Growth and Development

Bright Futures Parent Handout: 4 Year Visit

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Here are some suggestions from Bright Futures experts that may be of value to your family

School Readiness

Getting Ready for School

  • Ask your child to tell you about her day, friends, and activities.

  • Read books together each day and ask your child questions about the stories.

  • Take your child to the library and let her choose books.

  • Give your child plenty of time to finish sentences.

  • Listen to and treat your child with respect. Insist that others do so as well.

  • Model apologizing and help your child to do so after hurting someone's feelings.

  • Praise your child for being kind to others.

  • Help your child express her feelings.

  • Give your child the chance to play with others often.

  • Consider enrolling your child in a preschool, Head Start, or community program. Let us know if we can help.

Child and Family Involvement and Safety in the Community

Your Community

  • Stay involved in your community. Join activities when you can.

  • Use correct terms for all body parts as your child becomes interested in how boys and girls differ.

  • Teach your child about how to be safe with other adults.

    • No one should ask for a secret to be kept from parents.

    • No one should ask to see private parts.

    • No adult should ask for help with his private parts.

  • Know that help is available if you don't feel safe.

Developing Healthy Personal Habits

Healthy Habits

  • Have relaxed family meals without TV.

  • Create a calm bedtime routine.

  • Have the child brush his teeth twice each day using a pea-sized amount of toothpaste with fluoride.

  • Have your child spit out toothpaste, but do not rinse his mouth with water.



  • Use a forward-facing car safety seat or booster seat in the back seat of all vehicles.

  • Switch to a belt-positioning booster seat when your child reaches the weight or height limit for her car safety seat, her shoulders are above the top harness slots, or her ears come to the top of the car safety seat.

  • Never leave your child alone in the car, house, or yard.

  • Do not permit your child to cross the street alone.

  • Never have a gun in the home. If you must have a gun, store it unloaded and locked with the ammunition locked separately from the gun. Ask if there are guns in homes where your child plays. If so, make sure they are stored safely.

  • Supervise play near streets and driveways.

Television and Media

TV and Media

  • Be active together as a family often.

  • Limit TV time to no more than 2 hours per day.

  • Discuss the TV programs you watch together as a family.

  • No TV in the bedroom.

  • Create opportunities for daily play.

  • Praise your child for being active.

What to Expect at Your Child's 5 and 6 Year Visits

We will talk about

  • Keeping your child's teeth healthy

  • Preparing for school

  • Dealing with child's temper problems

  • Eating healthy foods and staying active

  • Safety outside and inside

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