Pediatric developmental milestones

first year

play is exploratory and social; primarily related to bonding with caregivers

first year

exploratory play (sensorimotor)- activity performed simply for the enjoyment of the physical sensation it creates

second year

the infant engages in functional, or relational play; an objects function is understood (putting telephone to ear), and that function determines the action

by end of second year

child can combine actions into play sequences, and the child directs actions away from themselves

gross motor play becomes more apparent. the child enjoys movement

what happens as the child becomes mobile?

sensory functions infants: birth to 2 years

newborn can interpret body sensations and respond reflexively. relaxes in mother's arms and expresses discomfort from a wet diaper

habituation infants: birth to 2 years

ability to extinguish incoming sensory information

gross motor and mobility 4 months

prone infant can lift head to visualize activities in the room

gross motor and mobility 6 months

rolls sequentially to move across the room (usually first time is prone to supine)

gross motor and mobility 6 months

sit alone by propping forward on the arms, using a wide base of support

gross motor and mobility 7 months

sits independently with hands freed to play with toys

gross motor and mobility 7 months

begins to crawl forward (belly first, then reciprocal)

gross motor and mobility 10-12 months

crawls rapidly over various surfaces, up and down inclines

gross motor and mobility 10 months

practices rising and lowering in upright postures while holding onto furniture

gross motor and mobility 12 months

first steps with holding onto parent's finger

gross motor and mobility 18 months

prefers walking to other forms of mobility, but balance still immature

fine motor manipulation 1 to 2 months

infant can swipe at objects placed at his or her side

fine motor manipulation 5 months

reaches towards objects with accuracy

fine motor manipulation 6 months

unilateral and bilateral reaches are observed

fine motor manipulation 4 to 5 months

palmar grasp with flexed fingers and adducted thumb

fine motor manipulation 6 months

radial palmar grasp (first two fingers hold object against thumb)

fine motor manipulation 10 to 11 months

pincer grasp develops (small objects between thumb and finger pads)

fine motor manipulation 7 to 8 months

voluntary release of objects develop

fine motor manipulation 10 months

objects are purposefully released into a container

fine motor manipulation 15 to 18 months

releases raisin into a small bottle, stacks two cubes

cognitive 8 to 9 months

infant has an attention span of 2 to 3 minutes and combines objects when playing

cognitive 12 months

understanding of the functional purpose of objects increases

social

sense of basic trust or mistrust depending on relationship with caregivers

social 2 months

express emotions such as smiling or laughing

social 5 to 6 months

interested in mirrors, recognizes self

social 2 years

interested in other children but would prefer to watch them than verbally interact

gross motor and mobility 2 years

walks with an increased length of stride and an efficient and well-coordinated gait (beforehand, shuffling gait- waddling)

gross motor and mobility 3 to 4 years

true running, with trunk rotation and arm swing, emerges

gross motor and mobility 5 to 6 years

mature running pattern develops and children challenge each other to races

gross motor and mobility 2 years

walks up stairs without holding onto a parent's hand

gross motor and mobility 3.5 years

walks up and down stairs by alternating feet and without needing to hold onto a rail

gross motor and mobility 3 years

can pedal a tricycle but will run into objects

gross motor and mobility 4 years

can steer and maneuver a tricycle around obstacles

gross motor and mobility 2.5 years

can catch a 10 inch ball

gross motor and mobility 2 to 3 years

kicking emerges

gross motor and mobility 6 years

kicking to a target

fine motor manipulation 4 years

in-hand manipulation develops

fine motor manipulation 3 years

holds pencil with static tripod grasp (not using intrinsic hand muscles yet)

fine motor manipulation 5 years

mature, dynamic tripod grasp

fine motor manipulation 5 years

can draw a person with multiple and recognizable parts

fine motor manipulation 3 years

snips with scissors

fine motor manipulation 4 to 6 years

cuts out simple shapes

fine motor manipulation 5 to 6 years

mature use of scissors

cognitive age 3-5 preschool

symbolic representations of real life objects and events during play (playing house, restaurant)

