BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuDevelopmental milestones record - 4 yearsNormal childhood growth milestones - 4 years; Growth milestones for children - 4 years; Childhood growth milestones - 4 years; Well child - 4 yearsThe typical 4-year-old child will demonstrate certain physical and mental skills. These skills are called developmental milestones. Information All children develop a little differently. If you are concerned about your child's development, talk to your child's health care provider.PHYSICAL AND MOTORDuring the fourth year, a child typically:Gains weight at the rate of about 6 grams (less than one quarter of an ounce) per day 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 bedSENSORY AND COGNITIVEThe 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 themPLAYAs 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.Open ReferencesReferencesAmerican Academy of Pediatrics website. Recommendations for preventive pediatric health care. www.aap.org/en-us/Documents/periodicity_schedule.pdf. Updated March 2020. Accessed January 14, 2021.Carter RG, Feigelman S. The preschool years. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 24.Marcdante KJ, Kliegman RM. Normal development. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 7.AllVideoImagesTogRelated Information Review Date: 10/2/2020 Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.