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Important Milestones

By The End Of 3 Months

Babies develop at their own pace, so it’s impossible to Developmental Health Watch
tell exactly when your child will learn a given skill. Alert your child’s doctor or nurse if your child displays any
The developmental milestones listed below will give you of the following signs of possible developmental delay for
a general idea of the changes you can expect, but don’t this age range.
be alarmed if your own baby’s development takes a
slightly different course. n Does not seem to respond to loud noises
n Does not notice hands by 2 months
Social and Emotional n Does not follow moving objects with eyes by 2 to 3 months
n Begins to develop a social smile n Does not grasp and hold objects by 3 months
n Enjoys playing with other people and may cry when n Does not smile at people by 3 months
playing stops n Cannot support head well by 3 months
n Becomes more expressive and communicates more with n Does not reach for and grasp toys by 3 to 4 months
face and body n Does not babble by 3 to 4 months
n Imitates some movements and facial expressions n Does not bring objects to mouth by 4 months
n Begins babbling, but does not try to imitate any of your
Movement sounds by 4 months
n Raises head and chest when lying on stomach n Does not push down with legs when feet are placed on
n Supports upper body with arms when lying on stomach a firm surface by 4 months
n Stretches legs out and kicks when lying on stomach n Has trouble moving one or both eyes in all directions
or back n Crosses eyes most of the time (occasional crossing of the
n Opens and shuts hands eyes is normal in these first months)
n Pushes down on legs when feet are placed on a firm n Does not pay attention to new faces, or seems very
surface frightened by new faces or surroundings
n Brings hand to mouth n Experiences a dramatic loss of skills he or she once had
n Takes swipes at dangling objects with hands
From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
n Grasps and shakes hand toys
Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.
Vision
n Watches faces intently
n Follows moving objects
n Recognizes familiar objects and people at a distance
n Starts using hands and eyes in coordination

Hearing and Speech


n Smiles at the sound of your voice
n Begins to babble
n Begins to imitate some sounds
n Turns head toward direction of sound
Department of Health and Human Services
Centers for Disease Control and Prevention

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 7 Months

Babies develop at their own pace, so it’s impossible to Developmental Health Watch
tell exactly when your child will learn a given skill. Alert your child’s doctor or nurse if your child displays any
The developmental milestones listed below will give you of the following signs of possible developmental delay for
a general idea of the changes you can expect, but don’t this age range.
be alarmed if your own baby’s development takes a
slightly different course. n Seems very stiff, with tight muscles
n Seems very floppy, like a rag doll
Social and Emotional n Head still flops back when body is pulled to a sitting
n Enjoys social play position
n Interested in mirror images n Reaches with one hand only
n Responds to other people’s expressions of emotion n Refuses to cuddle
and appears joyful often n Shows no affection for the person who cares for him or her

n Doesn’t seem to enjoy being around people


Cognitive n One or both eyes consistently turn in or out

n Finds partially hidden object n Persistent tearing, eye drainage, or sensitivity to light

n Explores with hands and mouth n Does not respond to sounds around him or her

n Struggles to get objects that are out of reach n Has difficulty getting objects to mouth

n Does not turn head to locate sounds by 4 months

Language n Does not roll over in either direction (front to back or

n Responds to own name back to front) by 5 months


n Begins to respond to “no” n Seems impossible to comfort at night after 5 months

n Can tell emotions by tone of voice n Does not smile on his or her own by 5 months

n Responds to sound by making sounds n Cannot sit with help by 6 months

n Uses voice to express joy and displeasure n Does not laugh or make squealing sounds by 6 months

n Babbles chains of sounds n Does not actively reach for objects by 6 to 7 months

n Does not follow objects with both eyes at near (1 foot)

Movement and far (6 feet) ranges by 7 months


n Does not bear weight on legs by 7 months
n Rolls both ways (front to back, back to front)
n Does not try to attract attention through actions by 7 months
n Sits with, and then without, support on hands
n Does not babble by 8 months
n Supports whole weight on legs
n Shows no interest in games of peek-a-boo by 8 months
n Reaches with one hand
n Experiences a dramatic loss of skills he or she once had
n Transfers object from hand to hand
n Uses hand to rake objects
From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
Vision of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.

