Developmental milestones record - 4 years

  • Definition
    • The typical 4-year-old child will demonstrate certain physical and mental skills. These skills are called developmental milestones.

  • Alternative Names
    • Normal childhood growth milestones - 4 years; Growth milestones for children - 4 years; Childhood growth milestones - 4 years

  • Information
    • 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

      • Weighs 40 pounds (18 kilograms) and is 40 inches (1 meter) tall
      • Has 20/20 vision
      • Sleeps 11 to 13 hours at night, usually 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 four or five words
      • Can use the past tense
      • Can count to four
      • 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.
  • References
    • Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 10.