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Fallout 3 Hints
Level 4 Perks
* Child at Heart: The only thing this perk does is give new conversation options with some children, and they're usually just ways to skip Speech Challenges (which are easy to handle with the "quicksave and restore if necessary" plan). There's no good reason to take this perk.
* Comprehension: A must-have for any player. It doubles the skill points you get from using skill books, so you should save all the skill books you find until after you get this perk, and use them all then. You can raise every skill by about 60 points by getting its bobblehead and using all of its skill books after getting this perk, the only bad part being that it'll take a lot of time and effort to hunt up all those skill books.
* Educated: This is also a must-have for any player, since it gives you three more skill points on all future level-ups. You could rationalize that you don't need it due to the Comprehension perk and all the skill books in the game, but the extra level-up skill points you'll get from this perk will really come in handy, especially early in the game, before you can hunt up a significant number of skill books.
* Entomologist: This is another limited-use damage-increasing perk. As with the Lady Killer / Black Widow perk, its usefulness will rapidly diminish as you level up and get better weapons. It can help noticeably when you're attacked by pairs of giant radscorpions, but only if you don't have a dart gun to slow them down with, a follower to distract them, and a good combat shotgun or minigun to finish them off with. (So get those things instead of this perk.)
* Iron Fist: This perk is only good for characters who are focused on unarmed combat, which generally doesn't give enough range, power, or weapon variety to be worth investing in.
* Scoundrel: This is another skill-increase-only perk (Speech and Barter, in this case), and therefore is not recommended.
No matter what your character focus is, I strongly recommend that you take the Educated perk at level 4 to get more level-up skill points, and the Comprehension perk at level 5 to get more skill points from skill books. You could switch the two, but that would lose you three skill points, and it doesn't take all that long to go from level 4 to level 5.