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| MILESTONE | AVERAGE AGE OF ATTAINMENT (MO) | DEVELOPMENTAL IMPLICATIONS |
|---|---|---|
| GROSS MOTOR | ||
| Holds head steady while sitting | 2 | Allows more visual interaction |
| Pulls to sit, with no head lag | 3 | Muscle tone |
| Brings hands together in midline | 3 | Self-discovery of hands |
| Asymmetric tonic neck reflex gone | 4 | Can inspect hands in midline |
| Sits without support | 6 | Increasing exploration |
| Rolls back to stomach | 6.5 | Truncal flexion, risk of falls |
| Walks alone | 12 | Exploration, control of proximity to parents |
| Runs | 16 | Supervision more difficult |
| FINE MOTOR | ||
| Grasps rattle | 3.5 | Object use |
| Reaches for objects | 4 | Visuomotor coordination |
| Palmar grasp gone | 4 | Voluntary release |
| Transfers object hand to hand | 5.5 | Comparison of objects |
| Thumb-finger grasp | 8 | Able to explore small objects |
| Turns pages of book | 12 | Increasing autonomy during book time |
| Scribbles | 13 | Visuomotor coordination |
| Builds tower of 2 cubes | 15 | Uses objects in combination |
| Builds tower of 6 cubes | 22 | Requires visual, gross, and fine motor coordination |
| COMMUNICATION AND LANGUAGE | ||
| Smiles in response to face, voice | 1.5 | More active social participant |
| Monosyllabic babble | 6 | Experimentation with sound, tactile sense |
| Inhibits to “no” | 7 | Response to tone (nonverbal) |
| Follows one-step command with gesture | 7 | Nonverbal communication |
| Follows one-step command without gesture | 10 | Verbal receptive language (e.g.,“Give it to me”) |
| Says “mama” or “dada” | 10 | Expressive language |
| Points to objects | 10 | Interactive communication |
| Speaks first real word | 12 | Beginning of labeling |
| Speaks 4–6 words | 15 | Acquisition of object and personal names |
| Speaks 10–15 words | 18 | Acquisition of object and personal names |
| Speaks 2-word sentences (e.g.,“Mommy shoe”) | 19 | Beginning grammaticization, corresponds with 50+ word vocabulary |
| COGNITIVE | ||
| Stares momentarily at spot where object disappeared | 2 | Lack of object permanence (out of sight, out of mind) [e.g., yarn ball dropped] |
| Stares at own hand | 4 | Self-discovery, cause and effect |
| Bangs 2 cubes | 8 | Active comparison of objects |
| Uncovers toy (after seeing it hidden) | 8 | Object permanence |
| Egocentric symbolic play (e.g., pretends to drink from cup) | 12 | Beginning symbolic thought |
| Uses stick to reach toy | 17 | Able to link actions to solve problems |
| Pretend play with doll (e.g., gives doll bottle) | 17 | Symbolic thought |
| NEONATAL PERIOD (1ST 4 WK) | |
|---|---|
| Prone: | Lies in flexed attitude; turns head from side to side; head sags on ventral suspension |
| Supine: | Generally flexed and a little stiff |
| Visual: | May fixate face on light in line of vision;“doll's-eye” movement of eyes on turning of the body |
| Reflex: | Moro response active; stepping and placing reflexes; grasp reflex active |
| Social: | Visual preference for human face |
| AT 1 MO | |
| Prone: | Legs more extended; holds chin up; turns head; head lifted momentarily to plane of body on ventral suspension |
| Supine: | Tonic neck posture predominates; supple and relaxed; head lags when pulled to sitting position |
| Visual: | Watches person; follows moving object |
| Social: | Body movements in cadence with voice of other in social contact; beginning to smile |
| AT 2 MO | |
| Prone: | Raises head slightly farther; head sustained in plane of body on ventral suspension |
| Supine: | Tonic neck posture predominates; head lags when pulled to sitting position |
| Visual: | Follows moving object 180 degrees |
| Social: | Smiles on social contact; listens to voice and coos |
| AT 3 MO | |
| Prone: | Lifts head and chest with arms extended; head above plane of body on ventral suspension |
| Supine: | Tonic neck posture predominates; reaches toward and misses objects; waves at toy |
| Sitting: | Head lag partially compensated when pulled to sitting position; early head control with bobbing motion; back rounded |
| Reflex: | Typical Moro response has not persisted; makes defensive movements or selective withdrawal reactions |
| Social: | Sustained social contact; listens to music; says “aah, ngah” |
| AT 4 MO | |
| Prone: | Lifts head and chest, with head in approximately vertical axis; legs extended |
| Supine: | Symmetric posture predominates, hands in midline; reaches and grasps objects and brings them to mouth |
| Sitting: | No head lag when pulled to sitting position; head steady, tipped forward; enjoys sitting with full truncal support |
