DEVELOPMENTAL MILESTONE CHART FOR CHILDREN

DEVELOPMENTAL MILESTONE CHART FOR CHILDREN
Physical, Sensory, Cognitive, Linguistic, & Behavioral Milestones From Birth to Eighteen Years
From Birth to Age One
• Physical Milestones
o 0-4 months 50-300 ml/day urine production
o 0-7 years PMI (point of maximum impulse of heart) located at 3rd or 4th intercostal space, just left of midclavicular line
o 0-2 years respiration rate 24 to 34 respirations per minute
o 0-1 years pulse rate 135 ± 3.1
o 0-1 year blood pressure 90 ± 25 systolic, 61 ± 19 diastolic
o 0-1 year pulse 70-180, respiration 30-40
o 0-1 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
o 0-1 year PaO2 85-100, PaCO2 35-45
o 0-15 months eliminates urine & feces automatically; may need up to 30 diapers a day as newborn
o 0-2 1/2 years naps easily
o 2 months weight gain between 1 lb. 4 oz. and 1 lb. 12 oz.
o 2 months height gain of 2 inches
o 2 months a 1-inch increase of head circumference
o 2 months closure of posterior fontanel
o 2 months doll's eye reflex, dance reflex, grasp reflex, and crawling reflex disappearing


Grasp reflex: The infant will try to grasp a finger placed in the infant's open palm. Attempting to remove the finger causes the grip to tighten.

Crawling reflex: The infant will make crawling motions when placed on abdomen.
• 2 months hands are frequently open
• 2 months less head lag
• 2 months when on stomach, able to lift head almost 45 degrees
• 2 months decreased flexion of extremities while on stomach
• 4 months the average child should weigh 14 lb. height 25 in. (weight gain between 2 lb. 8 oz. and 3 lb. 8 oz. and a height gain of 4 inches from 2 months)
• 4 months - 2 years 350-550 ml/day urine production
• 4 months a 2 inch increase of head circumference from 2 month old size
• 4 months Moro reflex, tonic reflex, rooting reflex, and Perez reflex disappearing


Moro reflex: If the infant's weight is removed by lifting it's body slightly and releasing suddenly. The infant should have a "startled" look, and fling it's arms out sideways with the palms up and the thumbs flexed.

Tonic reflex or fencer's position: The tonic neck reflex is elicited when the head of a relaxed child, lying supine, is rotated to the side. The arm toward which the infant is facing extends straight away from the body with the hand partially open while the arm on the side away from the face is flexed and the fist is clenched tightly. Reversing the direction in which the face is turned reverses the position.

Rooting reflex: If the cheek is stroked the infant will turn toward the side that was stroked and begin to make sucking motions with its mouth.
• 4 months almost no head lag while in a sitting position
• 4 months able to sit straight up if propped
• 4 months able to raise head 90 degrees when placed on stomach
• 4 months able to roll from back to one side
• 4 months tries to reach objects with hands, but commonly overshoots
• 4 months plays with rattle when placed in hands, but unable to pick it up if dropped
• 4 months grasps rattle with both hands
• 4 months able to place objects in mouth
• 5-9 months lower central incisors (2) [deciduous]
• 6 months accommodation (pupil dilation for distant objects) present
• 6 months the average child should weigh 18 lb. height 26 1/2 in.
• 6 months should have doubled birth weight
• 6 months height gain of 6 inches
• 6 months a 3-inch increase of head circumference
• 6 months able to lift chest and head while on stomach bearing the weight on hand
• 6 months able to sit in a high chair with a straight back
• 6 months beginning of teething
• 6 months increased drooling
• 6 months beginning of Landau reflex


