developmental milestones and red flags
DESCRIPTION
developmental milestones from 1 month up to 12 years of age. red flags from 1 month up to 5 years.TRANSCRIPT
CASTRO, Kevin Cedrick R. 2010-06974
B SE – CA-English and SPED EDSP 102
Developmental Milestones and Disabilities that Can Affect the Individual’s Development
Age
Physical
Cognitive Language Social/Emotional Self-help
Fine Motor Skills Gross Motor Skills
0 month
Purposeful grasp Transfer objects from hand to hand Plays with fingers, hands and toes Holds and manipulates objects; sucks on everything! Can grab at objects (by 6 months) Can smile at self in mirror (by 5 months)
Head at 90 degree angle, uses arms to prop Visually track through midline Roll over Head lag disappears Plays with feet Exercises body by stretching, moving Touch genitals, rock on stomach for pleasure Usually responds to objects or faces as they move Reacts to sound of voices, rattle or bell
Listens attentively to sounds and voices (by 1 month) Cries deliberately for assistance (by 1 month) Coordinates eye movements (by 2 months) Discovers hands and feet as extension of self (by 3 months) Likes to repeat enjoyable acts (by 4 months) Recognizes and responds to name (by 5 months) Studies objects intently (by 6 months)
Reacts to loud sounds Calms down or smiles when spoken to Recognizes your voice and calms down if crying When feeding, starts or stops sucking in response to sound Coos and makes pleasure sounds Has a special way of crying for different needs Smiles when he or she sees you
Reacts to discomfort and pain Recognizes parent’s voice Makes eye contact Shows affection by looking, waving, kicking and smiling Shows feelings of security when held or talked to Expresses delight May form attachment to one special object Laughs when tickled Builds trust when cries are answered
Can coordinately suck when they are breastfeeding or drinking formulae milk through a nipple artificial
1 month
2 months
Has already been able to open their mouth when see breast or nipple artificial
3 months
Show their interest or enthusiasm feeling when seeing mother’s breast (ASI) or nipple artificial
4 months
Follows sounds with his or her eyes Responds to changes
Start to place their toys into their mouth
5 months
Vocalizes to him/herself, people and toys Can raise him/herself up on forearms (while on tummy) and hold head up Rolls from back to tummy (by 4-6 months)
in the tone of your voice Notices toys that make sounds Pays attention to music Babbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m Laughs Babbles when excited or unhappy Makes gurgling sounds when alone or playing with you
May begin to cling to primary caregiver
Put their both hands on mother’s breast or bottle when milk-feeding.
6 months
Able to hold their bottle by themselves. Able to feed themselves by using their thumb and finger tips. Start to be able to hold the spoon and try to feed themselves. Drink water or milk from the covered cup or directly drink it from the open cup by sips via the edge of the cup.
7 months “Raking” with hands Finger-thumb opposition Eye-hand coordination, but no hand preference Transfers toys from hand to hand
Sits in “tripod” Push head and torso up off the floor Support weight on legs Gets to and from sitting Crawls, pulls to standing
Anticipates events (by 7 months) Finds hidden objects (by 10 months) Can point to body parts Puts nesting toys together correctly Develops expectations about familiar events
Enjoys playing peek-a-boo and pat-a-cake Turns and looks in the direction of sounds Listens when spoken to Understands words for common items such as “cup,” “shoe,” or “juice”
Enjoys being near people and played with No longer smiles indiscriminately Responds gaily to play interactions with others Cries, smiles, kicks, coos, laughs to attract social attention
8 months
9 months
Stooping and recovering Learns to crawl, stand up and walk Sits without support (by 8 months) Sees almost everything with good vision Begins to cruise and eventually walk
Waves bye-bye
Responds to requests (“Come here” or “Want more?”) Babbles using long and short groups of sounds (“tata, upup, bibibi”) Babbles to get and keep attention Communicates using gestures such as waving or holding up arms Imitates different speech sounds Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday
Responds differently to strangers (stranger anxiety by 8 months) Shouts for attention (by 8 months); rejects confinement Cries if other child cries
10 months
Pays attention to his/her own name Recognizes different tones of voice and responds Able to interpret the emotional expression of familiar adults Copies simple actions of others Recognizes himself as an individual apart from mother Learning to cooperate; shows guilt at wrongdoing Actively seeks to maintain interactions with adult
11 – 11.9 months
Displays separation anxiety when apart from mother Tries to alter mother's plans through persuasion or protest Teases and tests parental limits Can demonstrate affection Discriminates positive and negative attention
1 – 1.6 year
Picks up small objects with pointer finger and thumb Turns pages in a book Can build a tower of cubes
Can throw a ball Walks well Can walk while holding an object More complex motor skills
Identifies family members in photographs Enjoys cause and effect-relationship Is able to make choices between clear alternatives Begins to solve problems Remembers more
Knows a few parts of the body and can point to them when asked Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”) Enjoys simple stories, songs, and rhymes Points to pictures, when named, in books
Prefers to keep caregiver in sight while exploring environment Demands personal attention May reveal stubbornness Unable to share Responds to simple requests
Eating
Feed him/herself with a spoon.
