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  • What’s happening at this age?

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    According to the American Academy of Pediatrics, the time between the ages of 4 and 5 marks your child’s transition from being toddler to a preschooler. While his physical growth and motor skills might still be slow to development, you can expect to see some great intellectual, social and emotional changes.

    Below are lists developmental milestones – things that most children can do at these ages – as well as signs of possible developmental delays at this age according to the Centers for Disease Control and Prevention.


    DEVELOPMENTAL MILESTONES:

    Below are lists of developmental milestones – things that most children can do at these ages – as well as signs of possible developmental delays at this age according to the Centers for Disease Control and Prevention.

    4 years

    Social and Emotional

    • Enjoys doing new things
    • Plays “Mom” and “Dad”
    • Is more and more creative with make-believe play
    • Would rather play with other children than by themselves
    • Cooperates with other children
    • Often can’t tell what’s real and what’s make-believe
    • Talks about what they likes and what they are interested in

    Language/Communication

    • Knows some basic rules of grammar, such as correctly using “he” and “she”
    • Sings a song or says a poem from memory such as the “Itsy Bitsy Spider” or the “Wheels on the Bus”
      video icon
    • Tells stories
    • Can say first and last name

    Cognitive (learning, thinking, problem-solving)

    • Names some colors and some numbers
      video icon
    • Understands the idea of counting
    • Starts to understand time
    • Remembers parts of a story
    • Understands the idea of “same” and “different”
    • Draws a person with 2 to 4 body parts
    • Uses scissors
    • Starts to copy some capital letters
    • Plays board or card games
    • Tells you what they think is going to happen next in a book video icon

    Movement/Physical Development

    • Hops and stands on one foot up to 2 seconds
    • Catches a bounced ball most of the time
    • Pours, cuts with supervision, and mashes own food

    Act early by talking to your child’s doctor if your child:

    • Can’t jump in place
    • Has trouble scribbling
    • Shows no interest in interactive games or make-believe
    • Ignores other children or doesn’t respond to people outside the family
    • Resists dressing, sleeping, and using the toilet
    • Can’t retell a favorite story
    • Doesn’t follow 3-part commands
    • Doesn’t understand “same” and “different”
    • Doesn’t use “me” and “you” correctly
    • Speaks unclearly
    • Loses skills they once had

    English | Español (Spanish)

    5 years

    Social and Emotional

    • Wants to please friends
    • Wants to be like friends
    • More likely to agree with rules
    • Likes to sing, dance, and act
    • Is aware of gender
    • Can tell what’s real and what’s make-believe
    • Shows more independence (for example, may visit a next-door neighbor by himself [adult supervision is still needed])
    • Is sometimes demanding and sometimes very cooperative

    Language/Communication

    • Speaks very clearly
    • Tells a simple story using full sentences
    • Uses future tense; for example, “Grandma will be here.”
    • Says name and address

    Cognitive (learning, thinking, problem-solving)

    • Counts 10 or more things
    • Can draw a person with at least 6 body parts
    • Can print some letters or numbers
    • Copies a triangle and other geometric shapes
    • Knows about things used every day, like money and food ideo icon

    Movement/Physical Development

    • Stands on one foot for 10 seconds or longer
    • Hops; may be able to skip
    • Can do a somersault
    • Uses a fork and spoon and sometimes a table knife
    • Can use the toilet on their own
    • Swings and climbs

    Act early by talking to your child’s doctor if your child:

    • Doesn’t show a wide range of emotions
    • Shows extreme behavior (unusually fearful, aggressive, shy or sad)
    • Unusually withdrawn and not active
    • Is easily distracted, has trouble focusing on one activity for more than 5 minutes
    • Doesn’t respond to people, or responds only superficially
    • Can’t tell what’s real and what’s make-believe
    • Doesn’t play a variety of games and activities
    • Can’t give first and last name
    • Doesn’t use plurals or past tense properly
    • Doesn’t talk about daily activities or experiences
    • Doesn’t draw pictures
    • Can’t brush teeth, wash and dry hands, or get undressed without help
    • Loses skills they once had

    English | Español

    To download the full checklist of developmental milestone from ages 2 months to 5 years old and delays to look out for, click here. Or download the Milestone Tracker mobile app.

