DEVELOPMENTAL MILESTONES CHART for use by MEDICAL STUDENTS (version May 2018)

Birth 6 weeks 3 months 6 months 9 months 12 months 18 months 2 years 3 years 4 years 5 years

Domains Norm Norm Norm Norm Norm Norm Norm Norm Norm Norm Norm
Gross - Ha s a significant- Ha s head in - Hol ds head a t - Rol ls over (4 - Si ts without - Sta nds without - Wa l ks - Runs well - Wa l ks up and - Hops on 1 foot - Sta nds on 1
Motor hea d lag on l i ne with the 45°- 90° i n months) s upport s upport i ndependently - Jumps with 2 down s tairs with - Has ski l ls i n ball foot for 10s
pul ling up body on ventral ventra l - Si ts with a - Cra wl s - Wa l ks with one (15 months) feet off ground a l ternate feet ga mes - Ski ps
- Pri mi tive s us pension s us pension rounded back - Pul l s to stand ha nd held - Stoops a nd - Ki cks a ball - Peda ls tricycle (throwing, - Ri des a
refl exes present - Props up - Si ts in a tripod - Sta nds with recovers - Sta nd on 1 foot ca tchi ng, bi cycl e
(Moro, Stepping, RF: Fl oppy baby on forearms pos ition s upport RF: Does not - Wa l ks up stairs
RF: for 3 s ecs bouncing)
ATNR) s ta nd with wi th one hand -Una ble to walk
RF: Una bleto roll RF: Una bleto sit s upport hel d up s tairs with RF: Does not
RF: Fl oppy baby over wi thout support hel p run or jump
RF: Not wa l king - Wa l ks
i ndependently uns teadily
Vision / - Turns eyes - Fi xes a nd - Ha nds - Rea ches for - Ha s a n - Ha s a mature - Scri bbles - Copi es a - Copi es a circle - Copies a square - Copi es a
Fine towa rds large fol lows past unfisted objects i mma ture pincer pi ncer grasp - Bui l ds a tower verti ca l line (2.5 - 3 yrs ) - Bui lds tower of tri a ngle
Motor a nd diffuse mi dline (90°) - Gra s ps - Tra ns fers from gra s p - Ca s t objects wi th 3 blocks - Bui lds tower of - Copi es a 12 bl ocks - Dra ws a person
s ource of light objects 1 ha nd to the - Ba ngs 2 cubes 6 cubes cros s (3.5 yrs ) wi th 6- 8 body
- Gra s p reflex - Ha s hand other hel d in hand RF: No immature - Bui lds a tower RF: Does not pa rts
pres ent rega rd pi ncer grasp RF: Una ble to of 9 bl ocks copy a ci rcle
- Fi xes and RF: Does not RF: Does not s cri bble RF: Does not
fol l ows past rea ch out for tra ns fer objects RF: Does not copy a s quare
180° objects copy a verti cal
RF: Does not l i ne
fi x a nd follow
Hearing / - Ha s a startle - Qui etens to - Turns head to - Turns head to - Understands - Fol lows 1 s tep - Fol lows 1 - Fol lows 2 s tep - Fol lows 3 step - Ca n follow 'wh' Ca n follow
Speech and rea ction to mother’s voice s ounds a t ear s ounds out of 'No' a nd 'Bye' comma nd with s tep comma nd comma nd questions (i.e rul es
Language s udden loud l evel s i ght ges ture comma nd wha t, where)
(Receptive s ounds wi thout RF: Does not RF: Does not
ability) ges ture fol low 1 s tep fol low 2 s tep RF: Does not
RF: no response RF: no res ponse comma nd comma nd fol low 3 s tep
to s udden loud to s ound comma nd
s ounds
 DEVELOPMENTAL MILESTONES CHART for use by MEDICAL STUDENTS (version May 2018)
Birth 6 weeks 3 months 6 months 9 months 12 months 18 months 2 years 3 years 4 years 5 years

