Developmental Milestones

0-3 months

• infants at this age mainly eat & sleep

• do not move or interact a lot

• limited communication (lay quietly, wriggle, grunt, cry)

• cry a lot

• must support their head

3-6 months

• infants at this age start to hold their head up, smile, reach for objects, & coo

• don’t tend to cry as much

• tend to lie or sit still & watch whatever you want them to

6-9 months

• infants at this age start to move around significantly

• may start to crawl to toys, play with them, & babble

• may develop stranger anxiety

9 months

at around ______ of age, infants should be crawling & may start to walk

1. watch a person’s face intently

2. follow people & objects with their eyes

3. smile & coo

4. laugh out loud

5. startle when they hear a loud sound

between 3-6 months, infants should achieve the following skills in regard to their responses to the environment:

1. hold their head steady independently when held sitting

2. lift their head & chest when on their stomach

between 3-6 months, infants should achieve the following skills in regard to their gross motor skills:

1. grasp a rattle when placed in their hand

between 3-6 months, infants should achieve the following skills in regard to their fine motor skills:

1. turn body to locate the source of a sound

2. respond to their name

3. babble & begin to combine sounds

by 9 months, infants should achieve the following skills in regard to their responses to the environment:

1. roll over

2. move from sitting with support to sitting independently

3. crawl on their hands & knees

4. support their weight on their feet when held in an upright position

by 9 months, infants should achieve the following skills in regard to their gross motor skills:

1. transfer objects from hand to hand

2. use the thumb & fingers to pick up small objects

by 9 months, infants should achieve the following skills in regard to their fine motor skills:

1. use vocabulary of 4-10 words

2. follow simple verbal directions to perform a single task

3. point to at least 2 pictures on request

4. talk in long jabbering sentences as if holding an understandable conversation with you

by 1-1.5 years, infants should achieve the following skills in regard to their responses to the environment:

1. walk alone with heels flat on the floor

2. walk up stairs with one hand held

by 1-1.5 years, infants should achieve the following skills in regard to their gross motor skills:

1. coordinate the use of both hands well

2. throw a ball easily

3. be able to scribble with a large crayon

4. feed themselves finger foods & begin to try to use a spoon

5. use their thumb & first finger easily to pick up a very small object

by 1-1.5 years, infants should achieve the following skills in regard to their fine motor skills:

social/emotional:

1. begin to smile at people

2. can briefly calm himself

3. tries to look at parent

language:

1. coos, gurgles

2. turns head towards sounds

cognitive:

1. pays attention to faces

2. begins to follow things with eyes & recognize people at distance

3. begins to act bored if activity doesn’t change

movement:

1. can hold head up & begins to push up when lying on stomach

2. makes smoother movements w/ arms & legs

what are some developmental milestones at 2 months?

social/emotional:

1. smiles spontaneously especially at people

2. likes to play with people

3. copies some movements & facial expressions

language:

1. babbles

2. babbles w/ expressions & copies sounds he hears

3. cries in different ways to show hunger, pain, or being tired

cognitive:

1. lets you know if happy or sad

2. responds to attention

3. reaches for toy with 1 hand

4. uses hands & eyes together (seeing toy & reaching)

5. follows moving things with eyes from side to side

6. watches faces closely

7. recognizes familiar people & things at a distance

movement:

1. holds head steady, unsupported

2. pushes down on legs when feet are on a hard surface

3. may be able to roll over from tummy to back

4. can hold a toy & shake it & swing at dangling toys

5. brings hands to mouth

6. pushes up to elbows when lying on stomach

what are some developmental milestones at 4 months?

social:

1. knows familiar faces & begins to know if someone is a stranger

2. Likes to play with others, especially parents

3. Responds to other people’s emotions and often seems happy

4. Likes to look at self in a mirror

language:

1. Responds to sounds by making sounds

2. Strings vowels together when babbling and likes taking turns with parent while making sounds

3. Responds to own name

4. Makes sounds to show joy and displeasure

5. Begins to say consonant sounds

cognitive:

1. Looks around at things nearby

2. Brings things to mouth

3. Shows curiosity about things and tries to get things that are out of reach

4. Begins to pass things from one hand to the other

movement:

1. Rolls over in both directions (front to back, back to front)

2. Begins to sit without support

3. When standing, supports weight on legs and might bounce

4. Rocks back and forth, sometimes crawling backward before moving forward

what are some developmental milestones at 6 months?

social:

1. May be afraid of strangers

2. May be clingy with familiar adults

3. Has favorite toys

language:

1. Understands “no”

2. Makes a lot of different sounds like “mamamama” and
   “bababababa”

3. Copies sounds and gestures of others

4. Uses fingers to point at things

cognitive:

1. Watches the path of something as it falls

2. Looks for things he sees you hide

3. Plays peek-a-boo

4. Puts things in her mouth

5. Moves things smoothly from one hand to the other

6. Picks up things like cereal o’s between thumb and index finger

movement:

