3-Year-Old Well Child Check

Three-year-olds are friendly, talkative and exuberant about life's experiences!

Feelings

Because three is a time of rapid change,  many children use security blankets and thumb sucking to help them cope with pressure. That's normal, and it's better to accept it than to take your child's "crutches" away. 

Sadness is another emotion a child can experience at three, when he loses a pet or a friend, or begins missing a grandparent after a visit. At three, children may have bad dreams (fear again), and are interested in the differences between boys and girls. Sibling rivalry may appear too, and is primarily for the benefit of the parents. 

Talking

Threes are talkers, and they just love language. By the end of the year, your child will know about a thousand words and how to use them. By about three-and-a-half, children are learning the rules of grammar, and using prepositions, helping verbs, and using words for abstract ideas and feelings. 

Playing

Because this is the year of make-believe, your child will probably spend a lot of time in creative play. Playing house or store, dressing up, and role-playing with dolls are big favorites with three-year-olds, whether they're boys or girls. It's more important that your child has a few good toys or household things that he can be creative with than a lot of unlimited toys. 

Development

Movement
  • Climbs well and runs easily
  • Walks up and down stairs, alternating feet
  • Pedals tricycle
Hand And Finger Skills
  • Holds pencil and makes vertical, horizontal and circular strokes
  • Turns book pages one at a time
  • Builds tower of more than 6 blocks
Language
  • Uses four and five word sentences
  • Strangers can understand most of her words
  • Has 300 words and about 75% of their speech is understandable
Cognitive
  • Makes mechanical toys work
  • Plays make believe with toys and people
  • Sorts objects by shape and color
Social
  • Imitates adults and peers
  • Can take turns in games
  • Shows affection for family and peers
Emotional
  • Expresses a wide range of emotions
  • Separates from parents by age three
  • Objects to changes in routine

Growth & Nutrition

Food problems, common in the second year of life, may be stabilizing in the third year. It's important to feed your child a well balanced diet, and to know how much of each food group she needs at this stage. It's also important to limit the things she doesn't need; sugary foods, junk foods, and chemically treated foods. 

It's also important not to overfeed at this stage, for the total number of fat cells are determined now. Try not to use food as a bribe, a reward, or a punishment. If the table becomes a testing ground, set a thirty-minute meal limit, or feed the child before your own dinner.

Your three-year-old may be a "picky-eater." Offer a variety of foods and continue to offer refused foods on occasion. Don't try to force your child to eat and don't be overly concerned about the sporadic eating habits. This will improve over time, and children will usually grow at a healthy rate.

Common Issues & Concerns

Discipline

Discipline is very important at this age, because children can't set their own limits. Without discipline, children can get anxious, provocative, demanding and "spoiled." Three is an age of testing, and often negative behavior is a normal way of seeing how far your child can go.

Watch your child for difficult times of the day, late in the day buildups or during exciting, overstimulating times, and ask him to let you know when he's getting tired. You will need to be firm, and explain to the child what he did wrong. That's the way you help your toddler learn to set limits, and learn self-discipline.

Safety

Most playground accidents consist of minor cuts, abrasions and bumps, but there is always the chance of something more. Watch out for sharp metal edges and well-anchored equipment, and make sure the sandbox and slide are in the shade. Use sunscreen of at least SPF 30 before your child goes outside.

Teach your child never to go swimming without your permission. Home pools should have a childproof fence. Never leave water in a pool or bathtub, and always watch your child while she is in the water. It's never too early to start swimming lessons. Start having your child wear a safety helmet when riding a tricycle or in a seat on an adult bicycle.

The most common cause of nonfatal accidents in the home is poison. Aspirin, medications, caustics, lead, and hydrocarbons are the most common serious poisons. Many items you use everyday can be poisonous to a child in large doses - even your vitamins. It's important to take preventative measures and keep cleaning and medical supplies out of reach of small climbers. Always have Poison Control's phone number handy.

For further information on safety, you may also visit Healthychildren.org.

Toilet Training

It is best to begin potty training when your child is ready. Readiness to potty train usually occurs between ages two and four and involves three aspects:

  • Physical readiness: involves maturity of the sphincter muscles which give child ability to control "peeing" and pooping"
  • Communication readiness: child must be able to indicate the urgency to you: even saying "pee pee" or pointing to her diaper is sufficient.
  • Emotional readiness: child must show interest or desire to use the potty.
Car Seat

Your child should remain in a forward-facing safety seat, properly installed in the back seat. When she weighs 40 lbs and is 40" tall, she may be moved to a booster seat using the vehicle lap and shoulder belt, always in the back seat.

Dental Care

Routine dental visits should begin at two years of age. Teach your child to brush her teeth after meals and at bedtime; assistance will still be necessary. A pea-sized dab of fluoridated toothpaste can be used in total for the day.

Next Well Child Visit

The next routine physical examination is at four years of life.