Developmental milestones record

Growth milestones for children; Normal childhood growth milestones; Childhood growth milestones

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Developmental milestones are behaviors or physical skills seen in infants and children as they grow and develop. Rolling over, crawling, walking, and talking are all considered milestones. The milestones are different for each age range.

There is a normal range in which a child may reach each milestone. For example, walking may begin as early as 8 months in some children. Others walk as late as 18 months and it is still considered normal.

One of the reasons for well-child visits to the health care provider in the early years is to follow your child's development. Most parents also watch for different milestones. Talk to your child's provider if you have concerns about your child's development.

Closely watching a "checklist" or calendar of developmental milestones may trouble parents if their child is not developing normally. At the same time, milestones can help to identify a child who needs a more detailed check-up. Research has shown that the sooner the developmental services are started, the better the outcome. Examples of developmental services include: speech therapy, physical therapy, and developmental preschool.

Below is a general list of some of the things you might see children doing at different ages. These are NOT precise guidelines. There are many different normal paces and patterns of development.

Infant -- birth to 1 year

Able to drink from a cup
Able to sit alone, without support
Babbles
Displays social smile
Gets first tooth
Plays peek-a-boo
Pulls self to standing position
Rolls over by self
Says mama and dada, using terms appropriately
Understands "NO" and will stop activity in response
Walks while holding on to furniture or other support

Toddler -- 1 to 3 years

Able to feed self neatly, with minimal spilling
Able to draw a line (when shown one)
Able to run, pivot, and walk backwards
Able to say first and last name
Able to walk up and down stairs
Begins pedaling tricycle
Can name pictures of common objects and point to body parts
Dresses self with only a little bit of help
Imitates speech of others, "echoes" word back
Learns to share toys (without adult direction)
Learns to take turns (if directed) while playing with other children
Masters walking
Recognizes and labels colors appropriately
Recognizes differences between males and females
Uses more words and understands simple commands
Uses spoon to feed self

Preschooler -- 3 to 6 years

Able to draw a circle and square
Able to draw stick figures with two to three features for people
Able to skip
Balances better, may begin to ride a bicycle
Begins to recognize written words, reading skills start
Catches a bounced ball
Enjoys doing most things independently, without help
Enjoys rhymes and word play
Hops on one foot
Rides tricycle well
Starts school
Understands size concepts
Understands time concepts

School-age child -- 6 to 12 years

Begins gaining skills for team sports such as soccer, T-ball, or other team sports
Begins to lose "baby" teeth and get permanent teeth
Girls begin to show growth of armpit and pubic hair, breast development
Menarche (first menstrual period) may occur in girls
Peer recognition begins to become important
Reading skills develop further
Routines important for daytime activities
Understands and is able to follow several directions in a row

Adolescent -- 12 to 18 years

Adult height, weight, sexual maturity
Boys show growth of armpit, chest, and pubic hair; voice changes; and testicles/penis enlarge
Girls show growth of armpit and pubic hair; breasts develop; menstrual periods start
Peer acceptance and recognition is of vital importance
Understands abstract concepts

References

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. The health record. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Siedel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 5.

Kimmel SR, Ratliff-Schaub K. Growth and development. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 22.

Lipkin PH. Developmental and behavioral surveillance and screening. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 28.

Review Date: 1/24/2023

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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