Child Development Milestones

#Child Development Milestones (0-6 years) Note: The milestones here are average ones; there is wide variation in what is normal. Premature birth should also be taken into consideration when assessing development. Initial assessment: 1. History - "red flags": (-) Prematurity (<28/40 or <1500 g). (-) Developmental regression (loss of previously acquired skills). (-) Chromosomal abnormality, dysmorphism, hearing or vision problems. (-) Major psycho-social family risk factors. (-) Left/right differences with respect to strength, movement or tone. (-) Lack of response to sound or visual stimuli. (-) Lack of, or limited, eye contact. (-) Abnormally low (floppy) or high (tense) muscle tone. (-) Strong parental concerns. Comment on any (+) answers: 2. Physical examination: (-) Normal growth parameters (percentiles). (-) Normal neurological examination (in particular vision and hearing). (-) Normal observations during play (where appropriate, with blocks, books, puzzles, drawing instruments, other children). Comment on any abnormalities: TYPICAL MILESTONES AND "RED FLAG" CYCLES CHECKLISTS: (Comments for any responses out of range) 0-6 WEEKS - typical milestones: (+) Primitive reflexes present. (+) Smiles. Comments: 6-8 WEEKS - typical milestones: (+) Vocalises - "ooo", "aah". Comments: 9-12 WEEKS - typical milestones: (+) Holds head up when prone. (+) Grasp reflex disappears. (+) Holds hands open (not fist) most of the time. (+) Follows object with eyes. (+) Turns head to sound. (+) Squeals/laughs. (+) Imitates vowel sounds. Comments: 20 WEEKS - typical milestones: (+) Holds head steady. (+) Turns to voice. (+) Reaches for and grasps objects. (+) Takes objects to mouth. (+) Vocal play. Comments: 6 MONTHS - typical milestones: (+) Pulls self up to sit. (+) Sits up with support. (+) Rolls over. (+) Bears weight on legs with support. (+) Transfers from hand to hand. (+) Babbles. (+) Stranger shyness. Comments: 9-10 MONTHS - typical milestones: (+) Sits unsupported. (+) Crawls. (+) Double syllable sounds - "mumum" / dada (no meaning). (+) Pincer grip. (+) Looks for dropped toys. (+) Stranger apprehension. (+) Bladder control (dry during day): 8 months - 2 years. Comments: 12 MONTHS - typical milestones: (+) Stands up holding on. (+) Stands alone 1-2 seconds then collapses. (+) Babbles 2-3 words. (+) Waves goodbye. (+) Understands several words. (+) Bladder control (dry during day): 8 months - 2 years. Comments: 18 MONTHS - typical milestones: (+) Walks alone. (+) Can reach and pick up while standing without falling. (+) Up and down stairs holding rail. (+) Throws objects (ball). (+) Can sit on small chair. (+) Climbs furniture. (+) Can speak 10-25 intelligible words. (+) Can point to named objects (eg people, body parts). (+) Can build 2-4 cube tower. (+) Uses spoon to feed. (+) Holds and drinks from cup. (+) Demands parental attention. (+) Bowel control (18 months - 4 years). (+) Bladder control (dry during day): 8 months - 2 years. Comments: 2 YEARS - typical milestones: (+) Runs and jumps. (+) Can build 6 cube tower. (+) Forms 2-3 word sentences. (+) Knows 50+ words. (+) Knows and says own first name. (+) Uses pronouns (me, I , you). (+) Able to name body parts. (+) Parallel play (shows interest but does not interact with other children; plays independently). (+) Bowel control (18 months - 4 years). (+) Bladder control (dry during day): 8 months - 2 years. Comments: 3 YEARS - typical milestones: (+) Stairs - up 1-foot per step, down 2-feet per step. (+) Draws - copies circle, can draw man if asked. (+) Can build 9 cube tower. (+) Asks many questions. (+) Speaks in sentences. (+) Interactive play. (+) Can undress self. (+) Imaginary companions. (+) Bowel control (18 months - 4 years). Comments: 4 YEARS - typical milestones: (+) Stairs - down 1-foot per step. (+) Dresses self with assistance. (+) Uses toilet independently. (+) Fluent speech with many infantile substitutions. (+) Asks many questions. (+) Bowel control (18 months - 4 years). Comments: 5 YEARS - typical milestones: (+) Skips on both feet. (+) States age. (+) Fluent speech with few infantile substitutions. (+) Dresses without help. (+) Copies a triangle. Comments: 6 YEARS - typical milestones: (+) Knows left and right. (+) Counts fingers. (+) Fluent speech with no infantile substitutions. (+) Copies a diamond. Comments:

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External links

• Australian Early Development Index aedi.org.au
• Oberklain F, Drever K. Is my child normal? Milestones and red flags for referral. Aust Fam Physician 2011;40: 666-670 racgp.org.au/afp/201109/43835
• Parents' Evaluation of Developmental Status (PEDS) rch.org.au

References

1. Australian Early Development Index [http://www.rch.org.au/aedi/]
2. Is my child normal? Milestones and red flags for referral [http://www.racgp.org.au/afp/201109/43835]
3. Parents' Evaluation of Developmental Status (PEDS) [http://www.rch.org.au/ccch/rePLETED