Pediatric Primary Care

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Medical Care and Your 4- to 5-Year-Old

The Well-Child Visit

A checkup also is an opportunity for your doctor to talk to you about developmental and safety issues and for you ask questions you might have about your child's overall health.

What to Expect at the Doctor's Office

At yearly exams, your child will be weighed and measured, and these results will be plotted on growth charts for weight, height, and body mass index (BMI). Using these charts, doctors can see how kids are growing compared with other kids the same age and gender. The doctor will take a medical and family history and perform a complete physical examination.

During the visit, your child's blood pressure, vision, and hearing will be checked. Your child may be screened for anemia, lead poisoning, tuberculosis, or high cholesterol.

Other vaccines might be needed if the doctor determines that your child is at risk for conditions like meningococcal or pneumococcal disease.

The doctor will check for crossed eyes and any vision and hearing problems, and also check the teeth for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, or other problems. In addition to the doctor's dental evaluation, your child should be making regular visits to the dentist.

During this visit, the doctor also will check behavioral and social development, asking questions to see if your child's everyday behavior is age appropriate, how well your child does in social situations, and how well he or she communicates.

Developmental Milestones

Developmental milestones for 4-year-olds include being able to:

  • help with household tasks
  • play cooperatively with other kids
  • understand the concept of gender
  • identify colors

Developmental milestones for 5-year-olds include being able to:

  • dress independently and tie shoes
  • know their address and phone number
  • draw a person with head, body, arms, and legs
  • print some letters

Child safety is another topic of discussion. Your doctor will cover the importance of using car seats, supervising kids around swimming pools, using bicycle helmets and other protective gear, not smoking around kids, and using sunscreen. In homes with firearms, guns and ammunition should be stored separately and kept locked at all times.

If You Suspect a Medical Problem

Parents often can tell if their child is ill by his or her appearance, but certain symptoms warrant a call to your doctor. Though they may represent a minor illness such as a cold or ear infection, some symptoms also can signal a more serious infection or a chronic condition, such as asthma.

Significant symptoms include:

  • changes in weight or eating habits
  • changes in behavior or sleep patterns
  • failure to grow in height as expected
  • fever and acting sick
  • persistent vomiting or diarrhea
  • being unable to hold down liquids
  • signs of a skin infection or persistent rash
  • wheezing
  • persistent cough, or other breathing difficulties
  • localized pain, such as an ear infection

Typical Medical Problems

Problems often found in this age group include enuresis (bedwetting) and sleep disturbances, such as nightmares. Kids also might have growing pains in their calves at night.

Your doctor's office can answer questions about these and other common concerns and can be a helpful resource and support.

Reviewed by: Mary L. Gavin, MD
Date reviewed: January 2015