NORMAL DEVELOPMENT MILESTONE: BIRTH TO 18 YEARS

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