Development and milestones

The healthcare provider will ask questions and observe your child’s behavior to get an idea of their development. By this visit, your child is likely doing some of the following:

• Follows rules or takes turns when playing games with other children

• Answers simple questions about a book or story after you read or tell it to them

• Uses or recognizes simple rhymes (bat-cat)

• Uses words about time, like “yesterday” and “tomorrow,”

• Counting to 10

• Writes some letters in their name and names some letters when you point to them

• Hops on 1 foot

• Sings, dances, or acts for you

School and social issues

Your 5-year-old is likely in preschool or kindergarten. The healthcare provider will ask about your child’s experience at school and how they are getting along with other kids. The healthcare provider may ask about:

• Behavior and participation at school. How does your child act at school? Do they follow the classroom routine and take part in group activities? Does your child enjoy school? Have they shown an interest in reading? What do teachers say about the child’s behavior?

• Behavior at home. How does the child act at home? Is behavior at home better or worse than at school? (Be aware that it’s common for kids to be better behaved at school than at home.)

• Friendships. Has your child made friends with other children? What are the kids like? How does your child get along with these friends?

• Play. How does the child like to play? For example, does he or she play “make believe”? Does the child interact with others during playtime?

Nutrition and exercise tips

Healthy eating and activity are important keys to a healthy future. It’s not too early to start teaching your child healthy habits that will last a lifetime. Here are some things you can do:

• Limit juice and sports drinks. These drinks have a lot of sugar. This leads to unhealthy weight gain and tooth decay. Water and low-fat or nonfat milk are best for your child. Limit juice to a small glass of 100% juice no more than once a day. 

• Don’t serve soda. It’s healthiest not to let your child have soda. If you do allow soda, save it for very special occasions. 

• Offer nutritious foods. Keep a variety of healthy foods on hand for snacks, such as fresh fruits and vegetables, lean meats, and whole grains. Foods like french fries, candy, and snack foods should only be served once in a while. 

• Serve child-sized portions. Children don’t need as much food as adults. Serve your child portions that make sense for their age and size. Let your child stop eating when they are full. If the child is still hungry after a meal, offer more vegetables or fruit. It’s OK to place limits on how much your child eats. 

• Encourage at least 3 hours a day of physical activity through active play. Moving around helps keep your child healthy. Take your child to the park, ride bikes, or play active games like tag or ball.

• Limit “screen time” to 1 hour each day. This includes TV watching, computer use, and video games. 

• Ask the healthcare provider about your child’s weight. At this age, your child should gain about 4 to 5 pounds each year. If they are gaining more than that, talk with the healthcare provider about healthy eating habits and exercise guidelines.

• Take your child to the dentist at least twice a year for teeth cleaning and a checkup.

• Make sure your child gets the recommended amount of sleep each night. That's 10 to 13 hours in a 24-hour period for ages 3 to 5.

Safety tips

Learning to swim helps ensure your child’s lifelong safety. Teach your child to swim, or enroll your child in a swim class.

Recommendations for keeping your child safe include the following: 

• When riding a bike, your child should wear a helmet with the strap fastened. While roller-skating or using a scooter or skateboard, it’s safest to wear wrist guards, elbow pads, knee pads, and a helmet.

• Teach your child their phone number, address, and parents’ names. These are important to know in an emergency.

• Keep using a car seat until your child outgrows it. Ask the healthcare provider if there are state laws regarding car seat use that you need to know about.

• Once your child outgrows the car seat, use a high-backed booster seat in the car. This allows the seat belt to fit properly. A booster should be used until a child is 4 feet 9 inches tall and between 8 and 12 years of age. All children younger than 13 should sit in the back seat.

• Teach your child not to talk to or go anywhere with a stranger.

• Teach your child to swim. Many communities offer low-cost swimming lessons.

• If you have a swimming pool, it should be fenced on all sides. Gates or doors leading to the pool should be closed and locked. Don't let your child play in or around the pool unattended, even if they know how to swim.

• Teach your child about gun safety. Children should never touch a gun. If you own a gun, make sure it's always stored unloaded and locked up.

• Use correct names for all body parts, and teach your child the correct names of all body parts. Teach your child that no one should ask them to keep secrets from their parents or caregivers, to see or touch their private parts, or for help with an adults or other child's private parts. If a healthcare provider has to examine these parts of the body, be present.

• Teach your child it's OK to say "no" to touches that make them uncomfortable. For example, if your child does not want to hug a family member or friend, respect their decision to say “no” to this contact.

Vaccines

Based on recommendations from the CDC, at this visit your child may get the following vaccines:

• Diphtheria, tetanus, and pertussis

• Influenza (flu), annually

• Measles, mumps, and rubella

• Polio

• Varicella (chickenpox)

• COVID-19

Is it time for kindergarten?

You may be wondering if your 5-year-old is ready for kindergarten. Here are some things they should be able to do:

• Hold a pen or pencil the right way

• Write their name

• Know how to say the alphabet, count to 10, and identify colors and shapes

• Sit quietly for short periods of time (about 5 minutes)

• Pay attention to a teacher and follow instructions

• Play nicely with other children the same age

Your school district should be able to answer any questions you have about starting kindergarten. If you’re still not sure your child is ready, talk to the healthcare provider during this checkup.