Developmental Milestones

What is Child Development?

Child development refers to how a child becomes able to do more complex things as they get older. Development is different than growth.  Growth only refers to the child getting bigger in size.

When We Talk About Normal Development, We Are Talking About Developing Skills Like:

  • Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions.
  • Fine motor: using hands to be able to eat, draw, dress, play, write, and do many other things.
  • Language: speaking, using body language and gestures, communicating, and understanding what others say.
  • Cognitive: thinking skills: including learning, understanding, problem-solving, reasoning, and remembering.
  • Social: Interacting with others, having relationships with family, friends and teachers, cooperating, and responding to the feelings of others.
What Are Developmental Milestones?

Developmental milestones are a set of functional skills or age-specific tasks that most children can do at a certain age range.  Your pediatrician uses milestones to help check how your child is developing.  Although each milestone has an age level, the actual age when a normally developing child reaches that milestone can very quite a bit.  Every child is unique!

The First Year.

Your baby will give you the most important information—how he or she likes to be treated, talked to, held, and comforted. This section address the most common questions and concerns that arise during the first months of life.

AGE 0- 3 MONTHS
MOVEMENTSOCIAL SKILLSSENSORY MILESTONES
Raises head & chest when on stomachBegins to develop social smileFollows moving objects
Stretches & kicks on backEnjoys playing with peopleRecognizes familiar objects and people at a distance
Opens & shuts handsMore communicativeStarts using hands and eyes in coordination
Brings hand to mouthMore expressive with face & bodyPrefers sweet smells
Grasps & shakes toysImitates some movements & expressionsPrefers soft to coarse sensations
Keeps hands in tight fists.Hearing is fully mature
Developmental Health watch

If, during the second, third or fourth weeks of your baby’s life, they shows any of the following signs of developmental delay, notify your pediatrician.

  • Sucks poorly and feeds slowly.
  • Doesn’t blink when shown a bright light.
  • Doesn’t focus and follow a nearby object moving side to side.
  • Rarely moves arms and legs, seems stiff, appears excessively loose
    in the limbs, or floppy, lower jaw trembles constantly, even when not
    crying or excited.
  • Doesn’t respond to loud sounds.
Developmental Health watch

Although each baby develops in her own individual way and at her own rate, failure to reach certain milestones may signal medical or developmental problems requiring special attention. If you notice any of the following warning signs in your infant at this age, discuss them with your pediatrician.

  • Still has Moro reflex after 4 months
  • Doesn’t seem to respond to loud sounds
  • Doesn’t notice her hands by 2 months
  • Doesn’t smile at the sound of your voice by 2 months
  • Doesn’t follow moving objects with her eyes by 2 to 3 months
  • Doesn’t grasp and hold objects by 3 months
  • Doesn’t smile at people by 3 months
  • Cannot support her head well at 3 months
  • Doesn’t reach for and grasp toys by 3 to 4 months
  • Doesn’t babble by 3 to 4 months
  • Doesn’t bring objects to her mouth by 4 months
  • Begins babbling, but doesn’t try to imitate any of your sounds by 4 months
  • Doesn’t push down with legs when feet are placed on a firm surface by 4 months
  • Has trouble moving one or both eyes in all directions and crosses her eyes most of the time. (Occasional crossing of the eyes is normal in these first months.)
  • Doesn’t pay attention to new faces, or seems very frightened by new faces or surroundings
  • Still has the tonic neck reflex at 4 to 5 months
At 4 – 7 months your baby should…
MOVEMENTSOCIAL SKILLSSENSORY MILESTONESCOGNITIVE THINKING
Rolls both waysEnjoys social playWatches faces intently Finds partially hidden object
Sits with and without support of handsInterested in mirror imagesFollows moving objects Explores with hands and mouth
Supports whole weight on legsResponds to expressions of emotionsRecognizes familiar objects and people at a distanceStruggles to get objects that are out of reach
Reaches with one handAppears joyful oftenStarts using hands and eyes in coordinationUses voice to express joy and displeasure
Transfers object from hand to handResponds to own name Develops full color vision
Uses raking graspFollows moving objects
Developmental Health watch

Because each baby develops in his own particular manner, it’s impossible to tell exactly when or how your child will perfect a given skill. The developmental milestones will give you a general idea of the changes you can expect, but don’t be alarmed if your own baby’s development takes a slightly different course. Alert your pediatrician; however, if your baby displays any of the following signs of possible developmental delay for this age range.

