Summary Of Pediatric Developmental Milestones From Dr. Fox

For links to detailed resources on infant and child development see my post Pediatric Developmental Milestones – Resources From The Centers For Disease Control, October 16, 2017.

The following are excerpts from Developmental Milestones in the ED from Pediatric EM Morsels by Dr. Sean Fox:

Developmental Milestones Basics

Classically, childhood developmental milestones are divided into different domains:

Motor

Motor delays may be the first and most obvious sign of a global developmental disorder (Nortiz, 2013).

Social

Language

Cognitive

Not every kid develops at the same rate, but they generally should progress through the expected milestones in order.

Typical Infant Developmental Milestones

Again, kids achieve milestones are various paces… so these are just estimates… but can help define marked abnormalities.

Motor

Head Posture / Control

8 weeks – can hold head up while prone

12 weeks – has some head lag when being pulled from supine position

20 weeks – no head lag

6 months – complete head control

Fine Motor

2 months – grasps offered item

4 months – reaches for objects. Brings hands to mouth (now we are in trouble)

6 months – transfers objects form one hand to another

Gross Motor

2 months – begins to push up while prone

4 months – able to roll from tummy to back (essentially pushes self over). Bears weight on legs when feet are on a surface. Sits with curved spine.

6 months – able to roll from back to tummy. Can sit without support.

9 months – sits with straight spine.

18 months – should sit, stand, and walk independently.

Social / Language

2 months – attempts to look at parents. Smiles. Coos.

4 months – smiles at people spontaneously.

6 months – indicates desire to be picked up. Knows familiar faces and recognizes when someone is a stranger. Babbles.

9 months – the height of separation anxiety! Plays “peek-a-boo” and waves “bye-bye.” Understands “No.”

12 months – knows one – two words.

18 months – knows three – six words (body parts often).

24 months – uses two word phrases.

36 months – uses three word sentences.

Cognitive

Language and Social milestones are closely tied with Cognitive milestones, particularly early on.

2 months – regards faces, has differential coos and cries and can indicate wants.

4 months – reaches for objects, uses hands and eyes together.

6 months – shows curiosity. Uses visual and oral exploration of environment.

9 months – has object permanence (looks for item when it is hidden). Learns interactive games.

12 months – can follow simple instructions. Bangs objects together.