Developmental Milestones

AGE

GROSS MOTOR

FINE MOTOR
ADAPTIVE
Hands fisted
Grasp reflex
State-dependent
Ability to fix &
follow bright
object

PERSONAL
SOCIAL
Habitation and
some control of
state

SPEECH &
LANGUAGE
Cry
State-dependent
quieting and head
turning to rattle or
voice

COGNITIVE

Newborn

Flexor tone
predominates
In prone, turns
head to side
Automatic reflex
walking
Rounded spine
when held sitting

4 months

Head midline
Head held when
pulled to sit
In prone, lifts
head to 90 and
lifts chest slightly
Turns to supine

Hands mostly
open
Midline hand
play
Crude palmar
grasp

Recognizes
bottle

Circular
reaction, the
interesting
result of an
action motivates
its repetition

Maintains sitting
may lean on arms
Rolls to prone
Bears all weight;
bounces when
held erect
Cervical lordosis

Intermediate
grasp
Transfer cube
from hand to hand
Bangs objects

Differentiates
between
familiar person
and stranger
Holds bottle
Looks for
dropped object
Talks to mirror
image

Turns of voice
and bell
consistently
Laughs, squeals
Responsive
vocalization
Blows bubbles,
raspberries
Uses singlewords and doubleconsonant- vowel
combinations

7 months

Sensorimotor
0-24 months
Reflex stage

EMOTIONAL
Basic trust vs.
basic mistrust
(first year)
Normal
symbolic phase
does not
differentiate
between self
and mother
Lap baby,
developing a
sense of basic
trust

At 5 months
began to
differentiate
between mother
and self, i.e.,
beginning of
separationindividuation
Has a sense of
belonging to a
central person

10 months

14 months

18 months

Creeps on all
fours
Pivots in sitting
Stands
momentarily
Cruises
Slight bow leg
Increased
lumbar lordosis;
acute lumbosacral
angulation
Walks alone,
arms in high guard
or mudguard
Wide base,
excessive knee
and hip flexion
Foot contact on
entire sole
Slight valgus of
knees and feet
Pelvic tilt and
rotation

Pincer grasp,
mature thumb to
index grasp
Bangs two cubes
held in hands

Plays peek-aboo
Finger feeds
Chews with
rotary movement

Shouts for
attention
Imitates speech
sounds
Waves bye-bye
Uses mama
and dada with
meaning
Inhibits behavior
to no

Can retrieve
and object
hidden from
view

Piles two cubes

Scribbles
spontaneously
Holds crayon full
length in palm
Casts objects

Uses spoon
with over
pronation and
spilling
Removes a
garment

Uses single
words
Understands
simple commands

Differentiates
available
behavior
patterns for new
ends, i.e, pulls
rug on which is
a toy

Arms at low
guard

Emerging hand
dominance

Imitates
housework

Points to named
body part

Capable of
insight, i.e,

Practicing
phase of
separationindividuation,
practices
initiating
separations

Rapprochemen
t phase of
separationindividuation;
ambivalent
behavior to
mother
Stage of
autonomy vs.
shame and
doubt (1-3
years)
Issue of
holding on and
letting go
Pleasure in
controlling
muscles and
sphincters

2years

3 years

Mature
supporting base
and heel strike
Seats self in
chair
Walks backward
Begins running
Walks up and
down stairs alone
Jumps on both
feet in place

Runs well
Pedals tricycle
Broad jumps
Walks up stairs
alternating feet

Crude release
Holds crayon
butt end in palm
Dumps raisin
from bottle
spontaneously
Hand dominance
is usual
Building eightcube tower
Align cubes
horizontally
Imitates vertical
line
Places pencil
shaft between
thumb and fingers
Draws with arm
and wrist action
Irritates threecube bridge
Copies circle
Uses overhand
throw with
anteroposterior
arm and trunk
motion
Catches with
extended arms
hugging against
body

Carries, hugs
dolls
Drinks from
cup neatly

Identifies one
picture
Says no
Jargons

Pulls on
garment
Uses spoon
well
Opens door,
turning door
know
Feeds doll with
bottle or spoon
Toilet training
usually begun

Two-word
phrases are
common
Uses verbs
Refers to self by
name
Uses me,
mine
Follows simple
directions

Most children
toilet trained day
and night
Pours from
pitcher
Unbuttons;
washes and dries
hands and face
Parallel play
Can take turns
Can be
reasoned with

Three-word
sentences are usual
Uses future tense
Asks what, who,
where
Follows
prepositional
commands
Gives full name
May stutter in
eagerness
Identifies self as
boy or girl

solving a
problem by
mental
combinations,
not physical
groping

Preoperational
period (2-7
years)
Able to evoke
an object or
event not
present
Object
permanence
established
Comprehends
symbols

Preoperational
period
continues
Child is
capable of
deferred
imitation
symbolic play
drawing of
graphic images
mental images;
verbal

Stages of
initiative vs
guilt (3-5 years)
Deals with
issue of genital
sexuality

4 years

Walks down
stairs alternating
feet
Hops on one
foot
Plantar arches
developing
Sits up from
supine position
without rotating

Handles a pencil
by finger and wrist
action, like adults
Copies a cross
Draws a froglike
person with head
and extremities
Throws
underhand
Cuts with
scissors

5 years

Skips; tiptoes
Balances 10
secs. on each foot

Hand dominance
expected
Draws man with
head, body, and
extremities
Throws with
diagonal arm and
body rotation
Catches with
hands

