developmental milestones.
All children develop a little differently. If you are concerned about your child’s development, talk to your child’s health care provider.
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 or one third to one half pound (about 180 grams) per month.
- 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.
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.
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.
Normal childhood growth milestones – 4 years; Growth milestones for children – 4 years; Childhood growth milestones – 4 years; Well child – 4 years.
References
American Academy of Pediatrics Committee on Practice & Ambulatory Medicine. 2024 Recommendations for preventive pediatric health care: Policy statement. Pediatrics. 2024;154(1):e2024067201. PMID: 38910527 pubmed.ncbi.nlm.nih.gov/38910527/.
Carter RG, Feigelman S. The preschool years. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 25.
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.
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