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    Developmental milestones record - 4 years

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

    There are skills and growth markers expected in a typical 4-year-old child. These milestones are physical and mental developments considered normal for this age group.


    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 per day
    • The average 4 year old weighs 40 lbs and is 40 inches tall
    • Vision is 20/20
    • Sleeps 11 to 13 hours, usually without a nap
    • Grows to a height that is double the length at birth
    • 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 (normal)


    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 ask the most questions of any age
    • May use words that aren't fully understood
    • 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 him or her


    As the parent of a 4-year-old, you should:

    • Encourage and provide space for physical activity
    • Show the child how to participate in, and follow the rules of sporting activities
    • Encourage play and sharing with other children
    • Encourage creative play
    • Teach children to do small chores, such as setting the table
    • Read together
    • Limit television watching to 2 hours a day of quality programs
    • Expose the child to different stimuli by visiting local areas of interest


    Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 10.


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              Review Date: 11/9/2012

              Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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              St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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