Child Developmental Milestones & Safety (Age 4-10 years)

When should my child get a wellness checkup?

Once your child passes the “toddler” stage, their healthcare provider will recommend annual wellness checkups, or well visits, to track their health and development between the ages of 4 and 10. These visits are different from injury or illness visits because they focus on examining developmental milestones rather than a targeted health issue.

What can I expect during my child’s well visit?

During your child’s annual exams between the ages of 4 through 10, your healthcare provider will:

• Perform a physical exam: Checking height and weight, blood pressure, vision and hearing (if appropriate) and examining your child’s entire body, including their heart and lungs.
• Update immunizations.
• Ask questions about your child’s development, including potty training, eating and sleeping routines.
• Answer any questions you might have about your child’s development and health.

Pediatric Developmental Milestones

What are developmental milestones for my child?

Developmental milestones are behaviors and skills that your child learns at certain ages. Milestones help track your child’s growth to make sure they are progressing at a normal, healthy rate. Your child will grow and learn a lot between the ages of 4 and 10, and your child’s healthcare provider will keep track of these milestones during their annual well visit.

Some children reach milestones faster than their peers, but it is not a race to reach growth goals. Your child is unique and will develop at their own pace. If you suspect your child is missing major developmental milestones, talk with your healthcare provider to screen your child for potential delayed development disorders and address any concerns you might have.

Child developmental milestones: 4-year-old

Your 4-year-old is continuing to explore their environment and enjoy more social interactions. Playing remains critical to their social development.

Language and motor skills develop rapidly during this time. Your child's vocabulary will expand and they now understand two-step commands. Most of the time, they will use four- to five-word sentences. Your child will be able to tell a story, name one to two colors and count up to four objects.

Milestones for your 4-year-old child include:

• Using an active imagination during play.
• Playing with other children.
• Telling stories and reciting nursery rhymes.
• Naming at least one to two colors and numbers.
• Jumping, hopping, able to stand on one foot for a few seconds.
• Using fine motor skills like scribbling, coloring or drawing simple shapes.

What are safety tips for my 4-year-old child?

Make sure your 4-year-old child is safe by:

• Poison-proofing your home, paying special attention to cabinets at child level. In the event that your child ingests a potentially harmful substance, keep the container and call the poison control center at 1-800-222-1222.
• Keeping hot tap water at less than 120°F to prevent burns.
• Placing smoke and carbon monoxide detectors on each level of your home and outside of each bedroom.
• Keeping firearms unloaded and locked in a cabinet if you must have them in the home.
• Securing electrical cords and cover electrical outlets.
• Practicing fire drills at home.
• Riding a bicycle with a helmet.

Child developmental milestones: 5-year-old

Your child is becoming more independent as they prepare to enter a formal school setting. Your 5-year-old can get dressed by themselves, with the exception of tying shoelaces.

Verbal skills continue to develop. Your child should speak in five-word sentences and be easily understood by strangers. Your 5-year-old should be able to recite their address and telephone number, count up to 10, name primary colors and recall parts of their favorite stories.

Take pride in your child's new abilities and give them praise for their accomplishments.

Milestones for your 5-year-old child include:

• Wanting to please adults and friends.
• Agreeing with and following rules.
• Speaking clearly, telling a simple story and knowing their name and address.
• Counting to 10.
• Writing letters and numbers.
• Using the toilet on their own.
• Skipping and standing on one foot for 10 seconds or longer.
• Using fine motor skills like cutting with child-safe scissors, zipping up zippers, fastening buttons and snaps on clothing.

What are safety tips for my 5-year-old child?

Steps to keep your 5-year-old child safe include:

• Riding in their forward-facing car seat until they exceed the manufacturer’s height or weight limit. They should then move to a belt-positioning booster seat until they are 4 foot 9 inches tall and between 8 and 12 years of age.
• Supervising children during play and always being present when your child is crossing the street.
• Discussing stranger safety.
• Swimming with supervision at all times. All pools and water areas should be inaccessible to your child.

