Developmental Milestones

A method of evaluation has been developed using an interview technique in which parents are asked questions regarding milestones in achievements that most will remember. The child's developmental quotient (DQ) can be determined according to the parents' answers. A DQ less than 70% signifies a delay requiring further evaluation.
AGE	GROSS MOTOR	VISUAL-MOTOR/PROBLEM-SOLVING	LANGUAGE	SOCIAL/ADAPTIVE
1 month	Raises head slightly from prone, makes crawling movements	Birth: visually fixes 1 mo: has tight grasp, follows to midline	Alerts to sound	Regards face
2 month	Holds head in midline, lifts chest off table	No longer clenches fist tightly, follows object past midline	Smiles socially (after being stroked or talked to)	Recognizes parent
3 month	Supports on forearms in prone, holds head up steadily	Holds hands open at rest, follows in circular fashion, responds to visual threat	Coos (produces long vowel sounds in musical fashion)	Reaches for familiar people or objects, anticipates feeding
4 month	Rolls front to back, supports on wrists and shifts weight	Laughs, orients to voice	Enjoys looking around environment
5 month	Rolls back to front, sits supported	Transfers objects	Says “ah-goo,” blows raspberries, orients to bell (localizes laterally)	—
6 month	Sits unsupported, puts feet in mouth in supine position	Unilateral reach, uses raking grasp	Babbles	Recognizes strangers
7 month	Creeps	—	Orients to bell (localized indirectly)	—
8 month	Comes to sit, crawls	Inspects objects	“Dada” indiscriminately	Fingerfeeds
9 month	Pivots when sitting, pulls to stand, cruises	Uses pincer grasp, probes with forefinger, holds bottle, throws objects	“Mama” indiscriminately, gestures, waves bye-bye, inhibits to “no”	Starts to explore environment; plays gesture games (eg, pat-a-cake)
10 month	Walks when led with both hands held	—	“Dada/mama” discriminately; orients to bell (directly)	—
11 month	Walks when led with one hand held	—	One word other than “dada/mama,” follows 1-step command with gesture	—
12 month	Walks alone	Uses mature pincer grasp, releases voluntarily, marks paper with pencil	Uses two words other than “dada/mama,” immature jargoning (runs several unintelligible syllables together)	Imitates actions, comes when called, cooperates with dressing
13 month	—	—	Uses three words	—
14 month	—	—	Follows 1-step command without gesture	—
15 month	Creeps up stairs, walks backwards	Scribbles in imitation, builds tower of 2 blocks in imitation	Uses 4 to 6 words	15 to 18 mo: uses spoon, uses cup independently
17 month	—	—	Uses 7 to 20 words, points to 5 body parts, uses mature jargoning (includes intelligible words in jargoning)	—
18 month	Runs, throws objects from standing without falling	Scribbles spontaneously, builds tower of 3 blocks, turns 2 to 3 pages at a time	Uses 2-word combinations	Copies parent in tasks (sweeping, dusting), plays in company of other children
19 month	—	—	Knows 8 body parts	—
21 month	Squats in play, goes up steps	Builds tower of 5 blocks	Uses 50 words, 2-word sentences	Asks to have food and to go to toilet
24 month	Walks up and down steps without help	Imitates stroke with pencil, builds tower of 7 blocks, turns pages one at a time, removes shoes, pants, etc.	Uses pronouns (I, you, me) inappropriately, follows 2-step commands	Parallel play
30 month	Jumps with both feet off floor, throws ball overhand	Holds pencil in adult fashion, performs horizontal and vertical strokes, unbuttons	Uses pronouns appropriately, understands concept of “1,” repeats 2 digits forward	Tells first and last names when asked; gets self drink without help
3 year	Can alternate feet when going up steps, pedals tricycle	Copies a circle, undresses completely, dresses partially, dries hands if reminded	Uses minimum 250 words, 3-word sentences; uses plurals, past tense; knows all pronouns; understands concept of “2”	Group play, shares toys, takes turns, plays well with others, knows full name, age, sex
4 year	Hops, skips, alternates feet going down steps	Copies a square, buttons clothing, dresses self completely, catches ball	Knows colors, says song or poem from memory, asks questions	Tells “tall tales,” plays cooperatively with a group of children
5 year	Skips alternating feet, jumps over low obstacles	Copies triangle, ties shoes, spreads with knife	Prints first name, asks what a word means	Plays competitive games, abides by rules, likes to help in household tasks
Custer, J.W., Rau, R.E., and Lee, C.K. (Eds.) (2008). The Harriet Lane Handbook (18th ed.). Philadelphia: Elsevier