4-Year Visit - 4 Years Features - Guiding Your Child Through The Early Years

Name:____________________

Date Of Visit:____________________

Weight:____________________

Height:____________________

Ask for an update on your child's health
Examine your child
Check your child's blood pressure, hearing and vision
Ask about possible exposure of your child to lead and test for lead, if indicated
Ask about your family's history of heart disease and test cholesterol levels, if indicated
Discuss your child's risk of anemia (iron-poor blood) and test for anemia, if indicated
Ask about possible exposure to tuberculosis (TB) and test your child, if indicated
Recommend one or more immunizations: MMR (measles, mumps, rubella), DTaP (diphtheria, tetanus, pertussis/whooping cough), polio
Give you an opportunity to ask questions

Your child's growth and nutrition.

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Your child's behavior and development.

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Your child's interest in playing with other children and making friends.

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Ways to help siblings resolve problems and deal with their anger.

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Your child's sleeping habits.

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Any concerns about your child's language, hearing or vision.

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How things are going at your child's preschool or child-care program.

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Any other concerns you have.

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Always use a car seat or booster seat, and only place a car seat in the back seat.
Set firm rules for safe behavior. All caregivers must consistently enforce these rules.
Make sure that wherever your child plays (for example, the yard or playground) is safe.
Teach your child about stranger safety.
Make sure your child brushes his teeth at least twice each day.
Limit high-fat foods, sugary foods, juice and soda.
Praise your child for good behavior and for all of his accomplishments.
Plan time for your child to play together with other children.
Reinforce limits and use time-out or other consistent discipline for unacceptable behavior.
Take time to listen to your child. Show respect for her; make her feel that what she says is important.
Limit television and video watching to one hour per day. Watch programs with your child and discuss them.

Based on health-supervision guidelines from the American Academy of Pediatrics and from Bright Futures, which is funded by the U.S. Department of Health and Human Services, under the direction of the Maternal and Child Health Bureau.