Development - Developmental Milestones

Question 1

What are the 4 major domains of development?

Answer 1

Gross motor
Fine motor
Language
Personal and social

Question 2

What does gross motor refer to?

Answer 2

Development of large movements e.g. sitting, standing, walking and posture

Question 3

What are the milestones for gross motor?

Answer 3

4 months
Head control

6 months
Sits supported

9 months
Sits unsupported

12 months
Stands independently
Cruises

15 months
Walks independently

18 months
Can squat and stand

2 years
Runs
Kicks ball

3 years
Climbs stairs with support
Pedals tricycle

4 years
Hops on one foot
Stairs alternating feet

Question 4

Which primitive reflex should disappear by ~6 months?

Answer 4

Moro reflex

Question 5

What is fine motor development?

Answer 5

Development of precise and skilled movements
Also encompasses visual development and hand-eye coordination

Question 6

What are the early fine motor milestones?

Answer 6

2 months
Fix eye on object 30cm in front and try to follow
Preferance for face over objects

6 months
Raking grasp (palmar)

9 months
Inferior pincer grasp (thumb + side of index)

12 months
Pincer grasp (tip of thumb and forefinger)

14-18 months
Clumsy use of spoon to bring food from bowl to mouth

Question 7

Early signs of fine motor delay?

Answer 7

No reach by 6 months
No unsupported hands by 9 months

Question 8

What are the drawing skills milestones of fine motor development?

Answer 8

12 months
Holds crayon and random scribbles

2 years
Copy vertical lines

2.5 years
Copy horizontal lines

3 years
Copy circles

4 years
Copies cross and square

5 years
Copy triangle

Question 9

What are the tower or bricks milestones of fine motor development?

Answer 9

14 months
2 bricks

18 months
4 bricks

2 years
8 bricks

2.5 years
12 bricks

3 years
3 block bridge or train

4 years
Can build steps

Question 10

What are the pencil grasp milestones of fine motor development?

Answer 10

Under 2
Palmar supinate grasp (first grip)

2-3 years
Digital pronate grasp

3-4 years
Quadrupod grasp or static tripod grasp

5 years
Mature tripod grasp

Question 11

What are the other milestones of fine motor development?

Answer 11

3 years
Can thread large beads onto string
Can make cuts in side of paper with scissors

4 years
Can cut paper in half with scissors

Question 12

What do language milestones mean?

Answer 12

Understanding and use of speech and language to communicate

Question 13

What are the two components of language development?

Answer 13

Expressive language
Receptive language

Question 14

What are the expressive language milestones?

Answer 14

3 months
Cooing

6 months
Noises with consonants

9 months
Babbling

12 months
Single words e.g. Dada or Hi

18 months
Has 5-10 words

2 years
Combines 2 words, 50 words total

2.5 years
Combies 3-4 words

3 years
Using basic sentences

4 years
Tells stories

Question 15

Which language findings are concerning?

Answer 15

No babbling by 12 months
No words by 18 months
Loss of language

Question 16

What are the receptive language milestones?

Answer 16

3 months
Recognises parents and familiar voices
Gets comfort from these

6 months
Responds to tone of voice

9 months
Listens to speech

12 months
Follows very simple instructions

18 months
Understands nouns e.g. show me the spoon

2 years
Understands verbs e.g. show me what you eat with

2.5 years
Understands propositions e.g. put the spoon under the step

3 years
Understands adjectives e.g. show me the red brick

4 years
Follows complex instructions

Question 17

How can receptive language be thought of in terms of key words?

Answer 17

18 months
1 key word

2 years
2 key words

3 years
3 key words

4 years
4 key words e.g. put the red spoon under the step

Question 18

What are the personal and social milestones?

Answer 18

6 weeks
Smiles

3 months
Communicates pleasure

6 months
Curious and engaged with people

9 months
Cautious and apprehensive with strangers

12 months
Engages by pointing and handing objects
Waves bye
Claps hands

18 months
Imitates activities

2 years
Extends interests to others beyond parents
Waves to strangers
Parallel play
Dry by day

3 years
Seek out other kids and play with them
Bowel control

4 years
Best friends
Dry by night
Dresses self
Imaginative play

Question 19

What is parallel play?

Answer 19

Plays next to but not necessarily with other kids

Question 20

What red flags would suggest there is a developmental problem?

Answer 20

• Not able to hold objects at 5 months
• Not sitting unsupported at 12 months
• Not standing independently at 18 months
• No words at 18 months
• No interest in others at 18 months
• Not walking independently at 2 years
• Not running at 2.5 years

Question 21

When performing a developmental assessment what should you do?

Answer 21

Make it a game and fun
Praise when the child succeeds
Use parents to encourage them
Ask parents about mile stones
Make visual estimate of rough age
Observe what they are doing before moving on