Which is the first action of the nurse when a parent expresses concern about a child’s diet

Feelings and behaviour
At this age, preschoolers are exploring and learning to express motions. They do this in many ways – for example, by talking, using gestures, making noises and playing.

Preschoolers also like to be around people. Your child might want to please and be like preschool-age friends. Imaginary friends could be important to your child too. As part of getting along with others, you might hear your child saying sorry, agreeing to rules and being pleased when good things happen to other people.

When it comes to cooperating, your child is likely to be more helpful, but sometimes they might still be demanding. By the time your child is 5 years old, they’ll probably have more control over their behaviour and fewer temper tantrums.

Your child might feel anxious about starting school. Talking to your child about this and even visiting the school together can help to ease any worries.

In this year, your child might hide the truth about things sometimes, or even start telling lies. For example, they might say ‘I didn’t do it’ even when they did. This is a normal part of preschooler development.

Playing and learning 
Play is important because it’s still how children learn and explore feelings.

When it comes to play, your child likes to sing, dance and act. Your child also loves make-believe play and is learning the difference between fantasy and reality. Your child is more aware of their gender and might want to play gender-based games – for example, boys might want to play at being ‘Dad’. Your child might also try different roles and behaviour, like being a doctor or getting married.

Your child might be very curious about bodies – their own and other people’s. For example, you might find your child looking at their own and other children’s genitals. A combination of natural curiosity and role-playing is usually a normal part of childhood sexual behaviour. But if you’re concerned about a child’s sexual behaviour, it’s a good idea to talk with a GP, a paediatrician or another qualified health professional.

Thinking
Preschoolers understand more about opposites – for example, high/low. They know the names of letters and numbers out of order, and can count to 10. Your child might remember their own address and know the difference between left and right.

Talking
Children’s language develops a lot at 4-5 years. You might notice that your child loves telling stories and having conversations. Your child might also tell you how they feel, talk about their ideas, ask a lot of questions and say words that rhyme.

At 4 years, preschoolers know hundreds of words and can use 5-6 words or more in sentences. You can understand what your child is saying all the time.

By 5 years, preschoolers can speak more clearly and will know, understand and use even more words, often in more complex sentences of up to 9 words.

Daily life
Dressing themselves is pretty easy for children at this age. Also, your child can probably use a fork, spoon and sometimes a knife – for example, to spread butter on bread. You still need to supervise and help your child sometimes, but your child can go to the toilet and brush their teeth independently.

Moving
Preschoolers love moving and being active. Your child is getting better at walking down steps (maybe using the rail) with alternating feet, throwing, catching and kicking a ball, running, climbing, jumping, hopping and balancing on one foot.

Your child might also develop some new gross motor skills – for example, skipping, jumping backwards or jumping while running.

Your child’s fine motor skills are improving too. Your child can cut with child-safe scissors and write their first name and some letters. Your child might also be able to draw a circle and make detailed drawings of people with body parts and clothes.

Helping preschooler development at 4-5 years

Here are some simple things you can do to help your child’s development at this age:

• Give your child plenty of playtime: play helps preschoolers express feelings like joy, excitement, anger or fear. Your child might like messy play in sand or mud, pretend play with puppets, and outdoor play with plenty of running, tumbling and rolling.
• Make time for imaginative and creative play: this might be painting, drawing or dress-up games. Musical play is another idea – your child might like to dance, jump around or make music with simple instruments.
• Read with your child: reading together, telling stories, singing songs and reciting nursery rhymes all encourage your child’s talking, thinking and imagination.
• Do some cooking with your child: this helps your child to get interested in healthy food, learn new words and understand maths concepts like ‘half’, ‘1 teaspoon’ or ‘30 minutes’. You can give your child simple cooking activities, like tossing a salad or putting together sandwiches.
• Play games with your child that involve learning to share and taking turns. When you play, say things like, ‘Now it’s my turn to build the tower, then it’s your turn’, or ‘You share the red blocks with me, and I’ll share the green blocks with you’. Sharing is still hard for children at this age, so give your child plenty of praise when they share.

You might want to think about sending your child to preschool. At preschool your child can learn through play, make friends, and develop responsibility, independence and confidence. Preschool can support and encourage your child’s amazing development – and it can be a lot of fun too.

Parenting a preschooler at 4-5 years

As a parent, you’re always learning. It’s OK to feel confident about what you know. And it’s also OK to admit you don’t know something and ask questions or get help.

When you’re focused on looking after a child, you might forget or run out of time to look after yourself. But looking after yourself physically, mentally and emotionally will help your child grow and thrive.

Sometimes you might feel frustrated, upset or overwhelmed. It’s OK to take some time out until you feel calmer. Put your child in a safe place, or ask someone else to look after your child for a while. Try going to another room to breathe deeply, or call a family member or friend to talk things through.

Never shake a young child. It can cause bleeding inside the brain and likely permanent brain damage.

It’s OK to ask for help. If you’re feeling overwhelmed by the demands of caring for your child, call your local Parentline. You might also like to try our ideas for dealing with anger, anxiety and stress.

When to be concerned about child development at 4 years

See your child and family health nurse or GP if you have any concerns or notice that your 4-year-old has any of the following issues.

Seeing, hearing and communicating
Your child:

• has trouble seeing or hearing things
• doesn’t use sentences of more than 3 words.

Behaviour and play
Your child:

• can’t understand 2-part commands like ‘Put the doll down, and pick up the ball’
• doesn’t pretend during play – for example, doesn’t pretend to be mum or dad
• has very challenging behaviour – for example, has big tantrums over very small things or still clings or cries when you leave
• seems very afraid, unhappy or sad a lot of the time.

Movement and motor skills
Your child:

• is clumsy – for example, trips over a lot when walking or running
• finds it hard to handle small objects – for example, a pencil or crayon
• has trouble drawing shapes – for example, a circle or cross
• has difficulty eating, dressing or using the toilet.

When to be concerned about child development at 5 years

See your child and family health nurse or GP if you notice your 5-year-old has any of the following issues.

Seeing, hearing and communicating
Your child:

• has trouble seeing or hearing things
• isn’t developing conversational skills – for example, doesn’t understand how to talk, listen and respond.

Behaviour and play
Your child:

• can’t understand 3-part commands like ‘Put the doll down, get the ball from under the chair and put it in the box’
• doesn’t play with other children or acts in a very aggressive way
• seems very afraid, unhappy or sad a lot of the time
• is easily distracted and can’t concentrate on any single activity for more than a few minutes
• doesn’t pretend during play – for example, doesn’t play doctors and nurses, construction in the sandpit or cooking.

Movement and motor skills
Your child:

• is clumsy – for example, trips over a lot when walking or running
• finds it hard to use small objects – for example, a pencil or crayon
• has trouble drawing shapes – for example, a circle or square
• has difficulty eating, dressing or using the toilet.

You should see a child health professional if at any age your child experiences a noticeable and consistent loss of skills.

Children grow and develop at different speeds. If you’re worried about whether your child’s development is ‘normal’, it might help to know that ‘normal’ varies a lot. But if you still feel that something isn’t quite right, see your child and family health nurse or GP.