‫بسم هللا الرحمن الرحيم‬

Milestones for SMLE Exam 2023 Edition

‫بسم هللا والحمد هلل والصالة والسالم على رسول هللا‬
👶
- ‫ بإذن هللا‬- ‫ السابقة‬Milestones‫ُيغني عن ملفات ال‬
‫ال تنسونا من صالح الدعاء‬

‫ الخطأ وارد‬28Sep-2023 :‫آخر تعديل‬

ً ‫ وزدنا علما ً وعمالً وإخالصا‬،‫ وعلمنا ما ينفعنا‬،‫اللهم انفعنا بما علمتنا‬

📜Index:
‫ وإن كنت قد أخطأت فمن نفسي ومن الشيطان‬،‫إن كنت قد أحسنت وأصبت فمن هللا‬

Section Content

1 Skills/ developmental ages you need to know to solve SMLE milestones

questions

2 Tips to solve SMLE Milestones questions correctly

3 Direct and easy questions

4 A. Special milestones questions

B. Questions that there's disagreement regarding its answer

5 A. Milestones tables
B. References

‫ اللهم ال سهل إال ما جعلته سهال وأنت تجعل الحزن إذا شئت سهال‬،‫بسم هللا‬

Section 1: 🧸
Skills/ developmental ages you need to know to solve SMLE milestones questions:
● Firstly: developmental skills achieved by each age:
(*There's few contravention between references & unclear statements; these were
labeled with dark blue)
Age Developmental Milestones Achieved

2 months ● Partially Support the head

● Turns the head 180 degree
● Cooing
● Smile

4 months ● Sitting with support

● Roles from prone to supine
● Full head support
● Reach objects (reaches for midline objects= brings hands to midline)
● Laugh

6 months ● Sitting without support (tripod position)

● Roles from supine to prone (roll over)
● Babbles
● Stranger anxiety (when he saw the doctor he cried)
 ● Palmer grasp (raking)
● Transfer objects from hand to hands

9 months ● Crawl
● Stand with support
● Pull to stand (use a chair to stand)
● Cruising (walk around furniture) (walk holding furniture)
● Immature pincer grasp = weak pincer grasp
● Say mamma and dada (starts to talk)
● Wave hand bye bye
● Separation anxiety

10 months ● Put things into a bottle

12 months ● Start to walk alone or with one hand held

● mature pincer grasp (holds things between thumb and forefinger)

15 months ● Walk without support

● Crawl upstairs
● Scribbles (draw lines with crayons)
● Stack 3 cubes (=stack few cubes?*)
● Starts to use a spoon & fork (=feeds himself?*)
● Follow commands (understands few commands)
● Point to things he is interested/he needs
● Jargon

18 months ● Runs
● Climb stairs with assistance
● Stack 4 cubes
● Imitate mother/father role (Feeds the doll)
● Say 6-10 words (cannot complete a sentence)
● Hold, throw, kick a ball [15-18 months]
● Points to body parts (points only! not know body parts!)

2 years ● Jumps on 2 feets

● Draw a straight line
● Stack 6 cubes
● 2 words sentence
● Compares 2 things
● Know body parts (say mouth, eye)
● Refer to himself "me" (know pronounce)

3 years ● Walk up and down stairs like adult

● Ride tricycle
● Undress without help
● Separates easily from parents (end of separation anxiety)
● Know age, sex, name
● Draw circle

4 years ● Hoping on one foot

● Dresses without help
● Play in group (*3 or 4 years; however it was mentioned in a question
where the answer is 6yr so it doesn’t matter)
● Tell a story = tell a short story (say 500 words)
● Articulates word (*there’s disagreement regarding the meaning of this
 statement)
● Toilet trained
● Stacks many cubes?
● Draw man with 3 parts (draw head & hands)
● Count to 5
● Know colors = know 4 colors (* 3 or 4 years, personally I go with 4,
but if said "when you point to colors he knows them" I'll go with 3)

5 years ● Draw a square / rectangular

6 years ● Tie shoes

● Draw triangle
Note: in some questions they mention "dress/undress with assistance" in this case choose
the immediate smaller age. Example: dresses alone at 4yr, so dress with assistance at 3
years.