n Develops full color vision


n Distance vision matures
n Ability to track moving objects improves
Department of Health and Human Services
Centers for Disease Control and Prevention

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 1 Year (12 Months)

Babies develop at their own pace, so it’s impossible to n Creeps on hands and knees
tell exactly when your child will learn a given skill. n Gets from sitting to crawling or prone (lying on
The developmental milestones listed below will give you stomach) position
n Pulls self up to stand
a general idea of the changes you can expect, but don’t
n Walks holding on to furniture
be alarmed if your own baby’s development takes a
n Stands momentarily without support
slightly different course.
n May walk two or three steps without support

Social and Emotional


n Shy or anxious with strangers Hand and Finger Skills
n Cries when mother or father leaves n Uses pincer grasp
n Enjoys imitating people in his play n Bangs two objects together
n Shows specific preferences for certain people and toys n Puts objects into container
n Tests parental responses to his actions during feedings n Takes objects out of container
n Tests parental responses to his behavior n Lets objects go voluntarily
n May be fearful in some situations n Pokes with index finger
n Prefers mother and/or regular caregiver over all others n Tries to imitate scribbling
n Repeats sounds or gestures for attention
n Finger-feeds himself Developmental Health Watch
n Extends arm or leg to help when being dressed
Alert your child’s doctor or nurse if your child displays any
of the following signs of possible developmental delay for
Cognitive
this age range.
n Explores objects in many different ways (shaking,
banging, throwing, dropping) n Does not crawl
n Finds hidden objects easily n Drags one side of body while crawling (for over one month)
n Looks at correct picture when the image is named n Cannot stand when supported
n Imitates gestures n Does not search for objects that are hidden while he
n Begins to use objects correctly (drinking from cup, or she watches
brushing hair, dialing phone, listening to receiver) n Says no single words (“mama” or “dada”)

n Does not learn to use gestures, such as waving or


Language shaking head
n Pays increasing attention to speech n Does not point to objects or pictures

n Responds to simple verbal requests n Experiences a dramatic loss of skills he or she once had

n Responds to “no”
From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
n Uses simple gestures, such as shaking head for “no” Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
n Babbles with inflection (changes in tone) of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.

n Says “dada” and “mama”


n Uses exclamations, such as “Oh-oh!”
n Tries to imitate words
Department of Health and Human Services
Movement
n Reaches sitting position without assistance
Centers for Disease Control and Prevention
n Crawls forward on belly
n Assumes hands-and-knees position

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 2 Years (24 Months)

Children develop at their own pace, so it’s impossible Hand and Finger Skills
to tell exactly when yours will learn a given skill. The n Scribbles on his or her own
developmental milestones below will give you a general n Turns over container to pour out contents
idea of the changes you can expect as your child gets n Builds tower of four blocks or more
older, but don’t be alarmed if your child takes a slightly n Might use one hand more often than the other
different course.

Social Developmental Health Watch


n Imitates behavior of others, especially adults and Alert your child’s doctor or nurse if your child displays any
older children of the following signs of possible developmental delay for
n More aware of herself as separate from others this age range.
n More excited about company of other children

n Cannot walk by 18 months


Emotional n Fails to develop a mature heel-toe walking pattern after
n Demonstrates increasing independence several months of walking, or walks only on his toes
n Begins to show defiant behavior n Does not speak at least 15 words
n Separation anxiety increases toward midyear then fades n Does not use two-word sentences by age 2

n By 15 months, does not seem to know the function of

common household objects (brush, telephone, bell,


Cognitive fork, spoon)
n Finds objects even when hidden under two or three covers n Does not imitate actions or words by the end of this period

n Begins to sort by shapes and colors n Does not follow simple instructions by age 2

n Begins make-believe play n Cannot push a wheeled toy by age 2

n Experiences a dramatic loss of skills he or she once had

Language
From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
n Points to object or picture when it’s named for him Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
n Recognizes names of familiar people, objects, and of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.

