Development
• Jumps, alternates feet when ascending stairs, can dress self. Pedals tricycle.
• Draws basic circle, starting to cut, thread beads.
• Speech 5-6 word sentences mostly intelligible to strangers.

Activities
• Consider preschool, playgroups, reading hours at the library. Research activities at the community center.
• Read together on daily basis.
• Keep screen time (TV, video, computer) to less than 1 hour a day. Have TV-free days to prevent the TV habit. Too much fast action and commercials can shorten children's attention spans.
• Puzzles, dress-up clothes, building toys, playgrounds, outdoor time.
• Playing quietly with self-directed play.

Safety
• Begin stranger training. Teach your child not to accept food, rides, or help from people without checking with you. Begin teaching phone numbers, parents' names. Identify "helping" and safe strangers when in the community.
• Continue car seat with a harness until 4 years or 40 pounds. Then switch to a belt-positioning booster seat. See www.boosterseat.org for more information about booster seats.
• Teach your child about your home fire response plan, meeting location, and how to get out.
• If there are guns in the home, lock them and store ammunition separately under separate lock. Talk to your children about gun safety. Keep knives out of reach.
• Make sure your child wears a properly fitted helmet when biking or scooting.
• Burn prevention: Don't have hot liquids and children in arms together; keep children out of the kitchen when cooking. Caution around the fireplace, wood stoves, grills, and campfires.
• Poisonings are common events. Lock up medicines, cleaners, detergents, & antifreeze. Syrup of Ipecac is no longer recommended for home treatment of poisoning by the American Academy of Pediatrics, although some experts continue to recommend its use in certain situations. In case of ingestion of poisons, call the Poison Control Center (1-800-222-1222) immediately before giving Ipecac.

Parenting
• Set aside some time from each busy day for conversation with your preschooler. Have story time each evening or talk about what happened that day at dinner. It is not necessary to constantly direct conversation to your child as self-directed play will help your child learn to think.
• Find time for you and your spouse to spend time together without children. Consider starting a "date night" policy.

Nutrition
• Balance food groups, encourage and praise when trying new things. Minimize mealtime battles. Your job is to provide healthy food, your child's job is to determine how much of it to eat. Model good nutrition.
• Eat together as a family, with no TV. One meal for everyone when possible.
• Encourage milk and water. Limit juice and sweetened drinks.
• Do not reward /comfort with food. Go to the playground or bookstore instead of going for a cookie or ice cream!
• Vitamins are not necessary unless you need fluoride supplementation. If you are concerned that he/she doesn't eat a balanced diet, a multivitamin is okay.

Dental Hygiene
• Dental visits are often successful this year.

Immunizations Today

Hepatitis A vaccine if not already done.

Next Visit

Please make an appointment when your child is 4 years old.

Resources/Books
• Positive Discipline for Preschoolers by Jane Nelsen et.al
• How to Talk So Kids Will Listen and Listen so Kids Will Talk by Adele Faber and E. Mazlish
• Raising an Emotionally Intelligent Child by John Gottman, PhD
• How to Get Your Kid to Eat - But Not Too Much by Ellyn Satter