Childhood development is a continuous process. Not all normally-developing children will demonstrate all of the following milestones at the stated ages. For children who have not achieved milestones, it is important to determine if progress is being made and to assess all areas of development: verbal-social, fine motor and gross motor. We routinely assess development at all well-visits and will discuss your child’s development with you at those visits as well as at other visits should concerns arise. Please notify our office if you are concerned about your child’s development.
The following milestones are typical emerging milestones for children of the ages noted. Children are expected to also demonstrate the milestones of younger children.
Babies can see close large objects and track movements from up to twenty feet. They are drawn to bright lights and contrasting black and white objects (like vertical blinds). They can not discriminate colors. They now smile and coo and can better control head movements but still need head and neck support when being held.
Babies can see more detail. They track well, smile responsively and coo. Neck control is improving. Babies can lift and turn their heads from a stomach-lying position. They can tolerate “tummy time” better but should still sleep on their backs.
Four month olds are more social. They will coo and laugh and smile. They reach for objects and bring them to their mouths. They roll over partly. From a stomach-lying position, babies can arch their backs.
Babies explore making sounds. They make high and low-pitched sounds, make “raspberries,” and babble conversationally. They have nearly mastered rolling in both directions. They can lift their chests from a surface and extend their arms fully. They bring objects to the middle of their bodies and transfer items between hands. They notice their feet and bring them to their mouths. They can sit for a few seconds and may put their arms out to catch themselves when falling from a seated position.
Nine month olds babble in multi-syllables (da-da-da-da, ba-ba-ba-ba…). They laugh when you play peek-a-boo with them. They throw things from highchairs for you to pick up so they can be thrown again. They respond to their names and know familiar people. They may become anxious around strangers and when separated from caregivers. They easily sit without support and may crawl. They can pick up small items using their first finger and thumb in a “pincer grasp.” They finger feed and can hold and use a bottle or sippy cup.
One year olds have one-word vocabularies. They point to items of interest and look at items to which you point. They show others items they are excited by to engage people and view their responses. They wave hands and shake their heads sideways to indicate “no.” They pull to a standing position, walk holding onto stationary objects or hands, and stand (and may walk) unsupported. They finger feed and drink messily from a cup. (They may still choose to drink from bottles.) They put items in and take items out of containers.
These children speak three to ten words. They may follow simple instructions. They know some body parts. They can turn pages in board books, arrange two to three items horizontally (in a train), put rings on a cone and manipulate “shape sorting” toys. They can scribble and use utensils purposely (often messily). They can “help” brush their teeth. They may run and climb stairs and chairs.
Children use six to twenty words. They understand more than they can express and may get easily frustrated. Children at this age may bite and hit. They can eat with utensils more neatly and stack three or more items vertically. They begin to pretend play.
Two year olds use fifty words, half of which are understandable, and combine two words to make sentences. They play next to other children, mimicking their actions. They jump, throw and kick balls. They try to catch balls. They can draw lines. They can assist with dressing and undressing and may be aware of when they need to pass urine and stool. They exhibit make believe play. Two year olds may follow two step directions, but are also becoming more independent and defiant.
These children have a vocabulary of one hundred words, two-thirds of which are understandable, and speak in two to three word sentences. They engage other children in play and play with them. They may scribble circles and jump from chairs.
Three year olds have a vocabulary of three hundred words, three-quarters of which are understandable, and speak in long sentences. They can say their names. They play creatively and point to items in books. They memorize favorite books and can make up their own stories to explain what a picture shows. They understand sharing, but may not choose to share, and can take turns in a game. They can draw a closed circle and build simple puzzles with a few pieces. They can stand on one foot for three seconds, pedal a tricycle, and walk up and down steps with one foot on each step.
Four year olds have too many words to count, ninety percent of which are understandable. They tell long stories. They draw squares and crosses/ “x’s.” They can use scissors and ride bikes with training wheels.
Five year olds are fully understandable (although articulation may not be fully mastered) when they choose to be understood. They draw triangles, “people” with multiple body parts and stick limbs, and write letters of their names. They can swing and balance better on a bike. They may enjoy singing, acting and dancing.
The schedule for immunizations in childhood is formulated to protect your child from diseases when you child is...