Hold a cup by the handles.
Drink from a cup, with little spilling.
Play with food.
1.6 – 2 years Can draw scribbles
Kicks backward and forward Stands on a balance beam Walks up stairs with help; learns to climb up stairs first, then down Runs well Enjoys riding small-wheeled riding toys
Sorts shapes and colors Mimics adult behavior Points to and names objects Refers to self by name Learns by helping Learns concepts such as size, shape and weight as he/she moves and plays with objects in the environment.
Acquires new words on a regular basis Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”) Puts two words together (“More cookie” or “No juice”) Uses many different consonant sounds at the beginning of words
Is possessive Begins to show empathy Reveals a sense of trust Begins to play next to children Shows emotions of pride and embarrassment May dawdle Engages in imaginative play Tests limits of behavior Performs for an audience
Suck from a straw.
Begin to chew food with mouth closed.
Give up nursing or drinking from a bottle near the age of two years.
Drinks from a straw
Dressing
Take off hat.
Take off socks.
Take off shoes when the laces are undone.
Unzip large zippers.
Grooming
Enjoy trying to brush teeth.
Wash and dry hands with help.
Household
Help with simple
2 – 2.6 years
Improving fine motor skills and eye-hand coordination: cut with scissors, draw shapes Strings large beads Holds scissors
Rule of Three: 3 yrs: 3 ft, 33 lbs. Weight gain: 4-5 lbs per year Growth: 3-4 inches per year Physically active,
Comprehends size Beginning to understand time sequences (e.g. before lunch) Matches shapes and colors
Has a word for almost everything Uses two- or three-word phrases to talk about and ask for things Uses k, g, f, t, d, and n sounds
Has a strong sense of ownership May begin cooperative play May show need for security object Is becoming more
2.6 – 3 years
correctly Zips and snaps
can’t sit still for long Clumsy throwing balls Refines complex skills: hopping, jumping, climbing, running, ride “big wheels” and tricycles Walks backwards Can balance on one foot (by 3 years) Learns to use the potty, most are toilet-trained Walks up and down stairs independently
Counts and manipulates objects Is beginning to think about consequences Is able to concentrate for longer periods of time
Speaks in a way that is understood by family members and friends Names objects to ask for them or to direct attention to them
independent household tasks
Push and pull doors open and shut.
3 – 3.9 years
Hears you when you call from another room Hears the television or radio at the same sound level as other family members Answers simple “Who?” “What?” “Where?” and “Why?” questions Talks about activities at daycare, preschool, or friends’ homes Uses sentences with four or more words Speaks easily without having to repeat syllables or words
Completely undresses self Independently puts on socks, coat, sweater, pants Manipulates large buttons and snaps Eats entire meal independently Uses a spoon and fork effectively Can pour liquid with some assistance Washes hands unassisted Learns toilet training Wipes nose unassisted
4 – 4.9 years
Can catch a beanbag Can copy a simple design Uses scissors to cut a straight line
Can hop on one foot, skip and jump Can catch a ball with both hands
Comprehends special concepts (e.g. around, in front, high, next to) Rote counts up to 20 Can complete a 6-8 piece puzzle Begins to understand time concepts Understands simple math concepts Recalls main details of a story
Pays attention to a short story and answers simple questions about it Hears and understands most of what is said at home and in school Uses sentences that give many details Tells stories that stay on topic Communicates easily with other children and adults Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th) Uses rhyming words Names some letters and numbers Uses adult grammar Uses possessives Uses double negatives Joins sentences
Enjoys being with other children Has an increased drive for independence Expresses anger more dramatically Is aware of social approval or disapproval Performs for others Has pride in personal accomplishments Develops sex role identification Begins taking turns and negotiating
Can cut with a knife independently Can put shoes on right feet; tie shoes Knows clothing front from back Toileting – fully independent Brushes teeth independently Buttons front buttons Feeds self with fork (held with fingers). Zips separating front zipper.