1. Stands, holding on

2. Can get into sitting position

3. Sits without support

4. Pulls to stand

5. Crawls

what are some developmental milestones at 9 months?

social:

1. Is shy or nervous with strangers

2. Cries when mom or dad leaves

3. Has favorite things and people

4. Shows fear in some situations

5. Hands you a book when he wants to hear a story

6. Repeats sounds or actions to get attention

7. Puts out arm or leg to help with dressing

8. Plays games such as “peek-a-boo” and “pat-a-cake”
   Cognitive (learning, thinking, problem-solving)

language:

1. Responds to simple spoken requests

2. Uses simple gestures, like shaking head “no” or waving “bye-bye”

3. Makes sounds with changes in tone (sounds more like speech)

4. Says “mama” and “dada” and exclamations like “uh-oh!”

5. Tries to say words you say

cognitive:

1. Explores things in different ways, like shaking, banging, throwing

2. Finds hidden things easily

3. Looks at the right picture or thing when it’s named

4. Copies gestures

5. Starts to use things correctly; for example, drinks from a cup, brushes hair

6. Bangs two things together

7. Puts things in a container, takes things out of a container

8. Lets things go without help

9. Pokes with index (pointer) finger

10. Follows simple directions like “pick up the toy”

movement:

1. Gets to a sitting position without help

2. Pulls up to stand, walks holding on to furniture (“cruising”)

3. May take a few steps without holding on

4. May stand alone

what are some developmental milestones at 1 year?

social:

1. Likes to hand things to others as play

2. May have temper tantrums

3. May be afraid of strangers

4. Shows affection to familiar people

5. Plays simple pretend, such as feeding a doll

6. May cling to caregivers in new situations

7. Points to show others something interesting

8. Explores alone but with parent close by

language:

1. Says several single words

2. Says and shakes head “no”

3. Points to show someone what he wants

cognitive:

1. Knows what ordinary things are for; for example, telephone, brush, spoon

2. Points to get the attention of others

3. Shows interest in a doll or stuffed animal by pretending to feed

4. Points to one body part

5. Scribbles on his own

6. Can follow 1-step verbal commands without any gestures; for example, sits when you say “sit down”

movement:

1. Walks alone

2. May walk up steps and run

3. Pulls toys while walking

4. Can help undress herself

5. Drinks from a cup

6. Eats with a spoon

what are some developmental milestones at 1.5 years?

social:

1. Copies others, especially adults and older children

2. Gets excited when with other children

3. Shows more and more independence

4. Shows defiant behavior (doing what he has been told not to)

5. Plays mainly beside other children, but is beginning to include other children, such as in chase games

language:

1. Points to things or pictures when they are named

2. Knows names of familiar people and body parts

3. Says sentences with 2 to 4 words

4. Follows simple instructions

5. Repeats words overheard in conversation

6. Points to things in a book

cognitive:

1. Finds things even when hidden under two or three covers

2. Begins to sort shapes and colors

3. Completes sentences and rhymes in familiar books

4. Plays simple make-believe games

5. Builds towers of 4 or more blocks

6. Might use one hand more than the other

7. Follows two-step instructions such as “Pick up your shoes and put them in the closet.”

8. Names items in a picture book such as a cat, bird, or dog

movement:

1. Stands on tiptoe

2. Kicks a ball

3. Begins to run

4. Climbs onto and down from furniture without help

5. Walks up and down stairs holding on

6. Throws ball overhand

7. Makes or copies straight lines and circles

what are some developmental milestones at 2 years?

social:

1. Copies adults and friends

2. Shows affection for friends without prompting

3. Takes turns in games

4. Shows concern for a crying friend

5. Understands the idea of “mine” and “his” or “hers”

6. Shows a wide range of emotions

7. Separates easily from mom and dad

8. May get upset with major changes in routine

9. Dresses and undresses self

language:

1. Follows instructions with 2 or 3 steps

2. Can name most familiar things

3. Understands words like “in,” “on,” and “under”

4. Says first name, age, and sex

5. Names a friend

6. Says words like “I,” “me,” “we,” and “you” and some plurals (cars, dogs, cats)

7. Talks well enough for strangers to understand most of the time

8. Carries on a conversation using 2 to 3 sentences

cognitive:

1. Can work toys with buttons, levers, and moving parts

2. Plays make-believe with dolls, animals, and people

3. Does puzzles with 3 or 4 pieces

4. Understands what “two” means

5. Copies a circle with pencil or crayon

6. Turns book pages one at a time

7. Builds towers of more than 6 blocks

8. Screws and unscrews jar lids or turns door handle

movement:

1. Climbs well

2. Runs easily

3. Pedals a tricycle (3-wheel bike)

4. Walks up and down stairs, one foot on each step

what are some developmental milestones at 3 years?

social:

