Child at 4 years
Updated 25 Oct 2026
What most children can do at 4 years
Social and emotional
- Your child enjoys doing new things
- Your child likes playing (pretending to be) "mum" or "dad". For example, they like pretending to be mum cooking or changing a baby's nappy
- Your child is becoming more and more creative in pretend play. They can make up scenarios when pretending to be a doctor, a police officer, a teacher or a firefighter
- Your child prefers playing with other children, such as friends, older or younger siblings, to playing alone
- Your child cooperates with other children
- Often cannot tell clearly what is real and what is make-believe
- Your child talks about things they like and are interested in
Language and communication
- Your child knows some basic rules of grammar. For example, they use third-person words such as "she", "he", "grandpa", "grandma"... correctly
- Your child can sing a song or say a poem from memory
- Your child can tell stories
- Your child can say their full name
Cognitive (learning, thinking and problem-solving)
- Your child understands counting. For example, when the teacher asks them to count apples, they understand how to count them even if they may not count accurately
- Your child can name some colours and numbers
- Starts to understand time
- Your child remembers parts of a story
- Your child understands what "same" and "different" mean
- Your child can draw a person with 2–4 body parts
- Your child can use scissors. Remember to choose child-safe scissors
- Your child starts learning to copy some capital letters
- Your child can play board games or card games
- Your child tells you what they think will happen next in a story
Movement / Physical development
- Your child can hop or stand on one foot for up to 2 seconds
- Your child catches a ball thrown to them most of the time
- With adult supervision, your child can pour and serve food into cups or bowls and plates
If your child shows any of the signs below, take them to see a doctor early
- Your child cannot jump on the spot
- Has trouble writing, even scribbling
- Your child shows no interest in pretend or make-believe games
- Your child ignores other children or does not respond to people outside the family
- Resists getting dressed, sleeping and using the toilet
- Your child cannot follow three-part instructions, for example, sit down, take off your shoes and put them in the cupboard
- Your child does not understand "same" and "different"
- Your child does not use first-person words (I, me…) and second-person words (dad, mum, brother, sister, grandpa, grandma…) correctly
- Your child does not speak clearly
- Your child loses skills they once had
Things you can do for your 4-year-old
- Play pretend with your child. Let them be the leader and copy what they do.
- Try suggesting that your child pretends something that might make them anxious is about to happen, such as going to nursery or staying overnight at their grandparents'
- Give your child simple choices whenever you can. For example, let them choose what to wear, which toy to play with or what to have for a snack. Limit it to 2 or 3 choices.
- During playdates, let your child solve problems with their friends on their own, but stay close by to help if needed
- Encourage your child to use words, share toys and take turns.
- Give your child toys that spark their imagination, such as dress-up clothes, kitchen sets and building blocks.
- Try to use correct grammar when talking to your child. Try not to shorten sentences, and avoid baby talk and mispronouncing words
- Use words like "first", "second" and "finally" when talking about daily activities. This helps your child learn about the order of events.
- Be patient and answer your child's "why" questions thoroughly. If you don't know the answer, say "I don't know" or help them find the answer in a book, on the Internet or from another adult.
- When reading with your child, ask them to tell you what has happened in the story as you go
- Name colours in books, pictures and things around the house with your child. Count everyday things, such as crisps, stairs or toy train carriages.
- Spend time teaching your child outdoor games such as tag and follow-the-leader
- Play your child's favourite music and dance together. Take turns copying each other's moves.
Signs that need a doctor now
If you notice any of the signs below, please go to the nearest health facility to be checked by a doctor.
Bluish skin around the lips, hands and feet, or the whole body
A bluish colour around the lips, on the hands and feet, or over the whole body is a sign the baby is short of oxygen. Call 115 or take your baby to the nearest hospital at once.
Difficulty breathing, fast breathing, chest indrawing
Breathing faster than 60 breaths a minute, chest indrawing, flaring nostrils or pauses in breathing are signs of breathing difficulty in a newborn. This sign needs to be checked by a doctor. Please take your baby to the nearest health facility now. If the baby stops breathing or turns blue, call 115.
Convulsions (fits) in a baby
A convulsion in a young baby is a danger sign. Call 115 or take your baby to the nearest hospital at once; lay the baby on their side and do not put anything in the mouth.
Signs of dehydration
No wet diaper for 6 hours, a dry mouth and lips, and few or no tears when crying are signs of dehydration. Sunken eyes, a sunken soft spot, cold hands and feet and excessive sleepiness are signs of severe dehydration and an emergency. Please take your baby to the nearest emergency department now or call 115.
Source: Vinmec – Mất nước ở trẻ sơ sinh
Fever of 38°C or higher in a baby under 3 months
A baby under 3 months with a temperature of 38°C or higher needs to be seen by a doctor, even if the baby seems otherwise well. Please take your baby to the nearest health facility now.
Jaundice spreading to the belly, arms and legs, or appearing early
Jaundice that spreads to the belly, arms, legs, palms or soles, appears within the first 24 hours after birth, or lasts more than 2 weeks needs to be checked by a doctor. Please take your baby in now, especially if the baby is feeding poorly or very sleepy.
Source: Bệnh viện Đa khoa Tâm Anh – Cách chăm sóc trẻ sơ sinh bị vàng da
Poor feeding, lethargy, hard to wake
Feeding problems, clearly reduced activity, or a baby who feels cold are danger signs in a newborn. This sign needs to be checked by a doctor. Please take your baby to the nearest health facility now.
Fever after birth
A temperature of 38°C or higher after giving birth can be a sign of infection. This sign needs to be checked by a doctor. Please go to the nearest health facility now.
Source: CDC – Hear Her: Urgent Maternal Warning Signs and Symptoms
Heavy bleeding after birth
Soaking through one or more pads in an hour, or passing large clots, is a sign that needs emergency care. Call 115 or have someone take you to the nearest hospital now.
Source: CDC – Hear Her: Urgent Maternal Warning Signs and Symptoms
Thoughts of harming yourself or your baby
You are not alone, and these thoughts need a doctor's support soon. Please tell someone you trust right away and go to the nearest health facility today. If you feel unsafe right now, call 115.
Source: CDC – Hear Her: Urgent Maternal Warning Signs and Symptoms
Sources
Content advised by our doctors.
- HealthyChildren.org (AAP) (accessed 22 Oct 2026)
- CDC (accessed 22 Oct 2026)
- Source for the signs that need a doctor: Vinmec – Triệu chứng suy hô hấp ở trẻ sơ sinh
- Source for the signs that need a doctor: WHO – Newborn mortality (fact sheet)
- Source for the signs that need a doctor: Vinmec – Mất nước ở trẻ sơ sinh
- Source for the signs that need a doctor: Vinmec – Trẻ bị sốt, khi nào cần đưa đi khám?
- Source for the signs that need a doctor: Bệnh viện Đa khoa Tâm Anh – Cách chăm sóc trẻ sơ sinh bị vàng da
- Source for the signs that need a doctor: CDC – Hear Her: Urgent Maternal Warning Signs and Symptoms
This article helps you understand and prepare. It does not replace a check-up. For an answer about your own situation, please ask the doctor who is caring for you.