5 – 5.9 years
Follows up to 4 step directions Uses third person Tells simple jokes Has a 2000 word vocabulary
6 years Ties shoe laces. Learns to skip with rope.
Draws with precision and to detail. Developing reading skills well. May write independently.
Fluent speech. Can pronounce majority of the sounds of his/her own language. Talk fluently and with confidence.
Stubborn and demanding Eager for fresh experiences May be quarrelsome with friends.
Able to perform and complete routine chores such as sweeping floors or cleaning desks with much more accuracy
Enjoys many activities and stays busy
Likes to paint and draw
Can already eat by him/herself
Bathe all by himself
7 years
Hand-eye coordination is becoming even more refined Able to write and draw with control and precision
Grows 2 to 2.5 inches Can perform more difficult movements such as standing in one place while twisting, turning, or spinning Can combine motor skills such as running and kicking a ball (such as in soccer) or performing dances to music
More interested in complicated projects because they have greater attention span
Uses serious,
logical thinking;
Is thoughtful and
reflective
Able to understand
reasoning and
Uses a vocabulary of several thousand words Begins to grasp that letters represent the sounds that form words
Desires to be
perfect and is quite
self-critical
Worries more; may
have low self-
confidence
Tends to complain;
has strong
emotional reactions
Understands the
difference between
Able to ride a bicycle without training wheels
make the right
decisions
Can tell time;
knows the days,
months, and
seasons
Can describe
points of similarity
between two
objects
Able to solve more
complex problems
Individual learning
style becomes
more clear-cut
right and wrong
Takes direction
well; needs
punishment only
rarely
Avoids and
withdraws from
adults
Is a better loser
and less likely to
place blame
Waits for her turn
in activities
Starts to feel guilt
and shame
8 years old
Finger control is
quite refined
Stamina increases
Can run and swim
further
Seeks to
understand the
reasons for things
Begins to feel
competent in skills
and have
preferences for
some activities and
Can converse at an almost adult level
Reading may be a
major interest
Has strong need
for love and
understanding,
especially from
mother
Can be helpful,
cheerful, and
pleasant as well as
Dresses and grooms self completely Can use tools (i.e., hammer, screwdriver) Can already eat by himself/herself Can do almost all
subjects
Thinking is
organized and
logical
Begins to
recognize concept
of reversibility
(4+2=6 and 6-2=4)
rude, bossy, and
selfish
May be quite
sensitive and
overly dramatic
Emotions change
quickly
Impatient; finds
waiting for special
events torturous
Makes friends
easily; develops
close friends of
same sex
Favors group play,
clubs, and team
sports; wants to
feel part of a group
More influenced by
peer pressure
Can be obsessed
with, and motivated
by money
household chores Bathe all by himself
9 years old
Have stronger and
smoother muscle
control,
May experience
the beginnings of
puberty.
May also be more
susceptible to
body image
issues. Increased coordination Pushes self to physical limits Fatigues easily Numerous injuries Somatic complaints Tension outlets such as nail-biting, hair-twisting, lip-pursing
Are incredibly
curious about the
world around them,
and may want to
research topics that
interest them.
Have longer
attention spans and
will tend to spend
lots of time on
activities and
subjects that they
are excited about.
Able to think
critically, and may
want to share their
opinions about
things.
Read and write
increasingly more
complicated texts
Learn how to work
with multiple digits,
geometry, and data
organization in
math.