Doma ins Norm Norm Norm Norm Norm Norm Norm Norm Norm Norm Norm

Hearing / - Cri es when - Coos - Coos and laughs- Ba bbles (non- - s a ys 'Mama' - Sa ys ‘ma ma’ - Sa ys ~ 10 s i ngle - Sa ys 2-3 - Sa ys 3-4 word - Us es correct - Spea ks fluently
Speech hungry or s pecific) a nd 'Dada' non ‘pa pa’ a nd 2-3 words with word phrases phra se gra mmar i n wi th l ong
and uncomfortable RF: Does not coo s pecifically words with mea ning. - has 50+ *Identify shapes s peech des criptions
Language or ma ke sounds RF: No ba bbling mea ning. words *Counts to 3 - Us es pronouns -Tel ls s tories
(Expressive RF: Sa ys l ess *Ma tches (I, you) plurals *Counts to 10
ability) RF: No s i ngle tha n 5 s ingle RF: Does not col ours a nd prepositions *Knows
Note: words words ha ve 2 word *Knows 4 colours a l phabets by
* refers to phra ses RF: No 3 word *Counts to 4 rote
cognitive phra se
abilitys RF: RF: Ca nnot give
- Ca nnot retell a fi rs t and last
fa vourite story na me
Personal - - Sl eeps a nd - Soci al smile - Smi l es - Stra nger - Wa ves bye - Poi nts to - Ha s parallel play - Copi es others - Ha s i nteractive - SHa s role
k play - Ha s a group of
Social feeds (s miles in s pontaneously a nxi ety - Cl a ps hands i ndicate wants; - Ha s pretend - Shows defiant pl a y fri ends
- Ca l ms down res ponse to - Shows - Res ponds to - Pl a ys peek-a- joi nt a ttention pl a y , copies beha vi or - Dres ses and - Fol lows games
when ca regiver) exci tement at na me ( 7 boo - Pl a ys with s i mple a ctions undresses with wi th rules
comforted fa miliar pleasant months) - Ma kes eye ca us e and a nd words RF: Does not hel p
s i tuation such as conta ct wi th effect toys - Ea ts wi th a copy a cti ons - Toi l et tra ined
feeding, bathing fa mi liar people - Imi tates s poon. a nd words
ges tures RF: Sol itary play.
RF: No s ocial RF: No res ponse - Dri nks from a RF: No pretend play
s mi le to na me cup - No poi nting
RF: No eye - No joi nt
conta ct with a ttention
fa miliar people
• DOMAIN: The four domains of development are 1.gross motor 2.vision and fine motor 3. hearing and speech and 4. personal social domains. Cognitive ability* has been included under
Speech domains
• NORM: The norm milestones by age refer to the 50th percentile norms by which 50% of children have achieved them
• Red flags (RF): RF refer to the 90th percentile cut off by which 90% of children have achieved them. The presence of 'red flags' is an indication of delay with need for further evaluation
• Assess the child by testing one domain first and finding the threshold between what the child can do and cannot do
• For each domain, the child's developmental level is determined by the highest level task achieved and the next level which was not achieved i.e. if a child uses 2 word phrase but not a
3 word phrase then their speech level is at a 2 year level and less than a 3 year level
• When assessing speech, use the child's ability to use words together to determine the speech level rather than the child's ability to name numbers and colours. The child's ability to use
words to communicate is the best measure of their speech ability. A child may demonstrate good 'cognitive ability' but still be speech delayed. e.g. The child knows numbers, letters and
colours but does not have a 2 or 3 word phrases used to communicate. This child has speech delay.
• Children may show variable rates of developmental progress across the different domains. In the context of a developmental delay, it is imperative that the students understand the
impact of the delay on the functional ability of the child.
• AT ANY TIME in a child's development if they LOSE SKILL (REGRESSION) they once had, this is a 'red flag' and reason for immediate referral for further evaluation.