Pediatrics Developmental Milestones

flexed posture; low tone

newborn Gross Motor

Head up when prone

2 months Gross Motor:

Rolling over

4 months Gross Motor:

Sitting up

6 months Gross Motor

Pulling to stand

9 months Gross Motor:

Walking

12 months Gross Motor:

Stoop and recover

18 months Gross Motor:

Jump on two feet

24 months Gross Motor:

Whole hand reach

4 months Fine Motor:

Whole hand grasp; transfer objects

6 months Fine Motor:

Pincer grasp

9 months Fine Motor:

Place blocks in cup

12 months Fine Motor:

Hold utensils

18 months Fine Motor:

Scribble

24 months Fine Motor:

cooing (vowel sounds)

2-3 months Expressive Language:

babbling (consonant sounds)

6 months Expressive Language:

Mama, dada non-specifically

9 months Expressive Language:

Mama, dada specifically

10 months Expressive Language:

First real word

12 months Expressive Language:

7-10 words

18 months Expressive Language:

speech 50% understandable to strangers

24 months Expressive Language:

turns to name

6 months Receptive Language:

Joint attention

9 months (impaired in autism) Receptive Language:

Follows a 1 step direction with gesture

11 months Receptive Language:

Follows a 1 step direction without a gesture

15 months Receptive Language:

Identifies body parts

18 months Receptive Language:

Understands prepositions, more complex sentences

30 months Receptive Language:

Fixes on face

2 months Social:

Monitors gaze

4 months Social:

Stranger anxiety, peek-a-boo

9 months Social:

Points for requests

12 months Social:

Points to show interest

18 months Social:

Early pretend play

24 months Social:

Gross Motor Red Flags (Infant, Toddler)

Head lag >3 months (low muscle tone), Rolling <2-3 months (may be increased muscle tone instead of strength), not walking by 15-18 months

Fine Motor Red Flags (Infant, Toddler)

Fisting > 3 months; hand preference < 18 months (may indicate poor hand function rather than preference)

Language Red Flags (Infant, Toddler)

<50 words or on 2 word phrases by 2 years

Social-Emotional Red Flags (Infant, Toddler)

No pointing, gaze monitoring or pretend play by 2 years

Pedal Tricycle

3 years Gross Motor:

Copy a circle, cut with scissors

3 years Fine Motor:

Hop on one foot

4 years Gross Motor:

Copy a cross; button and snap

4 years Fine Motor:

Gallop, skip

5 years Gross Motor:

Print some letters; write name

5 years Fine Motor:

speech 75% understandable

3 years Expressive Language:

Identify 2 colors, knows age

3 years Receptive language:

speech 100% understandable

4 years Expressive Language:

Knows gender of self and others

4 years Receptive Language:

Uses future tense

5 years Expressive Language:

Knows phone number and address

5 years Receptive Language:

imaginary play

3 years Social:

Social: Understands perspective of others

4 years Social:

Social: Can cooperate with chores

5 years Social:

Gross Motor Red Flags (Preschooler)

Trouble with stairs, pedaling, jumping or hopping

Fine Motor Red Flags (Preschooler)

Trouble with fasteners, drawing shapes

Language Red Flags (Preschooler)

Trouble understanding directions; speech difficult to understand

Social-Emotional Red Flags (Preschooler)

Lack of complex play; disinterest in peers; persistent difficulty regulating emotions

Gross Motor: bike riding, sports

School aged Gross Motor:

Fine Motor: handwriting

School aged Fine Motor:

Speech and Language: reciprocal conversations

School aged Speech and Language:

Social-Emotional: Peer groups; best friends

School aged Social-Emotional:

Cognitive: Academics; complex reasoning

School aged

Red Flags for School Aged Children

Academic challenges, difficulties with peer interactions, mood problems, disruptive behavior, inattention

Ages for general developmental screen

9, 18, and 24-30 months (PEDS and Ages and Stages)

Autism-specific screen ages

18 and 24-30 months (M-CHAT)

Social: concepts of good and bad predominate

3 years

Social: complex roles and stories in play

5 years

Receptive Language: recognizes most letters

5 years

Expressive Language: can give definition of words

5 years

Receptive Language: knows first and last name

4 years

Receptive Language: can count to 4

4 years

Expressive Language: 4-5 word sentences

4 years

Expressive Language: uses past tense

4 years

Expressive Language: 3-4 word sentences

3 years

Expressive Language: several hundred word vocabulary

3 years

Expressive Language: 3-4 word sentences

24 months

Expressive Language: 50 words

24 months

Newborn Reflexes

Grasp, sucking, Babinski, gaze at face, Moro, atonic neck reflex (archer, fencer)

Smiles

2 months

Tracking past midline

2 months

Lifts head when on belly and rotates it

2 months

Anticipatory Guidance: Sleeping

sleep on back with no stuffed animals, only small blankets

Anticipatory Guidance: Smoking

NO SMOKING

Anticipatory Guidance: Water Heater

Set <120 F

Lifts head when prone and rotates it

2 months

Sits up unassisted

4 months

Raises head 90 degrees while on stomach

4 months

Plays with a rattle

4 months

When lifted there is no head lag

4 months

Laughs

4 months

Anticipates feeding

4 months

Fusses for attention

4 months

Can begin cereal

4-6 months

Has doubled birth weight

6 months

Lifts chest and head while bearing weight on stomach

6 months

Rolls from back to belly and belly to back

6 months

Can sit in a high chair and hold a bottle

6 months

Likes sound of own voice

6 months

Recognizes parents

6 months

Likes mirrors and toys

6 months

Reaches for objects

6 months