General Pediatric Milestones

While Prone:

• lifts head

• turns head side to side

• bears weight on forearms

0-4 Months

In prone:

• has equilibrium reactions

• lies with hips and legs extended

• can shift weight on extended arms

5-6 months

In prone:

• lifts chest and thighs off surface

• moves from prone to sitting

6-8 months

In supine:

• turns head from side to side

0-3 months

In supine:

• holds head in midline

• tuck chin, extend neck

3-4 months

In supine:

• plays with hands in midline away from the body

4-5 months

In supine:

• lifts head independently

• kicks legs

• feet to mouth

• hands to feet

• reaches for toy with one or both hands

• maintains thumb and finger extension with open palm

5-6 months

In sitting:

• sits alone momentarily

• increased back extension

• sits propped forward on arms

5-6 months

In sitting:

• can rotate UB while LB stays stationary

• protective responses when falling to the side

7-8 months

In sitting:

• sits well w/o support

• can remain fully upright (legs straight)

• variety of positions ( W, side sit, etc.)

• plays

• IND sits from prone

8-10 months

In sitting:

• protective extension backwards (arms bent → straight)

• in and out of sitting into other positions

• fully dev. trunk control

10-12 months

In sitting:

• supine to sit by rolling to side then pushing up

11-24+ months

In standing:

• can take weight on legs when held

• legs may give way

0-3 months

In Standing:

• bears weight when held proximally

• pelvis and hips behind shoulders

3-4 months

In standing:

• increased ability to bear weight

• less support: held at hands or arms

• can bounce

5-6 months

In standing:

• pulls to stand using furniture

  • kneel → half kneel

6-9 months

In standing:

• pulls to stand using legs only

• stand alone momentarily

• can shift weight onto one leg while stepping with opposite leg

9-12 months

Can roll from prone → supine, supine → side, and supine → prone

5-6 months

Age of crawling on belly, using hands and knees

7 months

Age of creeping belly in the air, using hands and knees

7-10 months reciprocal

Age they can creep on hands and feet

10-11 months

11-12 months creeps with incline and decline

baby cruises sideways

8 months

Baby can walk when hand held by an adult and cruises any direction w/o hesitation

10-12 months

walks IND and can start/stop

When can they run stiffly with eyes fixed on the ground?

12-15 months

toddler can climb on/off surfaces

15-18 weeks

progression of stair climbing

15 months - creeps up stairs

18-24 months - walks up/down stairs holding on and creeps backwards down stairs

2-2.5 years - walks up/down stairs in a step to fashion

2.5-3 years - walks up stairs alternating feet

3-3.5 years - walks down stairs alternating feet

progression of jumping/hopping

2 yrs. - jumps down from a step

3 yrs. - jumps off floor w/ two feet

3-4 yrs. - gallops

4-5 yrs. - jumps over things and hops on one foot

5 yrs. - hops straight

5-6 yrs. - skips, alternating feet

successful reach in supine and weight shift to reach in prone (unsuccessful reach with closed fist)

5 months

successful grasp in supine and successful reach and grasp in prone with weight shift

6 months

weight shift and successful grasp with weight shift on hands and knees

7 months

9 months increased accuracy

progression of cube grasp

3 months - ulnar side w/ no thumb involvement and flexed wrist

4-5 months - palmar grasp, adducts thumb and fingers pressed ulnarly (ulnar palmar grasp)

5 months - palmar grasp with thumb adducted

6-7 months - radial palmar grasp with opposed thumb on radial side wrist becomes straight at 7 months

8-9 months - radial digital grasp w/ opposed thumb space is visible and wrist extends at 9 months

progression of grasping a pellet

6 months - swiping/raking grasp used

9 months - inferior pincer grasp (distal thumb joint extended, beginning of opposition)

12 months - fine pincer grasp (distal thumb joint flexed)

Object Manipulation:

• grasped object moved by flexing elbow

• 2 objects can be held in two different hands

3-4 months

Object Manipulation:

• one hand holds the other manipulates

• holds items needing both hands to support it before the other releases (2 stage transfer)

5-7 months

Object Manipulation:

• two hands no longer needed to work together one hand can take and the other can release simultaneously (one stage transfer)

• voluntary release

7-9 months

Object Manipulation:

• can voluntary release into a small container

9-15 months

Object Manipulation:

• finger to palm translation

• can manipulate more than one item at a time

15 months - 2 years

Object Manipulation:

• palm to finger translation (place coin in slot)

• simple rotation ~90 degrees (unscrew bottle cap)

2-2.5 years

Object Manipulation:

• Shift - linear movement of an object on finger surfaces

  • turn pages

3-6 years

can rotate an object 360 degrees

• turn pencil around to erase

in hand manipulation with stabilization

• pick up coins with thumb and forefinger and store them ulnarly

6-7 years

prewriting and handwriting progression

1-1.5 years - scribbles and uses a palmar supinate grasp arm moves as unit

2-3 years - digital pronate grasp, arm moves as unit

3.5-4 years - static tripod, hand moves as unit

4.5-6 years - dynamic tripod

• copies letters, #, and possibly name (4-5)

• write name using upper and lowercase (5-6)

Scissor skill progression

2-3 years - hold and snips controlled

3-4 years - jagged snips, straight and curve cuts w/ guide

4.5-5 years - cuts simple geometry (triangles , squares )

5.5-7 years -variety of shapes increased complexity

Play is … from 0-2 years

Exploratory, mostly with parents and caregivers.

• 12-18 months is symbolic play (make-believe play)

  • 18-24 months make-believe with more objects

Play is … from 2-4 years

social/parallel

• more imagination (blocks now a phone)

• more cooperative

Play is … from 4-7 years

creative

• combines actions on multiple objects

• master school and work related activities

• cooperative peer groups

Play is … from 7-12 years

games

• rules, competition, and development of skills

• friends validate primarily for play choices

oral motor prior to birth

35 wks gestation - jaw and tongue moves for feeding

40 weeks gestation - rooting, gag, and cough reflexes present

Age rhythmic sucking develops

1 month

Age strong up/down tongue movement and good lip closure develops

6 months

• 4-5 months lip closure, munching, and tongue up/down movements are present

Age diagonal chewing develops

7-8 months

• with soft and mashed foods

Age lateral tongues and cup drinking develops

9 months

Age firm jaw and rotary chew develops

12 months

Age tongue tip elevation and sustained bite develops

18 months

Age child able to chew most foods (meat and raw veggies) and drink with cup with a firm jaw

24 months

Age of finger feeding

9-13 months

Age of successful spoon use to mouth

15-18 months

Age that object permanence emerges

6-8 months

Age that baby can recognize strangers

6-9 months

Age of interest in fork use to stab food items

24-30 months

dressing at 1 year old

• arms up to don/doff shirts

• extends legs to get socks and pants on

• removes socks

dressing at 1.5-2 year old

• removes untied shoe types

• removes unfastened jackets

• helps pull pants down

• pushes arms through holes in pullover shirt

dressing at 2.5-3 year old

• pulls down and removes elastic pants

• dons and doffs pullover shirts with some assistance

• unbuttons large buttons and unsnaps snaps

• unzips and zips when places on track

dressing at 3.5-4 year old

• dons slip on slippers and shoes

• buttons large buttons

• buttons a series of 3-4

• zips zippers

• snaps front snaps

• fastens front hooks

• unbuckles belt

dressing at 4.5-5 year old

• IND dress UB and LB

• may need some assistance to tie shoes

dressing at 5-6 year old

• ties and unties shoes

• buttons small buttons

• closes back fasteners

• zips back zippers