6-Year-Old Well Child Check

The six year old child stands on a threshold of exciting new cognitive and social experiences.


Many of the feelings your child has this year will have to do with school. During the first month or so, almost every child reacts to the stress of first grade. Irritability, crying, bed-wetting, thumb-sucking, nail-biting, or a change in eating habits can all be considered "tension relievers" or a way to let off steam. After the first month, if the problem persists, or if your child really doesn't want to leave for school in the morning, please contact our office.


Although you may find it hard to believe, six-year-olds like to talk even more than five-year-olds. In show-and-tell, for example, they will tell all if given a chance. Your six-year-old loves to let you know exactly what's on her mind, and in fact, it's very important that she do just that. It's important, too, that a child learn to take turns talking, and to listen.


  • Enjoys testing muscle strength and skills
  • Good sense of balance
  • Can catch small balls
  • Begins to learn some specific sports skills like batting a ball
Hand And Finger Skills
  • Uses crayons and paints with some skill, but has difficulty writing and cutting
  • Enjoys copying designs and shapes, letters and numbers
  • Draws person with body
  • Can tie shoelaces
  • Language has vastly improved
  • Common to have word reversals or letter reversals. This is the result of perceptual motor skills that are not quite fully developed and are not necessarily an indication of dyslexia
  • Says name and address
  • Enjoys planning and building
  • Reading may become a major interest
  • Increased problem-solving ability
  • Asks endless "how-what-when-where-why" questions
  • Still has a short attention span (about 15 minutes maximum)
Social And Emotional
  • May have unpredictable mood swings
  • Is quite sensitive to criticism
  • Has difficulty considering the feelings of others
  • Values independence
  • Being with friends becomes increasingly important
  • Interested in rules and rituals

Growth And Nutrition

Childhood obesity has become one of the main concerns of our nation in the Twenty-First Century.

Daily nutritional guide for the 4-to-6 year old

Grains -6-11 servings/day

  • Bread, ½ slice
  • Cereal rice, pasta cooked, 1/3 cup
  • Cereal, dry ½ cup Crackers, 3 to 4

Vegetables -2-3 servings/day

  • Vegetables, cooked or canned ¼ cup
  • Salad, ½ cup

Fruits -2-3 servings/day

  • Fruit, cooked or canned, ¼ cup
  • Fruit, fresh, ½ piece
  • Juice, 1/3 cup

Dairy -2-3 servings/day

  • Milk (does not have to be whole) ½ cup
  • Cheese, 1 ounce
  • Yogurt, ½ cup

Meats and Proteins -2 servings/day

  • Meat, fish, poultry, tofu, 1 ounce (2 1 inch cubes)
  • Beans, dried, cooked, 1/3 cup
  • Egg, 1

Calcium 1000 mg/day

Keep snacks healthy, encourage drinking water and keep juice to a minimum.

Common Issues And Concerns


Some psychologists feel that a child isn't truly ready to read before age seven, but again, that depends on the individual child. Reading requires skills different from repeating words heard in conversation. A child needs to be able to associate a visual symbol (word) with a sound and meaning she already knows.

Books are wonderful for the imagination, and a great way for a child to experience things outside her normal everyday world. If your child doesn't already have one, getting her a library card would be a wonderful thing for both of you this year. She can have the options of lots of books to choose from, and you can have peace and quiet as she reads.


Even though your child is older now, it's important to realize that until age seven, television and movies are risky business. Because your child still can't differentiate between reality and fantasy, certain scenes, even in classic family entertainment movies, can terrify her and cause nightmares. Studies have shown that although children can learn from imitating television, they do not learn to think or solve problems. It's been proven that children who watch hours of television every day lag behind their peers in development. Remember, children can't set their own limits.

Basic Guidelines for parent management of Television, Videos, and Computers:

  • Limit to 1 hour per day maximum
  • Plan what is watched, what games are played, what websites are ok.
  • NO TV during meals
  • No computers or TV recommended in child's bedrooms

Although a six-year-old can be very critical of her friends, she can also want to be like them.  She may act like them, too, so you may notice a new "uncouthness" at the table and a tendency to try to get away with more boisterous behavior. Although six-year-olds get along better with just one other person, your child may try to start a club this year, with much of the meeting time spent on deciding who can and can't be a member.

Given the competitiveness of six, and the stubborn need to be "right," friendships can tend to be turbulent this year. Making friends is important for children, and you can encourage friendships. Be friendly to the children she brings home, and include them in special outings. Let your child dress and act like the other children her age so she can fit in.


Because you know how much your six-year-old can do, it's frustrating to see how little he will do. At six, he's pretty independent. He's able to dress and undress himself, and can use a knife and fork. He can also brush his teeth, comb his hair, and help around the house.

Six is also a turbulent age, and often routines are areas of rebellion. One way that may show up is a messy room. The best coping mechanism you can have at this age is to lower your expectations for a while, and accept the fact that things won't always go like clockwork. If you can ignore things like bad table manners, for example, your meals might go a little smoother. Try not to let his little habits get to you, either. Much of the resistance will disappear like magic as your child makes the transition of adjusting to school.


Because your six-year-old is an adventurer, accidents can happen easily. Six-year-olds seem to be accident prone. Because he's clumsier than he was even six months ago, and can get carried away, you may see lots of scrapes, bruises and slivers.

At six, your child should have a good set of safety guidelines; rules for riding a bicycle, crossing the street, playing on the playground, and swimming. Accidents will happen, and to deal with the unexpected you should know some first aid. Get a good first aid book for children, and keep a copy on hand for your family.

Now that your child is in school, it's sometimes a temptation to think she can do more than she is really capable of. Six is still too young, for example, to cook on a stove unsupervised, to be left alone with a baby, or to spend time alone in the house. It's also important to protect your child in the neighborhood, on her way to or from the store, or school. She should be alert on the street, and never have anything to do with strangers.

For more age-specific safety tips, please visit Healthychildren.org.

Next Well Child Visit

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