East Tennessee Children's Hospital - Developmental Milestones

Children are constantly growing and changing. Every day new skills, new tasks and new personality traits are developing. A child goes through several developmental stages, each distinctive and important to his or her growth to adulthood.

Children develop at different levels, and it's often difficult to tell if your child is on schedule. There are, however, some typical developmental milestones that children achieve. Also, there are some signals that your pediatrician may need to be aware of. If you are unsure whether your child is on schedule, it is important to seek your pediatrician's advice early. Early intervention can make a difference in your child's later development.

Talk to your child's physician if you have concerns.

Watch your baby for these signs.

Typical Development		Possible Developmental Problems
pushes up on arms holds head up looks at eyes and face of person talking babbles and coos when talked to	By Three Months	stiff legs pushes back with head constantly fisted hand and stiff leg on one side does not visually recognize parent no social smile in response to stimulation
sits with support reaches directly for objects with both hands holds head up distinguishes strangers from family and friends smiles and vocalizes to a mirror image mouths toys	By Six Months	moves one side of the body less than the other side does not look at objects while handling them difficult to bend hips to sit does not look for dropped toys
easily transfers objects from hand to hand sits without support arms free to grasp and reach responds to simple requests with gestures begins combining syllables (ba, ba, ba) eats mashed table food	By Eight Months	uses one hand better than the other cannot sit without support unable to stand with support does not vocalize single syllables does not use upper lip to clean spoon when feeding
pulls to stand responds to simple verbal instructions bites through a soft cookie, drinks from a cup uses "mama" and "dada" appropriately babbles with inflection as if making sentences	By Twelve Months	unable to move from one place to another by creeping cannot pick up small objects constantly stands on tiptoes cannot use one to three words appropriately unable to bring hands together to clap or bang toys does not eat coarsely chopped table food
uses fingers to help turn pages of a book independent walking or standing uses jargon, points and vocalizes to indicate wants	By Fifteen Months	uses only the right or left hand to play with toys unable to take steps alone difficulty releasing objects does not imitate specific sounds upon request

Remember to correct your child's age for prematurity. For example, if your child was born eight weeks prematurely, at six months chronological age he or she will be functioning more like a four month old infant. However, premature babies have varying degrees of development. Due to complications that may occur in premature babies, your child's pediatrician is the best source of information in understanding your child's development.

Toddlers, one to three years old, are beginning to experiment with their independence. If they are not allowed to learn and develop on their own, toddlers may develop a sense of shame and doubt and learn to accept defeat in battles of will. Toddlers walk, run, climb and jump. They learn to feed and dress themselves, develop bladder and bowel control and eat solid foods. Toddlers are curious, develop a vocabulary of about 300 words, talk in simple sentences and begin to solve problems through trial and error.

Preschoolers, ages three to five, have a greatly expanded imagination because of their improved ability to communicate and move on their own. They are aware of male and female roles, enjoy "playacting" and may have an imaginary friend. At this age, children are able to climb, throw a ball, use scissors, brush their teeth and recognize different body parts. They talk more clearly and frequently, often asking, "Why?"

These are typical developmental milestones that an average healthy child will achieve. However, children develop at different paces and at their own rate. If your child has not reached a proper milestone or seems to be advancing past his or her age, this should not be a sign of alarm. It should, however, be a topic of conversation between you and your child's pediatrician.

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Revised 9-20-07