4 years old child

Normal Development:


Hops on one foot. Throws ball over hand. Uses scissors to cut out pictures. Climbs well.

Fine Motor:

Can copy a square and a cross. Draws a man with 2-4 parts besides head. Can point to the longer of two lines. Imitates construction of a “gate” of 5 cubes.


Able to speak full sentences and is totally understandable to a stranger. Tells a story. Can count 4 pennies accurately.


Plays with several children with beginning of social interaction. Likes to play roles like of a teacher or a parent. Goes to toilet alone.

Handedness is usually established by the third year. It is a normal variance of development and should not be attempted to be change.

At this time the kid can jump, gallop, tiptoes and run smoothly. He is therefore at a higher risk of injury. Make sure the home is well child proofed. All electrical sockets should be covered. There should be no cleaning supplies or medicines at their reach. There should be constant supervision. They should be stressed to wear their helmets when they ride their tricycle.

The appetite is still low and picky though it may be a little better than before. Their menu is still 4-5 stuffs but now they can be persuaded to try new foods. They still eat good one day and then be picky for next 2-3 days. As long as they are gaining weight and following their growth curve they should not be pressured. By attempting to control their intake only results in under or overeating.

Vitamins: Poly vi sol or chewable vitamin, one chew daily.

Dental check up should be regularly done.

How to promote development:

The kid should have a regular time every day for reading. He should be asked simple questions during reading like what is this or what color is the balloon. Repetitions, active participation and positive feedback like praise or stickers are ideal for language learning.

Let them play together with other kids. A 4 years old will like to play with rules and may want to change the rules according to the desire of the players. Encourage sharing. Drawing and painting and other artistic activities will help promote their imaginations.

Imagination: A 4 year old can create scenarios that can only be imagined like trip to moon. She may have imaginary friends. Their imaginative powers can also create intense fears like monsters. At that age she is unable to think in a rational way so usually she may not calm down by showing that there are no monster in the closet. Try to reassure them by telling your “great power” (eg monster spray or magical tape or chalk) will protect them. This magical thinking appeals to her more.

Behavior: It is still sometimes hard to understand her. She will still show dependency and independence at the same time like she wants mommy (dependent) to put her toy in the top drawer (place of her choice). Shifts between his angelic joy and uncontrollable rage may make you loose patience or hurt your self confidence. It is perfectly normal to feel anger guilt and confusion sometimes as preschool children are sometimes very challenging. Make sure that you are firm in setting limits and don’t give away to his tantrums. There are times when he needs to hear “no” and you may ignore his crying. Teach him to wait at times for a few minutes. Do not protect her from normal life challenges but always be available and supportive. Hold her and cuddle her and let her know you love her. All care takers should follow the same rules

Masturbation and curiosity about genitalia is normal at this age. Ignore it and try to distract them. Do not scold them. Modesty appears more around 5-6 years of age.

Farah Naz, MD - Pediatrics
2459 East Hebron Parkway, Suite 100, Carrollton, TX 75010
Office - (972) 395-8600 | Fax - (972) 395-7119