Landau reflex: when an infant is held in the prone position, the entire body forms a convex upward arc; gentle pressure on the head or gravity flexes the neck and hip, reversing the arc.
• 6 months able to bear almost all weight when supported in a standing position
• 6 months able to roll from back onto abdomen
• 6 months able to hold own bottle
• 6 months able to pick up a dropped object
• 6-7 months palmar grasp reflex disappears
• 6 -12 months sleeps 10-12 hours per night & 20min. to 3 hours daytime naps
• 8 months the average child should weigh 20 lb. height 27 in.
• 8-12 months upper central incisors (2) [deciduous]
• 8-12 months sit up strongly without support
• 8-12 months creep and pull himself up
• 8-12 months begin to use one hand more than the other
• 8-12 months begin chopped foods
• 8-12 months make sounds like da-da and ma-ma
• 9 months weight should increase by 2 lb. 4 oz. to 3 lb. 12 oz.
• 9 months height gain of 1 ½ inches since 6 months old
• 9 months bowel and bladder systems become more regulated
• 9 months parachute reflex appears


Parachute reflex: If the child is held upright and the body is rotated quickly face forward as if falling. The arms are reflexively extended as if to break a fall to protect self from falling.
• 9 months crawls
• 9 months can remain sitting for prolonged periods
• 9 months may pull self to standing position
• 9 months begins preference for dominant hand
• 9 months has a pincer grasp between thumb and index finger
• 9-12 months plantar reflex disappears


Plantar reflex: If the sole of the foot is irritated with an object, the infant's toes will contract
• 9-12 months neck righting reflex disappears


Neck righting reflex: The infant will rotate the truck in the direction in which the head of the supine infant is turned
• 10 months the average child should weigh 22 lb. height 29 in.
• 10-12 months upper lateral incisors (2) [deciduous]
• Sensory and Cognitive Milestones
o 2 months searches to locate sounds
o 2 months head turns from side to side with auditory stimulation at the level of the ear
o 2 months beginning to visually fix on close objects
o 2 months crying becomes differentiated
o 2 months coos
o 2 months vocal response to familiar voices
o 2 months smiles in response to stimuli
o 4 months close vision well established
o 4 months eye-hand coordination beginning
o 4 months can make the consonant sounds: n, k, p, g, b
o 4 months laughs out loud
o 4 months anticipates feeding when able to see a bottle (if bottle-fed)
o 4 months begins to show memory
o 4 months demands attention by fussing
o 6 months vision has improved to between 20/60 and 20/40
o 6 months can localize sounds not made in a direct plane with the ear
o 6 months prefers more complex auditory stimulation
o 6 months starts to imitate sounds
o 6 months sounds resemble one-syllable words
o 6 months enjoys hearing own voice
o 6 months makes sounds to mirror and toys
o 6 months begins to fear strangers
o 6 months recognizes parents
o 6 months begins to imitate actions
o 6 months begins to realize that if an object is dropped it is still there and just needs to be picked up
o 9 months development of depth perception
o 9 months can respond to simple commands
o 9 months understands the meaning of no
o 9 months may be afraid of being left alone
• Language Milestones
o Recognizes name
o Says 2-3 words besides "mama" and "dada"
o Imitates familiar words
o Understands simple instructions
o Recognizes words as symbols for objects: Car - points to garage, cat - meows
• Social/Behavioral Milestones
o 0-1 month Indefinite gaze at surroundings. Listens to sounds. Watches Mother's face when she feeds or talks to him.
o 3-4 months Spontaneous smile. Brings hands together and watches them. Pulls clothes over face when he plays. Recognizes feeding bottle.
o 5-6 months Puts everything in mouth. Plays with toes and grasps feet. Pats bottle with both hands when being fed. Smiles or talks to image in mirror.
o 7-8 months Pats image of self in mirror. Feeds self cracker. Holds bottle. Responds to name.
o 9-10 months Puts hands around cup. Plays peekaboo. Shows shyness, fear of strangers, and clings to familiar persons. May not want to be left by mother.
o 12 months Waves good-bye and pat-a-cakes. Cooperative with dress. Holds arm or leg out. Gives toys upon request. Drinks from cup without help.
Between One and Two
• Physical Milestones
o 1-2 years pulse rate 105 ± 1.8
o 1-2 year blood pressure 96 ± 27 systolic, 65 ± 27 diastolic
o 1-2 year pulse 80-140, respiration 28-32
o 1-2 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
o 1-2 year PaO2 85-100, PaCO2 35-45
o 12 months the average child should weigh 23 lb. height 30 in.
o 12 months weight should have tripled since birth and height should have increased by 50% over birth length
o 12 months the head circumference should equal that of the chest
o 12 months the anterior fontanelle (the front soft spot on the head) should be almost closed
o 12 months the average child should have 6 teeth; lower lateral incisors (2) [deciduous] & anterior molars (4) [deciduous]
o 12-18 months Babinski sign disappears


