Well Child Care, 5 Years Old

PHYSICAL DEVELOPMENT

Your 5-year-old should be able to skip with alternating feet and can jump over obstacles. Your 5-year-old should be able to balance on 1 foot for at least 5 seconds and play hopscotch.

EMOTIONAL DEVELOPMENTY

  • Your 5-year-old should be able to distinguish fantasy from reality but still enjoy pretend play.

  • Set and enforce behavioral limits and reinforce desired behaviors. Talk with your child about what happens at school.

SOCIAL DEVELOPMENT

  • Your child should enjoy playing with friends and want to be like others. A 5-year-old may enjoy singing, dancing, and play acting. A 5-year-old can follow rules and play competitive games.

  • Consider enrolling your child in a preschool or Head Start program if they are not in kindergarten yet.

  • Your child may be curious about, or touch their genitalia.

MENTAL DEVELOPMENT

Your 5-year-old should be able to:

  • Copy a square and a triangle.

  • Draw a cross.

  • Draw a picture of a person with a least 3 parts.

  • Say his or her first and last name.

  • Print his or her first name.

  • Retell a story.

IMMUNIZATIONS

The following should be given if they were not given at the 4 year well child check:

  • The fifth DTaP (diphtheria, tetanus, and pertussis-whooping cough) injection.

  • The fourth dose of the inactivated polio virus (IPV).

  • The second MMR-V (measles, mumps, rubella, and varicella or "chickenpox") injection.

  • Annual influenza or "flu" vaccination should be considered during flu season.

Medicine may be given before the doctor visit, in the clinic, or as soon as you return home to help reduce the possibility of fever and discomfort with the DTaP injection. Only give over-the-counter or prescription medicines for pain, discomfort, or fever as directed by the child's caregiver.

TESTING

Hearing and vision should be tested. Your child may be screened for anemia, lead poisoning, and tuberculosis, depending upon risk factors. Discuss these tests and screenings with your child's doctor.

NUTRITION AND ORAL HEALTH

  • Encourage low-fat milk and dairy products.

  • Limit fruit juice to 4 to 6 ounces per day. The juice should contain vitamin C.

  • Avoid high fat, high salt, and high sugar choices.

  • Encourage your child to participate in meal preparation.

  • Try to make time to eat together as a family, and encourage conversation at mealtime to create a more social experience.

  • Model good nutritional choices and limit fast food choices.

  • Continue to monitor your child's tooth brushing and encourage regular flossing.

  • Schedule a regular dental examination for your child. Help your child with brushing if needed.

ELIMINATION

Nighttime bedwetting may still be normal. Do not punish your child for bedwetting.

SLEEP

  • Your child should sleep in his or her own bed. Reading before bedtime provides both a social bonding experience as well as a way to calm your child before bedtime.

  • Nightmares and night terrors are common at this age. If they occur, you should discuss these with your child's caregiver.

  • Sleep disturbances may be related to family stress and should be discussed with your child's caregiver if they become frequent.

  • Create a regular, calming bedtime routine.

PARENTING TIPS

  • Try to balance your child's need for independence and the enforcement of social rules.

  • Recognize your child's desire for privacy in changing clothes and using the bathroom.

  • Encourage social activities outside the home.

  • Your child should be given some chores to do around the house.

  • Allow your child to make choices and try to minimize telling your child "no" to everything.

  • Be consistent and fair in discipline and provide clear boundaries. Try to correct or discipline your child in private. Positive behaviors should be praised.

  • Limit television time to 1 to 2 hours per day. Children who watch excessive television are more likely to become overweight.

SAFETY

  • Provide a tobacco-free and drug-free environment for your child.

  • Always put a helmet on your child when they are riding a bicycle or tricycle.

  • Always fenced-in pools with self-latching gates. Enroll your child in swimming lessons.

  • Continue to use a forward facing car seat until your child reaches the maximum weight or height for the seat. After that, use a booster seat. Booster seats are needed until your child is 4 feet 9 inches (145 cm) tall and between 8 and 12 years old. Never place a child in the front seat with air bags.

  • Equip your home with smoke detectors.

  • Keep home water heater set at 120° F (49° C).

  • Discuss fire escape plans with your child.

  • Avoid purchasing motorized vehicles for your children.

  • Keep medicines and poisons capped and out of reach.

  • If firearms are kept in the home, both guns and ammunition should be locked up separately.

  • Be careful with hot liquids ensuring that handles on the stove are turned inward rather than out over the edge of the stove to prevent your child from pulling on them. Keep knives away and out of reach of children.

  • Street and water safety should be discussed with your child. Use close adult supervision at all times when your child is playing near a street or body of water.

  • Tell your child not to go with a stranger or accept gifts or candy from a stranger. Encourage your child to tell you if someone touches them in an inappropriate way or place.

  • Tell your child that no adult should tell them to keep a secret from you and no adult should see or handle their private parts.

  • Warn your child about walking up to unfamiliar dogs, especially when the dogs are eating.

  • Have your child wear sunscreen which protects against UV-A and UV-B rays and has an SPF of 15 or higher when out in the sun. Failure to use sunscreen can lead to more serious skin trouble later in life.

  • Show your child how to call your local emergency services (911 in U.S.) in case of an emergency.

  • Teach your child their name, address, and phone number.

  • Know the number to poison control in your area and keep it by the phone.

  • Consider how you can provide consent for emergency treatment if you are unavailable. You may want to discuss options with your caregiver.

WHAT'S NEXT?

Your next visit should be when your child is 6 years old.