    What if I notice a delay?

    If you are concerned about any developmental delays your child may be experiencing, ask your child’s doctor or nurse, or talk with someone in your community who is familiar with services for infants and toddlers in your area.

    Your Child’s Health >

    How important are regular screenings?

    The checklists you find here are not a substitute for standardized, validated developmental screening tools such as those that might be administered by your child’s doctor.

    The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern. Ask your child’s doctor about his or her developmental screening.

    Learn More

    Getting ready for Kindergarten

    Learn More

    Getting your child ready for kindergarten is a big step. A child’s performance in kindergarten will inform much of their future performance in elementary school and beyond. Because there is no one right list that works for every family, here are some great tips for getting your child ready.


    Get the Family Ready

    Checklist for San Antonio
    Download this Kindergarten Checklist from the San Antonio Public Library to see what your child should be able to do before kindergarten, tips for helping them get there, and recommended experiences for early learning in San Antonio.

    6 Steps to Get Your Family Ready
    This helpful list from the Urban Child Institute has simple and powerful steps to ensuring that your child – and your family – is ready for kindergarten.

    1. Get Familiar with Your School
    2. Start Your Routine Early
    3. Set “At Home” Ground Rules
    4. Designate a Workspace
    5. Encourage Your Child to Ask Questions
    6. Teach the Importance of Sharing and Listening

    Get Ready for Kindergarten
    For tips from veteran principals on easing first-day stress and preparing for success, check out this article from SchoolFamily.com.

    Start Learning Early

    Kindergarten: What Your Child Should Know
    Here’s another good checklist by GreatSchools.org about what your child should know to be ready for Kindergarten.

    Get Ready to Read
    GetReadyToRead.org has a variety of activities for teachers and parents to do with kids. The downloadable handouts on this page can help you begin the skill development necessary for successful learning. You can also sign up for free activity cards and other resources.

    Preschool Activities to Do With Your Child
    Education.com has fun activities and games you can do with your preschooler to get ready for kindergarten including crafts, counting practice, easy science experiments, and art projects.

    Choosing a School and Considering Your Child’s Needs

    One important step to preparing for kindergarten is deciding what school will be best for your child. This resource from GreatSchools.org can help know what to consider, your child’s needs, and how to find the right fit.

    Child Care

    Choosing the right child care option for your family can help make the first year of school successful for everyone. These local options or resources can help you find the right fit.

    Child Care Assistance from the City of San Antonio
    The Child Care Services Program provides monetary help for child care to an average of 8,200 children per day through more than 750 local child care providers. Child care services are available for both full and part-time care for qualified families. Qualified families may encounter a wait period for service availability. To be eligible for CCS, individuals must meet certain criteria. For more information, check out this page on the City of San Antonio’s website.

    Quality Childcare Guide
    This downloadable brochure from the Child Care Services program has a list of steps to choosing the right care for your child, plus a checklist on what to look for when deciding whether that child care meets your quality standard. English | Español

    Quality Childcare Provider List
    This is a comprehensive list of Quality Child Care Providers in the San Antonio area from Workforce Solutions Alamo, including address, contact information and accreditations.

    Texas Workforce Commission: Texas Child Care Solutions

    Developed by the Texas Workforce Commission, the purpose of Texas Child Care Solutions is so provide parents access to accurate and consistent information to assist them in making informed choices to meet their child care needs. Learn More >

    Preschool Providers (free or low-cost)

    Find Preschool Near You

    Enrolling your child in pre-school is an important step in preparing them for kindergarten. Click here to find a free or low-cost pre-school provider near you.

    What is Head Start?