body parts
n Says several single words (by 15 to 18 months)

n Uses simple phrases (by 18 to 24 months)

n Uses 2- to 4-word sentences

n Follows simple instructions

n Repeats words overheard in conversation

Movement
n Walks alone
n Pulls toys behind her while walking
n Carries large toy or several toys while walking
n Begins to run Department of Health and Human Services
Stands on tiptoe
n

n Kicks a ball
Centers for Disease Control and Prevention
n Climbs onto and down from furniture unassisted
n Walks up and down stairs holding on to support

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 3 Years (36 Months)

Children develop at their own pace, so it’s impossible n Kicks ball


to tell exactly when yours will learn a given skill. The n Runs easily
developmental milestones below will give you a general n Pedals tricycle
idea of the changes you can expect as your child gets n Bends over easily without falling
older, but don’t be alarmed if your child takes a slightly
different course. Hand and Finger Skills
n Makes up-and-down, side-to-side, and circular lines
Social with pencil or crayon
n Turns book pages one at a time
n Imitates adults and playmates
n Builds a tower of more than six blocks
n Spontaneously shows affection for familiar playmates
n Holds a pencil in writing position
n Can take turns in games
n Screws and unscrews jar lids, nuts, and bolts
n Understands concept of “mine” and “his/hers”
n Turns rotating handles

Emotional
n Expresses affection openly Developmental Health Watch
n Expresses a wide range of emotions Alert your child’s doctor or nurse if your child displays any
n By 3, separates easily from parents of the following signs of possible developmental delay for
n Objects to major changes in routine this age range.

Cognitive n Frequent falling and difficulty with stairs


n Makes mechanical toys work n Persistent drooling or very unclear speech
n Matches an object in her hand or room to a picture in n Cannot build a tower of more than four blocks

a book n Difficulty manipulating small objects

n Plays make-believe with dolls, animals, and people n Cannot copy a circle by age 3

n Sorts objects by shape and color n Cannot communicate in short phrases

n Completes puzzles with three or four pieces n No involvement in “pretend” play

n Understands concept of “two” n Does not understand simple instructions

n Little interest in other children

Language n Extreme difficulty separating from mother or primary

n Follows a two- or three-part command caregiver


n Poor eye contact
n Recognizes and identifies almost all common objects
n Limited interest in toys
and pictures
n Experiences a dramatic loss of skills he or she once had
n Understands most sentences

n Understands placement in space (“on,” “in,” “under”) From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
n Uses 4- to 5-word sentences Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.
n Can say name, age, and sex

n Uses pronouns (I, you, me, we, they) and some plurals

(cars, dogs, cats)


n Strangers can understand most of her words Department of Health and Human Services
Movement Centers for Disease Control and Prevention
n Climbs well
n Walks up and down stairs, alternating feet (one foot
per stair step)

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 4 Years (48 Months)

