Developmental Milestones

Question 1

What are the 4 domains of developmental milestones?

Answer 1

Gross motor
Fine motor
Language
Personal and social

Question 2

What does gross motor refer to?

Answer 2

Child’s development of large movements e.g. sitting, standing, walking + posture

Question 3

What are the key gross motor developmental milestones?

Answer 3

• newborn: head lag on lifting up
• 6 weeks: lifts head 45 when lying on stomach
• 6 months: can maintain sitting posture but not balanced enough to sit unsupported
• 9 months: sits unsupported, crawling, pulls to standing
• 12 months: stand unsupported + cruises
• 15 months: walks unaided
• 18 months: squat + picks objects up from floor
• 2 years: run + kick a ball
• 3 years: climb stairs one foot at a time + ride a tricycle
• 4 years: hop, climb + go downstairs

Question 4

What are the key fine motor developmental milestones?

Answer 4

• 2-3 months: fixes eyes on object 30cm in front + attempts to follow it, reaches for object
• 6 month: palmar grasp
• 9 months: scissor grasp, points with finger
• 12 months: pincer grasp
• 14-18 months: clumsily use spoon to go from bowl to mouth

Question 5

What are the key fine motor developmental milestones - bricks + stacking?

Answer 5

• 15 months: stack 2
• 18 months: stack 3
• 2 years: stack 6
• 3 years: stack 9, can build bridge
• 6 years: steps

Question 6

What are the key fine motor developmental milestones - drawing skills?

Answer 6

• 12 months: scribbles
• 2 years copies vertical line
• 2.5 years: copies horizontal line
• 3 years: circle
• 4 years: square + cross
• 5 years: triangle

Question 7

What does hand preference before 12 months suggest?

Answer 7

It is abnormal
May indicate cerebral palsy

Question 8

When can children hold a pencil in proper tripod position?

Answer 8

5 years

Question 9

What are the two components of language in developmental milestones?

Answer 9

Expressive language
Receptive language

Question 10

What are the key expressive language developmental milestones?

Answer 10

• 3 months: cooing
• 6 months: noises with consonants (starting with g,b,p)
• 9 months: babbling
• 12 month: single words *e.g mama, dada, bye bye**
• 18 months: has 5-10 words
• 2 years: combines 2 words
• 2.5 years: combines 3-4 words
• 3 years: basic sentences, can identify colours, counts to 10
• 4 years: tells stories

Question 11

What are the key receptive language developmental milestones?

Answer 11

• 3 months: recognises parents + familiar voices
• 6 months: responds to tone of voice
• 9 months: listens to speech
• 12 months: can follow simple instructions
• 18 months: understand nouns
• 2 years: understands verbs
• 2.5 years: understands propositions e..g put the spoon under the cup
• 3 years: understands adjectives
• 4 years: follows complex instructions

Question 12

What are the key personal + social developmental milestones?

Answer 12

• 6 weeks: smiles
• 6 months: curious + engaged with people
• 9 months: become cautious + apprehensive with strangers, plays peek a boo
• 12 months: pointing + handing objects to others, waves bye + claps hands
• 18 months: imitates activities
• 2 years: waves to strangers, parallel play, engages in pretend play
• 3 years: seeks out other children + plays with them, dry by day + bowel control
• 4 years: has a best friend, dry by night, dresses self

Question 13

What are the developmental milestones for feeding?

Answer 13

• 12-15 months: drinks from cup + uses spoon
• 2 years: doesn’t spill cup + competent with spoon
• 3 years: uses spoon + fork
• 5 years: uses knife + fork

Question 14

Developmental milestones red flags

Answer 14

• lost developmental milestones
• not smiling by 10 weeks
• not holding object by 6 months
• not sitting unsupported by 9 months
• not standing independently by 12-15 months
• not talking by 15 months in girls or 18 months in boys
• not interested in others by 12 months
• no words by 18 months
• not running by 2 years

Question 15

At what age can children sit unsupported?

Answer 15

9 months

Question 16

At what age can children stand unsupported?

Answer 16

12 months

Question 17

At what age can children walk unaided?

Answer 17

15 months

Question 18

At what age can children run?

Answer 18

2 years

Question 19

What is global developmental delay?

Answer 19

When a child <5 has delayed development in 2 or more domains

Question 20

Causes of global developmental delay

Answer 20

• idiopathic
• antenatal conditions e..g fetal alcohol syndrome, congenital rubella syndrome
• perinatal conditions e.g. prematurity, hypoxic-ischaemic encephalopathy
• meningitis
• traumatic brain injury
• genetic conditions e.g. downs, fragile X
• phenylketonuria

Question 21

Red flags for gross motor delay in children

Answer 21

• not sitting unsupported by 9 months
• not walking by 15 months in girls + 18 months in boys
• abnormal muscle tone
• abnormal reflexes

Question 22

Causes of specific delay in gross motor skills

Answer 22

• cerebral palsy
• ataxic disdoer
• myopathy e.g. muscular dystrophy
• spina bifida
• visual impairment

Question 23

Red flags for fine motor delay in children

Answer 23

• not grasping objects by 6 months
• not transferring objects between hands by 9 months
• clear hand preference before 18 months

Question 24

Causes of a specific delay in fine motor skills

Answer 24

• dyspraxia
• cerebral palsy
• muscular dystrophy
• visual impairment

Question 25

Red flags for speech + language delay in children

Answer 25

- no babbling by 12 months - not responding to name or simple commands by 12 months - not words by 16 months - not combining two words by 2 years

Question 26

Causes of a specific delay in speech + language skills

Answer 26

- environmental factors *e..g exposure to multiple languages* - hearing impairment - autism - learning disability - cerebral palsy

Question 27

Red flags for personal + social delay in chidlren

Answer 27

- not smiling by 8/10 weeks - no interest in people by 6-9 months - not pointing or sharing interest by 18 months - no pretend play by 3 years

Question 28

Causes of a specific delay in personal + social skills in children

Answer 28

- autism - learning disability - visual or hearing impairment - emotional trauma, attachment disorder, neglect