Dr. M.J. Bazos, MD, Patient Handout
4 Year Old Frequently Asked Questions
HOW CAN I ASSIST IN MY CHILD’S INTELLECTUAL DEVELOPMENT?
Read to your child and respond to his interest in learning the letters and words on the page. Talk to your child as an adult throughout the performance of daily activities, explaining what you are doing and why. Allow your child to color, paint, cut, and paste even though it may be messy. Teach your child to do household tasks such as setting the table, washing and drying dishes, sorting laundry, carrying out the garbage, and dusting - if you can make a game out of these activities, the child may even enjoy doing them! Listen to music with your child, take him to museums, libraries, and zoos. Allow him to use the family computer to play games (with supervision, of course).

HOW DO I KNOW IF MY 4 YEAR OLD HAS A SPEECH PROBLEM?
Children develop language skills at different rates just as they grow and develop physically at different rates. A child who lags behind his peers during the preschool years will usually catch up with them once they are in school. Repeating whole words a few times is normal between the ages of 3 and 4 years. This speech pattern does not bother the child and usually stops within 6 months. True stuttering, which also first appears at this age, is characterized by repetitions of parts of words and causes obvious distress to the child. Talk to your child’s doctor if you notice any of the following problems between ages 3 and 5 or if you have any concerns at all about your child’s speech development:

• Your 4 year old leaves out consonant sounds from many words.
• Your child’s stuttering continues for longer than 6 months.
• While stuttering, your child shows any signs of distress, such as grimacing or breathing fast.
• While stuttering, your child loses eye contact with the person with whom he is speaking.
• Your child withdraws from talking to others because of his stuttering.
• Your child stutters and a parent or sibling also stutters.

HOW CAN I ENCOURAGE MY CHILD TO GET ENOUGH EXERCISE?
Exercise is essential for good health, even in the preschool years. Although regular exercise programs are not recommended for the pre-schooler, there are some things you can do to keep your child active and healthy:

• Spend lots of time together outdoors.
• Go for walks with your child.
• Go to the park or playground and let your child play on equipment appropriate for his age and abilities.
• Play active games with your child.
• Jump, hop, skip, dance, walk on tiptoe, and march to music with your child.
• Bounce, throw, kick, and roll balls with your child.
• Help form neighborhood sports teams and participate in them with your child.
• Be a good role model by being active yourself.

HOW MUCH SLEEP DOES MY 4 YEAR OLD NEED?
Preschoolers generally need between 10 and 12 hours of sleep each night (or at least during a 24 hour period). Some may sleep more and some less. Some may and some may not require or be interested in naps. Children who do not get enough sleep may be drowsy or irritable during the day and are more susceptible to illness. Put your child to bed at a reasonable time on a regular basis but do not be inflexible with bedtimes. If your child is consistently fighting sleep and is awake for more than 30 minutes before going off to sleep, you may want to consider delaying his bedtime.

WHEN DOES MY CHILD RETURN FOR HIS NEXT HEALTH SUPERVISION VISIT?
At 5 years of age your child should return for his next health supervision visit.