Four Year Visit

By this age, kids have begun to develop some basic executive function skills. To really bring this out, challenge your child with multi-step commands that force him to think a few steps ahead. For example, ask him to get ready for bed without specifying the steps. This will serve your little student well as he learns to manage his cubby and negotiate his classroom.

Your 4-year-old is exploring their environment and to have increasing social interactions.  Play remains critical to social development.  Your child will like being with friends and will start to require less adult supervision.

Children develop at their own pace, so it’s impossible to tell exactly when your child will learn a given skill. The developmental milestones below will give you a general idea of the changes you can expect as your child gets older but don’t be alarmed if your child takes a slightly different course.

  • Four- to five-word sentences are used most of the time
  • tells a story
  • count up to four objects
  • dress without assistance (except tying the shoes)
  • can distinguish between genders and might engage in male-female role play
  • can copy a cross and circle
At this visit you should expect your child to:
  • have hearing and vision screening performed
  • have blood pressure taken
  • receive four booster vaccines (Dtap, polio, MMR and chicken pox). It is important to be honest with your child about receiving vaccines.
Safety Tips
  • your child should always wear a helmet while riding a bicycle or scooter
  • you should discuss stranger safety
  • you should check to make sure playground equipment is secure and there are no loose parts
  • your child should never swim without supervision
What vaccines and/or screening tests should I expect at this visit?

At this visit your child will receive the MMR, Varicella, Dtap, and polio vaccines. These are all boosters to vaccines your child has had before. If the season is appropriate, your child may also receive the Influenza vaccine. Your child may be eligible to have the Influenza vaccine as a nasal spray instead of an injection. You can discuss this option with your doctor.