● Secondly: Differentiate skills categories:

Gross motor: e.g walk, crawl, sitting
Fine motor: e.g pincer grasp
Speech and language: e.g tells a story
Personal-Social: e.g stranger anxiety
Cognitive: e.g Compares 2 things

Section 2: 🍭
Tips to solve SMLE Milestones questions correctly:
● Pay attention to the numbers, and whether it is in weeks, months or years. In the
exam they might mention 2 months or 8 weeks which means the same thing.

● The baby skills mentioned in the same question usually have different developmental
ages, always choose the older age among them. For example:
Q: Child sit and support his head, laughing and cooing:
A. 4 weeks
B. 6 weeks
C. 8 weeks
D. 16 weeks
In this question: head support & laughing = 4 months
Cooing = 2 months
Choose the older age, so the answer is 4 months = D. 16 weeks

● If you couldn't find the same developmental age, choose the immediate older age
among choices, Never choose a smaller age because it is closer. For example:
Q: Baby smile still not sitting with support but can raise his head slightly. Age in
months?
A 3 months
B 5 months
C 7 months
D 9 months
 Answer: the age must be 2 months, since not mentioned in the choices, go with the
immediate older age. Never choose a smaller age because it is closer

● Most likely achieved Qs & how to reassure a mother of a child with developmental
delay Qs→ Choose the most primitive skill

🍃 ‫سبحان هللا‬
…‫فاصل ونواصل‬

🍃 ‫الحمد هلل‬
🍃 ‫ال إله إال هللا‬
🍃 ‫هللا أكبر‬
🍃 ‫ال حول وال قوة إال باهلل‬
🍃 ‫أستغفر هللا‬
Section 3: 🍼
This section contains all direct developmental age questions (can be solved easily after
knowing the concept of section 1 and 2)
Question Answer/notes

1) Baby can say a few words or 3 words! Whats the age? Answer: A
A. 1Yr
B. 2 Yr
C. 3Yr
D. 4Yr

2) child that can raise his head slightly when prone and smiles. Answer: B
He has head lag when you pull him to sit. How old is he?
A. 4 weeks
B. 8 weeks
C. 12 weeks
D. 16 weeks

3) A child can sit without support and roll over and unable to do Answer: B
pincer grasp
A. 4 months
B. 6 months
C. 9 months
D. 12 months

4) Which of the following is most typically seen in 4 years old Answer: D

baby?
A. Skip
B. Ride bicycle
C. Copy triangle and square.
D. Toilet trained

5) Baby smile still not sitting with support but can raise his head Answer: A
slightly . Age in months?
A. 3 months
B. 5 months
C. 7 months
D. 9 months
6) Child can sit without support, Stands with support, say dada, Answer: B
crawl . What is the age of this child ?
A. 8 months.
B. 10 months.
C. 12 months.
D. 15 months

7) infant sit in tripod position , role from prone to supine , reach Answer: B
object
A. 4 month
B. 6 month
C. 12 month
D. 24 month

8) What age the child started to know few words Answer: C

A. 3 months
B. 6 months
C. 12 months
D. 15 months

9) A child can pull to sand and cawl Answer: B

A. 8 months
B. 10 months "Pull to stand"
C. 12 months
D. 15 months

10) Infant crawl ,transfer object from hand to hand, had palmer Answer: C
grasp , nopincer grasp, age by month
A. 5
B. 7
C. 9
D. 12

11) A child can sit, have immature pincer grasp and crawl, age in Answer: C
months?
A. 4
B. 7
C. 9

12) Child came to the clinic with his mother was having ball, the Answer: A
doctor asked him to throw the ball to him , he through it to the
doctor and he went away to take the ball back • what is the
developmental milestone of this child ?
A. 15 months
B. 24 months
C. 36 months
D. 48 months

13) Baby wave his hand(bye bye) which developmental milestone Answer: B
age?
A. 7 months
B. 9 months
C. 12 months
D. 15 months
14) Milestones , baby healthy run to the doctor , play a role model Answer: B
as his father ,can’t complete a sentence , can’t eat well with
spoon , age ?
A. 12 M
B. 18 M
C. 24 M
D. 36 M

15) A baby setting in his father lab unsupported. When the Answer: C
doctor spoke, the baby turned around, laughed and babbled to
the doctor. How old is the baby? Ignore this sentence “
A. 2 months When the doctor
B. 4 months spoke, the baby
C. 6 months turned around”
D. 8 months

16) Mother came with her child he can walk with one hand held Answer: B 12mo
had good pincer grip cant put cubes in a bottle, He says few
words besides mama and dada. Age?
A. 9
B. 12
C. 15
D. 18