  • Seems very stiff with tight muscles
  • Seems very floppy like a rag doll
  • Head still flops back when body is pulled up to a sitting position
  • Reaches with one hand only
  • Refuses to cuddle
  • Shows no affection for the person who cares for him
  • Doesn’t seem to enjoy being around people
  • One or both eyes consistently turn in or out
  • Persistent tearing, eye drainage or sensitivity to light
At 8 – 12 months your baby should…
MOVEMENTSOCIAL SKILLSSENSORY MILESTONESCOGNITIVE THINKING
Gets to sitting position without helpShy or anxious with strangersSmiles at the sound of your voice Explores objects in different ways
Crawls forward on bellyCries when parents leaveBegins to babble chains of consonants Finds hidden objects easily
Assumes hands and knees positionsEnjoys imitating people in playBegins to imitate some soundsLooks at correct picture when the image is named
Gets from sitting to crawling positionPrefers certain people and toysTurns head toward direction of sound Imitates gestures
Pulls self up to standTests parental responseBecomes more communicative & expressive with face & bodyBegins to use objects correctly
Walks holding on to furnitureFinger-feeds himselfImitates some movements and facial expressionExplores objects in different ways
Enjoys playing with other people, and may cry when playing stops Begins to develop a social smile Begins to respond to "no"Distinguishes emotions by tone of voice
Developmental Health watch

Each baby develops in his own manner, so it’s impossible to tell exactly when your child will perfect a given skill. Although the developmental milestones will give you a general idea of the changes you can expect as your child gets older, don’t be alarmed if his development takes a slightly different course. Alert your pediatrician if your baby displays any of the following signs of possible developmental delay in the 8- to 12-month age range.

  • Does not crawl
  • Drags one side of body while crawling (for over one month)
  • Cannot stand when supported
  • Does not search for objects that are hidden while he watches
  • Says no single words (“mama” or “dada”)
  • Does not learn to use gestures, such as waving or shaking head
  • Does not point to objects or pictures
At 12- 24 months your baby should…
MOVEMENTSOCIAL SKILLSSENSORY MILESTONESCOGNITIVE THINKING
Stands momentarily without support Pays increasing attention to speech Identify an object in a picture book Explores objects in many different ways (shaking, banging, throwing, dropping)
May walk two or three steps without support Responds to simple verbal requests Laugh at silly actions (as in wearing a bowl as a hat) Finds hidden objects easily
Walks aloneResponds to "no"Look for objects that are out of sight Looks at correct picture when the image is named Imitates gestures
Pulls toys behind when walkingUses simple gestures, such as shaking head for "no"Put a round lid on a round pot Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)
Begins to runBabbles with inflection Says "dada" and "mama"Follow simple 1-step directions Explores objects in many different ways (shaking, banging, throwing, dropping)
Stands on tiptoeUses exclamations, such as "Oh-oh!"Solve problems by trial and error Finds hidden objects easily
Kicks a ballEnthusiastic about company of other childrenSay 8-10 words you can understand Finds objects even when hidden 2 or 3 levels deep
Like to pull, push, and dump things Imitates behavior of othersLook at a person who is talking to him Sorts by shape and color
Pull off hat, socks, and mittens Aware of herself as separate from othersAsk specifically for her mother or father Plays make-believe
Turn pages in a book Become anxious when separated from parent(s) Use "hi,""bye," and "please," with reminders Recognize herself in the mirror or in pictures
Stack 2 blocks Seek attention Protest when frustrated
Carry a stuffed animal or doll Seem selfish at times Ask for something by pointing or by using one word Compete with other children for toys
Scribble with crayons May have temper tantrumsDirect another's attention to an object or action Knows what ordinary things are for; for example, telephone, brush
Bring toys to share with parent act out a familiar activity in play May be afraid of strangersLaugh at silly actions (as in wearing a bowl as a hat) Identify an object in a picture book
Points to show others something interestingShows affection to familiar peoplePut a round lid on a round pot Look for objects that are out of sight
Explores alone but with parent close byMay cling to caregivers in new situationsDrinks from a cupFollow simple 1-step directions
Plays simple pretend, such as feeding a dollEats with a spoon Solve problems by trial and error
Points to show someone what he wantsCan help undress themselvesPoints to one body part
Play alone on the floor with toys Can follow 1-step verbal commands without any gestures; for example, sits when you say “sit down”
Developmental Health watch

Act early by talking to your child’s doctor if your child:

  • Doesn’t gain new words
  • Doesn’t have at least 6 words
  • Doesn’t notice or mind when a caregiver leaves or returns
  • Loses skills he once had
  • Doesn’t point to show things to others
  • Can’t walk
  • Doesn’t know what familiar things are for
  • Doesn’t copy others
At 24-36 months your toddler/preschooler should…
MOVEMENTSOCIAL SKILLSSENSORY MILESTONESCOGNITIVE THINKING, LANGUAGE
Builds towers of 4 or more blocks Repeats words overheard in conversationFollows two-step instructions such as “Pick up your shoes and put them in the closet.”Knows names of familiar people and body parts
Might use one hand more than the other Says sentences with 2 to 4 wordsDoes puzzles with 3 or 4 piecesBegins to sort shapes and colors
Stands on tiptoe Plays simple make believe games Builds towers of more than 6 blocks Completes sentences and rhymes in familiar books
Kicks a ball Takes turns in gamesCopies a circle with pencil or crayon Names items in a picture book such as a cat, bird, or dog
Begins to run Shows concern for crying friend Scribbles spontaneouslyUnderstands the idea of “mine” and “his” or “hers”
Climbs onto and down from furniture without helpShows a wide range of emotions Points to object or picture when it’s named for himCan name most familiar things
Walks up and down stairs holding onSeparates easily from mom and dad Demonstrates increasing independenceUnderstands words like “in,” “on,” and “under”
Throws ball overhand May get upset with major changes in routineCan work toys with buttons, levers, and moving parts Says first name, age, and sex
Makes or copies straight lines and circles Copies adults and friendsTurns book pages one at a time Names a friend
Developmental Health watch

