PEDIATRICS HIGH-YIELD FACTS IN 379

TA B L E 2.13 - 4. Developmental Milestones

AGEa GROSS MOTOR FINE MOTOR LANGUAGE SOCIAL/COGNITIVE

2 months Lifts head/chest when Tracks past midline. Alerts to sound; coos. Recognizes parent; exhibits
prone. social smile.

4–5 months Rolls front to back, back to Grasps rattle. Laughs and squeals; Enjoys looking around;
front (4 months). orients to voice; begins to laughs.
make consonant sounds.

6 months Sits unassisted. Transfers objects; Babbles. Demonstrates stranger

demonstrates raking grasp. anxiety.

9–10 months Crawls; cruises; pulls to Uses 3-finger (immature) Says “mama/dada” Waves bye-bye; plays
stand. pincer grasp. (nonspecific); says first word pat-a-cake.
at 11 months.

12 months Walks alone; throws object. Uses 2-finger (mature) Uses 1–3 words. Imitates actions; exhibits
pincer grasp. separation anxiety.
Follows 1-step commands.

2 years Walks up/down steps; Builds tower of 6 cubes. Uses 2-word phrases. Follows 2-step commands;
jumps. removes clothes.

3 years Rides tricycle; climbs stairs Copies a circle; uses Uses 3-word sentences. Brushes teeth with help;
with alternating feet (3–4 utensils. washes/dries hands.
years).

4 years Hops. Copies a cross (square at Knows colors and some Exhibits cooperative play;
4.5 years). numbers. plays board games.

5 years Skips; walks backward for Copies a triangle; ties Uses 5-word sentences. Exhibits domestic role
long distances. shoelaces; knows left and playing; plays dress-up.
right; prints letters.

a
For premature infants < 2 years of age, chronologic age must be adjusted for gestational age. For example, an infant born at 7 months’ gestation
(2 months early) would be expected to perform at the 4-month level at the chronologic age of 6 months.

TA B L E 2.13 - 5. Major Milestones in Language Development

AGE MILESTONE

12 months 1 word, 1-step command.

15 months 5 words.

18 months 8 words.

2 years 2-word phrases, 2-step commands. Speech 50% (1/2) intelligible.

3 years 3-word phrases. Speech 75% (3/4) intelligible.

4 years Speech 100% (4/4) intelligible.

258 SEC TION II PUBLIC HEALTH SCIENCES PUBLIC HEALTH SCIENCES—THE WELL PATIENT
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PUBLIC HEALTH SCIENCES—THE WELL PATIENT

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Early developmental Milestone dates are ranges that have been approximated and vary by source. Children not meeting
milestones milestones may need assessment for potential developmental delay.
AGE MOTOR
Infant Parents
0–12 mo Primitive reflexes disappear—
Moro (by 3 mo), rooting (by
4 mo), palmar (by 6 mo),
Babinski (by 12 mo)
Posture—lifts head up prone (by
1 mo), rolls and sits (by 6 mo),
crawls (by 8 mo), stands (by
10 mo), walks (by 12–18 mo)
Picks—passes toys hand to
hand (by 6 mo), Pincer grasp
(by 10 mo)
Points to objects (by 12 mo)
Toddler Child
12–36 mo Cruises, takes first steps (by
12 mo)
Climbs stairs (by 18 mo)
Cubes stacked—number
= age (yr) × 3
Cutlery—feeds self with fork
and spoon (by 20 mo)
Kicks ball (by 24 mo)
Preschool Don’t
3–5 yr Drive—tricycle (3 wheels at
3 yr)
Drawings—copies line or
circle, stick figure (by 4 yr)
Dexterity—hops on one foot
(by 4 yr), uses buttons or
zippers, grooms self (by 5 yr)
SOCIAL
Start
Social smile (by 2 mo)
Stranger anxiety (by 6 mo)
Separation anxiety (by 9 mo)
Rearing
Recreation—parallel play (by
24–36 mo)
Rapprochement—moves away
from and returns to mother
(by 24 mo)
Realization—core gender
identity formed (by 36 mo)
Forget, they’re still
Freedom—comfortably spends
part of day away from mother
(by 3 yr)
Friends—cooperative play, has
imaginary friends (by 4 yr)
VERBAL/COGNITIVE
Observing,
Orients—first to voice (by
4 mo), then to name and
gestures (by 9 mo)
Object permanence (by 9 mo)
Oratory—says “mama” and
“dada” (by 10 mo)
Working,
Words—200 words by age 2
(2 zeros), 2-word sentences
Learning!
Language—1000 words by age
3 (3 zeros), uses complete
sentences and prepositions
(by 4 yr)
Legends—can tell detailed
stories (by 4 yr)

Car seats for children Children should ride in rear-facing car seats until they are 2 years old and in car seats with a
harness until they are 4 years. Older children should use a booster seat until they are 8 years old
or until the seat belt fits properly. Children < 12 years old should not ride in a seat with a front-
facing airbag.