2. Check your child's blood pressure, vision,
and hearing using standard
3. Ask questions, address concerns, and offer advice about how
your child is:
Schedule three meals and two nutritious snacks
a day. If you have a picky eater, keep offering a variety of healthy foods for your
child to choose from. Kids should be encouraged to give new foods a try, but
don't force them to eat them.
Peeing and pooping. By 4 years old, most kids are using the toilet.
But many preschoolers who are potty
trained during the day are not able to stay dry all night. It's also common for
busy preschoolers to have an occasional daytime accident. Look for signs of "holding
it" and encourage regular potty breaks. Talk to your doctor if your child is not yet
potty trained or was previously trained and is now having problems.
sleep about 10–13 hours a day. Many 4-year-olds have given up their afternoon
nap, but be sure to schedule some quiet time during the day.
Developing. By 4 years, it's common for many kids to:
be completely understood by strangers
know their first and last name and gender
relate events or tell a story
hop on one foot
walk up stairs, alternating feet
identify some colors and numbers
enjoy playing with other children
4. Do a physical exam with your child undressed while you are
present. This will include listening to the heart and lungs, observing motor skills,
and talking to your child to assess speech
and language development.
5. Update immunizations.Immunizations
can protect kids from serious childhood illnesses, so it's important that your child
get them on time. Immunization
schedules can vary from office to office, so talk to your doctor about what to
If your child is still in a rear-facing car seat, check the maximum
weight and height limits recommended by the manufacturer. Turn the car seat around
when your child is the right size. Kids should stay harnessed in the car seat until
they reach the highest weight or height limit allowed by the seat's manufacturer.
When your child has outgrown this seat, switch to a belt-positioning booster
seat until your child is 4 feet 9 inches (150 cm) tall, usually between
8 and 12 years of age.
Protect your child from gun
injuries by not keeping a gun in the home. If you do have a gun, keep
it unloaded and locked away. Ammunition should be locked up separately. Make sure
kids cannot access the keys.
Discuss appropriate touch. Teach your child that some body parts
are private and no one should see or touch them. Tell your child to come to you if
anyone ever asks to look at or touch his or her private parts, if he or she is ever
asked to look at or touch someone else's private parts, or is asked to keep a secret.
Talk to your doctor if you're concerned about your living situation.
Do you have the things that you need to take care of your child? Do you have enough
food, a safe place to live, and health
insurance? Your doctor can tell you about community resources or refer you to
a social worker.
These checkup sheets are consistent with the American Academy of Pediatrics
(AAP)/Bright Futures guidelines.