17) Child can say 500 words , hop on one leg ? Answer: A
A. 48 m
B. 36 m
C. 24 m
D. 60 m

18) Child in the hospital play and come to his parents say stories Answer: B
, draw head and hands what is the age of this child ?
A. 3yrs Ignore this sentence
B. 4yrs “play and come to his
C. 5yrs parents”
D. 2yrs

19) A child can run and tell stores and tie , and dress himself Answer: D
without help his shoes • His age
A. 3 years
B. 4 years
C. 5 years
D. 6 years

20) Child that throws a ball at you and draws a straight line and Answer: D
stacks “few” cubes on each other . What is the age?
A. 12 months In the real recall they
B. 14 months didn’t mention the
C. 18 months exact number of
D. 24 months cubes he can stack.
21) Developmental milestone expected in a 3 year old? Answer: A
A. Climbs stairs
B. Catches ball with foot
C. hoping in one foot
D. Tell story

22) Child came to with his mother to your clinic. He said to you Answer: D
(hi) and then he said to his mother something , then his mother
touch his head and he said ( no ) Then his mom ask him what is
this he said lip then she touch his body ( I think ) and ask who
this he said ( me )What is his age ?
A. 12 months
B. 15 months
C. 18 months
D. 24 months

23) Mother brought her child for routine check up. The doctor Answer: C
played with the child as he threw a ball and the child catch it and
threw it back to the doctor, the child can draw his brother head Draw man with 3 parts
HANDS, and Feet After that the child undress himself for = 4yr
examination as the doctor ask him, after examination was done
and while the doctor was speaking to the mother the child was
playing with cubes and putting them above each other(he said
many not detect the No. of cubes ) the child also was able to
draw straight line. What is the age of this child
A. 2yr
B. 3yr
C. 4yr
D. 5yr

24) Child sit and support his head, laughing and cooing : Answer: D
A. 4 weeks
B. 6 weeks
C. 8 weeks
D. 16 weeks

25) Infant with mother for routine checkup, when the mother put Answer: C
the baby he was laughing and when he saw the doctor he cried
to reach his mother what is most likely his age Stranger anxiety = 6
A. 2 month months
B. 4 month
C. 6 month
D. 8 month

26) Child can run , say short stories , what is the age: Answer: C
A. 2 years
B. 3 years
C. 4 years
D. 5 years.
27) Child can walk without support , crawling ,build 3 cubes point Answer: B
to something he interested in , so what is the age of the child ?
A. 9 month
B. 15 month
C. 2 years
D. 3 years

28) 4-month child with developmental milestone? Answer: D

A. try to crawl
B. roll over from side to side
C. sit without support
D. complete fixation of the head

29) mother of 5 months old baby, asking about what he can do at Answer: D
his age at that age?
A. pincer grasp
B. sit without support
C. wave bye bye
D. trying to reach objects

30) A child came with his father for routine childhood evaluation. Answer: D
He can walk and hold a ball. He also can hold cubic and put them
above one another. He can draw a line. What is the expected age They didn’t mention
for this child? the number of cubes
A. 15 months old in the question
B. 18 months old
C. 1 year old
D. 2 years

31) A child can walk alone and build a tower of 2 to 4 cubes. Answer: C
What is the expected age for this child?
A. 9 months
B. 10 months
C. 18 months
D. 24 months

32) Child can walk steadily words point to body parts and say 5-6 Answer: B
words?
A. 24 month
B. 18 months
C. 12 months
D. 6 months

33) Child can sit without support , moving objects from hand to Answer: B
hand and babbling • Age
A. 4 months
B. 6 months
C. 12 months
D. 9 months
34) Baby runs and need climb stairs with assistance and still not Answer: A
talking 3 words sentences
A. 18 months
B. 15 months
C. 24 months
D. 30 months

35) Baby can name body parts and run ? Age in months: Answer: A.
A. 24
B. 19
C. 17
D. 12

36) Child can count to 5, dresses up by himself and hop on one Answer: B
leg, what’s the expected age?
A. 3 years
B. 4 years
C. 5 years
D. 6 years

37) Milestone know 4 colored 5 word Need assistance when Answer: D

wearing clothes Jump on 1 foot Ansewr by month :
A. 12
B. 18
C. 24
D. 48

38) A child says his name, feeds himself, separates easily from Answer: B
his parents (was written like this), and ride tricycle:
A. 2 yr
B. 3 yr
C. 4 yr
D. 5 yr

