DEVELOPMENTAL

MILESTONES AND
OTHER
Eleni Kitsos PGY-3
• Twelve months
Evaluate the motor developmental progress/status of an infant at 12 months of age
Evaluate the cognitive and behavioral developmental progress/status of an infant at 12 months of age
• Fifteen months
Evaluate the motor developmental progress/status of a child at 15 months of age
Evaluate the cognitive and behavioral developmental progress/status of a child at 15 months of age
• Eighteen months
Evaluate the motor developmental progress/status of a child at 18 months of age, including recognition of abnormalities
Evaluate the cognitive and behavioral developmental progress/status of a child at 18 months of age
• Twenty-four months
Evaluate the motor developmental progress/status of a child at 24 months of age
Evaluate the cognitive and behavioral developmental progress/status of a child at 24 months of age, including
recognition of abnormalities
• Thirty-six months
Evaluate the motor developmental progress/status of a child at 36 months of age
Evaluate the cognitive and behavioral developmental progress/status of a child at 36 months of age, including
recognition of abnormalities
• Four years
Evaluate the motor developmental progress/status of a child at 4 years of age
Evaluate the cognitive and behavioral developmental progress/status of a child at 4 years of age
• Five years
Evaluate the motor developmental progress/status of a child at 5 years of age
Evaluate the cognitive and behavioral developmental progress/status of a child at 5 years of age
• Six years to twelve years
• Evaluate the cognitive and behavioral developmental progress/status of a child at 6 to 12 years of age
12 Months
 12 Month
RED
GrossFlags-MOTOR
Motor Fine Motor
• Stands well with arms high and legs • Scribbles after demonstration
Splayed
Does NOT Stand or • Fine Pincer grasp of pellet
• Posterior protection
• Holds crayon
• Independent Steps
• Attempts tower of 2 cubes
Does Not Bear weight with support
 12 Month
The first true word appears in concert with an infant's discovery of object permanence.
Receptive Language Expressive Language
RED Flags-LANGUAGE
Picture books now provide an ideal context for verbal language acquisition.
• Follows 1 step command with gesture • Points to get desired object (Proto-
With a familiar book as a shared focus of attention, a parentimperative pointing)
and child engage in repeated cycles of pointing
• Recognizes name of 2 objects and
• Child does NOT respond to name
and labeling, with elaboration and feedback by the parent.
looks when named • Uses several gestures with vocalizing
• Waving
• Reaching
• Does NOT understand NO
 12 Months
RED Flags-SOCIAL/EMOTIONAL
Social/Emotional Problem solving and Self Help
• Shows objects to parent to share • Rattles spoon in cup
Interest
• Indifferent or resistant to• caregiver
Lifts box lid to find toy
• Points to get desired object

• Does NOT look where caregiver points

• wide-based gait with hyperflexion of hips and knees, and initial contact with the
heel. By the age of 2 yr, the wide gait diminishes, reciprocal arm swing begins, and
there is increased stride length and velocity. Adult fluid gait patterns usually start
developing by 3 yr and mature to an adult-like pattern by age 7 yr.

• Use of the 2-spoon method of feeding (1 for the child and 1 for the parent), finger
foods, and a high chair with tray table can avert potential problems. Tantrums
make their first appearance as the drives for autonomy and mastery come in
conflict with parental controls and the infants' still-limited abilities.
15 Months
• Video
 15 Months
RED
GrossFlag-MOTOR
Motor Fine Motor
• Stoops to pick up toy • Builds three-to-four-cube tower
NO pincer
• Creeps grasp
up stairs • Places 10 cubes in cup
• Runs stiff-legged • Releases pellet into bottle
• Walks carrying a toy
• Climbs on furniture
 15 Months
RED flag-LANGUAGE
Receptive Language Expressive Language
• Points to one body part • Uses 3-5 words
• Points to one object of 3 when named • Mature jargoning with real words

Does NOT use words such as mama, papa/dada

• Gets object from another room upon
demand
 15 month
Social/Emotional Self-Help and problem solving
RED Flags-SOCIAL/EMOTIONAL
• Shows empathy • Uses SPOON with some spilling
• Hugs adult in reciprocation • Attempts to brush own hair
• • Recognizes
Absence of proto imperative
without demonstration
pointing (desired
• Fusses to be changed
object)
that at toy requires activation
• Will hand to adult if unable to operate
• Turns pages in book
• Places circle in single-shape puzzle
 18 Months
RED
GrossFlags-MOTOR
Motor Fine Motor
• Creeps down stairs • Makes 4 cube tower
Inability
• Runs wellto walk independently
• Crudely imitates vertical strokes

• Seats self in small chair

• Throws ball while standing
 18 Months
RED flag-LANGUAGE
Receptive Language Expressive Language
• Points to two of three objects when • Uses 10 to 25 words
named
• Not using at least 6 words.
• Uses giant words (all gone, stop
• Points to three body parts
that)
• Points to self
• Imitates environmental sounds
• Understands “Mine”
(eg, animals)
• Points to familiar people when
named • Names one picture on demand
 18 Months
Social/ Emotional Self Help and Problem Solving
RED Flags-SOCIAL/EMOTIONAL
• Passes M-CHAT • Removes garment
Engages in pretend play with
• • Gets onto adult chair unaided
Absence of (eg,
other people proto-declarative
tea party, pointing
• Moves about house without adult
birthday party)
(point to show interest) or showing
• Begins to show shame (when
gestures.
does wrong) and possessiveness • Matches pairs of objects
• Replaces circle in form board after it
has been turned around (usually with
trial and error)
 24 months
RED
GrossFlags-MOTOR
Motor Fine Motor
• Walks Down stairs holding rail, both • Makes a single line “ train” of cubes
feet on each step
Inability to walk WELL • Imitates circle
• Kicks ball without demonstration
• Imitates horizontal tall line
• Throws overhand
 24 Months
RED flag-LANGUAGE
Receptive Language Expressive language
• Follows two-step command • Two-word sentence (noun + Verb)
• Understands Me/You • Telegraphic speech

