Important Milestones: Your Child By Four Years

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In 2022, CDC’s milestones and parent tips were updated and checklist for ages 15 and 30 months were added. For more information about the CDC’s developmental milestones, please review the Pediatrics journal article and these important key points.

How your child plays, learns, speaks, acts, and moves offers important clues about your child’s development. Developmental milestones are things most children (75% or more) can do by a certain age.

Check the milestones your child has reached by 4 years by completing a checklist with CDC’s free Milestone Tracker mobile app, for iOS and Android devices, using the Digital Online Checklist, or by printing the checklist [755 KB, 2 Pages, Print Only] below.

“Learn the Signs. Act Early.” materials are not a substitute for standardized, validated developmental screening tools.

What most children do by this age:

Social/Emotional Milestones

Pretends to be something else during play (teacher, superhero, dog)

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Asks to go play with children if none are around, like “Can I play with Alex?”

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Comforts others who are hurt or sad, like hugging a crying friend
Avoids danger, like not jumping from tall heights at the playground

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Likes to be a “helper”

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Changes behavior based on where she is (place of worship, library, playground)

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Language/Communication Milestones

Says sentences with four or more words

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Says some words from a song, story, or nursery rhyme

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Talks about at least one thing that happened during her day, like “I played soccer.”

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Answers simple questions like “What is a coat for?” or “What is a crayon for?”

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Cognitive Milestones (learning, thinking, problem-solving)

Names a few colors of items

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Tells what comes next in a well-known story

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Draws a person with three or more body parts

Movement/Physical Development Milestones

Catches a large ball most of the time
Serves herself food or pours water, with adult supervision
Unbuttons some buttons

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Holds crayon or pencil between fingers and thumb (not a fist)

Learn more about physical development

Other important things to share with the doctor…

What are some things you and your baby do together?
What are some things your baby likes to do?
Is there anything your baby does or does not do that concerns you?
Has your baby lost any skills he/she once had?
Does your baby have any special healthcare needs or was he/she born prematurely?

Download CDC’s free Milestone Tracker App

View

Concerned About Your Child’s Development?
Act Early.

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.

For more on how to help your child, visit cdc.gov/Concerned.

Tips and Activities: What You Can Do for Your 4 year old

As your child’s first teacher, you can help his or her learning and brain development. Try these simple tips and activities in a safe way. Talk with your child’s doctor and teachers if you have questions or for more ideas on how to help your child’s development.

Help your child be ready for new places and meeting new people. For example, you can read stories or role play (pretend play) to help him be comfortable.
Read with your child. Ask him what’s happening in the story and what he thinks might happen next.
Help your child learn about colors, shapes, and sizes. For example, ask the color, shapes, and size of things she sees during the day.

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.

Special acknowledgments to the subject matter experts and others who contributed to the review of data and selection of developmental milestones, especially Paul H. Lipkin, MD, Michelle M. Macias, MD, Julie F. Pajek, PhD, Judith S. Shaw, EdD, MPH, RN, Karnesha Slaughter, MPH, Jane K. Squires, PhD, Toni M. Whitaker, MD, Lisa D. Wiggins, PhD, and Jennifer M. Zubler, MD.

Sincere gratitude to Natalia Benza, MD and José O. Rodríguez, MD, MBA for their thoughtful review of the Spanish-language translation of these milestones.