Cooperative
play- sharing
and interacting
Imaginative
make- believe
play
Dresses and
undresses with
supervision
distinguishing
from and back of
clothing and
buttoning
Does simple
errands outside
of home
Creative play
Competitive
team play
Uses fork for
stabbing food
Brushes teeth
Is selfsufficient in
toileting
Dresses
without
supervision
except tying
shoelaces

Recognizes three
colors
Gives connected
account of recent
experiences
Questions why,
when, how
Uses past tense,
adjectives, adverbs
Knows opposite
analogies
Repeats four
digits

Fluent speech
Misarticulations
of some sounds
may persist
Gives name,
address, age
Defines concrete
nouns by
compositions,
classification, or
use
Follows threepart commands
Has number

evocation of
events

Stage of
industry (5
yearsadolescence)
Adjust
himself to the
inorganic laws
of the tool
world

6 years

Rides bicycle
Roller skates

7 years

Continuing
refinement of
skills

Prints alphabet;
letter reversals still
acceptable
Mature catch and
throw of ball

Teacher is an
important
authority to
child
Use fork
appropriately
Uses knife or
spreading
Plays table
games
Eat with fork
and knife
Combs hair
Is responsible
for grooming

concepts to 10
Shows mastery
of grammar
Uses proper
articulation

Period of
concrete
operational
through (7
yearsadolescence
Child is
capable of
logical thinking

Stage of industry
vs inferiority
continues

Primitive Reflexes
PRIMITIVE
REFLEXES
Palmar Grasp Reflex

STIMULULUS &
RESPONSE
S: Palm stimulate
R: All fingers except thumb
close

Moro Reflex

S: Suddenly but gently lower

babys head
S: Hit surface beside baby

DURATION

CONCERNS

5 months gestation to 4
months postpartum

No palmar grasp may

indicate neurological
problems (spasticity).

Prenatal to 4-6 months

postpartum

May signify CNS

dysfunction if lacking.
May signify sensory

OTHERS
One of the most noticeable
reflexes.
May lead to voluntary reaching
or grasping.
Reaction time increases with
age

R: Arms and legs extend

Sucking Reflex
Searching Reflex

Asymmetric Tonic
Neck Reflex

Symmetric Tonic Neck

Reflex

Plantar Grasp Reflex

Babinski Reflex

S: Touch of lips
R: Sucking action
S: Touch cheek
R: Head moves toward
stimulus

In utero to 3 months
postpartum
Weeks prenatal to 3
months postpartum

S: Prone/supine, turn head to

one side
R: Limbs flex on one side,
extend on the other
S: Baby sitting up and tip
forward
R: Neck and arms flex, leg
extends
S: Baby sitting up and tip
backward
R: Neck and arms extend, legs
flex
S: Touching the ball of the foot
R: Toes grasp
S: Stroke bottom or lateral
portion of the foot
R: Great toe turns extension

After birth 3 months

After birth 3 months

Birth 1 year
Birth 4 months

motor problem if
persists.
May delay sitting and
head control if persists.
May indicate injury to
one side of the brain if
assymetrical.
No reflex: problem for
nutrition
No reflex: problem for
nutrition
No reflex or lack of
persistence: sign of CNS
or sensorimotor
dysfunction
Facilitates bilateral body
awareness
Facilitates hand-eye
coordination
Persistence may impede
many motor skills and
cause spinal flexion
deformities

Often in conjunction with

searching reflex
Often in conjunction with
sucking reflex.
Contributes to head/bodyrighting reflexes

Also called Bow and Arrow

or Fencers Position

Must disappear before the baby

can stand or walk

Palmar Mandibular
Reflex

Palamr Mental Reflex

S: Pressure to both palms or

hair to hand
R: Eyes close, mouth opens,
and/or neck flexes (which tilts
the head forward)
S: Scratch the base of palm
R: Lower jaw opens and closes

Birth 3 months

Also called the Babkin Reflex

Birth 3 months

Postural Reflexes
POSTURAL
REFLEES
Stepping Reflex

STIMULUS &
RESPONSE
S: Infant upright with feet
touching the surface

Crawling Reflex

S: Prone position on
surface, stroke alternate
feet
R: Legs and arms move in
crawling position
S: Infant held horizontally
R: Arms and legs move in
coordinated swimming type
action
S: Supine, turn body in
either direction
R: Head rights itself with
the body
S: Supine, turn head in
either direction
R: Body rights itself with

Swimming Reflex

Head-and-Body
Righting Reflex

DURATION

CONCERNS

After birth to 5-6

months

Essential forerunner to
walking

Birth to 3-4 months

Precursor to later voluntary

creeping

2 weeks after birth

5 months

Recognition of reflex led to

popularity of infant swim
programs

Head: 1 6 months
Body: 5 months 1
year

Related to voluntary rolling

movements

OTHERS
Sometimes called Walking
Reflex
Developmental changes in reflex
over time

Parachuting Reflex

Labyrinthine Reflex

Pull-up Reflex

the head
S: Off balance in upright
position
R: Protective movement in
direction of fall
S: Baby held upright, tilted
in one direction
R: Baby tilts head in
opposite direction
S: Sitting/standing. hold
hands, tip in one direction
R: Arms flex or extend to
maintain upright posture

4 months 1 year

2-3 months 1 year

Assessed in preterm babies

as markers of neurological
development.
Related to upright posture.
Related to upright posture

3 months 1 year

Related to upright posture

Also called propping reflex.

Occurs downward, sideways and
backward.
Also considered as a primitive
reflex