Physical Development

Permanent teeth start to appear; “baby teeth” disappear
Grows about 2 inches and gains approximately 5-6 pounds a year

Social and Emotional Development

Has a short attention span (about 15 minutes)
Bathes, eats, dresses independently. Values independence.
Embarrasses easily and shows guilt
Might tattle, name call, hit and shove
Learns address and phone number; recognizes letters and words. Counts to 100.
Enjoys board games. Likes to win (may change rules or cheat).
Likes active play; can be reckless. Begins to learn sports skills.
Tires easily and has mood swings
Sensitive to criticism and has difficulty admitting mistakes; feels guilty.
Cooperates but may impose rules on others. Has difficulty understanding others’ feelings.

Mental Development

Continue family routines; assign household chores.
Show affection and respect.
Discuss acceptable ways to handle anger/frustration and how to manage/resolve conflict.
Model self discipline.
Encourage social interactions with children his or her age.

School Issues

Prepare your child for school. Tour the school and meet the teacher(s).
Discuss with teachers any performance, progress, behavior or learning issues.
Know your child’s friends and classmates.
Visit the school, volunteer and observe your child in class.
Talk about bullying. Set clear expectations for behavior and help develop a “tell someone” plan should he/she see this happening at school or elsewhere.
Discuss acceptable ways to handle anger/frustration and how to manage/resolve conflict.
Immediately discuss any school concern with a teacher or counselor. Do not wait until things get out of control.

WHAT YOU CAN DO WITH YOUR CHILD

Read and tell stories to your child.
Play dress up with clothes, hats, jewelry.
Explore outdoors. Your child should get at least 60 minutes of outdoor activity every day!
Visit your local Outdoor Discovery Center and parks.
Allow your child to help with routine tasks such as setting the table.
Teach him or her how to draw shapes and people and the use of blunt-tipped scissors.
Provide activities such as art, story time, play groups and trips to the school, library, museum.
Practice skills such as hopping, jumping, skipping, throwing/catching, clapping/marching.
Do not allow a TV in your child’s bedroom.
Hugs and “smiles of appreciation” build a healthy spirit! Use praise frequently.
Model healthy behaviors. “Actions speak louder than words”.

KEEP YOUR CHILD SAFE

Car and Bike Safety

Children are required to ride in a booster seat until they are 8 years of age or 4 feet tall (57 inches). It is recommended that they stay in the booster seat until the regular car seatbelt fits correctly; the shoulder harness must rest on your child’s shoulder and not on his/her neck. Refer to www.michigansafekids.org for additional information.
Model safe behavior by wearing your seatbelt or bike helmet.
Require ALL members of your family to use booster seats, seatbelts, bike helmets and protective sports gear.
Talk about traffic and bicycle safety.
Everyone in your family should always wear CPSC-approved helmets for bike rides.

Poison Control

Keep household cleaners, soaps, medicines and vitamins locked up and out of reach.
If your child eats or has contact with something that could be poisonous, call the Poison Control Center at 1-800-222-1222 immediately.
Do not make your child vomit unless directed to do so by the center.

Burns

Store matches and lighters out of the reach of your child.
Keep your child away from hot stoves, fireplaces, grills, and fire pits.
Your water heater should be set no higher than 120 degrees Fahrenheit.
Use cool mist humidifiers.
Working smoke and carbon monoxide detectors should be installed on every level of the home and near sleeping areas.

Guns and Sharp Objects

The safest thing is to never have a gun in the house.
Always store guns unloaded and locked with the ammunition stored and locked separately.
Keep knives, scissors and other sharp objects out of reach.

General Safety Tips

Teach your child to swim and watch your child constantly whenever near water.
Keep your child away from moving cars, lawn mowers, and garage doors.
Teach your child to play in the yard and away from the road.
Teach your child to ask permission before approaching any dog.
Never leave your child alone in the house, car or yard. Supervise all play.
Have your child learn his/her first name, last name, age, address, city and telephone number.
Teach telephone use and how/when to dial 911. Discuss emergency situations.
Teach stranger safety.
Talk about “private parts” , “good touch” and “bad touch”.
Always supervise computer/internet use. Install parental control/monitoring programs.

KEEP YOUR CHILD HEALTHY

Fever

Fever at this age is a normal response to illness. You may give acetaminophen to relieve any discomfort.
Please call our office for an appointment if your child’s fever lasts more than 72 hours or there are symptoms that concern you.

Vaccines

Keep your child vaccinated on the schedule recommended by the American Academy of Pediatrics and your doctor. Splitting doses can be risky and is NEVER recommended by your doctor! Check with your insurance company before each well visit. Ask about deductibles, maximum benefits and if they pay for ANY PART of the cost of vaccines.
It is normal to have a fever for a couple of days after vaccination.

Smoking

Do not smoke.
Consider stopping smoking if you do smoke.
Do not smoke in your house or in your car.
Do not allow others to smoke around your child.

Hands

Encourage your child to wash hands before meals and snacks.

Nutrition

Offer your child skim, ½% or 2% milk.
Juice is not needed.
Offer water if still thirsty.
Serve your child 3 regular meals each day with 1 or 2 planned healthy snacks each day. Offer a variety of foods.
Snacks may include fresh fruit, applesauce, cheese, whole grain bread or crackers.
Remember that your child will eat when he/she is hungry. Do not force him/her to eat but encourage him/her to try new foods. Keep mealtime pleasant and encourage good manners.

Dental Health

Have your child brush with a soft toothbrush after each meal. Floss daily.
Have regular dental visits.

Sleep

Children at this age need about 11 hours of sleep each night.

Skin Protection

Limit play in direct sunlight. Apply sunscreen (SPF 30) and reapply frequently as needed.
If needed, insect repellents with a DEET concentration of 30 % or less may be used.

Adapted from Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents—Third Edition: Joseph F. Hagan, Jr. MD, FAAP; Judith S. Shaw, RN, MPH, EdD; and Paula Duncan, MD, FAAP