• • Points
Lack of picutres
to 5-10 • Uses 50+ words
words and two-word meaningful
• 50% intelligibility
sentences. Inability to follow simple
• Refers to self by name
commands. • Names 3 pictures
 24 Months
Social/ Emotional Self-Help and Problem Soving
RED Flags-SOCIAL/EMOTIONAL
• Parallel play • Opens door using knob
• Begins to mask emotions for social • Sucks through a straw
• Does not imitate actions or
etiquette words
• Takes ofwithout buttons
off clothes
caregivers. Poor eye contact.
• Pulls off pants

• Sorts objects and matches objects to

pictures
• Shows use of familiar objects
 36 Months
RED
GrossFlags-MOTOR
Motor Fine Motor
• Balances on Foot for 3 seconds • Copies circle
Frequent Falling
• Goes up stairs, or feet,
alternating difficulty
no with Stairs
• Cuts with scissors: Side-to-Side
rail
• Strings small beads well
• Pedals tricycle
• Imitates bridge of cubes
• Walks heel to toe
• Catches ball with stiff arms
 36 months
RED flag-LANGUAGE
Receptive Language Expressive Language
• Points to parts of picutures • Uses 200+ words
• Names body parts with fuction • Three word sentences

• • Understands
Inabilitynegatives • Uses pronouns correctly
to use three-word sentences
• Groups objects (foods, toys) • 75% intelligibility
• Uses plurals
• Names body parts by use
• Asks to be read to
 36 Months
Social/ Emotional
RED Flags-SOCIAL/EMOTIONAL
• Starts to share with/without prompt
• Fears imaginary things
Self-Help and Problem Solving
• Independent eating
• Pours liquid from one container to another

• • Imaginative
Lack of playpretend play • Puts on shoes without laces
• Uses words todescribe what someone else • Unbuttons
is thinking (”Mom thought I was asleep”)
• Draws a two- to three-part person
• Understands long/short, big/small,
more/less
• Knows own gender
• Knows own age
• Matches letters/numerals
 4 years
RED
GrossFlags-MOTOR
Motor Fine Motor
• Balances on one foot for 4-8 seconds • Copies square
• • Hops
Does NOT
on one jump
foot 2-3 times in place • Ties single knot
• Standing broad jump 1-2 feet • Cuts 5-inch circle
• Gallops • Uses tongs to transfer
• Throws ball overhand 10 feet • Writes part of first name
• Catches bounced ball • Imitates gate with cubes
 4 years
RED flag-LANGUAGE
Receptive Language Expressive Lnaguage
• Follows 3 step commands • 300-1000 words
• • Points
Unclear
to same speech.
vs different • Tells story

• • Names
Does not
things answer
when • 100% intelligibility
described simple questions

• Inability to use pronouns

• Understands adjectives • Uses “ feeling” words

• Uses words about time

 4 years
Social/ Emotional Self-help
RED Flags-SOCIAL/EMOTIONAL
• Deception: “tricking” others and • Goes to toilet alone
worried about being tricked
• Wipes after BM
• • Has
Ignores other children
a “best” friend
• Washes hands and face
• Labels emotions in self
• Brushes teeth
• Group play
• Buttons
• Uses fork well
4 year Problem-Solving
• Draws a four- to six-part person
• Can give amounts (usually less than 5) correctly
• Simple analogies:
; ;
dad/boy:mother/??? ice/cold: fire/??? ceiling/up:floor/???
• Points to five to six colors
• Points to letters/numerals when named
• Rote counts to 4
• ”Reads” several common signs/ store names
 5 year
RED
GrossFlags-MOTOR
Motor Fine Motor
• Walks down stairs with rail, • Copies Triangle
alternating feet
• • Balances
Does on not draw
one foot>8sec
pictures, a square, or a cross. Poor
• Puts paper dip on paper
• Can use clothes-pins to transfer small
balance.
• Hops on one foot 15 times objects
• Skips • Cuts with scissors
• Running Broad jump 2-3 feet • Writes first name
• Walks backward heel-toe • Builds stairs from model
• Jumps backward
 5 year
RED flag-LANGUAGE
Receptive Language Expressive Language
• Knows right and left on self • Repeats 6-8 word sentence

• • Points
Inability toonerhyme
to different in series • Defines simple words
• Understands “-er” endings (batter, • Uses 2000 words
• skater)
Inability to recognize shapes, letters, colors
• Knows telephone number
• • Enjoys
Resists
rhyming dressing, sleeping,
words and alterations using the toilet
• Responds to “why” questions
• Produce words that rhyme
• Retells story with clear beginning,
• Points correctly to “side” , “middle”, middle, end
“corner”
 5 year
Social/ Emotional Self-Help
RED Flags-SOCIAL/EMOTIONAL
• Has a group of friends • Spreads with knife
• Apologizes for mistakes • Independent dressing
• • Responds
Unusually fearful, sad, shy,
verbally to good fortune of
angry
• Bathes independently
• others
Does not distinguish between real and make-
believe.
Problem-Solving
• Draws 8-10 part person
• Gives amounts <10
• Identifies coins
• Names letters/ numerals out of order
• Rote counts to 10
• Names 10 colors
• Uses letter names as sounds to invent spelling
• Knows sounds of consonants and short vowels by end of kindergarten
• Reads 25 words