| Standing: | When held erect, pushes with feet |
| Adaptive: | Sees pellet, but makes no move to reach for it |
| Social: | Laughs out loud; may show displeasure if social contact is broken; excited at sight of food |
| AT 7 MO | |
| Prone: | Rolls over; pivots;crawls or creep-crawls (Knobloch) |
| Supine: | Lifts head; rolls over; squirms |
| Sitting: | Sits briefly, with support of pelvis; leans forward on hands; back rounded |
| Standing: | May support most of weight; bounces actively |
| Adaptive: | Reaches out for and grasps large object; transfers objects from hand to hand; grasp uses radial palm; rakes at pellet |
| Language: | Forms polysyllabic vowel sounds |
| Social: | Prefers mother; babbles;enjoys mirror; responds to changes in emotional content of social contact |
| AT 10 MO | |
| Sitting: | Sits up alone and indefinitely without support, with back straight |
| Standing: | Pulls to standing position;“cruises” or walks holding on to furniture |
| Motor: | Creeps or crawls |
| Adaptive: | Grasps objects with thumb and forefinger; pokes at things with forefinger; picks up pellet with assisted pincer movement; uncovers hidden toy; attempts to retrieve dropped object; releases object grasped by other person |
| Language: | Repetitive consonant sounds (“mama,” “dada”) |
| Social: | Responds to sound of name; plays peek-a-boo or pat-a-cake;waves bye-bye |
| AT 1 YR | |
| Motor: | Walks with one hand held (48 wk); rises independently, takes several steps (Knobloch) |
| Adaptive: | Picks up pellet with unassisted pincer movement of forefinger and thumb; releases object to other person on request or gesture |
| Language: | Says a few words besides “mama,” “dada” |
| Social: | Plays simple ball game; makes postural adjustment to dressing |
| 15 MO | |
|---|---|
| Motor: | Walks alone; crawls up stairs |
| Adaptive: | Makes tower of 3 cubes; makes a line with crayon; inserts raisin in bottle |
| Language: | Jargon;follows simple commands; may name a familiar object (e.g., ball) |
| Social: | Indicates some desires or needs by pointing; hugs parents |
| 18 MO | |
| Motor: | Runs stiffly; sits on small chair; walks up stairs with one hand held; explores drawers and wastebaskets |
| Adaptive: | Makes tower of 4 cubes; imitates scribbling; imitates vertical stroke; dumps raisin from bottle |
| Language: | 10 words (average); names pictures; identifies one or more parts of body |
| Social: | Feeds self; seeks help when in trouble; may complain when wet or soiled; kisses parent with pucker |
| 24 MO | |
| Motor: | Runs well, walks up and down stairs, one step at a time; opens doors; climbs on furniture; jumps |
| Adaptive: | Makes tower of 7 cubes (6 at 21 mo); scribbles in circular pattern; imitates horizontal stroke; folds paper once imitatively |
| Language: | Puts 3 words together (subject, verb, object) |
| Social: | Handles spoon well; often tells about immediate experiences; helps to undress; listens to stories when shown pictures |
| 30 MO | |
| Motor: | Goes up stairs alternating feet |
| Adaptive: | Makes tower of 9 cubes; makes vertical and horizontal strokes, but generally will not join them to make cross; imitates circular stroke, forming closed figure |
| Language: | Refers to self by pronoun “I”; knows full name |
| Social: | Helps put things away; pretends in play |
| 36 MO | |
| Motor: | Rides tricycle; stands momentarily on one foot |
| Adaptive: | Makes tower of 10 cubes; imitates construction of “bridge” of 3 cubes; copies circle; imitates cross |
| Language: | Knows age and sex; counts 3 objects correctly; repeats 3 numbers or a sentence of 6 syllables |
| Social: | Plays simple games (in “parallel” with other children); helps in dressing (unbuttons clothing and puts on shoes); washes hands |
| 48 MO | |
| Motor: | Hops on one foot; throws ball overhand; uses scissors to cut out pictures; climbs well |
| Adaptive: | Copies bridge from model; imitates construction of “gate” of 5 cubes; copies cross and square; draws man with 2 to 4 parts besides head; identifies longer of 2 lines |
| Language: | Counts 4 pennies accurately; tells story |
| Social: | Plays with several children, with beginning of social interaction and role-playing;goes to toilet alone |
| 60 MO | |
| Motor: | Skips |
| Adaptive: | Draws triangle from copy; names heavier of 2 weights |
| Language: | Names 4 colors; repeats sentence of 10 syllables; counts 10 pennies correctly |
| Social: | Dresses and undresses; asks questions about meaning of words; engages in domestic role-playing |