Growth of Language Patterns Used:
Descriptive
Loves vocabulary and language play and information
Baby-talk sometimes re-emerges
Use of hyperbole
Age of negatives; “I hate it”, ”I can’t”, “boring”, “yeah right”
Dirty jokes
Graffiti
Are more
emotionally mature
Are better able to
handle conflicts
and frustrations.
More independent,
and will be
emotionally more
ready to socialize
without their
parents (such as at
sleepovers at
friends' houses).
Have a strong
desire to belong to
a group and to fit
in, and may be
more susceptible to
peer influence and
peer pressure
May be more
moody and feel
more stress and
pressure, and will
rely upon the
support and love
provided by
parents.
10 years old Handwriting often sloppier than at nine
Large muscle development Needs outdoor time and physical challenge Snacks and rest periods helpful for growing bodies
Memorizing details
productively
Increased ability to
abstract
Likes rules and
logic
Classification and
collections of
interest; likes to
organize
Able to
concentrate, read
for extended
periods
Good problem
solvers
Proud of Academic
products
Good listeners, actively receptive Voracious readers Expressive, talkative, like to explain
Fairness issues peak and can be solved Quick to anger – quick to forgive Generally content Works well in groups Enjoys both family and peers Likes clubs, sports, and activities Usually truthful; developing more mature sense of right and wrong, good at solving social issues Cooperative and competitive
Can accomplish tasks in a shorter time due to longer attention span Can do all things by him/herself Can discriminate dangers when engaging in an activity
11 years old Fine motor capability is good
Vast appetite for food and physical activity Growth spurt of early adolescence for some girls Constant motion; restless More illness: colds, flu, ear infections Need for more sleep Physical aggression not uncommon
Prefers new tasks and experiences to reflection or revision of previous work Able to abstract Deductive reasoning advances Can establish and modify rules, develop hypotheses Increased ability to de-center and see world from various perspectives Loves to argue
Impulsive – talks before thinking Can be cruel or harsh with words Argumentative; debater Appreciates humor Imitates adult language
Moody; sensitive Oppositional; tests limits Often does best away from home Impulsive; rude; unaware Loves to argue Difficulty with decisions Self-absorbed Extremes of emotion Inclusion/exclusion; height of cliques; seeks to belong
12 years old
High Energy
Much Rest needed
Growth spurt:
signs of puberty
Menstruation for
majority of girls
Food important,
Increased ability to abstract in intellectual pursuits May show emerging ability in a particular skill or content area Can and will see both sides to an argument High interest in current events, politics, social
Sarcasm emerges Double meanings, word play, jokes of intellectual interest Enjoys conversation with adults and peers Peer “vocabulary” (slang) important
Adult personality begins to emerge More reasonable, tolerant than at 11 Enthusiastic, uninhibited Will initiate own activity Empathetic
especially mid-
morning in school
Physical education
and sports valued
justice; also pop culture, materialism Research and study skills advance with increase of organizational discipline
Self-aware, insightful Can set realistic goals in the short term Appears secure Peers more important than teachers and parents
References:
http://www.parentingme.com/1yrshelp.htm
http://childparenting.about.com/od/physicalemotionalgrowth/tp/Child-Development-Your-Nine-Year-Old-Child.htm
http://childparenting.about.com/od/physicalemotionalgrowth/tp/Child-Development-Your-Nine-Year-Old-Child.htm
http://www.child-development-guide.com/child-development-milestone.html
http://childparenting.about.com/od/physicalemotionalgrowth/a/Your-7-Year-Old-Child-Physical-Development.htm
http://www.greatschools.org/special-education/health/731-developmental-milestones-your-7-year-old-child.gs
http://www.greatschools.org/special-education/health/903-developmental-milestones-your-8-year-old-child.gs
Red Flags for the Development for Each Area until Age 5
Age Physical
Cognitive Language Social/Emotional Self-help Fine Motor Skills Gross Motor Skills
1 month
2 months
3 months Persistent fisting (hypertonia)
Rolling prior to 3 months (hypertonia)
4 months
5 months
6 months
Hands frequently clenched (motor, visual, and/or cognitive deficits, neuromuscular disorder)
Not reaching for and holding (grasping) toys (motor, visual, and/or cognitive deficits)
Not rolling
Not holding head and shoulders up when on tummy
(neuromuscular or neuromotor disorders)
No visual tracking (visual impairment)
No response to sounds (hearing impaired)
Not beginning to repeat actions to elicit pleasurable results
Avoids close contact or cuddling
Inconsolable at night
Difficult self soothing/regulating
Doesn't attempt to attract attention
No interest in games like peek-a-boo
Not starting to babble (hearing deficit)
Does not smile or squeal in response to people (visual loss, attachment problems, maternal depression)
7 months W-sitting and bunny hopping (spasticity or hypotonia)
Absent stranger anxiety
8 months
9 months Unable to hold and/or Not sitting without No gestures (e.g. pointing, showing,
