Milestones Study Guide

scissors 1.5- 2 years

Explores scissors, begins to hold them, may attempt to open/close with two hands

scissors 2-2.5 years

may open/close blades and snip paper

scissors 2.5 - 3 years

opens and closes scissors with entire hand; makes simple snips

scissors 3-3.5 years

starts to make jagged, appr. 6” snips across a piece of paper

scissors 3.5-4 years

cuts across straight lines and curved lines within 1/4” of a guideline. Cuts out simple circle while using helper hand

scissors 4.5-5 years

starts to cut out shapes, like squares and triangles, while using helper hand

scissors 5-6 years

cuts complex shapes within 1/4” of guideline

reach 1-3 months (exploratory)

swipes with inaccuracy; does not combine reach and grasp

reach 3-6 months (perceptual learning)

reaching more accurate, combines reach with grasp; reaches to midline

reach 6-9 months (skill achievement)

can change direction mid-reach; accurate; by 8-9 months, can reach smoothly in all directions. Combines reach and grasp to carry items through space

drawing 2-3 years

scribbles on paper (non-symbolic, repetitious, exploratory)

drawing 3-4 years

interprets drawing. shapes emerge from scribbling

drawing 4-5 years

draws simple and intentful images; Some shapes and distinct elements; human with 4-7 features

drawing 5-6 years

increased crayon control; draws human with 8-11 features

grasp 3-5 months (exploratory)

• squeeze grasp first few months

• no thumb involvement (radial)

• Voluntary grasp begins 2-3 months, release is random

grasp 6-12 months (perceptual learning)

• begins using radial side to hold items; active thumb; transfers hand-to-hand but does not yet move from palm

• Voluntary release begins 6-7 months

• Inferior pincer grasp 9 months

grasp 12-24 months (skill achievement)

• superior pincer grasp by 12 months

• precision pincer release by 18 months

• Grasping skills dynamic by 2 years for tool use (holds toothbrush, spoon)

• Blended grasping patterns

grasp development 4 months

ulnar palmer

grasp development 5 months

palmer

grasp development 6 months

radial palmer

grasp development 7 months

raking

grasp development 8 months

radial digital

grasp development 9 months

inferior pincer

grasp development 10 months

fine pincer

fine motor manipulation- birth-6 months

tracks with eyes; develops reach to object; palmar grasping patterns- ulnar to radial; grasps and brings to mouth

fine motor manipulation- 6-12 months

Mouths toys; accurately reaches for toys; plays at midline and transfers hand-to-hand; bangs objects - likes sound effects; releases into a container; rolls the ball to adult; points with index finger; grasps items in fingertips

Fine motor manipulation- 12- 18 months

Holds crayon to scribble; holds two toys at once, including one and both hands; volitional release into containers; fits toys to space - formboards, stacks blocks; opens/shuts containers; points to pictures; uses two hands in play (one to stabilize)

Fine motor manipulation- 18-24 months

Builds 4-block tower; 4-5 piece puzzles; holds crayon in fingertips and draws lines/circles; uses simple tools, i.e., hammer; completes multi-step tasks, i.e., simple commands; turns pages of the book

Fine motor manipulation- 24-36 months

Snips with scissors; traces a cross; colors large forms; draws circles; builds towers; emerging fingertip motions to control crayon; 4-5 piece puzzles; enjoys toys with moving parts (beginning to problem-solve)

Fine motor manipulation- 3-4 years

Uses precision grasp on crayon and pencil - tripod/quadruped; colors within lines; copies simple shapes; begins to copy letters; cuts simple shapes; 3-block bridge; manipulates objects within hand (integrating radial and ulnar sides of hand)

Fine motor manipulation- 4-5 years

Dynamic tripod/quad grasp; copies simple shapes; 10-piece puzzle; cuts out squares; colors within lines; asymmetrical bilateral coordination; draws stick figures; copies first name; strings small beads (dexterity)

Fine motor manipulation- 5-6 years

Cuts more complex shapes; prints name; copies triangle, traces diamond; 20-piece puzzle; traces letters & copies some letters; manipulates small items within fingertips; both hands work as a "team"

Fine motor manipulation- 6-10 years

Hand dexterity allows for complex craft completion; bilaterally coordinates hands when building things; precise drawing; completes complex puzzles.

gross and fine Birth- 3 months

Lifts and turns head on stomach; Gross grasp reflex

gross and fine 3-6 months

Rolls; Reach

gross and fine 6-9 months

Sits; holds objects in hands; pokes; crawls

gross and fine 9-12 months

creeps; pincer grasp

gross and fine 12- 18 months

walks; stacks objects

Dressing Skill 1 year

Removes socks, dons loose hat, assists with sleeves.

Dressing Skill 2 years

Removes shoes, simple clothing, pulls off socks.

Dressing Skill 3 years

Dons t-shirt with help, puts on shoes incorrectly.

Dressing Skill 4 years

Inserts zipper shank, laces shoes, places socks correctly.

