Is Your Child on Track?

All children develop at individual and different rates, and there is a wide range of “typical” development. If you have any questions about your child’s development, or the rate at which he/she is meeting milestones, call MKSA at 516-731-5588 and our professionals will answer any questions and guide you in your child’s development. Feel free to print this page to share and discuss with your child’s pediatrician. Birth to 3 months 4 to 6 months 7 to 12 months MILESTONES MILESTONES MILESTONES Tracks a slowly moving object 8-12” away Plays with rattle placed in hand Finds hidden objects Brings hand to mouth Purposely drops an object to watch it fall Pokes with index finger Mouths toys Pulls a cloth from face Looks at pictures in a book Turns head toward direction of sound Smiles a lot; can laugh; coos when caregiver Says “ma-ma” and “da-da”; waves bye-bye Startled by loud noises speaks Responds to name; follows simple spoken com- Makes noises other than crying Babbles chains of sounds mand; uses simple gestures, such as shaking Looks at human faces or black and white pat- Responds to own name head for “no” terns Enjoys social play Points to request something Cries, but is comforted when picked up and held Expresses desire to be picked up Shows specific preferences for certain people Begins to develop a social smile Interested in mirror images and toys Swallows liquids with no difficulty Swallows pureed foods Plays simple games Sleeps for 4- to 10-hour intervals Uses tongue to move food in mouth Plays well for short time with two or three chil- Enjoys bath time Closes lips while swallowing dren Raises head briefly when lying on stomach Transfers object from hand to hand Feeds self finger foods; closes mouth on rim of Grasps and shakes hand toys Sits up and stands with support cup; picks up cup and takes 4-5 swallows Moves arms and legs more smoothly Rolls both ways - front to back, back to front Sleeps through the night; takes 1-2 daytime naps Helps with dressing or undressing SUGGESTED ACTIVITIES SUGGESTED ACTIVITIES Crawls on belly; pulls self up to standing position; Present colorful objects for baby to look at Present objects such as rattles, for baby to play walks while holding onto furniture Talk and sing to baby with Uses pincer grasp (between thumb and forefin- Hang mobiles, play music, make animated faces Help baby sit up with support during play time ger); scribbles spontaneously Help baby’s motor development by engaging in and during bath time Moves from back to sitting without help ‘tummy time’ every day Encourage baby to practice ‘tummy time’, roll Give baby plenty of cuddle time and body mas- over, and reach for objects while playing SUGGESTED ACTIVITIES sages Offer toys that allow two-handed exploration Play “peek-a-boo”, puppets, wave bye-bye; en- Encourage baby’s responses by presenting ob- and play courage two-way communication by responding jects with bright colors and faces Talk to baby to encourage language develop- to baby’s noises Talk to baby every day to show that language is ment; baby may begin to babble Establish a regular bedtime with a calming ritual used to communicate Respond with pleasure to baby’s sounds starting one hour prior Communicate with baby; imitate baby’s noises Help baby stand while holding baby’s hands WHEN TO BE CONCERNED and praise him/her when he/she imitates yours Baby-proof baby’s environment Doesn’t respond to loud noises Use gestures such as waving goodbye to help Cannot support head well WHEN TO BE CONCERNED convey meaning; name and describe objects Has trouble moving one or both eyes in all direc- Refuses to cuddle during everyday activities tions Doesn’t show affection for caregiver Use picture books to work on communication Crosses eyes most of the time (occasional cross- Seems very stiff, or very floppy and bonding ing is normal in first few months) Head still flops back when body is pulled to a While standing at sofa, set a toy slightly out of Doesn’t grasp and hold objects sitting position reach to encourage walking while using furniture Doesn’t follow moving objects with eyes Doesn’t respond to sounds around him/her as support Doesn’t smile at people Doesn’t smile, laugh or make squealing sounds Doesn’t babble Has difficulty getting objects to mouth WHEN TO BE CONCERNED Doesn’t push down with legs when feet are Doesn’t roll over in either direction – front to Doesn’t learn to use gestures, such as waving placed on firm surface back, or back to front hand or shaking head Cannot sit with help Drags one side of body while crawling (for over one month); asymmetry between the two sides of body; or body too stiff or too floppy Doesn’t search for objects baby sees being hid- den Doesn’t respond to name or say single words; doesn’t babble Doesn’t point to objects or pictures Can’t stand when supported; can’t sit with help Doesn’t actively reach for objects Doesn’t follow objects with both eyes at near (one foot) and far (six feet) ranges Shows no interest in games of peek-a-boo Is Your Child on Track?