1. Enjoys doing new things

2. Plays “Mom” and “Dad”

3. Is more and more creative with make-believe play

4. Would rather play with other children than by himself

5. Cooperates with other children

6. Often can’t tell what’s real and what’s make-believe

7. Talks about what she likes and what she is interested in

language:

1. Knows some basic rules of grammar, such as correctly using “he” and “she”

2. Sings a song or says a poem from memory such as the “Itsy Bitsy Spider” or the “Wheels on the Bus”

3. Tells stories

4. Can say first and last name

cognitive:

1. Names some colors and some numbers

2. Understands the idea of counting

3. Starts to understand time

4. Remembers parts of a story

5. Understands the idea of “same” and “different”

6. Draws a person with 2 to 4 body parts

7. Uses scissors

8. Starts to copy some capital letters

9. Plays board or card games

10. Tells you what he thinks is going to happen next in a book

movement:

1. Hops and stands on one foot up to 2 seconds

2. Catches a bounced ball most of the time

3. Pours, cuts with supervision, and mashes own food

what are some developmental milestones at 4 years?

social:

1. Wants to please friends

2. Wants to be like friends

3. More likely to agree with rules

4. Likes to sing, dance, and act

5. Is aware of gender

6. Can tell what’s real and what’s make-believe

7. Shows more independence (for example, may visit a next-door neighbor by himself [adult supervision is still needed])

8. Is sometimes demanding and sometimes very cooperative

language:

1. Speaks very clearly

2. Tells a simple story using full sentences

3. Uses future tense; for example, “Grandma will be here.”

4. Says name and address

cognitive:

1. Counts 10 or more things

2. Can draw a person with at least 6 body parts

3. Can print some letters or numbers

4. Copies a triangle and other geometric shapes

5. Knows about things used every day, like money and food

movement:

1. Stands on one foot for 10 seconds or longer

2. Hops; may be able to skip

3. Can do a somersault

4. Uses a fork and spoon and sometimes a table knife

5. Can use the toilet on her own

6. Swings and climbs

what are some developmental milestones at 5 years?

sensorimotor stage

• birth-2yrs

• learning occurs through activity, exploration, & manipulation of the environment

• motor & sensory impressions form the foundation of learning

• child develops the concepts of self as something separate from the world, the consequences of actions, object permanence

preoperational

• 2-7yrs

• child becomes capable of symbolic representations of the world (language, play, imitation)

• still not capable of sustained systematic thought

• can now take greater account of other people’s POV

concrete operations

• 7-11yrs

• child becomes capable of limited logical thought process as long as the manipulable concrete materials are available

• become aware that some things remain despite change of appearance (conservation)

• start to see themes of relationships

formal operations

• 12yrs-adulthood

• child can reason logically & abstractly, formulate & test hypotheses, & explore possibilities

• can process abstract ideas, analogies, & metaphors

• you can now expect your patient to respond essentially as an adult for the purposes of your exam

family history, pregnancy, delivery, neonatal period, developmental milestones

what are important categories to ask about in an extensive medical/developmental history for a child?

birth & onwards

when do children develop the ability to follow with their eyes & increase their side-to-side range?

3-5mo

when do children develop hand regard?

3-4mo

when do children start reaching out?

6-8mo

when do children transfer objects from hand to hand?

9-10mo

when do children develop a pincer grasp b/t the thumb & forefinger?

9-10mo

when do children touch objects with their forefinger?

9-10mo

when do children look for fallen toys?

18mo

when do children build a tower of 3 bricks?

3y

when do children copy circles?

3y

when do children know their colors?

4y

when do children draw a man with a head, trunk, arms, & legs?

<1mo earlier

in general, black children achieve motor milestones ____ than white children

delayed

premature children are _______ in their locomotor development

8-9

____% of the normal population shows an early locomotion method, bottom shuffling, in preference to crawling & these children walk later on as well

70

___% of congenitally handicapped babies have additional major handicaps

33

____% of 91 babies were found to be hypotonic

68

____% of 100 visually impaired children were at ¾ the level of development or less for their age

later

severely visually impaired children’s expressive language tends to develop ______ than that of sighted children

31

developmental set-back in their 2nd or 3rd year of life occurred in ____ of 32 children who were totally blind

relatively the same

compare the motor development of a vision impaired child & sighted child for the 1st few months of life

self-initiated mobility

delays in motor development for a visually impaired child occur in ________

6mo

the parachute response of a visually impaired child is delayed by _____

legs, arms

visually impaired children tend to move their _____ more than their _____

3-4mo

reaching out is delayed _____ for a visually impaired child

1yr

the development of pincer grasp is delayed ____ for a visually impaired child

slow to localize sounds by reaching out to touch them & tends to become still to the sound

describe the response to sound in a young blind baby as compared with a sighted baby

slower

visually impaired children are ______ to localize their eyes to the part of the body that is touched

normal time

when do visually impaired children start to smile?

weaker

social competence for a visually impaired child is ______