Not sharing enjoyment with others using eye
release toys
Cannot move toy from one hand to another
Persistence of primitive reflexes (neuromotor disorders)
support
Not moving (e.g. creeping, crawling)
Does not take weight well on legs when held by an adult
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
waving)
Not using 2-part babbles (e.g. mama, dada)
contact or facial expressions (autism, vision impairment)
10 months
Not sitting independently
Not crawling ("commando" crawling--moving across the floor on his belly)
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
Inability to localize sound (unilateral hearing loss)
11 months
12 months
Majority of nutrition is still puree/liquid
Cannot chew solid food
Unable to pick up small items using index finger and thumb
Not creeping (on all fours, what is typically called "crawling")
Not sitting upright in a child-sized chair
Not pulling to stand
Not crawling or bottom
Doesn't search for hidden/removed objects (intellectual disability)
Continues to problem solve using repetition actions rather than trial and error (intellectual
No babbled phrases that sound like talking (
No response to familiar words (articulation disorder)
Not performing for social attention (autism, sensorial disorders)
Does not notice someone new (intellectual disability, autism, sensorial
shuffling
Not standing holding on to furniture
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
disability, learning disability)
Not anticipating effects of actions (knocking over blocks) (intellectual disability, learning disability, autism, ADHD)
Not using toys for intended purposes functional play (intellectual disability)
Not showing interest in children her age (autism,behavioral problems)
Extreme difficulty waiting for desired item (ADHD)
Rigidity regarding routine, food items, clothing, etc. (autism)
Limited or fleeting eye contact (communication disorder, autism)
Persistent mouthing of objects (intellectual disability)
impairment)
Does not play early turn-taking games (autism)
13 months
14 months Not standing alone (neuromuscular
Not feeding him/herself
disorders) finger foods
15 months
Not imitating body action on a doll (i.e., kiss the baby, feed the baby) (visually impaired, autism, intellectual disabilities)
Lack of consonant production (mild hearing loss, production problems)
Does not use at least 3 words (hearing impaired, intellectual disability)
Not attempting to use a spoon
Not picking up and drinking from a regular open cup
Not able to pull off hat, socks or mittens on request
16 months Lack of imitation (hearing loss, cognition problems, autism)
17 months
18 months
Not holding or scribbling with crayons (dysgraphia, intellectual disabilities)
Does not attempt to tower blocks (behavioral problems, intellectual disabilities)
Hand dominance (contralateral weakness)
Not attempting to walk without assistance
Not standing alone
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
Doesn't understand function of common objects (intellectual disability)
Continues to mouth or use sensory/exploratory tactics to play (intellectual disability)
Constantly moving from one item to another/inability to attend for brief periods (ADHD)
Requires constant attention to remain engaged (ADHD)
Lack of protodeclarative pointing (problem in social relatedness)
No clear words (articulation disorder, hearing impairment)
Cannot understand short requests (intellectual disability, hearing impairment, receptive disorders)
Does not say mama, dada or other names (articulation disorder, hearing impairment, intellectual disability)
Lacks interest in playing and interacting with others (autism, behavioral problems)
19 months Not attempting to wash own hands or face
20 months
21 months
22 months
Advanced noncommunicative speech (echolalia) (autism)
Not assisting with dressing tasks (excluding clothes fasteners)
23 months
24 months
Inability to walk up and down stairs
Unable to run
Unable to throw a ball
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
Does not have at least 50 words, and use at least 25 (intellectual disabilities)
Not putting words together, e.g. push car
Most of what is said is not easily understood
(communication disorders, receptive, production and articulation problems)
Not imitating actions and movements (autism)
Not engaging in pretend play (autism)
Not showing interest in children her age (autism, behavioral problems)
Extreme difficulty waiting for desired items (ADHD)
Too passive (autism, inert behavioral problems)
No interest in self-care skills, e.g. feeding, dressing
25 months
26 months
27 months
Not able to match two sets of objects by item (i.e., blocks in one container and people in another) (intellectual disability, learning
disability)
Not able to imitate a model from memory (i.e., show me how you brush your teeth) (intellectual disability, autism, ADHD)
28 months
29 months
30 months
Not jumping (neuromuscular disorders)
Not independent on stairs (up and down) (neuromotor or neuromuscular disorders)
No 2-word spontaneous phrases
31 months
Not able to match two sets of objects by color (visual impairment, intellectual disability, down syndrome)
32 months
33 months
34 months Not able to deliberately undo large buttons, snaps and shoelaces
35 months
3 years Difficulty manipulating small objects e.g.
