Milestones, by task
Language, Fine motor, Gross motor, Eating, Drawing, Dressing, Blocks, Climbing stairs, School readiness
Drawing
15 mo copies scribbles
18 mo spont
scribbles
2 yr vertical, 2.5 years horizontal line
3 yr circle (therefore sign)
4 yr cross (4 crosses)
4.5 yr square
5 yr triangle
6 yr diamond
Circle, Cross, Square, Triangle in alphabetical order…
Blocks
15 mo 2 blocks, 18 mo 4,
2 yr 6 (24 mos=2+4=6), 2.5 yr 8,
3 yr bridge (3 blocks),
4 yr gate (4 letters),
5 yr steps (5 letters)
Climbing stairs
15 mo crawl up, 18 mo crawl down
2 yr 2 feet per step, holding on.
3 yr up alternating feet
4 yr down alternating feet
Inability to walk up and down stairs may be due to lack of opportunity
Vision
1 mo: fix and follow to midline
2 mo: follow past midline
3 mo: follow 180 degrees
Language
nbn alerts to sound
2 mo coos, 4 mo squeals/orients
to voice, 6 mo babbles
8 m/o peekaboo
9 mo recognizes name, mama/papa/baba nonspecific
10 mo comprehends 'no', understands name
9-12 mo mama, dada specific, 1
step command with gesture, JARGON
15 mo 3 word, 1 step command no gesture, 1 body part
18 mo 15-20 words (18 words) words,
3-5 body parts, 1 picture, points to self
2 yr 20-50 words, 2 word phrase, 2 step command,
refers to self by name, ECHOLALIA
3 yr too many words to count, 3 word sentence, plurals, pronouns, adjectives, 3 questions: sex, name,
age. 2-3 prepositions, present tense
4 yr: understand 100%. Past, present
tense, Names 1 color, knows 4 prepositions. Questions: when? why? how?
5 yr: past, present, future
Vowel->consonants–Back of throat to front (“g” before “d” before “m”sound)
Note: Understandability per PREP is slightly different than what we typically
think of:
-50% at 3 yr, -75% at 4 yr, -100% at 5 yr
Naming body parts
15 mo one body part
18 mo 3-5 body parts
2.5 yo all body parts
Fine motor
1 mo hands tightly fisted.
2 mo eyes to midline, when prone, moves
head side to side. Hands fisted 50%
3 mo eyes pan 180 degrees, ulnar grasp. Persistent fisting is the earliest
symptom of neuromotor dysfunction.
4 mo hands to midline
6 mo transfer objects, sitting,
pass cubes
7 mo raking
9 mo radial pincer grasp, bang
blocks
12 mo fine finger thumb pincer grasp, block in a cup
5-6 yo ties shoelaces
Gross motor
1 mo head up prone
2 mo lift head up 45 degrees, turn head side to side.
If held sitting, head bobs erect.
3 mo lift head up 90 degrees. Partial head lag. (rests on forearms in prone).
Bats at objects
4 mo roll front to back, good
head control when upright, no head lag
when pulled to sit, Tripod (Red flags for hypertonia: rolling prior to 3 months, or
pulling directly to standing at 4 mos (vs sitting))
5 mo roll back to front, sit w/ support
6 mo sit up alone (6-7 mos), or sits propped on hands.
7 mo commando crawls. Feet to mouth. Lateral protection. Red Flag: W-sitting and
bunny hopping, may indicate adductor spasticity or hypotonia.
9 mo crawling, gets into seated position
10 mo cruising
12 mo walking, posterior
protection
14 mo walks well
16 mo runs stiff-legged, walks backward, stoop and recover
18 mo stiff runner, throw ball, sit in chair
2
yo runs well, kick ball, jump off step/
jump up, throw ball overhand
3 yo balance 1 foot 1 second, broad jump
forward, hop in place, pedal tricycle
4 yo balance 1 foot 3 seconds, tiptoes, tandem walk, hop forward
4x
5 yo hop forward 10x, jump rope, skip, tandem walk backward
6 yo rides a bicycle, knows left from right.
Eating
9 mo feed self w/ fingers
12 mo drinks from cup, held by another person
15 mo drinks from cup, held by self
18 mo feed self w/ spoon (solids, ie cheerios)
2 yo feed self w/ spoon and fork (spoons purees)
3 yo uses spoon well
5-6 yo spread w/knife, prepare bowl of cereal
7 yo cut w/ knife
Dressing
2 yo removes clothes, puts on hat, washes and dries hands
3 yo puts on T-shirt/shorts, unbuttons
4 yo dresses alone, buttons
5 yo ties shoelaces
Social
Smiling: Reciprocal social smile by 6 weeks; spontaneous social smile in
response to familiar face by 16 weeks
0-3 mos: bonding (parent to child)
3 mos and on: attachment (child to parent)
6-9 mos: stranger anxiety
9-12 mos: separation anxiety
12-15 mos: empathy, sharing
15-18 mos: shy stage, leg huggers
21-24 mos: parallel play, imitates others
3 yo: group play
4 yo: tells stories
5 yo: cards, board games
Response to stress
Toddler: regression
Preschool: guilt/grief
School-age: anger
Teen: depression/suicide
School readiness
ability to separate from parents several hours
plays well w/ other children
takes turns, able to sit still
follows directions in a group activity
able to tell stories