NORMAL DEVELOPMENT MILESTONE: BIRTH TO 18 MONTHS

Age Gross Motor Fine Motor Sensory Motor/Play Self Care Social Emotional Cognitive
 Random movements with  Reflexive ulnar grasp  Startles spontaneously  Strong reflexive suck-  All primary emotions are present  Remembers object that
flexor withdrawal  Alerts to sounds swallow reflex enables  Reciprocal communication reappears after 2 seconds
 Thoracic extension  Beginning to localize to sounds baby to fed developing, learning that crying  Random vocalizations
developing  Quieted by music  Generally no leads to being picked up  Piagetian Sensorimotor Stage
 Lifts and turns head in  Alert 1 of every 10 hours established feeding  Eyes fix on another’s face if within of Development begins (birth
supportive sitting  State of modulation, ability to either schedule, feeds on visual range to 2 years)
 Reflexive stepping and be awake or to block out all stimuli demand
Birth swimming present and sleep present
to 1  Hearing, smell, sight, touch, and
month awareness of positional shifts are
intact
 Sensitive to pain
 Attends to objects that are bright red
or yellow or that have sharp
contrasting colors
 Fixates on object and tracks objects in
90-degree plane
 Lifts head 45-degrees  Elicits grasp and  Slowly tracks objects with eyes  Developing  Responds to people with interest  Clearly discriminates among
when prone on belly attempts to bring hand  Self-regulation emerging rudimentary sleep-  Smiles when sees human voices, people, and objects
2  Holds head fairly erect but to mouth  Quiets self by sucking wake cycle  Studies own movements and can
months it remains wobbly  Beginning to bat at  Studies hands repeat them
 Turns from side to back hanging objects
 Involuntary release
 Holds head up with  Ulnar grasp reflex  Beginning of exploratory and  Beginning to establish  Watches people  Memory developing
control when prone on disappearing interactive play a feeding schedule  Recognizes primary caregivers  Distinguishes speech from
belly  Beginning of voluntary  Explores face, eyes, and mouth with with longer intervals  Primary attachment relationships other sounds
 Raises head and chest grasp hands between feedings developing  Coos
3 when prone on belly  Attempts to reach and  Localizes to sound  Seeks out the attention of
months
 Rolls from back to front grasp, but unable to pick  Visually seeks out source of sounds caregivers
 Kicks and straightens legs up objects  Improving visual tracking; eyes track in  Temperament styles and activity
 Sits with support 180 degree plane levels emerging
 Social smile established
 Lifts head up 90 degrees  Voluntary ulnar and  Responsive for more than an hour at a  Recognizes bottle  Beginning to smile at self in mirror  Beginning to vocalize more
when prone belly grasp developing time  Beginning to take  Responds to familiar people  Beginning to imitate sounds
 Pulls to sit with assistance  Reaches for and grasps  Shakes rattle pureed food  Social laughter
4  Hands and arms come to objects  Explores objects with mouth  Feeding equated with
months midline  Brings hands together at  Pulls dangling toy to mouth to explore play
midline  Can focus at different distances and
see in full color
 Can follow moving object
  Rolls from back to front  Grasps object with whole  Orients self to sound  May begin to teethe  Smiles at mirror image of self  Imitates more sounds and
 Pulls to sit with no head hand and explores object  Depth perception has developed  Holds rattle with one  Clearly recognizes parents and body movements
lag  Beginning to release and  Increased sensory exploration or both hands siblings  Blows “raspberries”
 Balances head steadily transfer objects from  Tries to make contact with others  Makes vowel sounds and a
and holds it erect in hand to hand through smiles and vocalizations few consonant (d, b, l, m)
5
supported sitting  Expresses displeasure sounds
months
 Begins locomotion by  Babbling begins (ma ma, da
rocking, rolling, and da)
twisting
 Brings feet to mouth to
suck on toes
 Rolls in all directions  Radial palmar grasp  Follows path of falling object  Likes to play with food  Beginning of subjective sense of  Beginning of Piagetian
 Balances well in ring emerging  Beginning to use self schemas (action plans)