    Head Start is a federal program that promotes the school readiness of children through age 5 from low-income families by enhancing their cognitive, social and emotional development. For contact information of local Head Start providers, click here.

    Pre-K 4 SA

    Pre-K 4 SA is a full-day prekindergarten program that also offers free afterschool care until 6:00 p.m. The program is highlighted by experienced teachers, high quality curriculum, and bilingual education options. Students are provided healthy and delicious meals including breakfast, lunch, and snacks at no extra cost and transportation is also available. To learn more, click here. To find out about eligibility and enrollment, click here.

    Learn More

    Health & Fitness

    Learn More

    Getting your child ready for a healthy life starts early. Healthy eating and physical activity habits are very important, and need support from the whole family.

    Here are some resources to help your child have a healthy start to their preschool years. When children are not at their healthiest it may keep them from attending school, which takes away valuable learning time in preschool and later in their education.


     

    Health Development

     

    What are some examples of healthy development?

    These short informational videos explain physical activity, healthy weight, and safety by age.

     

    Where can I find advice and knowledge?

    KidsHealth.org is a widely-used children’s health and development site with advice and information for parents and fun material on health for kids.

     

    What does sleep have to do with healthy development?

    When preschool children don’t get enough sleep, it can affect their mood, behavior, eating habits, and ability to focus during the day. Learn more about what you can do to improve sleep from WebMD.

     

    Physical Activity

     

    Why do preschoolers need physical activity?

    Today’s children are four times less active in their day-to-day lives than their grandparents were, according to the American Academy of Pediatrics. Being active helps your child stay healthy, learn good habits early, gives them an outlet for natural energy, and keeps them from high risk of obesity and other health problems throughout life.

     

    How much physical activity does my preschooler need?

    What is physical activity for preschoolers? Physical activity can be playing actively, family fun such as hiking or swimming, and anything that gets your child moving! Aim for 60 minutes a day, and check out these USDA resources for tips to get moving.

    • Encourage your preschooler to play actively several times every day. Preschoolers’ activity may happen in short bursts
    • Limit TV, tablet, and other screen time to less than 1 hour total per day.
    • Preschoolers need quiet time
    • Be a role model and limit your own inactivity
    • Look for active childcare settings that engage children in play and regular physical activity
    • Make active play fun for the whole family. Take a walk together after dinner, play catch, kick a ball, or turn up the music and dance.

     

    How do we get started with physical activity?

    Getting active can be free and easy. Check out this resource from PBS for tips to get active at your local park.

    • Encourage your children to watch for wildlife.
    • Go on a scavenger hunt.
    • Picnic in the park
    • Make art from nature
    • Play with dirt and mud
    • Watch the clouds

    Where can I find free kid-friendly places for physical activity in San Antonio?

    This guide offers useful information to kid-friendly parks in San Antonio.

     

    Medical Home

     

    What is a medical home?

    Today, a child needs a home base for medical and non-medical care supported by a partnership between you, the parent or caregiver, your family, and your primary doctor or provider.
    If you have insurance, it is likely you have already established a medical home. If you have not yet enrolled in medical insurance for your family, this is an important step to secure the medical support your child needs for healthy development. To get information about enrolling or one-on-one help, please visit enrollsa.com.

     

    When should I call a pediatrician?

    Handling illnesses or medical issues can sometimes be confusing for parents both new and old. Wondering when to call a pediatrician? Here are some helpful tips from WebMD.

    • High Fever – The American Academy of Pediatrics says to call your pediatrician right away if your child’s temperature repeatedly goes above 104 degrees.
    • Vomiting or Diarrhea – If it’s a single episode, there’s no need to worry. Call your pediatrician if your child’s symptoms become more severe or last for more than a few hours.
    • Coughs, Colds, and Other Respiratory Problems – When your child is older than 3 months, call the pediatrician if there is trouble breathing, a cough lasts more than a week, or there is also ear pain.
    • Rash –  Although most clear up on their own, call your pediatrician if your kid doesn’t have any energy, feels pain at the site of the rash, or has a rash that goes deep into the skin.
    • Pain While Peeing – Call your pediatrician, especially for girls, as it could be a possible UTI.

