Normal Developmental Milestones
Robin K Blitz, MD
Motor Milestones
Gross Motor
1 month
2 months
Head up, Prone to chin
Head up, Prone to chest
3 months
Head up, Props to forearm
4 months
Head up, props to wrist; roll prone to supine
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
13 months
15 months
16 months
Roll supine to prone; sits supported (tripod)
Sits alone
Creep (combat crawl)
Come to sit; quadruped crawl; pull to stand
Cruise
18 months
20 months
21 months
24 months
30 months
36 months
Stand alone; walk with one hand held
Walk alone
Climbs stair on hand and knees
Gets into standing without support
Walk upstairs with help, marking time
Beginning to jump; throws ball; seats self in
chair
Walks carrying large objects or pushing toy;
runs stiffly; climbs
Walks upstairs alone, marking time; creeps
down backwards; squats
Walks up and down stairs alone, marking
time; walks backwards; runs; kicks ball
Jumps w/both feet; walks on tiptoes; picks
up object
Upstairs alternating feet; downstairs marking
time; gallops; tricycle; jumps from bottom
step with feet together; stands on one foot
for seconds
Fine Motor
Hands mostly fisted; grasp reflex
Hands 50% open
Hands 75% open; grasp reflex gone;
voluntary grasp
100% un-fisted; manipulates fingers; holds
toy > 15 seconds
Pulls down ring; transfers; reaches for toy
Obtains cube; lifts cup; radial rake
Attempts pellet; pulls out peg; finger feeds
Pulls ring by string; secure pellet
3 finger grasp; bangs toys together
Fingers pegboard; pincer grasp
Mature pincer; takes covers off of boxes
Release cube; crayon mark
Scribbles in imitation
Scribbles spontaneously
Three cube tower; uses spoon well
Unscrews lid; turns doorknobs; turns pages
in book; strings large beads
Holds pencil in hand instead of fist;
horizontal and vertical stroke with pencil
Closes fist and wiggles thumb; folds paper
along dotted line; good wrist rotation; snips
with scissors; copies circle; imitates cross
©2013RobinKBlitz
Normal Developmental Milestones
Robin K Blitz, MD
Language Milestones
Receptive
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
14 months
16 months
18 months
21 months
24 months
30 months
36 months
Alters to sound
Orients to voice
Orients to bell laterally
Expressive
Range of cries
Social smile
Coos
Laughs aloud
“ah-goo” razzes
babbles
Orients up/indirect
“dada”, “mama” inappropriately
Orients up/direct, Bye, peek-a-boo,
pat-a-cake,
Understands No
1-step command w/ gesture
1-step command w/o gesture
Body parts; points to 1 picture
Points to 2 pictures
2-step command
Concept of 1; points to 7 pictures
2 prepositional commands
“dada”, “mama” appropriately
1 other word
2 word vocabulary
3 word vocabulary; imitation; jargon
4-6 work vocabulary
7-10 words; mature jargon
20 words; 2 word phrases
50 words; pronouns inappropriate
Pronouns appropriate
250 words; 3 digits; tells age, sex, full name
Self-Help/Self-Awareness Milestones
Birth
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
12 months
15 months
18 months
24 months
30 months
36 months
Sucks and swallows liquids; roots
Pulls at clothing; gazes at own hand
Plays with own hands; comforts self by thumb-sucking or finding pacifier; may eat food from spoon
Holds onto side of tub; plays with own foot; objects to mouth; holds objects voluntarily
Splashes in tub; closes eyes to washcloth; drinks from cup when held to lips; holds bottle
Discovers genitals; feeds self biscuit; chews
Chews small lumps
Removes bottle and replaces it
Finger feeds meal
Holds cup; cooperates in dressing
Takes shoes off; chews table food; uses spoon, may rotate near mouth
Spoon and cup well; takes off socks, unzips; identifies body parts; pull on simple garments; pulls up pants;
opens doors; pulls out drawers; indicates wet pants; may awaken at night with wet diaper
Helps in dressing; washes hands and face; refers to self by name; puts on and takes off shoes and socks;
requests food when hungry
Refers to self with pronoun; undresses completely; puts on shirt and coat; brushes hair; may be toilet trained
