Milestones by 4 Years

You know your child best. Don't wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child's doctor, share your concerns, and ask about developmental screening.

If you or the doctor are still concerned:

• Ask for a referral to a specialist who can evaluate your child more; and
• Call your state or territory's early intervention program to find out if your child can get services to help. Learn more and find the number at cdc.gov/FindEI.

• Encourage your child to use "his words" to ask for things and solve problems but show him how. He may not know the words he needs. For example, help your child say, "Can I have a turn?" instead of taking something from someone.
• Help your child learn about others' feelings, and about positive ways to react. For example, when he sees a child who is sad, say "He looks sad. Let's bring him a teddy."
• Use positive words and give attention to behaviors you want to see ("wanted behaviors"). For example, say "You're sharing that toy so nicely!" Give less attention to those you don't want to see.
• Tell your child in a simple way why she can't do something you don't want her to do ("unwanted behavior"). Give her a choice of what she can do instead. For example, "You can't jump on the bed. Do you want to go outside and play or put on some music and dance?"
• Let your child play with other children, such as at a park or library. Ask about local play groups and pre-school programs. Playing with others helps you child learn the value of sharing and friendship.
• Eat meals with your child when possible. Let her see you enjoying healthy foods, such as fruits, vegetables, and whole grains, and drinking milk or water.
• Create a calm, quiet bedtime routine. Avoid any screen time (TV, phone, tablet, etc.) for 1 to 2 hours before bed and don't put any screens in your child's bedroom. Children this age need 10 to 13 hours of sleep a day (including naps). Consistent sleep times make it easier!
• Give your child toys or things that encourage his imagination, such as dress-up clothes, pots and pans to pretend cook, or blocks to build with. Join him in pretend play, such as eating the pretend food he cooks.
• Take time to answer your child's "why" questions. If you don't know the answer, say "I don't know," or help your child find the answer in a book, on the Internet, or from another adult.
• Count simple things, such as fingers, toys, or bananas. This will help your child learn about numbers and counting.
• Give your child choices that are simple and healthy. Let her choose what to wear, play, or eat for a snack. Limit choices to 2 or 3.
• Continue to teach your child skills to play with others, such as using words, sharing toys, and taking turns.
• Teach your child to play outdoor games with friends, such as tag, follow the leader, and hide and seek.
• Spend time speaking to your child in complete sentences, using "grown-up" words. This will help her learn better speaking skills and helps with future reading and writing skills.
• Let your child help with simple chores, such as bringing in the mail, feeding a pet, or wiping down tables. This helps build independence.
• Teach your child to stop and wait when excited by playing red light, green light, or freeze dance (play music, turn it off, and have everyone freeze when it stops).
• Play your child's favorite songs and dance with your child. Take turns copying each other's moves.
• Give your child time to solve her own problems with friends. For example, if they are arguing over who gets to be which superhero, let them work it out. Stay nearby to help if needed. If they can't work it out, use questions to help them think of other solutions.
• Use words, such as "first," "second," and "finally." When playing, telling stories, or doing chores, ask your child what comes next. This will help your child learn about the order of events.
• Comfort your child if he is afraid and talk about his fears. For example, "Monsters can feel scary even though they are not real and can't hurt you." Help your child learn things he can do when he is afraid, such as hugging a stuffed animal.
• Play simple games, such as Tic-Tac-Toe or matching games.
• Try to make time for active play each day. Your child will have more fun if she can choose the activity. For example, give her choices, such as playing music and dancing together, playing outside, or taking a walk together.
• Help your child notice when he hurts someone's feelings by describing what you see. Encourage him to say sorry and help him find a way to make the person feel better.
• Take trips to the library to let your child pick out books.
• Limit screen time (TV, tablets, phones, etc.) to no more than 1 hour per day of a children's program with an adult present. Don't put any screens in your child's bedroom. Children learn by talking, playing, and interacting with others.