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Well Child Care > Well child care: 4-6 Years

Well child care: 4-6 Years

Information regarding developmental goals, safety, immunizations, and nutrition information.

Developmental Goals

  • Can skip, walk on tiptoes, throw a ball over-hand, brush teeth, name 4 or 5 colors, tell a simple story, dress themselves, and recite nursery rhymes.
  • Can copy a triangle and draw a person with head, body, arms, and legs.
  • Begins to understand “right and wrong” and the concept of game rules.
  • Encourage reading and looking at books every day. Discuss what is happening in the story.
  • Encourage proper sleep for normal growth, development, and behavior.
  • Learn more about different types of sleep problems in our sleep problems section.
  • See also Speech Development


  • Watch portion sizes. Obesity is a major health problem.
  • Offer a plant (fruit or vegetable) plus a protein (dairy, meat, nut, legumes, egg) each meal and snack to help your child eat a healthy variety of foods and reach the 5-a-day fruit + veggie recommendation.
  • Balance the diet over the course of the week. If your child doesn't like a particular food, try to offer other foods that have similar nutritional value.
  • Giving multivitamins with iron can help achieve adequate nutrition in picky eaters.
  • All children need a supplement of Vitamin D. Click here for more information on vitamin D.
  • Limit juice and minimize sugary snacks. Juice offers little nutrition and has a lot of sugar! See Dr Stuppy's blog summarizing the AAP Juice Guidelines
  • Limit beverages that contain empty calories, especially soda, to no more than once per week.
  • Establish a pleasant mealtime atmosphere for discussing the day’s events.
  • Keep kids active. Exercise at least 30 minutes every day!
  • Begin or continue skim milk.
  • Click here for more age specific feeding recommendations!


  • Teach about safe touch and private body parts. Yes, start now!
  • Learn to keep your child from wandering and getting lost - see Dr Stuppy's blog. Ask what your child would do in certain situations, such as if a stranger asks for help finding a lost puppy, or if your child is lost.
  • Teach how and why to call 911. They need to give their name, address and why.
  • Practice fire drills! Show how to get out of different places in the home or how to wait by a window if unable to get safely downstairs. Pick a family meeting place at a neighbor’s front porch.
  • Keep medicines and other poisons locked and out of sight and reach.
  • Teach water safety.
  • Use life jackets while boating.
  • Keep lighters, matches, alcohol, and electrical tools locked.
  • Do not let your child near lawn mowers, farm equipment or cars.
  • Change batteries on your smoke alarms yearly with the time change.
  • Keep guns unloaded and locked with the ammunition locked separately.
  • Never place a child under 13 years old in front of an air bag.
  • Booster seats are required until 8 years old and/or 4’9” tall. Using a seat with a harness is safer until the shoulders reach above the straps.
  • Make sure your child wears a properly fitting helmet (skateboard, bike, roller blades, sledding). Use wrist, elbow and knee pads.
  • Set a good example - wear seat belt, helmet and don’t smoke in front of children.
  • Do not force your child into sports. Allow only one sport per season to avoid burnout at a young age.
  • Click here to learn safe and earth-friendly ways to dispose of unused/expired/recalled medications.
  • Click here for more over all safety information (i.e. bug safety, sun safety, internet safety, etc.)!


  • Use family meetings to bring the family together, improve communication, recognize/reward progress, and express feelings.
  • Meetings should be pleasant and last no more than 30 minutes.
  • Time outs are the preferred form of punishment at this age.
  • Click here for information on thumbsucking.
  • Praise good behaviors frequently. Kindness is contagious!
  • See our "Discipline" page for more information.


  • Some TV programs/video games promote learning, but many have detrimental messages.Click here to screen what movies and video games are recommended for various ages.
  • Violence is common and leads to aggression among kids.
  • Children do not understand that the claims of commercials are not true and base their choices on what they see. Watch television with your child. Discuss what you see.
  • Keep televisions/computers out of your children’s bedrooms and in open areas of the house.
  • Turn television off during mealtime.
  • Limit screen time to less than 10 hours per week (TV + computer + video games).
  • Watch with your children to help them understand what they're watching and to apply it to the world around them. Talk about the importance of online safety and treating others with respect - both in person and online.
  • Designate media-free times, such as during dinner, and media-free spaces, such as bedrooms. Use the Family Media Use Plan tool from the AAP to help.

Visit our Dental Pages for information on dental health.


  • For current Kansas and Missouri vaccine requirements, see our vaccine pages.
  • Flu vaccine is recommended each Fall.
  • It is no longer recommended to prevent symptoms with a fever reducer with all vaccines. You can treat more severe symptoms with acetaminophen, but studies show that limiting the fever decreases the vaccine's effectiveness.

Be sure to obtain any required health forms at your well visit! You will be able to print them from the patient portal as well. 

WIC (Women, Infant, and Children) provides nutrition counseling, breastfeeding support, and food to families who have needs. For more information click here.


Review your insurance contract to see who is responsible for payment of specific things within your well visit. Many companies do not require a co pay for well care visits, but if additional topics are discussed (such as ill topics or refills of medications) they might require a payment from you. They might also require you to pay for all or part of any labs or testing done at well visits.

If you have questions about how your insurance handles codes performed at the time of well visits, please visit our insurance pages on patient responsibility with billing and Why am I being billed? I have insurance!

Find health information quickly in our parent toolkit.

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