39) Child started to develop sense of individuality. She recognize Answer: C

strangers and frightens when separated from her parents.
A. 6
B. 7
C. 10
D. 12

40) A child starts to develop an awareness for strangers and Answer: C

separation anxiety. How old is the child in months?
A. 6 months
B. 7 months
C. 12 months
D. 24 months

41) Jump on 2 feet build up 6 cubes sentence with 2 words Answer: B

compare 2 things
A. 1 y
B. 2 y
C. 3 y
D. 4 y
42) Child able to put 3 cubes on top of each other, walks, and Answer: C
crawls up the stairs, points to objects he wants, jargons and
understands commands. Draws lines with crayons. How old is "Draws lines with
he? It wasn’t draw or copy it was put line with crayons crayons" means
A. 9 months Scribbles not draw
B. 12 months straight line as a 2
C. 15 months year old
D. 24 months

43) 10 months, set without support, can't walk or crawl, say mom Answer: C
to hold him, grip pen what is the delay:
A. Socially At 10 months at least
B. Fine motor crawl, here he can't
C. Gross motor even crawl
D. Speech

44) Baby 8 can sit without support, he can grasp, says mama, Answer: D
wave bye bye to the dr. Which developmental milestone he has
defect in?
A. Gross motor
B. Fine motor
C. Language
D. normal development

45) A mother came to check up for her child he is 4 years old, he Answer: A
hops on one foot and stands on one for 10 seconds, he pretends
like his father, and draws a square, (the language part i forgot), Check the language
what will you tell his mother: part in exam, he
A. reassure her he is developing fine should be able to tell a
B. there is delay in gross and fine motor story by 4yr
C. there is delay in social
D. there is delay in language

46) Baby ride tricycle , draw circle but can’t draw square ? Answer: B
A. 2 years
B. 3 years
C. 4 years
D. 5 years

47) Milestone : child crawl , hand to hand but no pincer grip , Answer: B
what is the age ?
A. 7 m
B. 9 m
C. 10 m
D. 12 m

48) What is the age in month of child talk 6-10 words, point to 2 Answer: B
body parts, immature pencil grasp?
A. 17
B. 19
C. 12
D. 24
49) Milestones case, Child came at clinic carry a ball and release Answer: C
or kick it to the doctor. Also when the doctor go away the child
draw a stight line. Age:
A. 12M
B. 15M
C. 18M
D. 9M

50) Dress and undressed him self Tight his shoes Answer: 6 years
Play with group tie the shoes at 6yr

51) A newborn who is following objects 180 degrees, no head lag Answer: D
when pulled to sitting position, social smiling. Age by weeks?
A. 4
B. 8
C. 12
D. 16

52) baby can fixation of his head and sit withe father hand behind Answer: A
his back?
A. 5 months
B. 7 months
C. 8 months
D. 9months

53) A developmental normal on the examination table is sitting Answer: A

without support and babbling to herself, she picks up a cheerio
with a raking motion and moves it from her right hand to her left
hand, how old is she?
A. 6 months
B. 4 months
C. 12 months
D. 9 months

54) Child can tell story and undressed him self draw his sister Answer: A
head ,hand leg?
A. 4yr
B. 5yr

55) Baby crawling to the doctor, but has weak pincer grip what is Answer: C
the age of the baby with months
A. 6
B. 7
C. 9

56) A child came with his mother to well-baby clinic for general Answer: A
check up. The child can skip, draw rectangle, count from 1-10,
and know the opposite.
How old Is he?
A. 5
B. 4
C. 3
D. 2
Section 4: 🍬
A. Special milestones questions:
Question Answer/notes

1) Child 5 months, nurse said he has Answer: C

developmental delay in milestones, what
would you do to reassure the mother ? A, B and D are done at age >5 years old,
A. Pincer grasp and he’s having developmental delay, so he
B. wave bye bye cannot do any, C is achieved by 4 months
C. Reach things
D. Sit without supp

2) 5th month boy how to insure devolpment Answer: A

milestone ?
A. Try to reach for objects

3) Which of the following is characteristic for Answer: C

a 4-year child?
A. Play by himself if no “play in group” option, or other
B. Draw square and triangle characteristic skill of 4yr choose C
C. Express himself clearly

4) 18 months baby says baba mama only , Answer: C (needs double check)
what you will do for him?
A. Developmental assessment Saying mama baba should be at 12
B. Bone age
months. if not in choices choose A
C. hearing assessment
D. Something not related

