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Clinical Reference Systems: Pediatric Advisor 10.0

Normal Development: 4 Years Old

Physical Development

  • hops, runs, skips, climbs with increasing skill
  • tires easily
  • is accident prone
  • enjoys making loud noises, but is frightened by unexpected sounds
  • toilets independently
  • makes designs and draws recognizable objects
  • manipulates blunt scissors
  • dresses self (with exception of shoes)
  • small muscle control lags behind large muscle

Emotional Development

  • regresses to baby behavior periodically
  • shows new fears (becoming aware of more dangers)
  • has a penchant for silliness

Social Development

  • refers to parents as final authority
  • continues to test parental limits
  • uses "naughty" words to observe reaction
  • is ready for group activities
  • talks "with" another child, but does not listen to what other child says
  • is comfortable with other children, but shares grudgingly
  • tattles and name-calls
  • is more aware of sex role differences
  • imitates adult activities

Mental Development

  • is more likely to solve problems through words than aggressive action
  • has a vocabulary of about 1,500 to 2,000 words
  • speaks in 4 to 5 word sentences
  • fancies funny, exaggerated stories
  • can count to 5
  • identifies some shapes
  • begins to understand some concepts of time (yesterday, today, tomorrow)
  • asks endless "why" questions
  • usually can put toys and materials away without adult assistance
  • insists on finishing an activity or project
  • likes helping with simple tasks
  • begins to know difference between right and wrong
  • shows growing ability to distinguish real-life from make-believe
  • tells tall tales, but cannot always distinguish between honesty and dishonesty
  • believes the only viewpoint is his or her own
  • believes two unrelated events can have a cause-effect relationship

Each child is unique. It is therefore difficult to describe exactly what should be expected at each stage of a child's development. While certain attitudes, behaviors, and physical milestones tend to occur at certain ages, a wide spectrum of growth and behavior for each age is normal. These guidelines are offered as a way of showing a general progression through the developmental stages rather than as fixed requirements for normal development at specific ages. It is perfectly natural for a child to attain some milestones earlier and other milestones later than the general trend. Keep this in mind as you review these milestones.

If you have any concerns related to your child's own pattern of development, check with your pediatrician or family physician.

Written by Donna Warner Manczak, Ph.D., M.P.H.
Copyright 1999 Clinical Reference Systems