Healthy Child Development and Behavior

Below are milestones most children will reach between now and 4 years of age. Talk with your doctor at your child’s next well-visit if your child is not yet reaching these milestones or there are skills your child no longer shows each day.

Social and Emotional Milestones

• Pretends to be something else during play (teacher, superhero, dog)
• Asks to go play with children if none are around, like “Can I play with Alex?”
• Comforts others who are hurt or sad, like hugging a crying friend
• Likes to be a “helper”
• Changes behavior based on where they are (place of worship, library, playground)

Language and Communication Milestones

• Says sentences with four or more words
• Repeats words from a song, story or nursery rhyme
• Talks about at least one thing that happened during the day, like “I played soccer.”
• Answers simple questions like “What is a coat for?” or “What is a crayon for?”

Thinking and Learning Milestones

• Names a few colors of items
• Tells what comes next in a well-known story
• Draws a person with three or more body parts

Physical Development Milestones

• Catches a large ball most of the time
• Serves themselves food or pours water, with adult supervision
• Unbuttons some buttons
• Holds crayon or pencil between fingers and thumb (not a fist)

Healthy Ways to Help Your Child Learn and Grow

Development

• When talking with your child, use complete sentences with “grown up” words. Help your child use correct words and phrases.
• Read books together every day to help your child develop language and reading skills. Ask your child questions about the book and encourage your child to tell a part of the story.
• Ask your child questions about their day, such as the kind of activities they played with friends.
• Let your child help with simple household chores.
• Allow your child time to play with other children of the same age. This will teach your child how to share and make friends.

Behavior

• Allow your child to make choices when possible, such as deciding what to wear or what to eat for a snack.
• Be consistent and use clear, simple language when disciplining your child. Teach your child the behavior you expect. Whenever you say “no,” tell your child what to do instead.

Healthy Habits

• Give water and 16–24 ounces of whole milk each day. Limit juice to help prevent tooth decay.
• Eat meals together as a family when possible. Provide a variety of healthy foods and snacks including vegetables, fruits, lean meat and beans. Let your child decide how much to eat.
• Get ideas for healthy meals and snacks.
• Encourage your child to play and be active throughout the day. Model this behavior by being active together as a family as often as possible.
• Children this age need 10–13 hours of sleep a day, including a nap. Have a steady routine for bed (bathing, brushing teeth, books, bedtime). The hour before bedtime should be calm.
• Help your child brush teeth two times each day (after breakfast and before bed). Use a pea-sized amount of fluoride toothpaste. Take your child to the dentist twice each year.

Digital Media Use

• Limit screen time to one hour of high-quality, educational programs each day. Avoid putting a TV in your child’s bedroom.
• Consider making a family media plan to put rules in place for media use. Balance screen time with other family activities, including physical exercise. Learn how to achieve a healthy balance.
• Be aware of the types of TV shows, movies, games and music your child is watching and listening to. Focus media on preschool-age educational content whenever possible.

Vehicle Safety

• Be sure your child’s car seat is installed correctly in the backseat according to the car seat’s weight and height requirements. Learn more about car seat safety and installation.

Water Safety

• Drowning is silent and can happen quickly. Do NOT leave your child alone near any water (including bathtubs, toilets, pools, ponds, whirlpools). Install a four-foot-tall fence with a self-closing and self-latching gate around home pools. Your child should always wear a life jacket when on a boat or near the water’s edge. Learn more about water safety.

Home Safety

• Have your child wear a fitted helmet while riding a bike or trike.
• Never leave your child alone inside or outside your home.
• Always watch your child during play, especially near streets and driveways. Keep your child away from moving cars or machinery.
• Encourage your child to sit when eating and to chew food very well to prevent choking.

Sun Safety

• Protect your child’s skin from the sun by applying sunscreen, at least 30 SPF, 30 minutes before going outdoors. Have your child wear a hat and limit time outside when the sun is the strongest (10 am – 4 pm). Learn more about sun protection.

This information is to support your visit with your child’s doctor. It should not take the place of the advice of your pediatrician.

Sources: Centers for Disease Control and Prevention, Bright Futures (4th Edition) by the American Academy of Pediatrics