    Where can I find a pediatrician?Looking for a pediatrician in your area? Find one here.

     

    Well-Child Visits

    Why are Well-Child Visits important?

    Childhood is a time of rapid growth and change. At this exam, the health care provider will check your child’s growth and development in order to find or prevent problems. Your child should have more pediatric well-child visits when thy are younger and developing the fastest. Each visit includes a complete physical examination. Even if your child is healthy, well-child visits are an important time to focus on your child’s wellness. Learn more about well-child visits here.

    What should I expect from a Well-Child Visit?

    Check out this resource from KidsHealth for information about well-child visits and what you can expect from them.

    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 do a physical exam. During checkups, your child’s blood pressure, vision, and hearing will be checked.

     

    Immunizations

     

    Why should my child get immunizations?

    The use of vaccines has led to major improvements in child health over a relatively short period. Many of the infectious illnesses you or your parents had as children, from chickenpox to polio to measles, no longer affect most children today because of immunizations. If you follow the immunization guidelines recommended by the American Academy of Pediatrics (AAP), you can help make your child healthier than was ever possible in earlier generations. Learn more.

     

    What do I tell my kids about immunizations?

    This link from KidsHealth includes a simple guide to shots with interactive questions for parents and information for kids.

     

    Where do I go for immunizations?

    The Metro Health Immunization Clinic offers immunization services in San Antonio. Click here for more information.

     

    Reminder: Immunizations are required by law

    Immunizations are not only important for healthy development, but it’s also the law. Students who have not completed immunizations will not be allowed to register for kindergarten. Give yourself plenty of time during the spring of the year before your child enters kindergarten to have them done. Click here to download guidelines from the Centers for Disease Control and Prevention.

     

    Speech, Language and Hearing

     

    What about speech, language and hearing health?

    For more information about ensuring your child’s speech, language and hearing health, check out this helpful guide from the American Speech—Language-Hearing Association.

     

    Dental Health

     

    How do I help my preschooler keep that bright smile?

    Check out this Nick Jr. page for simple tips for making sure your kid is ready to keep a bright, healthy smile for life.

     

    How do I find a dentist that’s right for my child?

    The American Academy of Pediatric Dentistry (AAP), the recognized authority on children’s oral health, can help you find a dentist for your child in your area.

    Learn More

    Safety

    Learn More

    Child Safety

     

    How do I stay informed about child safety?

    Kids are going to fall, crash, slip and tumble. It’s all part of being a kid. But there are little things we can all do to ensure that kids avoid more serious injuries. Here is a go-to source from SafeKids.org for child safety information on a variety of topics.

     

    Texas-based Safety Tips and Resources

    The Department of Family and Protective Services provides information on child safety ranging from sleeping and water safety tips to how to report child abuse and neglect.

     

    How do I make my house healthy and safe for children?

    Check out this list of tips for making your home child-safe.

    •  Guard against Scalding
    •  Watch out for Windows
    •  Foil Other Falls
    •  Renovate Carefully
    •  Test for Radon
    •  Be Prepared for Fire
    •  Monitor Carbon Monoxide
    •  Ban Bugs Safely
    •  Avoid Allergens and Irritants
    •  Lock Up Poisonous Products

    First Aid and Safety Guidelines

    • Printable Safety Guides
    • Emergency First Aid Instructions

    Local First Aid and CPR training

    • Red Cross
    • American Heart Association
    • EMS University
    Learn More

    Food & Nutrition

    Learn More

    Providing healthy and nutritious meals is one of the most important things you can do to get your child to develop healthy eating habits for life. Your preschooler’s normal growth and development also play a big role in their eating habits. As preschoolers grow, they change physically, mentally, and socially. These changes affect everything they do, including eating.  To know what to expect, check out this helpful roadmap.