Child developmental milestones: 6- to 8-year-old

Children between 6- and 8-years old are starting to act very independently, but are not yet able to make wise decisions consistently. They need their caregivers to set limits for them. As they develop their sense of understanding, they need you to praise their successes and establish consequences for inappropriate behaviors. They are learning to develop confidence and will take on more challenging situations, whether they are intellectual, social or physical activities.

Encourage activities that will help them in their future, such as reading, actively participating in sports and hobbies, practicing personal hygiene and safety, eating healthy, exercising and developing interpersonal relationships with both peers and adults.

The most important task for you as their caregiver is to be a positive role model for them as they develop their own healthy, safe and ethical lifestyles. Share time together by doing things you both enjoy and keep mealtimes as a family activity whenever possible.

Milestones for your 6- to 8-year-old child include:

• Participating in team activities.
• Looking for acceptance by friends.
• Describing feelings and experiences with clarity.
• Starting to think about the future.

What are safety tips for my 6- to 8-year-old child?

Follow these tips to keep your 6- to 8-year-old child safe by:

• Wearing protective equipment when participating in athletic activities.
• Teaching them to swim.
• Making sure they wear their seat belt.
• Monitoring television programs and movies your children watch and setting time limits for watching television.
• Keeping lines of communication open with your children now so that they stay that way as adolescence approaches.

Child developmental milestones: 8- to 10-year-old

Your child is beginning to understand their place in the world and will be eager to make decisions for themselves. Their knowledge that actions have consequences and knowing that there is a cause and effect relationship to their behavior starts to blossom their moral character.

Outside of the home, you will find the opinion of your child’s peers to become increasingly important in their eyes. Your child will continue to initiate new friendships but will also learn that the termination of inappropriate friendships is the beginning of a lifelong process.

In school, it is important to monitor for the emergence of learning difficulties. As a caregiver, take initiative in their education. Discuss issues with their teachers at school. Educators may have advice on what steps you can take at home to help your child excel in the classroom. Remember, it is still important to praise your child’s accomplishments and don’t expect perfection as they learn and try new things.

Your child may experience some physical changes from puberty at this age. It is important to talk with your child about these physical and emotional changes as they enter middle or junior high school.

Milestones for your 8- to 10-year-old child include:

• Forming strong, more complex friendships.
• Becoming more aware of their body and experiencing physical growth spurts.
• Learning and being challenged academically in school.
• Visualizing point of view from others.
• Showcasing an increased attention span.

What are safety tips for my 8- to 10-year-old child?

Keep your 8- to 10-year-old child safe by:

• Talking about alcohol, smoking, drugs and other dangerous behaviors so that your child is aware of them in a realistic way and understands the dangers. Don’t wait for your child to learn from their peers.
• Helping your child develop a sense of responsibility by learning what is right and wrong.
• Keeping lines of communication open with your child now so that they stay that way as adolescence approaches.
• Encouraging an hour of physical activity each day.
• Making sure your child gets enough sleep; about nine to 12 hours per day.

Follow-Up

What are developmental health concerns for my child?

If your child misses growth milestones, they could be at risk for developmental delays, which are skills that your child did not achieve according to expectations for their age. Developmental delays affect your child’s:

• Cognitive, problem-solving skills.
• Communication, speech and language skills.
• Motor skills.
• Social skills.

Signs that your child has a developmental delay include:

• Trouble communicating and socializing with others.
• Not understanding the consequences of their actions.
• Having difficulty learning in school.
• Not performing everyday tasks without assistance, like getting dressed.

If you suspect that your child has a developmental delay between the ages of 4 and 10, reach out to your child’s healthcare provider immediately to screen and treat for any developmental disorders.

What questions should I ask my healthcare provider?

• Is my child developing well for their age?
• What should I do if my child misses a developmental milestone?

A note from Cleveland Clinic

Your child is building stronger interpersonal relationships, gaining responsibility and becoming more independent as they navigate through early childhood. As their caregiver, support them every step of the way by helping them with their education, showing interest in their activities and being a positive role model.