Unbuttons; chooses clothes; uses fork; spreads butter on bread with knife; toilet trained; tells full name; knows
sex
©2013RobinKBlitz
Normal Developmental Milestones
Robin K Blitz, MD
Visual Milestones
1 month
2 months
3 months
4 months
5 months
7 months
8 months
9 months
Fixes on red ring
Follows horizontally and vertically
Follows ring in circle
Regards hand; immediately attends to dangling object
Regards pellet; smiles at mirror image
Pats own image in mirror
Watches intently movements of own hand in mirror
Looks over edge for toy
Hearing Milestones
1 month
2 months
4 months
5 months
7 months
9 months
10 months
11 months
15 months
18 months
24 months
Alerts to sounds
Accepts loud sound as part of environment; does not reach violently
Orients to voice
Orients to bell laterally
Orients to bell upwardly and indirectly
Orients to bell upwardly and directly
Understands No
Imitation indicates s/he can hear sounds and match them with his/her own sound production
Investigates sound
Swings rhythmically in response to music
Responds to sound patterns; can distinguish sounds that are different and begins to guess their source
Psychological Milestones
1 month
2-3 months
4 months
6 months
8 months
10 months
15 months
18 months
24 months
30 months
36 months
Smiles at mother in response to overtures
Recognize parents
Smiles at any smiling adult
Smiles and vocalizes at mirror image; may show fear of strangers; actively clings to familiar person
Responds to name; fear of strangers
Repeats performance laughed at; waves bye-bye; separation anxiety; plays social games: peek-a-boo;
expresses several clearly recognizable emotions
Claim possessions and make distinctions between “yours” and “mine”; separation protest diminishes; hugs
parents
May be negativistic, but is also loving; seeks affection
Uses language to communicate with others; parallel play; smiles when praised; hangs head when
reprimanded; temper tantrums; imitates adult activities
Traditional objects; pride in ability to accomplish tasks (“do it myself mommy”); knows family members well
Begin make-believe; words to express feelings; cooperative play; delayed gratification; shows sympathy; may
show jealousy; accepts explanations; likes to show-off
©2013RobinKBlitz
Normal Developmental Milestones
Robin K Blitz, MD
Cognition, Play and Language
Piagetian
Stage
Age
I
Birth- 1 mo.
II
III
IV
V
VI
1 to 4 mo.
4 to 8 mo.
Object
Permanence
Shifting images
Stares at spot from
which object
disappeared (looks
at hand after yard
drops)
Visually follows
dropped object
through vertical
trajectory (tracks
dropped yarn to the
floor)
Finds an object after
watching it hidden
18-24 mo.
Play
Generalization of
reflexes
Primary circular
reactions
(thumb-sucking)
Receptive
Language
Expressive
Language
Turns to voice
Range of cries
(hunger, pain)
Cooing
Vocal contagion
Searches for
speaker with
eyes
Secondary circular
reactions: recreates
accidentally discovered
environmental effects
(kicks mattress to
shake mobile)
Coordination of
secondary circular
reactions
Same behavior
repertoire for all
objects (bangs,
shakes, puts in
mouth, drops)
Responds to
own name and
to tones of
voice
Babbling
Four distinct
syllables
Visual motor
inspection of
objects
(peek-a-boo)
First real word
“Jargoning”
Symbolic
gestures (shakes
head “no”)
Recovers hidden
object after multiple
visible changes of
position
Tertiary circular
reactions (deliberately
varies behavior to
create novel effects)
Recovers hidden
object after invisible
changes in position
Spontaneously uses
non-direct causal
mechanisms (uses key
to move wind-up toy)
Awareness of
social function of
objects
Symbolic play
centered on own
body (drinks
from toy cup)
Symbolic play
directed toward
doll (gives doll a
drink)
Listens
selectively to
familiar words,
responds to
“no” and other
verbal requests
Can bring
familiar object
from another
room
Points to parts
of body
Follows series
of 2 or 3
commands
Pointes to
pictures when
names
Telegraphic twoword sentences
9-12 mo.
12-18 mo.
Causality
Many single
words- uses
words to express
needs
Acquires 10
words by 18 mo.
©2013RobinKBlitz