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Developmental milestones record - 4 years


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


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 (18.14 kilograms) and is 40 inches 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 1 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 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 2 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.


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.

Review Date: 11/20/2014
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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