Babinski sign: when the lateral aspect of the sole of the relaxed foot is stroked, the great toe is flexed
• 12 months - 2 1/2 years sleeps 10-12 hours night
• 12 months needs 6-8 diapers a day minimum
• 12 months may recognize when he has wet or soiled himself
• 12 months may walk a wide-legged gait, but may prefer crawling
• 12 months may walk with the support of one hand
• 12 months may stack blocks and try to build a tower out of two blocks
• 12 months turns through pages of a book by flipping many at a time
• 12 months can sit down without help
• 12 months may get to a standing position from a squat, pivot a quarter of the way around, and lower himself to a sitting position
• 12 months may become a very picky eater, and become more negative, especially at meals and naptime
• 12 months may give attention to people and objects
• 12 months may have renewed fear of strangers and strange situations
• 12-15 months walk alone or with a little help
• 12-15 months lower himself from a standing to a sitting position
• 12-15 months hold a cup to drink from
• 12-18 months learns bowel control
• 12-24 months voids urine 8+ times a day
• 12-24 months Landau reflex disappears
• 14 months the average child should weigh 24 lb. height 31 in.
• 15-18 months show a little cooperation at being dressed
• 15-18 months walk alone
• 15-18 months use a spoon
• 15-18 months build a tower of two blocks and fit a peg into its proper hole
• 18 months fontanelle closes
• 18 months the average child should have 12 teeth
• 18 months the average child should weigh 26 lb. height 32 1/2 in.
• 18 months growth slows
• 18 months the child is physically able to control sphincter muscles, but the child may not be psychologically ready to use the toilet
• 18 months there are usually two bowel movements per day; after breakfast and after supper, there may be a third in the midmorning standing at the side of the crib or playpen
• 18 months able to run with a lack of coordination
• 18 months falls frequently
• 18 months able to jump in place
• 18 months able to get onto chairs without assistance
• 18 months can build a tower of 3 to 4 blocks
• 18 months can turn the pages of a book two or three at a time
• 18 months abdomen protrudes, arms and legs lengthen
• 18 months fine muscle coordination begins to develop
• 18 months big muscles become well developed
• 18-24 months urinates every 2-3 hours
• 18-24 months canines (4) [deciduous]
• 18-24 months good control with a spoon
• 18-24 months throw a ball into a box
• 18-24 months build a high tower with blocks
• 18-24 months may start toilet training
• Sensory and Cognitive Milestones
o 12 months follows a fast moving object
o 12 months has control over response to sounds
o 12 months searches for objects that are hidden, but unable to consider alternative locations
o 12 months may develop attachment to a toy or object
o 12 months experiences separation anxiety and may cling to parents
o 12 months may make brief exploratory journeys away from parents in familiar settings
o 18 months understands and able to identify through pointing common objects
o 18 months frequently imitates
o 18 months able to take off some clothing items; gloves, shoes & socks
o 18 months begins to feel a sense of ownership identifying people and objects by saying "my"
• Language Milestones
o 12 months comprehends several words
o 12 months can say mamma, papa and at least two other words
o 12 months comprehends simple commands
o 12 months tries to imitate animal sounds
o 12 months associates names with objects
o 12-15 months say a few words
o 12-15 months combines two words such as "daddy bye-bye"
o 15-18 months have a five to ten word vocabulary
o 18 months can say 10 or more words
o 18 months uses words such as "more" to make wants known
o 18-24 months say short sentences
• Social/Behavioral Milestones
o 12 months Waves good-bye and plays pat-a-cake
o 12 months Gives a toy when asked
o 12 months Pints to his or her toes, eyes, and nose