sitting  Transfers objects from spoon with assist  Beginning to focus away from  Studies objects for a long
 Crawls by pulling stomach hand to hand interactions with attachment time
with legs and steering  Reaches for toys with figures to the external  Turns when name is called
6 with arms one or both hands environment  Starts to entertain self for a
months  Mental representations very short period of time
developing, baby is able to keep  Coos or hums to music
parent “in mind” even when not in  Makes v, th, f, s, sh, m, n
sight sounds
 Sense of humor developing
 Wary of strangers
 Pushes up on hands and  Attempts to grasp  Explores body with mouth and hands  Drinks from a cup with  Emotions of anger, fear, and  Improved concentration
knees and rocks objects using raking  May enjoys noisy toys assist sadness become more evident  Imitating variety of sounds
 Beginning creeping motion  Enjoys peek-a-boo  Shows interest in being part of and noises
7  Bounces when held in  Holds 2 objects social interactions
months standing simultaneously in hands  Sense of humor developing
 When holding objects in  Understands “no”
each hand, may hit them
together
 Sits independently  Lateral pinch developing  Enjoys social games  Tastes everything  Firmly attached to primary  Imitates hand movements
 Assists in pull to stand  Can pick up a string  Plays vigorously with noisy toys  Holds bottle caregiver (usually mother)  Points and follows what
from sitting  Claps independently  Objects to confinement others point to
8  Creeping on hands and  Can hold an object in one hand and  Shouts for attention  Explores features of familiar
months knees, forward and play with a different toy in the other  Pushes away undesirable things people
backwards hand (like food)  Recalls past events
 Creeps with object in  Beginning to do simple
hand problem solving
  Creeps  Inferior pincer grasp  Beginning to actively explore the world  Grasps handle of cup  Beginning of attachment  Beginning of object
 Equilibrium/righting emerging; able to pick up beyond the door to drink behaviour and separation anxiety permanence (ability to
reflexes emerging small objects with  Deliberately chooses special toys to  Self feeds finger foods  Beginning of empathy; may cry understand even when
 Beginning to take steps flattened thumb and play with when another baby cries in his/her something is out of sight, it
with hands held finger  Fears heights, afraid of vertical presence still exists)
 Stand with hands placed  Voluntary release of surfaces  Performs for attention  Simple imitative motor
9 on furniture objects behaviours improving
months  Bangs objects together  Imitates non-speech sounds
or singularly  Imitates consonant/vowel
combinations
 Beginning gestural language
 Understands and obeys some
words and commands
 Waves bye-bye
 Half kneeling emerging  Three-jaw chuck grasp  Able to focus for about 5 minutes to  Eats mashed table  Seeks out attention and  Object permanence
 Pulls to stand to achieve developing play alone or with another adult foods companionship established
supportive standing  Removes objects from  Enjoys water play  Uses lidded cup  Shows moods through whole body  Memory skills improving
position containers  Not sensitive to bright lights expression  Follows simple directions
10
 Cruises along furniture  Carries two small objects  Responds to music by bouncing and  Fears strange and new places  Imitates parents’ gestures
months
 Beginning to throw balls in one hand swaying  Sexual identity emerging like waving or shaking head
 Working on figuring out
simple relationships (such as
how a button turns a toy on)
 Squats and stoops  Tip pinch emerging  Uses fingers to poke and touch objects  Swallows with mouth  Not always cooperative  Looks at familiar objects and
 Walks with one hand held  Picks up tiny objects in play closed persons when named
11  Crawls upstairs  Lifts lids from boxes  Developing greater  First meaningful words
months  Turns pages of book (not skill with use of
necessarily one at a utensils
time)
 Lowers self to sitting  Mature pincer grasp  Enjoys squeezing, twisting and pulling  Feeds self with  Beginning of social referencing;  Memory improving
