Developmental-Delay.com Pediatric Occupational, Physical,
ABA/Behavioral, Feeding, Speech
and Language Therapies
1445 East 10th Street
Cookeville, TN 38501
Phone: (931) 372-2567   Please call today to get started!
Fax: (931) 372-2572
Email: [email protected]

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Four Years (48 - 59 months)

Gross Motor

  • Stands 1 foot for 4 seconds (53-54 mo 6 sec; 59-60 mo. 10 sec) (3, 11)
  • Broad jumps-standing, 8-10" (60-71 mo.) (1, 9, 11)
  • Running broad jump 23-33" (11)
  • Hops on one foot (1, 9, 11)
  • Bounces ball awkwardly (51-52 mo.) (1, 3)
  • Throws ball overhand (42-48 mo.) (1, 11)
  • Bilateral Integration

  • Runs with good arm-leg coordination (1, 11)
  • Up and down stairs reciprocally (1, 9, 11)
  • Gallops (11)
  • Skips, 1 foot only (4 ½ year) (11)
  • Sit ups
  • Crosses midline by imitation (1)
  • Stabilizes paper during coloring or writing (3-5 year) (11)
  • Holds paper during scissors use (3-5 year) (11)
  • Fine Motor Coordination

  • Copies gate (4 ½ years) (1)
  • Builds 6 block pyramid (53-54 mo.) (1, 3, 8, 11)
  • 12 – 16 block tower (8, 11)
  • Static tripod/dynamic beginning (11)
  • Demonstrates an open web space in tripod pencil grasp
  • Copies X and square (49-50 mo.) (1, 3)
  • Begins copying block letters (11)
  • Cuts across paper following straight and curved lines (4-5 years) (1, 11)
  • Cuts 2 inch triangle within ½" in 45 sec (11)
  • Cuts 6" square within ¼" in 45 sec (53-54 mo.) (3, 11)
  • Colors pictures but may have difficulty remaining in lines
  • Spreads paste on one side of paper and turns over to stick it to another paper (11)
  • Folding paper in half with edges meeting (55-56 mo.) (3, 11)
  • Places paperclips (3)
  • Completes non-inset puzzle of 3-5 pieces
  • 10 Pellets into bottle in 25 seconds
  • Places key in lock and opens lock (9, 11)
  • Palm to finger translation with coin, 2-3 objects
  • Use shift to separate magazine pages or cards
  • Rolls piece of clay into ball (11)
  • Pick up marker or crayon using rotation (11)
  • More isolated finger movements to include finger spreading and opposition of thumb in sequence to all fingers (1, 11)
  • Visual Perception

  • Matches shapes of same color and size (11)
  • Can find simple familiar overlapping outline figures (8, 11)
  • Visual Motor

    Smoothly follows moving objects in all directions with eyes (11)

    Sensory Development

  • Discriminates different scents
  • Compares different textures, soft, smooth, rough (11)
  • Self-Care

    1. Dressing

  • Knows front and back of clothing (1, 9, 11)
  • Removes pullover garment independently (9, 11)
  • Puts on socks correctly (9, 11)
  • Puts on shoes with assistance tying laces (9, 11)
  • Manage buttons completely (9, 11)
  • Buckles shoes or belt (11)
  • Puts belt in loops (4 ½)
  • Zips jacket zipper – zipper separated (11)
  • 2. Feeding

  • Holds fork in fingers (11)
  • Can spoon soup without spilling (11)
  • Prepares simple foods for eating (11)
  • Opens container and removes foods (4 ½ yrs) (11)
  • Drinks from soda can or bottle (11)
  • Cleans up spills (11)
  • Uses napkin to wipe hands, mouth during and after meal (11)
  • Serves self and carries tray in line (4 ½-5 yrs) (1, 11)
  • 3. Hygiene

  • Brushes own hair (11)
  • Replaces cap on toothpaste (11)
  • Washes face when requested or on own (4-5) (1, 11)
  • Cognition:

  • Attends to task for 10 minutes without supervision (11)
  • Matches coins (11)
  • Counts orally to 5 – 10 (1, 11)
  • Understands concept of 3 (9, 11)
  • Names penny, nickel and dime (11)
  • Names heavier of 2 weights
  • Categorizes (11)
  • Knows primary colors (8, 11)
  • Body Scheme

  • Draws man with head and legs (3 parts) (1, 8)
  • Names and indicates teeth, shoulders, forehead, neck, cheeks, thumb, chin, fingernails, lips, heels
  • Self Identification

  • Tells month of birth (11)
  • Tells street name and town in address (4 ½ yrs) (11)
  • Tells father’s and mother’s first and last names (4 ½ yrs) (11)
  • Tells house number, street, town (11)
  • Recites telephone number (11)
  • Personal Welfare/Safety

  • Identifies dangerous situations verbally or with gestures (36-47 mo.) (9, 11)
  • Reports injury/danger to adult (1, 11)
  • Social Skills

  • Remains calm if change/disappointment occurs and no remedy is possible
  • Performs activities in presence of or when led by new person (7)
  • Behaves according to peer group norm in moderate structured situation (2)
  • Follows directions provided by authority figure (9)
  • Calls or acts out while raising hand of attention
  • Returns objects or materials to assigned place
  • Quiets down after activity period and waits for instructions
  • Volunteers for tasks (42-48 mo.) (1)
  • Takes turns in game activity 50-75% or more of time (1, 7)
  • Sits quietly for 10 minutes when listening to stories, music (4 ½ yrs)
  • Play

  • Plays and cooperates with others (1, 2, 7, 9, 11)
  • Role plays (1, 7)
  • Expressive Language

  • Has 1500 – 1600 word vocabulary
  • Asks many questions (11)
  • Uses more complex sentence forms (11)
  • Recounts stories and recent past
  • Counts 3-5 objects, though imperfectly (1, 11)
  • Repeats 3 digits (11)
  • Names primary colors, shapes and sizes (4 ½) (11)
  • Identifies gender
  • Identifies on, under, behind and beside in relation to body (11)
  • Receptive Language

  • Perceives differences in concrete events (4 ½)
  • Understands most questions about the immediate environment
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