o 12 months Brings object from another room when asked
o 15 months Feeds self. Uses a spoon, but is messy. Imitates Mother in household duties.
o 18 months Drinks without much spilling. Takes off clothes.
Between Two and Three
• Physical Milestones
o 2-12 1/2 years respiration rate 20 to 26 respirations per minute
o 2-3 years pulse rate 93 ± 1.0
o 2-3 year blood pressure 95 ± 24 systolic, 61 ± 24 diastolic
o 2-3 year pulse 80-140, respiration 28-32
o 2-3 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
o 2-3 year PaO2 85-100, PaCO2 35-45
o 2-3 1/2 years learns bladder control
o 24 months the average child should have 16 teeth
o 24 months the average child should weigh 28 lb. height 34 1/2 in.
o 2 years average female weight 26.4 lb. height 34 in.
o 2 years average male weight 28.6 lb. height 34 in.
o 2 years the circumference of the head should have increased to about 20 inches
o 2 years the circumference of the growing chest should be larger than that of the head
o 2 years the height is roughly half the total height the child will attain as an adult
o 2 years the percent of (male) adult value of thigh 37%, calf 42%, foot 52%, upperarm 40%, forearm 47%, hand 54%
o 2 years protruding abdomen less noticeable
o 2 years may be psychologically ready for toilet training
o 2 years may be bowel trained and may have daytime bladder control
o 2 years can run with better coordination, while the stance may remain wide
o 2 years can kick ball without loosing balance
o 2 years can pick up objects while standing without losing balance
o 2 years can build a tower of 6 to 7 cubes
o 2 years can browse through a book one page at a time
o 2 years able to turn a door knob
o 24-30 months posterior molars (4) [deciduous]
o 2 1/2 years the average child should have 20 teeth
o 30 months the average child should weigh 32 lb. height 36 in.
o 2 1/2 years average female weight 28.6 lb. height 351/2 in.
o 2 1/2 years average male weight 30.8 lb. height 35 1/2 in.
o 2 1/2 years has full set of baby teeth
o 2-3 years Lordosis and protuberant abdomen of toddler disappear
o 2-10 years 500-1000 ml/day urine production
• Sensory and Cognitive Milestones
o vision fully developed
o vocabulary has increased to about 300 words
o can organize phrases of 2 to 3 words
o able to communicate needs such as thirst, hunger, need to use the restroom
o increased attention span
o able to clothe self in simple apparel
• Language Milestones
o Identifies body parts
o Carries on 'conversation' with self and dolls
o Asks "what's that?" And "where's my?"
o Uses 2-word negative phrases such as "no want".
o Forms some plurals by adding "s"; book, books
o Has a 450 word vocabulary
o Gives first name, holds up fingers to tell age
o Combines nouns and verbs "mommy go"
o Understands simple time concepts: "last night", "tomorrow"
o Refers to self as "me" rather than by name
o Tries to get adult attention: "watch me"
o Likes to hear same story repeated
o May say "no" when means "yes"
o Talks to other children as well as adults
o Solves problems by talking instead of hitting or crying
o Answers "where" questions
o Names common pictures and things
o Uses short sentences like "me want more" or "me want cookie"
o Matches 3-4 colors, knows big and little
• Social/Behavioral Milestones
o 2 years Helps dress self. Less messy when eating. Turns down handle and opens door. Washes and dries hands.
o 2 ½ years Helps put things away. Domestic make believe play. Toilet trained during the day.
Between Three and Four
• Physical Milestones
o 3-4 years pulse rate 87 ± 0.7
o 3-4 year blood pressure 99 ± 23 systolic, 65 ± 19 diastolic
o 3-4 year pulse 80-120, respiration 24-28
o 3-4 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
o 3-4 year PaO2 85-100, PaCO2 35-45
o 3 years the average child should weigh 33 lb. height 38 in.
o 3 years average female weight 30.8 lb. height 37 1/2 in.
o 3 years average male weight 33 lb. height 37 1/2 in.
o 3 years the percent of (male) adult value of thigh 44%, calf 47%, foot 58%, upperarm 47%, forearm 52%, hand 56%
