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What to Expect at a Preschooler Well Check at 4 Years Old

What to expect at a preschooler wellness checkup at the pediatrician

Food and Nutrition

  • Interest in eating may be unpredictable and erratic from meal to meal, but overall consumption is fairly constant.
  • May have a limited attention span at the table.
  • Tend to eat following a pattern similar to adults but are not capable of choosing a well-balanced diet.

School Readiness

  • Watching your child interact with other children provides a valuable window into his or her social understanding and skills.
  • Listen to and always treat your child with the respect you offer a fellow adult. Insist that all family members treat one another with respect and model respectful behavior for your children.
  • Model apologizing if you are wrong or have hurt someone’s feelings. Help your child apologize for hurting others’ feelings too. Praise your 4-year-old when they demonstrate sensitivity to the feelings of others.
  • Help your child express such feelings as joy, anger, sadness, fear, and frustration.
  • Spend time alone with your child doing something you both enjoy.
  • Provide opportunities for your child to play with other children in playgroups, preschool, or other community activities.
  • Read interactively with your child. Reading with your child is important to help them like reading and being ready for school. Ask questions about what you have read.
  • As your child shows interest in words, engage them by pointing out letters and playing with sounds by naming rhymes of real and nonsense words.
  • Enlarge your child’s experiences through trips and visits to parks and other places of interest. Take them often to the library.
  • Help you child develop language skills by encouraging them to talk with you about preschool, friends, experiences, or observations.
  • Provide plenty of time for your child to tell stories or respond to questions. Hurrying a child’s response increases stuttering.

Healthy Habits

  • Create a calm bedtime ritual that includes reading or telling stories
  • Create a pleasant atmosphere at mealtimes by turning off the TV and having table conversation that includes your child.
  • Be sure that your child brushes his or her teeth twice a day with a pea-sized amount of fluoridated toothpaste. They should spit out the toothpaste after brushing. Supervise tooth brushing each time. Follow up with your pediatric dentist every six months.


  • Limit television and video viewing to no more than 2 hours per day. Be sure the programs are appropriate. If you allow your child to watch TV, watch with them and talk together about the programs.
  • Encourage your child to be active in many ways, including running, marching, and jumping.
  • As often as possible, be physically active as a family. Go on walks, play in the park or on a safe street, or ride bikes.
  • Anticipate your child’s normal curiosity about his body and the differences between boys and girls.
  • Use correct terms for all body parts, including genitals.
  • Explain to your child that certain parts of the body (those areas normally covered by a bathing suit) are private and should not be touched by others without permission.
  • We used to be worried about strangers. Now we know that abusers are often a person the child should be able to trust. Teach your child rules for how to be safe with other adults using three principles: (1) no adult should tell a child to keep secrets from parents, (2) no adult should express interest in private parts, and (3) no adult should ask a child for help with his or her own private parts.


  • Child Safety Seat Inspection Station Locator: | Toll-free Number: 866-SEATCHECK (866-732-8243)
  • Continue to use a size-appropriate forward-facing car safety seat that is properly installed in the back seat according to the manufacturer’s instructions.
  • The back seat is the safest place for the children to ride.
  • Never leave your four-year-old alone when they are outside.
  • Supervise all play near streets or driveways. Your child is not ready to cross the street alone.
  • The best way to keep your child safe from injury or death from guns is to never have a gun in the home.
  • Remember that young children simply do not understand how dangerous guns can be despite your warnings.
  • Loaded guns should never be located where the child can get to them. Guns should be stored unloaded and locked, with the ammunition locked separately from the gun.
  • Ask if there are guns in homes where your child plays. If so, make sure they are stored unloaded and locked with the ammunition locked separately before allowing your child to play in the home.

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