Milestones: birth to four years

This is a time of moving from babyhood to childhood.

Children will know more words, can express some ideas and have a rich imagination.

They love to play and enjoy doing physical things.

Children are now learning how to get along with others, and to share and take turns.

They are happier to spend some time away from parents. They have less need for everything ‘right now’.

Relationships and feelings

By three to four years children can usually:

• play cooperatively with other children some of the time
• share and take turns - but cannot manage competitive games
• be apart from parents more easily in places they know well
• be more independent and not want help
• show caring for other children in distress
• use complex make-believe play
• find it hard to know what is pretend and what is real.

Talk to a community nurse or your doctor if your child is:

• not interacting with other children or adults in play
• overly aggressive with other children or withdrawn from them
• repeating the same simple play activity over and over again for long periods.

Doing

During this year children usually begin to:

• climb ladders
• walk along a plank
• stand, walk and run on tiptoes
• use pedals on a tricycle and turn safely
• stand on one foot for several seconds
• hop up and down on either left or right foot at least once without losing balance
• learn to cut with scissors
• roll or bounce a ball
• catch a ball with both hands, and throw a ball overarm
• eat well with a spoon and fork
• manage toileting - they may still wet the bed or have accidents when they are stressed or tired or are busy playing and forget to go to the toilet
• enjoy helping adults around the house
• start to draw pictures of people
• sort and match - identify small and big
• play pretend games such as super heroes and imaginary friends
• dress without help (except zips and buttons)
• explore and collect things.

Talk to a community nurse or your doctor if your child:

• is not doing the above activities as well as other children
• cannot jump with two feet together
• is not able to be toilet trained and is still ‘wetting’ during the day, by four years
• is starting to ‘wet’ again during the day after becoming dry.

Learning to talk

By this age children can usually:

• use four to five word sentences
• talk in complex sentences that are mostly grammatically correct
• say things most people can understand - even if there are sounds they cannot make, for example. s, r, z, th, v, f
• enjoy stories and jokes
• ask lots of questions about the world such as ‘why?’ and ‘how?’
• tell you how old they are
• talk about what happened yesterday and about tomorrow
• start to put together pieces of a simple puzzle.

Talk to a community nurse or your doctor if your child:

• does not speak clearly - and you can’t understand them most of the time
• is not talking in sentences of three or more words
• is not able to follow simple instructions
• is not talking during play
• does not seem to understand what parents say to them.