3 Year Well-Child Visit

Height____________ Weight____________General: This is the beginning of a wonderful, but very challenging new stage. At age 3 we are seeing the emergence of magical thinking. This ability to fantasize about an object or person affects your child’s emotional growth, play and fears. We begin to see imaginary friends and untruths. We also see the emergence of fears about the darkness, monsters and imaginary creatures.

  • Feeding: Appetites continue to be variable and growth slows. Continue to offer 3 meals and 1-2 nutritious snacks per day. Your child should be eating what the rest of the family eats. You should decide what you’re going to serve and your child should decide how much he wants to eat. It’s appropriate to begin teaching good table manners, and it’s important to share mealtimes as a family.
  • Elimination: Nighttime wetting is still quite common at this age. A pull-up or diaper is an appropriate way to manage nighttime wetting. Don’t attempt nighttime training until your child is waking from sleep dry at least fifty percent of the time.
  • Sleep: Children sleep 10-11 hours at night and some continue to nap once a day, but many have given up this practice by age 3. Bedtime stories are a great way to wind down before bed, but remember about the vivid imaginations of 3 year olds and choose your stories wisely. A night light can be helpful to provide comfort and make them feel safe.

Development:

  • Motor Skills: Children this age love to run, jump and climb. They ride a tricycle well and balance on one foot. They can throw and kick a ball and learn to do somersaults. They also are improving their fine motor skills including coloring, stringing large beads, finger painting and cutting with blunt scissors.
  • Communication/Socialization: Your child’s vocabulary now is nearly 1000 words. 3 year olds know the difference between boys and girls. They know their full names, ages and speak clearly most of the time. Many can count and are beginning to learn the alphabet song. There are endless questions and challenges. They begin to understand the concept of sharing and show affection toward their siblings. Stuttering or “dysfluency” is common at this age. Do not tell your child to “slow down”, but stop what you are doing and look directly at your child while she finishes her statement. This will signal to her that she has your full attention. If this does not improve over a 3-6 month period, contact your doctor.

Safety:

  • Continue to use a car safety seat. If you have a passenger side airbag, your child needs to remain in the back seat until age 12 years.
  • Never leave your child alone in the car, tub, home or yard. Your child is becoming independent and may run away from you when you’re not looking.
  • Use life jackets and helmets. Set a good example for all children.
  • Any guns in the home should be locked up with ammunition kept separately.
  • Keep matches, lighters and cigarettes in a high, latched cabinet. Never allow smoking in your home or car.
  • Keep the Poison Control number by your phone (1-800-222-1222).
  • Protect any open windows with secure screens or barriers.
  • Begin to talk with your child about dealing with strangers.

Parenting: Discipline with love by using firm, consistent rules. “Time Out” can be an effective discipline technique at this age with 1 minute for every year of age as a recommended duration of time out. Whenever possible make the punishment reflect the offense. For example, “if you color on the walls, then you cannot play with the color crayons.” Generously praise your child for good behavior. Limit TV watching to less than 2 hours per day of good quality children’s entertainment.

Play: Reading remains one of the most important activities that you can share with your child and they are beginning to enjoy longer stories. Allow your child to tell stories using books and pictures. Children this age also enjoy imaginative play – give them some of your clothes and shoes to use as costumes. Outdoor play with riding toys, bats and balls are fun. Helping parents with domestic chores including cleaning, gardening and shopping is fun for your child.

Next visit is at 4 years of age.