12 to 18 months 19 months to 2 years 2 to 3 years old MILESTONES MILESTONES MILESTONES Looks at picture book with adult Can name 5 or more objects Can tell his/her own age Places objects into cups; dumps out contents Follows 2-step directions (pick up your toy and Understands “one,” “one more,” and “all” Knows what everyday objects are for (brush, put it in the basket) Imitates behavior of others; especially adults and telephone, etc.) Stacks 6-7 blocks older children Points to wanted object Has 20-50 words; begins to imitate 2-word Begins to sort by shapes and colors Can follow 1-step verbal command without ges- sentences Says between 50-200 words; understands tures (i.e. “sit down”); protests by saying “no,” Points and names objects in a book between 500-900 words shaking head or frowning Can point to and name 15 or more pictures of Uses 2-3 word sentences Uses at least 5 words; points to at least 3 body common objects when named Knows difference between boys and girls parts when asked Sings familiar songs Loves picture books Separates easily from caregiver in familiar envi- Listens quietly to story, music or TV Begins make-believe play ronment; may cling in new situations; may have Curious; gets into everything; often defiant; has Is shy around strangers tantrums difficulty sharing; wants caregiver nearby if upset Recognizes when someone else is happy or sad Plays alone for short periods; extends toy to Verbalizes bowel and bladder needs (50% of the Feeds himself with spoon show others time); tries to wash own hands and face Removes shoes, socks, and pants; unzips zipper Enjoys simple make-believe play Begins using fork; uses spoon independently Kicks large ball; jumps in place; stands on tiptoe Chews textured foods; eats finger foods; stirs Puts on simple clothing Uses adult grasp when holding a pencil with spoon; drinks from cup; sips from straw Walks well; walks backward Catches ball, trapping against chest Sleeps through the night; one daytime nap Dances, jumps, runs and kicks; rides tricycle Fusses when diaper needs changing Draws using circular, vertical and horizontal SUGGESTED ACTIVITIES Walks alone; walks backwards, and down stairs strokes Explore the pages in a book each day; point to with help and label pictures Enjoys pushing or pulling toys while walking SUGGESTED ACTIVITIES Play make-believe and dress up Holds crayon with fingers, hand on top, forearm Give your child two choices when possible Allow toddler to play with spoons, cups, pots turned so thumb is directed downward Read to your child; label, describe and talk about pans pictures in the book Label items throughout the day especially when SUGGESTED ACTIVITIES Color with your child and teach him games out in the community Give your child choices whenever possible; ask Teach your child simple clapping games Play outdoors with water or sand box; play in- your child questions to help stimulate decision- Teach your baby what sounds animals make and doors with arts and crafts such as play-doh and making process practice by using an animal picture book paints Offer toys such as ride and pull toys, jack-in-the- Teach your child to throw and catch a ball Sing and dance to music; engage in finger play to box, music toys, and balls Teach your child about dangerous things; conse- rhymes and music Let your child scribble with thick washable cray- quences should be given for dangerous behavior Practice sorting, matching objects around the ons or markers after warnings home such as socks Encourage child to stack blocks and then knock Let your child make choices about food them down Reduce in-between snacks so he/she will be hun- WHEN TO BE CONCERNED Establish consistency with routines like meal- gry at mealtimes Does not make eye contact; does not respond to times and bedtimes name Sing, play music for, and read to your child regu- WHEN TO BE CONCERNED Does not use gestures to communicate such as larly Doesn’t point to objects when named pointing Teach your baby to imitate your actions, includ- Doesn’t spoon-feed and drink from cup inde- Doesn’t follow simple instructions; doesn’t use ing clapping your hands, blowing kisses, and play- pendently two-word sentences; doesn’t imitate actions or ing finger games Doesn’t stack 2-4 objects words Doesn’t copy others Can’t push a wheeled toy WHEN TO BE CONCERNED Doesn’t gain new words Repetitive movements with objects; repetitive Doesn’t point to objects that he wants Cannot walk movements or posturing of body, arms, hands, or Doesn’t spoon-feed and drink from cup inde- Doesn’t make eye contact fingers pendently Doesn’t use 2-word sentences Child seems more interested in objects than peo- Doesn’t stack 2-4 objects Experiences a dramatic loss of skills he/she once ple; does not show interest in other children Doesn’t make eye contact had Resists change in daily routine Does not respond to name Uses people as "tools" to meet their needs Cannot walk Spins objects, has odd play Doesn’t seem to know function of common Experiences a dramatic loss of skills he/she once household objects had Doesn’t respond to simple verbal requests; does- n’t have at least 5 words Experiences a dramatic loss of skills he/she once had Is Your Child on Track?

