INFANCY

Type of Play: Solitary play 

Fear: Stranger Anxiety 

 Begins: 6 – 7 months 

 Peaks: 8 months  

 Diminishes: 9 months

NORMAL PATIENT’S DEVELOPMENTAL

DEVELOPMENTAL MILESTONE

MILESTONE

Neonate Complete head lag 

Largely reflex visual fixation for human face 

Hands fisted with thumbs in 

Cries without tears

1 month Looks at mobile; follows midline 

Alert to sound, regards face

2 months Holds head up when in prone  • Social Smile started

Social smile, cries with tears, cooing sound 

Head lag when pulled to sitting position 

No longer clinches fist tightly 

Recognizes parents
3 months Holds head and chest up when in prone 

Holds hands open at rest 

Hand regard, follows object past midline 

Grasp and tonic neck reflexes are fading 

 Reaches for familiar people or object

4 months Head control complete 

Turns front to back; needs space to turn 

Laughs aloud; Babbling sound

Babinski Reflex disappears 

5 monthts Turn both ways (roll over)   Started oral feeding in form of cereal

Moro reflex disappears (4-5 months)  (cerelac) at 5-6 months old

Enjoys looking around environment

6 months Reaches out in the anticipation of being picked- Sat with support

up 

Sits with support 

Puts feet in mouth in supine position 

Eruption of first temporary teeth ( Lower 2

central incisors) 

Vowel sounds “ah, eh” 

Uses palmar grasp; handless bottle well 

Recognizes strangers 

Sucking reflex disappear

7 months Transfer objects from hand to hand (6 – 7 months) 

Likes objects that are good sized for transferring

8 months Sits without support   Sat without support at 8 ½ months

Plantar reflex disappears (6-8 months)

9 months Creeps or crawls; need space for creeping  

combine 2 syllables “mama & dada”

10 months Pulls self to stand 

Understand the word no 

Respond to name

11 months stand with assistance 

Walking while holding to his crib’s handle 

One word other than mama and dada

12 months Stands alone  Walks with support (walking alone at

Walk with assistance  16 months)

Drink from cup, cooperates in dressing 

Says two words other than mama and dada

Imitates actions, comes when called 

Follows one – step command and gesture  

TODDLER (1-3)
Type of Play: Parallel Play 

Fear: Separation Anxiety

 Begins: 9 months  

 Peaks: 18 months 

Toddler Characteristic Traits 

Negativistic: says no most of the time

15 months lateness in walking is a sign of mild mental

retardation

4 – 6 words

Scribbles voluntarily with pencil, holds spoon

well, seat self in a chair

18 months Height of POSSESIVENESS – favorite word

MINE 

Bowel control achieved 

Can run and jump in place 

Names one body part

24 months Turns pages one at a time, removes shoes, pants,

etc 

Can open doors by turning door knobs, unscrew

lids 

50 – 200 words (2 word sentences), knows 5

body parts 

Walk upstairs alone, still using feet on the same

 step at same time 

Daytime Bladder Control 

30 months Makes simple lines or stroke or crosses with

pencil 

Can jump down from chair 

Knows full name, holds up finger to show age 

Copy a circle 

Temporary teeth complete (posterior molar: last

to erupt) 

36 months Tooth brushing with little supervision 

Unbutton buttons 

Draws a cross, learns how to share 

Knows full name and sex 

Speaks fluently, 200 – 900 words 

NIGHTIME BLADDER CONTROL achieved 

Rides tricycle

PRESCHOOLER (3-6)

Type of Play: Cooperative play

Fears: (1) Castration/ Body Mutilation, (2) Dark places and witches, (3) Thunder and lightning, (4)

Ghost

Preschooler’s Characteristic Traits 

• Telling tall tales 

• Imaginary friend 

• Sibling rivalry

• Regression

 o Signs: bedwetting, Thumbsucking, Baby talk, Fetal position 

• Masturbation

4 years old Noisy, aggressive and stormy 

Vocabulary of 1500, knows the basic color

Says song or poem from memory 

5 years old Jumps over low obstacles 

copy triangle 

Imaginary playmates 

2100 words 

Identification with same sex 

Attachment to opposite sex

SCHOOL AGE (6-12)

Type of play: Competitive Play

 Fears: (1) School Phobia, (2) Displacement from school, and (3) Death

Significant Person: Teacher and Peer of same sex 

• Stoppage of height coincide with the eruption of wisdom tooth 

• Prone to fracture: Common Green stick 

• Mature vision o 20/200 legal blindness

6 years old Temporary teeth begin to fall, permanent teeth begin

to appear (1st: First Molar) 

Tooth brushing alone 

A year of continuous motion, clumsy moving 

1st grade teacher becomes authority

Beginning interest with God

7 years old Age of assimilation  Able to read and write.

Copies a diamond  Cooperative on interview.

Enjoys teasing and playing alone  Speaks a few sentences in English

8 years old Smoother movements 

Normal homosexual 

Loves to collect objects 

Counts backwards 

9 years old Coordination improves 

Tells time correctly 

Hero worship 

Stealing and lying are common 

Takes care of body needs completely 

Teachers find their group difficult to handle 

10 years old Age of special talents 

Write legibly 
 Ready for competitive games 

More considerate and cooperative 

Joins organizations 

Well-mannered with adults and critical with adults

11-12 years Pre-adolescent 

old Full of energy and constantly active 

Secret languages are common 

Share secrets with friends 

Sense of humor is present 

Social and cooperative

ADOLESCENCE (13-18)

13-14 years  Girls body fat increases.

old  Boys muscle mass increases.

 Girls’ breasts enlarge, Boy’s genitals enlarge.

 Both Boys and Girls voices lower, with the

Boys voices lower much more.

 Girls experience their first menstrual cycle

(typically around the same time as their mother

experiences her’s)

 Body hair grows.

  Sweat glands become more active.

 Questioning of school and family rules.

 Concrete thinking styles something is right or

wrong, good or bad.

 Begin to think that bad things will not happen to

them.

 self- conscious.

 Begin to spend more time with friends and less

time with family.

 Start to form an identity, through hobbies,

friends, school activities, clothes, hairstyles,

music, etc.

 Moodiness is common throughout the search for

an identity.

 Often push the limits of adults to assert their

independence.

 Spending a lot of time on the phone is normal,

and a way of developing social skills for

adolescents.

15-18 years  Facial hair begins to appear.

old  Girls are usually at full development.

 Girls are very concerned with the way they

 look. More than 50% of high school girls are

dieting.

 Better at solving problems than younger teens,

but are inconsistent.

 They tend to make rash decisions even though

they weigh the consequences first.

 Organizational skills improve and are better at

balancing school, activities, social life, and

work.

 Attempt to answer the questions, Who am I?

and What will I be? by exploring job and

college options, religion, social and political

issues.

 Frequently question and challenge rules

 More self assured and thus are better at resisting

peer pressure.

 Spend even less time with family.

 Make close friends.

 Want control over more aspects of their lives.

 Are excited, but also overwhelmed about the

future (college, workforce, military, moving

away from home, marriage, etc).

 Teens get depressed. However, like with adults

 if this lasts more than 2 weeks see a health care

professional.

 Begin to have strong sexual urges and may

become sexually active.

 Become aware of sexual orientation.