Not running well
Cannot kick or throw a
Not demonstrating simple categorization
Speech difficult to understand
Extreme difficulty separating from parent
Difficulty helping with self-care skills (e.g.
threading beads (cerebral palsy, dysgraphia)
ball
Cannot jump with 2 feet together
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
(learning disability, intellectual disabilities)
Not using simple sentences e.g. big car go
Does not ask by name for objects
Repeats phrases in response to questions
Not initiating or reciprocating simple interactions with children her age
Abnormal aggression
Not interested in pretend play
Difficulties in noticing and understanding feelings in themselves and others
feeding, dressing)
4 years
Unable to use pencils in scribbling or drawing (dysgraphia, intellectual disabilities)
Cannot pedal a tricycle
Cannot catch, kick or throw a ball
Cannot balance well standing on one leg
for all included here (neuromuscular or neuromotor disorders, cerebral palsy)
No understanding of time, or recognizing concepts like "yesterday" and "next summer" (dyscalculia, intellectual disability)
Unable to draw lines and circles (dysgraphia, intellectual disability)
Speech difficult to understand
Unable to follow direction with two steps
Unable to play games with other children and agree to rules
No spontaneous singing, dancing, or acting
Unwilling to play cooperatively
Not toilet trained by day
5 years Cannot draw simple pictures (dysgraphia, intellectual disabilities)
Awkward when running, walking, climbing, and using
Cannot answer questions in a simple conversation (articulation disorders, receptive
disorders)
Play is different than their friends (autism)
Unable to dress him or herself
Unable to go to the
stairs (dyspraxia, physical impairment)
Ball skills are very different from other peers (neuromuscular
Unable to hop 5 times on each foot
Unable to follow the rules of a simple game (behavioral problems, intellectual disabilities)
Cannot draw simple pictures (dysgraphia,
Concerns from teacher about school readiness
Difficulty telling a parent what is wrong
bathroom without assistance
Unable to help with simple chores
Any age
Difference between left and right sides of body in strength, movement, or tone (cerebral palsy)
Loose or floppy movements (low tone) or stiff and tense (high toe) (dyspraxia, cerebral palsy)
Lack of response to sound or visual stimuli (sensorial impairments)
Lack of or limited eye contact (autism, visual impairment) all from self-help
(intellectual disabilities, autism, neuromotor or neuromuscular disorders, or lack of training from caregivers)
Poor interaction with adults or other children (behavioral problems, autism)
Strong parental concern
Significant loss of skills
Not achieving indicated developmental milestones
References:
http://www.fpnotebook.com/Peds/Neuro/DvlpmntlMlstn.htm
http://www.earlyinterventionsupport.com/development/cognitive/default.aspx
http://www.uic.edu/classes/sped/sped506/milestones.html
http://www.sensory-processing-disorder.com/child-developmental-checklist.html
http://www.health.qld.gov.au/rch/professionals/brochures/red_flag.pdf