Your Child at 4 Years Old

During the past year, your child has grown physically, mentally and emotionally. He or she hops and skips, buttons clothes, catches a ball, knows colors and tells imaginary stories. He or she can also draw likeness of themselves in the form of a simple stick figure. Your 4 year old can also walk on tiptoes, cut and paste, hold a pencil well, can dress and undress him or herself, and asks many questions.

In addition, your 4 year old should be able to sleep in his or her own bed, do simple chores, follow rules and begin to play board games. Be sure to limit TV watching and the time spent using the computer and video game systems. While these things can be very educational, too much of a good thing may not be so good for your 4 year old. Encourage your child to be physically active. You may want to consider participation in organized sports teams in your community. This activity not only promotes physical activity, it also allows your child to become more socially involved with other 4 year olds.

At this age, your child may begin asking about sex and his or her gender. Answer your child’s questions about sex accurately and limit your answers only to the questions asked. Set limits to the place and time on when your child may “explore” his or her own body (i.e. at bath time). Don’t forget your regular dental check-ups. The State of Ohio requires proof of regular dental care for admission into kindergarten.

Disciplining Your 4 Year Old

Four year old children can begin learning the “Law of Natural Consequences.” This concept allows children to make their own mistakes and learn from those mistakes. This concept may not be appropriate in all situations, especially when your child could place him or herself in danger. However, in simple terms, if your child refuses to wear a coat on a cold day, don’t argue the point. Allow him or her to make the decision and learn the consequences of not having a jacket (the discomfort of being cold). When children are permitted to learn from their mistakes, they are more likely not to make the same mistake twice.

Your Child’s Safety

To continue promoting safe practices, consider the following:

Continue to talk to your child about strangers and safety while crossing the street or walking in parking lots.
Teach your child what to do in case of fire. Have a family plan and practice with a home fire drill.
Lock up tools, guns, matches and poisonous chemicals.
Use an approved booster car seat.
When riding bikes, require the use of a helmet 100% of the time.
If your child has an interest in roller blades, remember to use a helmet, wrist guards, knee and elbow pads.
Use sunscreen SPF 15 or 30 and insect repellant when outdoors.

Immunizations and Your Next Appointment:

The immunizations your child may receive at this age have been discussed. By now, you have read the information about them that we have supplied you. Most children do not have a reaction to these immunizations. If there is a reaction, most likely it is a slight fever or fussiness. You may give your child Tylenol or other acetaminophen products for these symptoms. If you feel the Tylenol has not helped or you are concerned about other symptoms let us know. If your child’s temperature exceeds 102 degrees F. orally, let us know. Your child’s next well appointment will be at 5 years old. We will continue to evaluate your child’s development and discuss additional information.

Reducing the Negative Impact of Television

Television has a tremendous influence on how children view our world. Many youngsters spend more hours watching television from birth to 18 years of age than they spend in the classroom. The positive aspects of television viewing include seeing different lifestyles and cultures. Children today are entering school more knowledgeable than children before the era of television. In addition, television has great entertainment value. Although television can be a good teacher, many children watch it excessively and therefore experience some of the negative consequences described below.

Harmful Aspects of Television

Television displaces active types of recreation. It decreases time spent playing with peers. A child has less time for self–directed daydreaming and thinking. Television takes away time from participating in sports, music, art, or other activities that require practice to achieve competence.
Television interferes with conversation and discussion time. It reduces social interactions with family and friends.
Television discourages reading. Reading requires much more thinking than television. Reading improves a youngsters’ vocabulary. A decrease in reading scores may be related to too much time in front of the television.
Heavy television viewing (more than 4 hours per day) definitely reduces school performance. This much television interferes with study, reading, and thinking time. If children do not get enough sleep because they are watching television, they will not be alert enough to learn well on the following day.
Television discourages exercise. An inactive lifestyle leads to poor physical fitness. If accompanied by frequent snacking, watching television may contribute to weight problems.
Television violence can affect how a child feels toward life and other people. Viewing excessive violence may cause a child to be overly fearful about personal safety and the future. Television violence may numb the sympathy a child normally feels toward victims or human suffering. Young children may be more aggressive in their play after seeing violent television shows.

Prevention of Television Addiction

Encourage active recreation. Help your child become interested in sports, games, hobbies, and music. Occasionally turn off the television and take a walk or play a game with your child.
Read to your children. Begin reading to your child by 1 year of age and encourage him or her to read on his or her own as your child becomes older. Some parents help children earn television or video game time by spending an equivalent time reading. Help your child improve his or her conversation skills by spending more time talking with him or her.
Limit television time to 2 hours per day or less. An alternative is to limit television to 1 hour on school nights and 2 or 3 hours per day on the weekends. You occasionally may want to allow extra viewing time for special programs.
Don’t use television as a distraction or a babysitter for preschool children. Preschoolers’ viewing should be limited to special television shows and videotapes that are produced for young children. Because the difference between fantasy and reality is not clear for this age group, regular television may cause fears.
If your child is doing poorly in school, limit television time to ½ hour each day. Make a rule that home work and chores must be finished before television is watched. If your child’s favorite show is on before he or she can watch, try to record it for later viewing.
Set a bedtime for your child that is not altered by television shows that interest your child. Children who are allowed to stay up late to watch television are usually too tired the following day to remember what they are taught in school. By all means, don’t permit your child to have a television set in his bedroom because this eliminates your control over television viewing.
Turn off the television set during meals. Family time is too precious to be squandered on television shows. In addition, don’t have the television always on as a background sound in your house. If you don’t like a quiet house, try to listen to music without lyrics.
Teach critical viewing. Turn the television on only for specific programs. Don’t turn it on at random and scan for something interesting. Teach your child to look first in the program guide.
Teach your child to turn off the television set at the end of a show. If the television stays on, your child will probably become interested in the following show and then it will be more difficult for your child to stop watching.
Encourage your child to watch some shows that are educational or teach human values. Encourage watching documentaries or real-life drams. Use programs about love, sex, family disputes, drinking and drugs as a way to begin family discussions on these difficult topics.
Forbid violent television shows. This means you have to know what your child is watching and turn off the television set when you don’t approve of the program. Develop separate lists of programs that are acceptable for older and younger children to watch. Make your older child responsible for keeping the younger ones out of the television room at these times.
Set a good example. If you watch a lot of television, you can be sure your child will also. The types of programs you watch also send a clear message to your child.

Instructions for Pediatric Patients, 2nd edition, 1999 by WB Saunders Company. Written by Barton Schmitt, M.D., pediatrician.

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