 Stands alone established different types of textured objects spillage looking to parent to gauge own  Responds to directions
 Takes first steps using  Puts objects into and  Plays with toys in a representational  May refuse to try new emotional response  Identifies animals in pictures
wide based gait removes them from way, such as a spoon is used to feed a foods  Resists napping and may throw  Uses 2 to 3 words
12 to 15  Crawls up and down stairs containers baby  Assists with dressing; tantrums  Completes simple foam
months  Rolls ball in imitation  Places blocks in box pulls off socks, hats,  Beginning to care for dolls or board puzzles
 Stacks rings mittens stuffed toys
 Opens and closes things  Beginning to identify body parts
 Imitates gestures and facial
expressions
  Walks with stable stops  Uses and reaches with  May begin to use objects in play in  Assists by extending  Becoming interested in mirror  Follows 1-step commands
and starts preferred hand symbolic ways, such as a spoon arms and legs image of self  Able to point to body parts
 Walks forward and (dominance not yet becomes an airplane  May continue to be distressed when asked
backwards established) when separated from primary  Uses 10 to 12 words and
 Walks up and down steps  Builds tower with 4 caregiver accompanying gestures to
15 to 18
with railing or assist from blocks communicate thoughts
months
an adult  Puts small objects into  Beginning of holographic
 Beginning to run and removes them from speech; one word conveys an
 Climbs on furniture a narrow neck bottle entire thought
 Marks spontaneous
marks with crayons
 Walks with stable gait  Moves small objects  Beginning to accept different types of  Spoon feeds  Developing sense of self  Knows body parts
 Seats self in small chair from fingers to palm of touch, such as cuddling and independently  Beginning to display greater range  Follows 2-step commands
 Throws ball same hand roughhousing  Takes clothes off of emotions  Functional use of objects
 Puts pegs in holes  Able to tolerate different textures of  Proficient with cup  Consistently recognizes self in well-established
18 to
 Puts objects into cups or clothes drinking mirror  Hums
24
containers  Symbolic play (substituting one object  May show interest in  Shows attachment and nurturance
months
 Scribbles using a for another) toilet training towards a stuffed toy
primitive grasp  Beginning of parallel play
 Plays alone or with others for 15
minutes
 Walks up and down stairs  Moves small objects  Picks out a toy on own  Puts shoes on and  Developing coping mechanisms  Piagetian Preoperational
independently from palm to fingers of  Plays next to other children (parallel takes them off (limited) Stage of Developmental (2 to
 Runs proficiently same hand play) (fasteners)  Seeks parental approved 7 years)
 Catches large ball with  Builds 6-block tower  Plays house, imitates domestic tasks  Turns door knob  Says 3-word sentences
2 to 2.5 hands and arms  Able to open lids of jars  Uses spoon  Uses “I”
years  Beginning scissor skills proficiently  Refers to self by name
 Imitates vertical lines  Starting to ask questions
 Draws circles  Beginning to sort by shape
and color
 Able to find hidden objects
 Walks up stairs with  Builds 8-block tower  Beginning of pretend play  Starting to brush teeth  Frequent imitation of parent  Beginning of telegraphic
alternating feet  Can screw and unscrew  Beginning of reciprocal play and hair behaviour speech – short sentences
2.5 to 3  Tip toes 3-inch lids  Puts on simple clothes  Gender identity emerging that contain only essential
years  Walks backward  Strings 1-inch beads independently  Recognizes self in a picture words (“boy cookie” may
 Kicks ball  Hand dominance mean “I want a cookie”)
 Throws ball established
  Stands on one foot  Builds 10-block tower  Beginning to participate in more  Requires little help to  Beginning to understand different  Completes 8- to 10-piece
 Jumps in place  Makes a 3 to 4 block complex exploratory and imitative play dress and undress emotional response puzzle
 Rides tricycle train  Imaginative and creative play  Uses fork and spoon  Learning to regulate emotions  900 to 1000 word vocabulary
 Strings half-inch beads emerging  Stays dry at night  Displays humorous and  Speaks in short sentences (4
