3-Year-Old Milestones: What to Expect and When to Ask

Between three and four, most children can:

These come from WA Health's guide to child development at 3 to 4 years, written by the Child and Adolescent Health Service. Children develop skills at different rates.

If you are worried about any area, speak with your GP or child health nurse. Do the same if your child can no longer do things they used to do.

WA Health and Speech Pathology Australia list what most children do between three and four, and the signs worth raising with a GP or child health nurse:

Most 3-year-olds can put four to five words into a sentence and ask "what", "where" and "who" questions, according to Speech Pathology Australia. They can also follow a two-part instruction, such as "give me the teddy and throw the ball".

WA Health adds that a 3-year-old usually understands 1,000 words or more and asks a lot of "why" questions. Understanding words is different from being able to say them. Some 3-year-olds speak very clearly and others still use some baby talk.

You can encourage your child's language development by building on what they say. If they say "big truck", you might say "Yes, a big red truck going fast". If your child gets a word wrong, WA Health suggests using the right word in your reply, without pointing out the mistake.

Some 3-year-olds stumble over words because the words cannot come out fast enough, and WA Health says this will probably clear up by itself. Stuttering is different: sounds or words are repeated or stretched, or your child gets stuck.

If you notice stuttering, speak with a speech pathologist, a health professional who helps with talking and understanding. Speech Pathology Australia advises getting help when it first appears, not waiting to see if it goes away. It also says stuttering in young children responds well to early intervention, which means therapy that starts soon after the stutter appears.

If your 3-year-old is not talking, or you are worried about a speech delay, speak with your GP or a speech pathologist. WA Health also suggests talking to your doctor or child health nurse if your child:

Ask your GP whether your child needs a hearing assessment or a speech pathology referral. You do not need to wait for the Medicare Healthy Kids Check to raise a concern.

Some will and some will not. Speech Pathology Australia says some late talkers catch up with other children before school, but some go on to have ongoing language difficulties, and it is hard to tell which early on. It advises getting a professional opinion early instead of waiting to see.

Hearing loss for any reason can delay learning to talk, according to Pregnancy, Birth and Baby. Your GP may recommend a hearing test and can check your child's overall health. They can also refer you to an audiologist, a health professional who tests hearing.

You do not need a doctor's referral to see a private speech pathologist in WA, according to WA Health, but you need one to claim a Medicare rebate. Parents can also refer their own child to WA Health's free Child Development Service for the Perth metropolitan area, though waits for some services can be long.

At three, most children love to run, jump, swing, climb and dance. WA Health lists walking along a plank, using the pedals on a tricycle, rolling and bouncing a ball, and throwing one. Catching is still hard.

Hand skills come along through the year. By four, most children can hold a pencil properly, button clothes and cut with scissors. Some can draw a person by then, usually a big round head with legs coming straight out of it.

WA Health suggests talking to your doctor or child health nurse if your child cannot jump with both feet together.

Many are starting to. Australian guides list counting and naming colours for children aged 3 to 5, not for age three alone.

StartingBlocks, the Australian Government's early childhood website, lists counting five to 10 things, matching and naming some colours, and copying shapes such as circles when drawing for children aged 3 to 5. The same list includes counting by rote, which means saying numbers from memory, and touching each object while counting.

WA Health says a 3-year-old understands tall, short, big and little, and a 4-year-old can copy a cross and a square. The US Centers for Disease Control and Prevention suggests counting games, such as counting stairs or body parts, because children this age are starting to learn about numbers.

Three-year-olds usually enjoy playing with other children, but sharing and taking turns are still being learned. WA Health says children of this age can control strong feelings better than they could at two, but most will still have some tantrums.

Fears are normal at three. Monsters, the dark, loud noises and some animals are common ones. It is also common for a child to still want a dummy or a favourite blanket when they are tired or away from home.

Talk to your GP or child health nurse if:

The new Medicare check looks at social and emotional development as well as talking and moving. The Royal Australian College of General Practitioners (RACGP), in its guide to the check, lists "significant parental concern" as a reason for early referral.

Signs of autism usually fall into two areas: difficulty with social interaction and communication, and limited or repetitive behaviours and interests, according to healthdirect. In young children, signs can include:

Not all children with these signs are autistic, as the Royal Children's Hospital points out. There is no single test for autism, and some signs overlap with other conditions, so a proper assessment matters. Start with your GP or child health nurse.

Under the national autism guideline, published by Autism CRC and approved by the National Health and Medical Research Council (NHMRC), your GP may look at your child's development themselves or refer you on. If autism is a possibility, the GP refers your child for assessment, for example to a paediatrician (a specialist doctor for children), a psychologist or a psychiatrist.

Healthdirect says it is best to start support as early as possible. The Sydney Children's Hospitals Network notes that early intervention services may be available while you wait for a diagnosis.

Many 3-year-olds are using the toilet during the day, with accidents still common, and plenty are still wet at night. A new baby in the house can set toilet training back for a while. WA Health suggests asking for help if your child is not interested in the toilet or is frightened to use it.

The GP asks about sleep, eating, screen time and toileting during the Medicare Healthy Kids Check. Write down anything you want to raise.

The Medicare Healthy Kids Check is a new health and development check for 3-year-olds. It starts on 1 November 2026, according to the Medicare Benefits Schedule (MBS) factsheet from the Department of Health, Disability and Ageing.

It is part of the federal government's Thriving Kids initiative, and the check can lead to a referral to Thriving Kids supports if your child needs them.

At Thorpe Street Health it takes 40 minutes: 20 minutes with Minna Tran, our registered nurse, then 20 minutes with a GP. It is bulk billed. You can book our Healthy Kids Check in Rockingham online on HotDoc.

According to the MBS factsheet, the check includes:

The check can identify concerns that need further assessment. If your child needs a closer look, the GP can refer them to a paediatrician. They can also refer to a speech pathologist or other support.

There is no routine vaccine due just because a child turns three. If your child is up to date, their next routine vaccine is at four years, according to the Western Australian Immunisation Schedule. All children have one injection then that covers diphtheria, tetanus, whooping cough and polio.

Aboriginal and Torres Strait Islander children, and children with some medical conditions, may also be due other vaccines at four. WA Health recommends a flu vaccine every year for all children from 6 months old, and the vaccine itself is free for children in WA. Your GP or nurse can check what your child needs.

The Healthy Kids Check includes a review of your child's immunisation status. If your child missed a dose, the team can arrange a catch-up schedule and nurse appointments. If your child needs a vaccine, our team can arrange it with the check.

For the Medicare Healthy Kids Check at Thorpe Street Health, bring:

Our GPs provide children's health care at Thorpe Street Health, 57 Thorpe Street, Rockingham. The check is bulk billed. It takes 40 minutes: 20 minutes with Minna Tran, our registered nurse, then 20 minutes with a GP.

To book the Healthy Kids Check in Rockingham, choose the 3 Year Old Medicare Healthy Kids Check on HotDoc, or call reception on (08) 6147 6547.

Worried about your child's development now? Call reception for a GP appointment and mention your concerns, so the team can book enough time. You do not need to wait for the health check.