Children develop at their own pace, so it’s impossible n Catches bounced ball most of the time
to tell exactly when yours will learn a given skill. The n Moves forward and backward with agility
developmental milestones below will give you a general
idea of the changes you can expect as your child gets Hand and Finger Skills
older, but don’t be alarmed if your child takes a slightly n Copies square shapes
different course. n Draws a person with two to four body parts
n Uses scissors
Social n Draws circles and squares
n Interested in new experiences n Begins to copy some capital letters
n Cooperates with other children
n Plays “Mom” or “Dad” Developmental Health Watch
n Increasingly inventive in fantasy play Alert your child’s doctor or nurse if your child displays any
n Dresses and undresses of the following signs of possible developmental delay for
n Negotiates solutions to conflicts this age range.
n More independent
n Cannot throw a ball overhand
Emotional n Cannot jump in place
n Imagines that many unfamiliar images may be “monsters” n Cannot ride a tricycle
n Views self as a whole person involving body, mind, n Cannot grasp a crayon between thumb and fingers
and feelings n Has difficulty scribbling
n Often cannot tell the difference between fantasy and reality n Cannot stack four blocks
n Still clings or cries whenever parents leave
Cognitive n Shows no interest in interactive games
n Correctly names some colors n Ignores other children
n Understands the concept of counting and may know n Doesn’t respond to people outside the family
a few numbers n Doesn’t engage in fantasy play
n Tries to solve problems from a single point of view n Resists dressing, sleeping, using the toilet
n Begins to have a clearer sense of time n Lashes out without any self-control when angry or upset
n Follows three-part commands n Cannot copy a circle
n Recalls parts of a story n Doesn’t use sentences of more than three words
n Understands the concepts of “same” and “different” n Doesn’t use “me” and “you” correctly
n Engages in fantasy play n Experiences a dramatic loss of skills he or she once had
From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
Language Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.
n Has mastered some basic rules of grammar
n Speaks in sentences of five to six words
n Speaks clearly enough for strangers to understand
n Tells stories
Department of Health and Human Services
Movement
n Hops and stands on one foot up to five seconds
Centers for Disease Control and Prevention
n Goes upstairs and downstairs without support
n Kicks ball forward
n Throws ball overhand

www.cdc.gov/actearly
Learn the Signs. Act Early.
Important Milestones
By The End Of 5 Years (60 Months)

Children develop at their own pace, so it’s impossible Developmental Health Watch
to tell exactly when yours will learn a given skill. The Alert your child’s doctor or nurse if your child displays any
developmental milestones below will give you a general of the following signs of possible developmental delay for
idea of the changes you can expect as your child gets this age range.
older, but don’t be alarmed if your child takes a slightly
different course. n Acts extremely fearful or timid
n Acts extremely aggressively
Social n Is unable to separate from parents without major protest
n Wants to please friends n Is easily distracted and unable to concentrate on any
n Wants to be like her friends single activity for more than five minutes
n More likely to agree to rules
n Shows little interest in playing with other children
n Likes to sing, dance, and act
n Refuses to respond to people in general, or responds
n Shows more independence and may even visit a
only superficially
next-door neighbor by herself n Rarely uses fantasy or imitation in play

n Seems unhappy or sad much of the time


Emotional
n Doesn’t engage in a variety of activities
n Aware of gender
n Avoids or seems aloof with other children and adults
n Able to distinguish fantasy from reality
n Doesn’t express a wide range of emotions
n Sometimes demanding, sometimes eagerly cooperative
n Has trouble eating, sleeping or using the toilet

Cognitive n Can’t tell the difference between fantasy and reality

n Can count 10 or more objects n Seems unusually passive

n Correctly names at least four colors n Cannot understand two-part commands using prepositions

n Better understands the concept of time (“Put the doll on the bed, and get the ball under the couch.”)
n Knows about things used every day in the home n Can’t correctly give her first and last name

(money, food, appliances) n Doesn’t use plurals or past tense properly when speaking

n Doesn’t talk about her daily activities and experiences


Language n Cannot build a tower of six to eight blocks
n Recalls part of a story n Seems uncomfortable holding a crayon
n Speaks sentences of more than five words n Has trouble taking off clothing
n Uses future tense n Cannot brush her teeth efficiently
n Tells longer stories n Cannot wash and dry her hands
n Says name and address n Experiences a dramatic loss of skills he or she once had

Movement From CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven
Shelov, Robert E. Hannermann, © 1991, 1993, 1998, 2004 by the American Academy
n Stands on one foot for 10 seconds or longer of Pediatrics. Used by permission of Bantam Books, a division of Random House, Inc.
n Hops, somersaults
n Swings, climbs
n May be able to skip

Hand and Finger Skills Department of Health and Human Services


Copies triangle and other shapes
Centers for Disease Control and Prevention
n

n Draws person with body


n Prints some letters
n Dresses and undresses without help
n Uses fork, spoon, and (sometimes) a table knife
n Usually cares for own toilet needs

www.cdc.gov/actearly
Learn the Signs. Act Early.

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