3 to 4 years old 4 to 5 years old 5 to 6 years old MILESTONES MILESTONES MILESTONES Can say name, age and sex Tells own age and full name Understands a few written words Stacks 9-10 blocks Interested in new experiences Draws a person with 6 recognizable parts Matches three colors Plays “mom” or “dad” Understands opposites; understands real and Points to pictures of common objects described Produces 4-6 word sentence; has vocabulary of make-believe by their use (e.g. “Show me what you eat with.”) about 2,000 words; speaks clearly Recites telephone number Understands between 800-1500 words; mean Asks for assistance when needed Plays group games following rules sentence length is 3.4 words Sings a song or says a poem from memory, i.e. Participates in conversations Understands most sentences “Wheels on the Bus” Understands concepts “yesterday/today” Follow instructions with 2 or 3 steps Follows directions and obeys authority figure; “before/after” “most/least” Starts asking “why”; understands “in,” “on,” and may increase misbehavior Identifies and counts up to 10 “under” Cooperates with other children; waits for turn Starts to print some letters of name Becomes more social; makes friends easily Sits quietly to listen to story/music Shares information about an event or story May show more fears (of dark, of monsters) Dresses and undresses; can lace shoes; brushes Answers “why” questions by giving reason Can take turns in games; starts sharing toys own teeth Puts on shirt and pants independently Changes activities when requested Wants to be independent Uses toilet independently Understands concept of “mine” and “his/hers” Is toilet trained and washes hands without help Can take shower or bath independently Eats on his own Catches ball with hands; rides bicycle with train- Cuts out shapes with scissors Stabs food with fork and brings to mouth ing wheels Throws ball 10 feet overhead Daytime control of toileting needs with occa- Walks up and down stairs alternating feet, with- Can do a somersault sional accidents out support Copies drawing a circle Holds crayon with thumb and finger; can copy a SUGGESTED ACTIVITIES Stands on one foot for 3 seconds; kicks a ball at square Use descriptive words and complete sentences least 6 feet; pedals tricycle to express thoughts and ideas Threads four small beads on string SUGGESTED ACTIVITIES Sort and count objects and identify written corre- Read aloud every day; tell stories that have inter- sponding number SUGGESTED ACTIVITIES esting characters; discuss the stories together Practice writing numbers and letters; practice Help child understand and ask questions Draw, finger-paint, cut and paste to help develop printing name Ask questions such as "Are you a boy?" motor skills; play with Legos and blocks Teach personal information such as age, phone Expand vocabulary; name body parts, and iden- Schedule weekly play dates or activities with number, and address tify what you do with them-- "This is my nose. I other children Give instructions that involve several simple di- can smell flowers.” Play with balls to throw, catch and kick rections in a row Use photographs of familiar people and places, Encourage development of large muscles by Read a story to the child and ask her/him what and retell stories of events allowing child to run, climb and swing on play- happened first, next and last Let your child help with cooking by pouring ingre- ground equipment. Give child simple tasks to do daily and praise dients and stirring things together Encourage independence in getting dressed, him/her for completion Cut and sort pictures from a magazine into cate- brushing his teeth and simple household chores Ask questions and engage child in conversation gories Encourage your child to use language to express about daily events Expand on social communication and storytelling ideas, and feelings Have child practice using scissors; cut out shapes skills and "acting out" Recite rhymes, poems and sing songs and objects in a magazine Practice writing letters and numbers Encourage independence and responsibility: give WHEN TO BE CONCERNED Use blocks, straws, sticks and other objects to child jobs like setting table, putting laundry away Frequent falling and difficulty with stairs make shape patterns etc. Persistent drooling or very unclear speech; can- not communicate in short phrases WHEN TO BE CONCERNED WHEN TO BE CONCERNED Cannot build a tower of more than four blocks Doesn’t follow simple instructions Shows extreme behavior (unusually fearful, ag- Cannot copy a circle by age 3 Doesn’t use 2-3 word sentences gressive, sad) No involvement in pretend play Doesn’t imitate actions or words Shows no interest in interactive games; does not Doesn’t understand simple directions Shows no interest in interactive games; does not interact with other children Little interest in other children interact with other children Still clings or cries when parents leave him Poor eye contact Still clings or cries when parents leave him Doesn't respond to people outside the family Extreme difficulty separating from mother or Ignores other children or doesn’t respond to Can’t tell what’s real and what’s make-believe primary caregiver people outside the family Can’t give first and last name Limited interest in toys; difficulty manipulating Can’t retell a favorite story Doesn’t draw pictures small objects Doesn't engage in fantasy or dramatic play Doesn't engage in fantasy or dramatic play Restricted and repetitive patterns of behavior or Appears to ignore speech; hears “only what he Appears to ignore speech; hears “only what he interests wants to” wants to” Unusual preoccupation with objects such as light switches, fans, spinning objects Experiences a dramatic loss of skills he/she once had