     

    What should my child be eating daily?

    MyPlate from the US Department of Agriculture provides daily food plans and ideas for your child, including tips for picky eaters and developing healthy eating habits.
    Limit the amount of added sugars, sodium, and saturated fat in your preschooler’s meals, drinks, and snacks.

    • Fruits – Focus on whole fruits
    • Vegetables – Vary your veggies
    • Grains – Make half your grains whole grains
    • Protein Foods – Vary your protein routine
    • Dairy – Move to low-fat or fat-free milk or yogurt

    Download the healthy eating for preschoolers checklist here.

    Want to know what to plan for? Check out this roadmap.

    What is good brain food for my child?

    This slide show from MedicineNet explains the top 10 brain foods for your child, which includes easy-to-get foods like peanut butter, eggs, oatmeal, and berries.

    1. Salmon
    2. Eggs
    3. Peanut Butter
    4. Whole Grains
    5. Oats/Oatmeal
    6. Berries
    7. Beans
    8. Colorful Veggies
    9. Milk & Yogurt
    10. Lean Beef (or Meat Alternative)

     

    10 Snacks Kids Can Make Themselves

    Helping your child create their own healthy snacks is a good practice to develop healthy eating habits. Check out these easy snacks your young child can make himself.

    1. Veggies and Dip
    2. Fruit and Cheese Kabobs
    3. Yogurt Parfaits
    4. Ants on a Log
    5. Cinnamon or Peanut Butter Toast
    6. Toasted Cheese Sandwich
    7. Microwave Popcorn
    8. Microwave Pizza
    9. Fruit Smoothies
    10. Edamame

    Delicious Healthy Recipes for the Whole Family

    Your family eating habits have a major influence on your child’s eating habits. Here are some healthy recipes that the whole family can enjoy.

     

    Learn More

    Social & Emotional Life

    Learn More

    Your child’s social and emotional development involves understanding their own feelings and behaviors as well as those of others, and applying this knowledge to interactions and relationships. Research has shown that those with high emotional intelligence have better attention skills and fewer learning problems, and are generally more successful in academic and workplace settings. This parent toolkit, developed by a leading organization on social and emotional learning include tips on child self-management, social awareness and relationship building.


    What You Can Do

     

    Good Parent/Child Communications

    Communicating with your child can be challenging, but good communication is key to building self-esteem and mutual respect, as well as making parenting more enjoyable and successful. These basic principles from the Child Development Institute can help you evaluate and strengthen communication in your family.

     

    Activities and Play Ideas

    Learning4Kids.net has lots of learning opportunities and play ideas for children age between 4 -5 years that explore sense, creativity and the imagination while also building important developmental skills like coordination.

     

    What if your child becomes angry?

    Here are some tips by the American Academy of Pediatrics for what you can do. Although these suggestions are specific to weight management and health, they apply to all scenarios that involve anger and discipline.

     

    What can you do for social-emotional development?

    This downloadable resource from the American Academy of Pediatrics has tips for parents and caregivers to promote healthy social-emotional development with your child.

     

    Local Events, Programs, and Services

    The SA Kids Directory can help you find resources throughout San Antonio to promote social and emotional development with your kids.

     

    Guidelines and Checklists

     

    How did you do today?

    This checklist can help you do a quick assessment of how your family is doing to develop social and emotional intelligence.

     

    Milestones and Tips for Home and Preschool

    This article from GetReadyToRead.org lists milestones to know whether your child is developing social and emotional skills appropriate to her age, and tips to encourage social and emotional learning at home and preschool.

     

    TV-Watching Guidelines

    Kids can have a lot of fun learning from many TV programs, but should not spend too much time in front of the screen. Here are some general guidelines from BabyCenter.com on how much screen time is too much, and how to monitor your child’s watching activity. The American Academy of Pediatrics (AAP) says some screen time is okay for children as young as 18 months, but the organization recommends limiting kids to an hour or less a day.

     

    Learn More

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