Act early by talking to your child’s doctor if your child:

  • Falls down a lot or has trouble with stairs
  • Drools or has very unclear speech
  • Can’t work simple toys, push a wheeled toy
  • Doesn’t speak in sentences or knows at least 15 words by 18 months
  • Doesn’t understand simple instructions
  • Doesn’t play pretend or make-believe
At 36-48 months your toddler/preschooler should…
MOVEMENTSOCIAL & EMOTIONAL MILESTONESCOGNITIVE THINKINGLANGUAGE & COMMUNICATION
Goes upstairs and downstairs without supportSocial and emotional milestonesCorrectly names some colorsUnderstands the concepts of “same” and “different”
Kicks ball forwardInterested in new experiencesUnderstands the concept of counting and may know a few numbersHas mastered some basic rules of grammar
Throws ball overhandCooperates with other childrenApproaches problems from a single point of viewSpeaks in sentences of five to six words
Catches bounced ball most of the timePlays “Mom” or “Dad”Begins to have a clearer sense of timeSpeaks clearly enough for strangers to understand
Moves forward and backward with agilityIncreasingly inventive in fantasy playFollows three-part commandsUnderstands the concepts of “same” and “different”
Milestones in hand and finger skillsDresses and undressesRecalls parts of a storyHas mastered some basic rules of grammar
Copies square shapesNegotiates solutions to conflictsUnderstands the concept of same/differentSpeaks in sentences of five to six words
Draws a person with two to four body partsMore independentEngages in fantasy playTells stories
Uses scissorsImagines that many unfamiliar images may be “monsters”Makes mechanical toys work
Hops and stands on one foot up to five secondsViews self as a whole person involving body, mind, and feelingsMatches an object in hand to picture in book
Pedals tricycleOften cannot distinguish between fantasy & realityPlays make believe
Bends over without fallingImitates adults and playmatesSorts objects by shape and color
Show affection for familiar playmatesCompletes 3 - 4 piece puzzles
Can take turns in gamesUnderstands concept of "two"
Understands "mine" and "his / hers"
Developmental Health Watch, Age 3 -4  

Act early by talking to your child’s doctor if your child:

  • Cannot throw a ball overhand
  • Cannot jump in place
  • Cannot ride a tricycle
  • Cannot grasp a crayon between thumb and fingers
  • Has difficulty scribbling
  • Cannot stack four blocks
  • Still clings or cries whenever his parents leave him
  • Shows no interest in interactive games
  • Ignores other children
  • Doesn’t respond to people outside the family
  • Doesn’t engage in fantasy play
  • Resists dressing, sleeping, using the toilet
  • Lashes out without any self-control when angry or upset
  • Cannot copy a circle
  • Doesn’t use sentences of more than three words
  • Doesn’t use “me” and “you” appropriately
At 48- 60 months your child should..
MOVEMENTSOCIAL & EMOTIONAL MILESTONESCOGNITIVE THINKINGLANGUAGE & COMMUNICATION
Stands on one foot for ten seconds or longerWants to please friendsCan count ten or more objectsRecalls part of a story
Hops, somersaultsWants to be like her friendsCorrectly names at least four colorsSpeaks sentences of more than five words
May be able to skipMore likely to agree to rulesBetter understands the concept of timeUses future tense
Milestones in hand and finger skillsLikes to sing, dance, and actKnows about things used every day in the home (money, food, appliances)Tells longer stories
Copies triangle and other geometric patternsShows more independence and may even visit a next-door neighbor by herselfSays name and address
Draws person with bodyAware of sexuality
Prints some lettersAble to distinguish fantasy from reality
Dresses and undresses without assistanceSometimes demanding, sometimes eagerly cooperative
Uses fork, spoon, and (sometimes) a table knife
Usually cares for own toilet needs
Swings, climbs
Developmental Health watch

Because each child develops in her own particular manner, it’s impossible to predict exactly when or how your own preschooler will perfect a given skill. The developmental milestones listed here will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if her development takes a slightly different course. Alert your pediatrician, however, if your child displays any of the following signs of possible developmental delay for this age range.

  • Exhibits extremely fearful or timid behavior
  • Exhibits extremely aggressive behavior
  • Is unable to separate from parents without major protest
  • Is easily distracted and unable to concentrate on any single activity for more than five minutes
  • Shows little interest in playing with other children
  • Refuses to respond to people in general, or responds only superficially
  • Rarely uses fantasy or imitation in play
  • Seems unhappy or sad much of the time
  • Doesn’t engage in a variety of activities
  • Avoids or seems aloof with other children and adults