5) 2 year old baby only says mama and Answer: B (needs double check)
baba. His brother had history of speech
delay until 3 years old, what is next?
A. Deveopmental assessment
B. Hearing assessment
C. Speech therapy
D. something

6) 13 month baby his mother came Answer: B (needs double check)

complains that he is not like other brother
and relatives and she thinks the baby has
delayed in milestone , what milestone the
mother thinks her baby delayed ? very
common Q)
A. Crawling
B. walk alone
C. wave bye bye
D. pencir grasp
7) Child 4 months His mother bring him the Answer: A
child can bring both hand in the middle
bring or reach to the toy Socially smile with Most likely achieved Qs → Choose the
facial expression, when the baby on his
most primitive one
tomy he can reach to elbow (‫)كأنه يزحف يعني‬

Which of the following suspects that the A = 4mo

child most likely achieves or have it ? B = 9mo
A. Completely head control C & D = 6mo
B. crawling
C. .‫يتقلب فالجهتين ظهره وبطنه‬
D. sit unsupported

8) 12 month only standaing of furnits , Answer: A

mother worrid about not waking:
A. Reassure
B. Refer clinc
C. TFT
D. Heat mri

B. Questions with disagreement regarding the answer:

Question Answer/notes

1) Child know his name, say mama dada , ride Answer: 3 or 4 years
tricycle, undressed with support , when the doctor
tell him red color he point to it " didn't say it just there’s contraversion in age at
point to the color" , What is his age in years? which a child can know colors; is it
A. 2 3 or 4 years
B. 3
C. 4 Personally if mentioned know colors
D. 5 when you point at them, I will
consider him 3 years
Similar:
Ride tricycle ,dress him self with help , point to the
colour when he asked this is which colour etc. know
his age, Difficulty in drawing square?
A. 3
B. 4
C. 5
D. 6

2) child can know color but with difficulty in making Answer: 3 or 4 years
square? Personally I would go with 4 years,
A. 2y drawing a square is at age 5, he
B. 3y
can draw square but with difficulty,
C. 4y
D. 5y so he is less than 5 but not by far
3) Child came for routine check up. He can walk Answer: A or B or C
steady independent, has immature pincer grasp.
Says 4-6 words, knows 2 body parts What is the Walk steady & independent = 15
developmental age in months?
mo
A. 24 months
B. 18 months immature pincer grasp = 9 mo
C. 15 months Says 4-6 words = 15 mo
D. 12 months knows body parts = 2yr
Point to body parts =18 mo

I think the real question mentioned

"point to 2 body parts" not "know"

D. Mahdi: C?

4) Child sits in tripod position, reaches out to things, Answer: B or C

flips from prone to supine and vice versa, cannot
hold cereal properly between two fingers how old is Everything goes with 6 mo.
he?
But which milestone is "cannot hold
A. 3 months
B. 6 months cereal properly between two
C. 9 months fingers"?
If raking = 6 mo
If immature pincer grasp: 9mo

Dr. Mahdi choose B

5) Sit without support, Crawl, hold things between Answer: B or C

thumb and index finger, walks around furniture, Dr. Mahdi & Badran: B
pulls up to be standing, say dada:
A- 8
All other skills are of a 9mo
B- 10
C- 12 Excpt "hold things between two
D- 14 fingers=pincer grasp?"

6) can climb stairs, eat by spoon and fork, and says Answer: I'd go with 24 months:
3-6 words:
A. 10 months Eat by spoon & fork = 15mo
B. 12 months
Says 3-6 words = 15mo
C. 15 months
D. 24 months
Climb stairs there is contraversion
E. 18 months (mentioned in some recalls) between references:
Nelson: walk up & down stairs: 2yr

But other references divide climbing

stairs to child manner and adult
manner:
Child manner 2yr
Adult manner: 3yr
Section 5:🚼
A. Milestones tables:
B. References:
Essential Nelson, Illustrated, Amboss, UTD,
Harriet Lane, Dr.Safder course, Dr. Mahdi, Dr. Badran channel.

Questions added to this file were collected from:

● Dr. Safdar course
● Dr. Mahdi channel (until 29 aug 2023)
● Dr. Mahdi file (5 july 2023 edition)
● All milestones file (collected from dr. Masoud file)
● Telegram channels (mainly Silent)

‫الحمد هلل‬