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Four Year Well Visit

The four year olds are talking well and very rarely mispronounce words. Contact the doctor if most of the words are mispronounced. The children can go to speech therapy at the local grade school.  Contact your local grade school. The four year old children are starting to write some letters and some will write their name. They normally will write the letters backwards and do this even through first grade. This is normal and not dyslexia. Be sure they are holding the pencil correctly so work on their grip. Read to them and point to the words as you read. Then they will look at the words and start memorizing some small words. Also point to the large letters and name them so they will learn their letters. Keep the television to 2 hours a day and do not show violent material (obviously). They need time to play and use their own imagination. Start to play board games and keep it age appropriate like Candyland, Memory Matching, and Hi Ho Cheerio. Later you can go to Sorry and Monopoly. Board games will teach them to concentrate, fair play, how to be a good winner and good loser(us dads have not learned that yet), counting spaces, reading cards, adding and subtracting money.   Also work on improving the eye hand coordination by using the mazes where you go from the start to the finish.  You have to draw the line in the ally ways and improve coordination.

The diet is the same as discussed in the last two visits. Give a balanced diet, 12 oz of milk, and a chewable vitamin (Flintstone). If they can’t drink milk, then give 500 mg of calcium in the calcium fortified orange juice, or chewable calcium (caramel Viactin) or give 2 antacids.  If they start to not like the vegetables, grind them up and bake them into other foods they like. Some will eat them raw and dip them into Ranch dressing, Cheese Wiz, or soak them in the pickle jar. Grind them up and cook them in pancakes, in the Ragu Spaghetti sauce, or in the scrambled eggs. There is a book called "Deceptively Delicious" that has recepies.   They are only gaining 4 lbs a year. That is 1 lb every 3 months and we can gain 1 lb in 1 day! So expect them to not eat much and be picky. Normal!

Vaccines are needed now and the doctor will tell which. The shot schedule has changed every year so we can’t tell you when the next one will be or which one. New vaccines are coming out soon. 

Most are potty trained and going on the potty now. But bed wetting can occur into grade school and Jr. High in many kids. See web page on bed wetting. No guilt trip here, for kid or mom.  They are sound asleep and do not have control over this.  Not any more than Dad can stop snoring.  Do not reward a dry morning because if you do and he wets the next morning, then he feels guilty.  So do not punish a wet morning nor reward a dry morning.  It is how deep a sleep he goes into.  If they are bedwetting in school age there is a medication that helps that night only but at this age there is nothing to do but wait.

Enjoy this year because it is usually the best.  I like 4-6 year olds.

Dr. Knapp