Developmental Milestones for a 4-Year-Old

Gross Motor Skills

• A 4-year-old girl should be able to climb stairs without support, demonstrating advancement from the 2.5-year milestone of alternating feet while climbing with support 1, 2, 3
• A 4-year-old girl should be able to skip on one foot, demonstrating balance and coordination development 1, 2, 3
• A 4-year-old girl should have already mastered earlier skills including pedaling a tricycle and climbing on/off furniture, achieved by age 3 1, 2, 3

Fine Motor Skills

• A 4-year-old girl should be able to draw a person with 6 body parts, a significant advancement from the 3-year-old ability to draw a person with only a head and one other body part 1, 2, 3
• A 4-year-old girl should be able to draw a simple cross, demonstrating visual-motor integration 1, 2, 3
• A 4-year-old girl should be able to button medium-sized buttons, showing refined finger dexterity and hand-eye coordination 1, 2, 3

Additional Developmental Domains

• Preschool-aged children at 48 months should demonstrate early elementary school readiness skills, including emerging handwriting abilities 3
• Preschool-aged children at 48 months should demonstrate communication abilities that promote participation with peers in group activities 3
• Preschool-aged children at 48 months should demonstrate feeding skills appropriate for independent eating in social settings 3

Clinical Surveillance Considerations

• Loss of previously attained skills should alert healthcare professionals to possible progressive neuromuscular disorders 3
• Concerns raised by preschool or childcare staff about motor development should be addressed promptly 3
• The American Academy of Pediatrics recommends standardized developmental screening at the 48-month visit, particularly when concerns exist about motor, speech, or oral motor development 3

Context for Assessment

• These milestones represent mean ages of performance, and some variation is normal, but marked delays beyond these ages warrant attention 1, 2, 3
• Developmental surveillance should be continuous throughout childhood, with additional screenings performed whenever concerns arise from parents, healthcare professionals, or educators 3, 5