1. MODULE IX 4 years

2. A. Physical Milestone This year, your preschooler will be more in control of her body and muscles. She will become adept at buttoning, zippering, and using a knife and fork. She will gain about 4 pounds this year and grow approximately 2 inches in height. She may seem thin because she is losing the plumpness of the toddler/preschool years -- which will gradually be replaced by muscle in the coming years. If her weight and height are rising together, you will know that she is growing normally. However, if weight rises faster than height, you will know she is getting fatter. If height doesn't rise perceptibly in 6 months, measure her again in 3 months. If there is still no increase, consult your pediatrician since some children do lack a growth hormone.

3. Smart Strategy for Caregiver Since a preschooler's growth pattern tends to make children slimmer at this age, it's unusual for many in this age group to be plump. However, if you suspect that your child is overweight, look at her upper arms and thighs. If there are rolls of fat in these areas, straining the sleeves and legs of clothes that otherwise fit, she probably is overweight. Before you take any action, such as restricting her food intake, talk with your pediatrician. It may not be that she's eating too much, but rather that she isn't eating the right foods.

4. Smart Strategy for Caregiver Examine eating patterns to reduce the amount of fat and up the fruit and veggies in her diet. Offer nutritious snacks instead of sugar-laden ones. And make sure she is getting plenty of exercise and not spending too much time in front of the television or computer.

5. B. Developmental Milestone Four-year-olds are obsessed with their bodies and what they can do. You may find your child exploring his private parts, getting undressed in front of other children, and playing "doctor" with friends. Your youngster may become obsessed with the parent of the opposite sex. Bathroom humor is also popular. Children this age think they know everything, as their attention span increases and they are able to play more independently. Your child may be able to spend more time apart from you without becoming too upset.

6. Smart Strategy for Caregiver Exploring his own body, alone and with other kids, is your child's way of learning about sex differences and is a normal part of growing up. Masturbation is normal, so set boundaries, but don't make a big deal of his curiosity. Self-identity flourishes now and his "know it all" mentality is evidence of this. He may even act rude when you ask him to do something he doesn't want to do. As difficult as this behavior may be to tolerate, it is actually a sign that he is the testing limits of his independence.

7. C. Emotional Milestone Some 4-year-olds flip-flop from wanting to be independent and needing to run back into the security of your arms. It's best to have gradual transitions to new situations, especially in group situations like preschool and birthday parties. Linger until your child is comfortable in her surroundings, then say goodbye. Children this age can comfort themselves by picturing you in their minds when you are not with them.

8. Smart Strategy for Caregiver Don't force your child into a situation where she isn't comfortable, or tell her that she's acting like a baby if she gets upset when you leave. Empathize with her, so that she is able to verbalize her feelings about being apart from you.

9. D. Cognitive Milestone Your child's vocabulary may include a whopping 1,500 words by year's end! He'll be able to speak in sentences of six to eight words and his speech should be clear enough that strangers can understand him. He can understand three-part directives such as "put the lid on the box", "pick it up", and "bring it to me." He will also begin to use "s" in verbs to show present tense (he runs, she eats).

10. Smart Strategy for Caregiver Reading to your child is a great way to boost his budding language skills. Books and stories help a preschooler add words to his vocabulary, make sense of grammar, and link meanings to pictures. Talking helps as well. Have conversations with your child -- especially at mealtimes and bedtime when things slow down and you can take the time to really listen to what he's saying.

11. E. Immunization 4 to 6 years - Fifth dose of Diphtheria, Tetanus, Pertussis (DTaP) 4 to 6 years - Fourth dose of Inactivated Polio (IPV) 4 to 6 years - Second dose of Measles, Mumps, and Rubella (MMR Depending on where you live, your pediatrician may recommend the Hepatitis A vaccine.