cognitive age 3-5 preschool

plans pretend scenarios in advance

cognitive age 3-5 preschool

abstract thinking begins in the preschool years as the child pretends an object is something else

cognitive age 3-5 preschool

discriminates objects size and shape in construction play (in stacking)

cognitive 3 years

crude attempts to represent people and objects in drawings

cognitive 4 years

can draw a recognizable person

cognitive 5 years

drawing becomes more refined, realistic, and better proportioned

social age 3-5 years preschool

interaction with peers becomes more important, moves away from parent

social age 3-5 preschool

more independence with self-care

social age 3-5 preschool

seek new experiences to learn about the environment

middle childhood 6-10 years

play becomes more structured and organized

middle childhood 6-10 years

games with rules become more predominate for physical and social play

7 to 8

personal need to win more important than rules

9 to 10

children become more conscious about obeying rules and can negotiate the rules

8 to 9

become interested in organized sports and physical play

middle childhood 6-10 years

interest in creating craft and art projects continues into middle childhood, the final project is highly valued

middle childhood 6-10 years

computer games and video games are increasingly popular

middle childhood 6-10 years

children play in cooperative groups and value peer interaction

middle childhood 6-10 years

social contact is increasingly virtual- email, texting, and social media

middle childhood 6-10 years

40% of waking hours are spent with peers

gross motor and mobility middle childhood 6 to 10 years

gross motor development reflects the refinement of previously acquired skills with increases in speed, precision of movement, and strength

gross motor and mobility middle childhood 6 to 10 years

motor capabilities are highly varied for this age group, balance and coordination improve throughout the middle childhood years

gross motor and mobility middle childhood 6 to 10 years

children who struggle with physical skills have lower self-esteem

fine motor manipulation 8 to 9 years

drawings have appropriate proportion and accuracy

fine motor manipulation middle childhood 6 to 10 years

handwriting skills improve in speed and accuracy

fine motor manipulation middle childhood 6 to 10 years

construction skills, manipulation, and abilities to use tools continue to generalize across performance areas, with increases in speed, strength, and precision

cognitive middle childhood 6 to 10 years

concepts and relationships in the physical world are understood and applied

cognitive middle childhood 6 to 10 years

past events are related to future plans (last christmas, i got this...)

cognitive middle childhood 6 to 10 years

thinking becomes more flexible and abstract

cognitive middle childhood 6 to 10 years

child can problem solve and weigh pertinent factors before making choices

social middle childhood 6 to 10 years

form close friendships and belong to one or more peer groups that influence their decisions, how they spend their time, and what they value

social middle childhood 6 to 10 years

focus on meeting challenges, and they appreciate the recognition that comes with successful completion of assignments or projects

social middle childhood 6 to 10 years

school-age children seek independence of identity (dressing differently)

social middle childhood 6 to 10 years

less interest in adults, including parents. values of peers becomes more important

performance skills adolescence 10-24 years

economic dependency on parents

performance skills adolescence 10-24 years

special needs- high school transition at 21 due to IDEA, transition plan needed

performance skills adolescence 10-24 years

concerns with mental health, ADD, bullying, lack of physical exercise, risky sexual behavior, substance abuse, and violence

performance skills adolescence 10-24 years

top causes of death- drug overdoses, car accidents, suicide, homicide

toileting 1 year

shows emotional distress when soiled

toileting 2 years

shows an interest in potty training

toileting 2.5 years

informs parent he needs to use the toilet

toileting 3 years

will often toilet on own

toileting 4 years

has few accidents

toileting 4.5 years

toilets independently, including clothing (not fasteners)

toileting 5 years

washing hands independently after toileting

sleep newborn (0-3 months)

14-17 hours of sleep

sleep infants (4-11 months)

12-15 hours of sleep

sleep toddlers (1-2 years)

11-14 hours of sleep

sleep preschoolers (3-5 years)

10-13 hours of sleep

sleep school-aged children (6-13 years)

9-11 hours of sleep

sleep teenagers (14-17)

8-10 hours of sleep

birth-6 months emotion regulation/sensory organization

quiets when picked up. relaxes, smiles, and vocalizes when held. cuddles. listens. uses hands and mouth to explore objects