Abby Barnes, M.S., CCC-SLP
When your child turns 4, they’re probably starting to seem more like a “big kid.” That’s partly because of all the new things they’re learning to do! Four-year-olds are typically able to play cooperatively with friends, get dressed themselves, brush their teeth, and start to identify some letters and numbers.
Occupational therapists (OTs) help preschoolers meet developmental milestones related to fine motor, social, cognitive, sensory, and self-care skills. Here’s what to watch for in these core areas of development once your child turns 4.
Key takeaways
Occupational therapists can support children’s fine motor and visual skills, social and play skills, regulation and sensory skills, cognitive skills, and self-care skills.
Fine motor skills for 4-year-olds help them start doing more with their hands, such as copying different shapes, learning to draw, and writing some letters.
Social and play milestones are important as kids make friends and are around other children more often. Examples of these skills include cooperating and playing imaginatively with other children.
Regulation and sensory milestones relate to how well a child tolerates different experiences and sensations, such as transitions, paying attention, and calming when upset.
Cognitive milestones such as sorting, matching, and problem solving are all part of this stage.
Self-care skills, like dressing and daily hygiene tasks, are important for a preschooler’s growing independence.
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Get startedWhat do occupational therapists assess and treat in children?
Occupational therapy can help with several areas of childhood development:
Fine motor and visual motor skills
Social and play skills
Cognitive development
Regulation and sensory organization
Self-care
Fine motor and visual development is how kids use their hands and eyes together to interact with items and their environment. Examples include holding a pencil or utensils correctly.
Social and play skills are how kids learn to engage with others, such as through play routines and cooperative play.
Cognitive growth includes problem-solving skills, matching and sorting abilities, and cause-and-effect understanding. Cognitive skills keep your child learning every day.
Regulation and sensory organization is how kids respond to sensory input like touch, sound, movement, or visual stimuli. It also includes how well they deal with different emotions. Good regulation skills help kids handle transitions, new experiences, and day-to-day routines more easily.
Self-care relates to skills children start doing themselves as they become more independent. Examples include washing their hands and getting themselves dressed. This is how they learn to care for themselves.
You can also check out our speech and language milestone checklist for 4-year-olds.
Speech and language growth is still happening at age 4. Here are the milestones to look for during your child’s fourth year.
4-year-old fine motor and visual milestones
At age 4, kids are continuing to develop better fine motor and visual perceptual skills. These skills typically include:
Drawing a person with 3 or more body parts
Copying a cross shape and other simple shapes
Beginning to copy some letters or write their own name
Using a mature grasp (with 3 fingers) on crayons or markers
Coloring within lines with increasing accuracy
Cutting along a line with scissors
Stringing small beads and doing simple lacing tasks
Building more complex block structures (e.g., bridges, enclosures)
Manipulating small objects with improved in-hand coordination, such as smaller buttons
Completing simple puzzles (8 to 12 or more pieces)
Demonstrating better hand-eye coordination during drawing and play (such as catching a smaller ball, like a baseball)
Fine motor skills are the small hand and finger movements we use for everyday tasks. Learn examples, activities, and how to support your child’s development at home.
4-year-old regulation and sensory milestones
Four-year-olds are better able to sit and pay attention or participate in tasks—especially ones they enjoy! Maybe they really love doing crafts, or putting together puzzles. You’ll start to see them sit for 10 to 15 minutes at a time to complete tasks like this.
Similarly, they’re better able to participate in structured social tasks, like circle time or story time with other children.
Four-year-olds can typically transition from one activity to another with less frustration than younger kids. They may not love having to stop one activity and do another, but they’ll tolerate it with less pushback.
Kids this age also start to tolerate sensations in their environment much better. So maybe they hear a loud fire truck and don’t get quite as nervous. Or maybe they’re ready to slide down the tall slide. All of these sensory experiences become a little easier as they grow older.
They should also be better able to calm down with help from an adult. Instead of needing to give a hug or model deep breathing every time, you may just need to say, “Calm down. Take a deep breath.” Even a simple “Let’s calm down” may do the trick at times.
How do babies and toddlers learn to play? Learn the milestones and stages of play development in early childhood.
4-year-old cognitive milestones
As your child gets older, there is a mountain of cognitive growth happening. Here are some of the concepts your 4-year-old should be learning:
The concept of same vs. different
Colors and shapes
Simple counting and numbers
Beginning to understand basic time concepts (morning and night)
Simple problem-solving (such as building or fixing something)
Following directions with 2-3 steps
Cause and effect
Sorting objects by color, shape, or function
Imagination and symbolic thinking (such as pretending to use a hairbrush as a microphone while playing)
Expected reading and writing skills for 4-year-olds, kindergarteners, and first graders. Plus, what to do if your child has a reading problem.
4-year-old social and play milestones
Four-year-olds are typically becoming more and more social. They’re playing with other kids more, and likely going to preschool. They can cooperate and interact better while playing with others. Sharing gets a little easier, as well.
Many 4-year-olds love to play pretend with set roles and stories, such as playing house, school, or doctor.
Empathy is also growing at this age. If your child sees a friend get sad or hurt, they will probably try to comfort them. This is a big step in forming friendships.
Some kids need a little help in making friends. Here’s what parents can do to help their child learn social communication skills.
4-year-old self-care milestones
You may be amazed at the amount of independence your preschooler begins to show you! They’re likely to dress and undress with very little help. They’re likely handling zippers and big buttons much more easily.
Four-year-olds can typically use the toilet and wash their hands on their own. Using utensils and cups to eat and drink should be going well, with your help only needed once in a while.
Your child should start learning how to get their shoes on (and on the correct feet!). But it’s normal if they still need help tying laces.
Four-year-olds are also starting to do some chores around the house, like picking up their toys.
How do you know if your child is ready for kindergarten? Learn the signs that your child might not be ready, and find out how to prepare them to start school.
What if your child isn’t meeting developmental milestones?
If you’re noticing that your child is missing some of these milestones, talk with your pediatrician or an occupational therapist. If occupational therapy could help your child, starting earlier will lead to faster progress for your child—and also help prepare them for kindergarten.
Here at Expressable, we provide personalized, virtual occupational therapy designed to fit your child’s needs. Reach out to us to schedule an OT evaluation and get your questions answered.
Frequently asked questions (FAQs)
Four-year-olds are growing in independence and rapidly learning all kinds of new skills. From an occupational therapy perspective, 4-year-olds should be able to draw more detailed figures, string beads, cut along a line with scissors, and copy some letters. They should understand concepts like colors, shapes, and “same vs. different.” They should also be starting to play pretend and expressing empathy toward friends. Four-year-olds are typically able to feed themselves with utensils and use the toilet mostly on their own.
Four-year-olds should have simple counting skills. They should know how to sort items by color or shape, complete simple puzzles, and follow directions with 2-3 steps. They should understand basic time concepts, like morning and night. They should also be starting to learn how to write their name.
At age 4, kids are typically better able to share and cooperate with other children. They should be able to play pretend with their friends, and show empathy when another child is sad or hurt.
Ideally, by the time your child is 4, even people who don’t know them well should be able to understand at least 50% of what they say. By age 5, we’d look for them to be 75% understood. If your 4-year-old's speech isn’t clear, talk to your pediatrician or a speech therapist. It’s normal for kids to have trouble pronouncing some sounds or words. However, if it’s hard for them to communicate clearly, speech therapy may be needed.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