o 3 years during the 3rd year there is usually a weight gain of about 6 pounds
o 3 years during the 3rd year there is usually a height gain of about 3 inches
o 3 years should have daytime control over bowel and bladder functions and may have nighttime control as well
o 3 years may stay dry all night
o 3 years able to ride three wheel toys such as a tricycle or Big Wheel
o 3 years improved balance
o 3 years able to briefly balance on one foot
o 3 years may walk up the stairs with alternating feet
o 3 years can construct a block tower of 9 to 10 cubes
o 3 years can easily place small objects in a small opening
o 3 1/2 years the average child should weigh 35 lb. height 39 in.
o 3 1/2 years average female weight 33 lb. height 38 1/2 in.
o 3 1/2 years average male weight 35.2 lb. height 39 in.
• Sensory and Cognitive Milestones
o 3 years able to completely clothe self, only requiring assistance with laces, buttons, and other fasteners in awkward places
o 3 years attention span increasing
o 3 years feeds self without difficulty
o 3 years able to prepare uncomplicated meals
o 3 years may experience an increase in imaginary fears
o 3 years realization of own self and that of others
o 3 years social encounters are acted out through play activities
o 3 years both thought and behavior are egocentric
o 3 years beginning to grasp the concept of time
o 3 years decrease in separation anxiety for short periods of time
• Language Milestones
o Can tell a story
o Has a vocabulary of nearly 1000 words
o Has a sentence length of 4-5 words
o frequently asks questions
o speech is nearly constant regardless of the presence of an audience
o Names at least one color
o Understands "yesterday," "summer", "lunchtime", "tonight", "little-big"
o Begins to obey requests like "put the block under the chair"
o Knows his or her last name, name of street on which he/she lives and several nursery rhymes
• Social/Behavioral Milestones
o 3 years Feeds self well. Drinks with help. Puts on socks. Likes to help mother (set table & clean). Sometimes shares things.
Between Four and Five
• Physical Milestones
o 4-5 years pulse rate 84 ± 0.7
o 4 years the average child should weigh 37 lb. height 40 1/2 in.
o 4 years average female weight 35.2 lb. height 40 in.
o 4 years average male weight 37.4 lb. height 40 1/2 in.
o 4 years the percent of (male) adult value of thigh 48%, calf 53%, foot 62%, upperarm 54%, forearm 56%, hand 60%
o 4 years muscle width, arm + calf 8.2cm
o 4 years weight gain of about 6 pounds during the 4th year
o 4 years the height should be double their length at birth
o 4 years improved balance
o 4 years hops on one foot without losing balance
o 4 years throws a ball overhand with coordination
o 4 years skillfully cuts out a picture using scissors
o 4 years may not be able to tie shoelaces
o 4 years dry though night
o 4-6 years average child weighs 44 lb. height 44 in.
o 4 1/2 years the average child should weigh 39 lb. height 41 1/2 in.
o 4 1/2 years average female weight 37.4 lb. height 41 1/2 in.
o 4 1/2 years average male weight 39.6 lb. height 42 1/2 in.
• Sensory and Cognitive Milestones
o 4 years tries to be very independent
o 4 years increased aggressive behavior
o 4 years readily discloses personal family matters to others
o 4 years imaginary playmates are common
o 4 years increased comprehension of time
o 4 years able to distinguish between two objects based on simple criteria (such as size, weight, and so forth)
o 4 years less egocentric behavior
o 4 years believes that their thought and emotions are causative events
o 4 years lack moral concept of right and wrong
o 4 years rebellion is common if expectations are excessive
• Language Milestones
o Has a vocabulary of nearly 1500 words
o Has sentence length of 4-5 words
o Uses past tense correctly
o Points to colors red, blue, yellow and green
o Identifies triangles, circles and squares
o Understands "In the morning" , "next", "noontime"
o Can speak of imaginary conditions such as "I hope"