 Folds piece of paper  Beginning to take turns in play mischievous behaviours plus words)
 Cuts snips with scissors  Negative and oppositional at times  Uses plurals and tenses (not
 Copies vertical and  Oedipal issues may emerge always correctly)
3 to 4
horizontal lines, circles, (romantic attachment to opposite  Can count to 10 by rote (no
years
squares, cross sex parent) 1-to-1 correspondence)
 Drawing of a person is  Tells simple stories
head with legs  Language supercedes actions
 Static tripod pencil grasp in communication
(3.5 to 5 years)  Follows 2-step directions
 Matches simple colors
 Recognizes simple shapes
 Descends steps with  Able to cut straight and  Pretend play is more logical  Unbuttons and  Beginning to mask emotions  Repeats a 5- to 10-word
reciprocal gait (4 years) simple curved lines with  Play becomes cooperative buttons large buttons  Morality is not rule-based; focused sentence
 Balances on one foot (4 25% accuracy  Dresses and undresses on rewards and punishments  Repeats 5 to 7 numbers
years)  Beginning to use tools independently  Increased ability to resolve  Carries on a conversation
 Hops (4 years) such as hammers  Beginning to tie shoes conflicts with peers  Beginning to be a more
 Catches ball using hands  Performs rapid (5 years)  Guilt develops logical thinker
(5 years) alternating forearm  Increased peer interaction  Developing cause and effect
 Bounces a ball (5 to 6 movements  Racial identity emerging thinking
4 to 6
years)  Can copy triangle, simple  Understands “why”
years
 Throws overhand (5 words, and name with questions
years) little awareness of  Beginning to understand
 Skips (6 years) spacing or size opposites such as big and
little
 Understands differences
such as circle and square
 1-to-1 correspondence with
counting 3 objects
  Masters ball skills  Becomes adept at the  Fantasy play becomes more ritualized  Uses knife to spread  Attachment needs are also met by  Piagetian Concrete
 Masters bike riding (6 to 7 use of school tools (6 to  Play takes on a work orientation and jelly or butter (6 peers, and not only parents Operational Stage of
years) 7 years) becomes more organized into the form years)  Social perspective taking Development (7 to 12 years)
 Learns to swim  Learns and masters of games  Uses brush or comb in (decentering) understanding  Reverse thinking; analyze
 Learns to skate manuscript writing (7  Beginning to be interested in functional matter other’s view developing from end then back to
years) collections and hobbies  Engages a zipper  Compliance with display rules of beginning
 Learns and masters  Beginning to emotions improving  Better perception of reality
cursive (9 to 10 years) participate in  Improved sense of self  Improved understanding of
 Drawing becomes instrumental activities  Self-esteem develops cause and effect
6 to 12 increasingly more of daily living (IADL)  Self-efficacy (recognizing strengths  Improved memory
years representational tasks and limits) emerges  Executive processes
 Use psychological traits to define emerging improved problem
self solving, better focus and
 Beginning to engage in more like – attention to tasks
gender social relationships  Applies logic to thinking
 Pragmatics of language
develop
 Piagetian Formal Operational
Stage of Development (12
years)
 Becoming proficient at all  Becoming proficient at  Participates in competitive team  Independent with self-  Defining identity is important task  Abstract thought is corner-
gross motor tasks all line motor skills and sports care  Self-concept becomes refined and stone of adolescence
applies this ability to all  Beginning to help with is based on other people’s  Able to think hypothetically
aspects of life including meal preparation and perspectives  Verbal and mathematical skill
school work, self-care take on other  Quest for autonomy may bring improve
and leisure pursuits household suite into parent-child relationship  Sense of invulnerability (“it
12 to 18
years
responsibilities (IADL  Issues of sexuality emerge can’t happen to me”) may be
tasks)  Dating begins problematic and danger
 Learns to manage provoking
money
 Learns to navigate
more independently
in the community