Dressing Skill 5 years

Dresses independently without assistance.

bottle to cup 6-9 mo

Holds a bottle with both hands & uses a cup with help

bottle to cup 12-15 mo

Holds a cup with both hands & takes a few sips without help

feeding 9-13 mo

Finger feeds soft foods, pincer grasp, and attempts to hold utensils

feeding 12-14 mo

Dips spoon and moves it to mouth

feeding 15-18 mo

Scoops with spoon and attempts to feed self

feeding 2-3 yr

Stabs with fork and uses spoon without spilling

self- feeding 6-9 mo

Wants to help with feeding, starts holding and mouthing crackers, & plays with a spoon

self- feeding 9-13 mo

Finger feeds soft foods and meltables & enjoys finger feeding

self- feeding 12-14 mo

Dips spoon in foods & moves spoon to mouth

self- feeding 15-18 mo

Scoops and feeds food to self

self- feeding 2-3 yr

Stabs food with fork & uses spoon without spilling

toileting 1 yr

Child is bothered when soiled

toileting 2 yr

Child initiates potty training interest

toileting 3 yr

Child will often toilet on their own

toileting 4 yr

Child has a few accidents

toileting 5 yr

Child washes hands independently

chores 2-3 yo

•Stacks books
•Puts toys in box
•Puts dirty clothes in hamper
•Fetches items
•Sets table
•Throws trash away

chores 8-9 yo

•Loads dishwasher
•washes and folds
•Laundry
•walks dog
•wipes off table
•sweeps small areas

chores 10-11 yo

•Vacuums
•cleans bathrooms
•prepares simple meals
•cleans countertops
•mows lawn
•brings in mail
•sweeps garage

chores 12 yo and up

•Mops floors
•changes lights
•paints walls
•trims hedges
•Irons
•watches younger siblings
•shops for groceries with a list
•bakes

emotional regulation
Birth to 2-3 months

Modulation of arousal, activation of organized patterns of behavior
Infants can self-soothe with nonnutritive sucking or respond quickly when soothed by parents. May be fussy, calm. Different routines of awake/sleeping cycles

emotional regulation
3-9 months

Behavior depends on social or environmental stimuli or events
Infant derives pleasure from sensorimotor play; infants seek sensory exploration. Some infants have difficulty modulating sensory behaviors

emotional regulation
12-18 months

Behavior demonstrates awareness of social demands. Toddler demonstrates compliance and self-initiated monitoring
Toddler's behavior is goal-directed. May show different levels of inhibition and compliance according to understanding of consequences

emotional regulation
24-48 months

The child's behaviors are in accordance with social expectations, developing a sense of identity. Behavior becomes more internally monitored
Child demonstrates knowledge of social rules/conventions. Has limited flexibility in adapting to new demands. May visually check in with parent before acting

emotional regulation
36+ months

The child develops behavioral flexibility according to situational demands and develops strategies to manage different situations. Has some self-awareness, including self-evaluation skills
Child may self-initiate cleanup. Adaptability increases, such that child can adapt to unexpected events (parents leaving because communication/language skills have increased)

Friendship 1 year

Looking, smiling, touching, imitating

Friendship 1-2 years

plays with caregiver, has fun, knows a friend by name

Friendship skills 3-5 Years

Begins reciprocal play, tries to please others.

Friendship skills 5-7 Years

Develops theory of mind, considers others' feelings.

Friendship skills 8-10 Years

Plays fair, shares interests, communicates effectively.

Friendship skills 10-12 Years

Builds trust, respects others, capable of negotiation.

Friendship 12-18 Years

Understands others and who they understand, can talk about feelings, problems, personal, social issues, support one another

Co-regulation

Active support (calm voice and presence, validate the emotion)

Model (demonstrate a coping mechanism through stable behavior)

Adjust (Sensory breaks, vestibular movement)

Activity Analysis (scaffold the skill)

Emotional Regulation

• Flexibility (children who are flexible can easily adjust to environmental changes)

• Building self-concept (use motivating activities and strengths-based approach when considering interventions with children

• Sensory techniques (stay active with young children, sing songs)

• Cognitive strategies (Zones of regulation)

Zone of regulation- blue zone

feeling sad, tired, sick, or bored

Zones of Emotional Regulation- Green Zone

Being calm, happy, focused, or in control

Zones of Emotional Regulation- Yellow Zone

Feeling stressed, anxious, excited, or silly

Zones of Emotional Regulation- Red Zone

Feeling angry, rage, terror, panic, or explosive behavior

Sensory Development- Birth- 6 months

smell, movement (vestibular) sensations important for attachment

Sensory Development- 4-6 months

Vestibular, proprioceptive, tactile, visual systems postural control

Sensory Development- 6-12 months

Refined tactile perception

Sensory Development- 1-2 years

Synaptic pruning occurs

Sensory Development- 2-3 years

Vestibular-proprioceptive-visual systems connect, strengthen, and refine

Sensory Integration Theory- Assumption 1

The CNS is plastic

• the brain can reorganize itself in response to interventions

Sensory Integration Theory- Assumption 2

Sensory Integration Develops in Stages

• Phase 1 tactile, vestibular, proprioceptive sense integrate during the 1st year of life

• Phase 2 tactile, vestibular, proprioceptive functions are building blocks for emotional stability and movement skills against gravity

• Phase 3 tactile, vestibular, proprioceptive, visual, and auditory senses integrate and work together to promote speech and language development

• Phase 4 Sensory integration should be well developed as a child becomes school-aged

Sensory Integration Theory- Assumption 3

The brain works as an integrated whole

• foundational skills pave the way for higher cortical brain functioning

Sensory Integration Theory- Assumption 4

Adaptive interactions are critical to sensory integration

• children learn by interacting with their environments and produce adaptive responses as they learn how to use feedback from vestibular, proprioceptive, and tactile systems

Sensory Integration Theory- Assumption 5

People have an inner drive to develop sensory integration through participation in sensorimotor activities

Always pair sensory with

function

follow vestibular with

proprioception (no puking)

Planning & Organization

Forethought for needed resources and goal achievement.

Time Management

Awareness of time required for task completion.

Working Memory

Remembering rules and sequences of expected behaviors.