o Asks many questions, asks "who?" And "why?"
o The age when the child will ask the most questions
o May use words outside their comprehension
o May begin using vulgar terms depending on their exposure
o Learns and sings simple songs
• Social/Behavioral Milestones
o 4 years Dresses self unassisted. Can button clothes. Washes and dries hands and brushes teeth unassisted. Understands taking turns.
Between Five and Six
• Physical Milestones
o 5-6 years pulse rate 79 ± 0.6 and respiratory rate may decrease
o 5 years the average child should weigh 42 lb. height 43 in.
o 5-9 years early Lordosis disappears
o 5-9 begins to lose baby teeth; first permanent teeth begin to erupt, permanent teeth then appear at a rate of 4 teeth per year from 7-14 years
o 5 years average female weight 39.6 lb. height 42 1/2 in.
o 5 years average male weight 41.8 lb. height 43 1/2 in.
o 5 years the percent of (male) adult value of thigh 54%, calf 57%, foot 66%, upperarm 57%, forearm 60%, hand 64%
o 5 years muscle width, arm + calf 8.5cm
o 5 years increased coordination
o 5 years skips, jumps, and skates with good balance
o 5 years able to maintain balance while standing on one foot with eyes closed
o 5 years able to tie own shoelaces
o 5 years increased skill with simple tools and writing utensils
o 5 1/2 years average female weight 41.8 lb. height 44 in.
o 5 1/2 years average male weight 44 lb. height 44 1/2 in.
o 6-7 years pulse rate 76 ± 0.6
o 6 years average female weight 44 lb. height 45 1/2 in.
o 6 years average male weight 46.2 lb. height 45 1/2 in.
o 6 years the percent of (male) adult value of thigh 58%, calf 62%, foot 70%, upperarm 62%, forearm 63%, hand 66%
o 6 years muscle width, arm + calf 8.8cm
o 6-7 years first molars (4) [permanent]
o 6 1/2 years average female weight 46.2 lb. height 46 1/2 in.
o 6 1/2 years average male weight 48.4 lb. height 47 in.
• Sensory and Cognitive Milestones
o 5 years increasingly responsible
o 5 years decreased aggressiveness
o 5 years some fears from earlier childhood are disappearing
o 5 years able to accept the validity of others view and perspective, but may not understand it
o 5 years increased mathematical skill
o 5 years does not hesitate to question others, including parents
o 5 years there is a strong identification with the parent of the same sex
• Language Milestones
o Has a vocabulary of around 2000 words
o Has a sentence length of 5-6 words
o Defines objects by their use (you eat with a fork) and can tell what objects are made of
o Knows spatial relations like "on top", "behind", "far" and "near"
o Knows the names of the primary colors and may know the names of many more
o Knows her address
o Identifies a penny, nickel and dime
o Knows common opposites like "big/little"
o Understands "same" and "different"
o Counts ten objects
o Asks questions for information
o Distinguished left and right hand in herself
o Can compose sentences with all parts of speech
o Questions are less superficial, addressing meaning and purpose
o Uses all types of sentences, for example "let's go to the store after we eat"
o At six years the vocabulary has increased to over 2100 words
o At six years readily composes sentences of 6 to 8 words
• Social/Behavioral Milestones
o 5 years Independent and self sufficient. Dresses and undresses self. Ties shoelaces. Uses knife and fork.
By Age Seven
• Physical Milestones
o 7 years PMI located 5th or 6th left intercostal space at the midclavicular line or slightly medial to it
o 7-8 years pulse rate 75 ± 0.7
o 7 years average female weight 48.4 lb. height 47 1/2 in.
o 7 years average male weight 50.6 lb. height 48 1/2 in.
o 7 years the percent of (male) adult value of thigh 63%, calf 65%, foot 73%, upperarm 66%, forearm 67%, hand 69%
o 7 years muscle width, arm + calf 9cm
o 7-8 years incisors (8) [permanent]
o 7-10 years average child weighs 62 lb. height 52 in.
o 7 1/2 years average female weight 52.8 lb. height 49 in.
o 7 1/2 years average male weight 52.8 lb. height 49 in.