Four Year Visit

Parenting

• Help your child develop language skills by encouraging her to talk about her experiences.  Read to your child daily and ask questions about the stories you read. Allow your child to finish sentences and thoughts, do not interrupt or hurry your child.  Speak in a relaxed tone.

• Your child should be participating in making healthy food choices, brushing his own teeth, washing his hands and fastening his safety belt.

• Create a bedtime ritual that includes storytelling to promote language development.  Rituals help calm children at night for peaceful sleep.

• Limit television viewing and computer time.  Make sure television programs and computer sites are appropriate. Talk to your children about what they watch.

• Encourage physical activity.  Praise your child for hopping, running, marching, jumping and dancing.  Include the family in walks, playing in the park, or riding bikes.  Participate in community activities for families.

• Anticipate normal curiosity your child may have about the differences between boys and girls.  Use correct terms for all body parts.  Explain to your child that some parts of the body are private and should not be touched by others.

• Children are sensitive and are easily encouraged or hurt; model respectful behavior.  Apologize if you are wrong and demonstrate sensitivity to feelings of others.   

• Consider structured learning like preschool or Head Start.  Attend community programs, museums, park, and libraries with your child.   

Safety

• If you do not feel safe in your home, or worry about the safety of your child, please talk to your health care provider about where to go for help.  

• Children this age still must be in a car seat or booster seat, depending on height and weight.  The back seat is always the safest place for a child.

• Do not smoke around your child or allow others to do so.  Keep your home and car as smoke free zones.  If you smoke and want to quit, talk to your physician for help and local resources.

• Never allow your child to play outside unsupervised.  Your child is too young to cross the street alone.

• Children do not understand how dangerous things like guns can be, even if you have warned them.  Keep guns out of the house, or locked with ammunition locked separately.

• Teach your child to be safe with other adults by following these principles:

o No adult should ever tell your child to keep a secret from his parents. Teach your child to tell you if this happens.

o No adult should ever touch your child’s private parts.

o No adult should ever ask a child to touch his private parts.

Oral Health

• Your child should be able to brush his teeth twice each day, with supervision, using a pea sized drop of toothpaste.  He should spit out the toothpaste when finished.

• Continue to see your dentist twice yearly.

Nutrition

• A small appetite or limited food preferences is not a cause for

concern.  Continue to offer a variety of foods.

• Make mealtime pleasant.  Turn off the TV and have table conversation

that includes your child.

• Don’t skip meals.  Offer healthy fruits and vegetable and whole grains.   

• Offer low fat milk and water, not sugary drinks or juice.