Milestones & Home Activities

0-6 Months

Hearing & Understanding

• Startle to loud sounds
• Quiets or smiles when spoken to
• Increases or decreases sucking in response to sound
• Moves eyes toward sound
• Responds to changes in tone of voice
• Notices toys that make sounds

Talking

• Makes pleasure sounds (coo, goo)
• Cries differently for different needs
• Smiles when sees you
• Babbling sounds more speech-like with different sounds (p,b,m)
• Laughs and chuckles
• Makes gurgling sounds

Red Flags: Child Does NOT…

• Turn eyes/head toward sound
• Watch your face when you speak
• Smile/laugh when you do
• Have different cries for different needs
• Make sounds in response to your sounds

7 Months to 1 Year

Hearing and Understanding

• Enjoys peek-a-boo, pat-a-cake
• Turns and looks in direction of sounds
• Listens when spoken to
• Recognizes words for common items (e.g. juice, shoe)
• Begins to respond to requests (“Want more?”)

Talking

• Babbling has long and short groups of sounds (tata, upup, bibibibi)
• Uses speech/non-crying sounds to get attention
• Uses gestures to communicate (waves bye-bye)
• Imitates different speech sounds
• Has 1-2 words around 1 year (may not be clear)

Red Flags: Child Does NOT…

• Respond to his/her name
• Babble (baba dadada mamama)
• Play social games (e.g. peek-a-boo)
• Follow simple 1 step directions
• Use gestures (e.g. wave bye bye)
• Get your attention using sounds and gestures while looking at your eyes.

1 to 2 Years

Hearing and Understanding

• Points to a few body parts when asked.
• Follow simple commands and understand simple questions (e.g. “roll ball;” “Where’s your shoe?”)
• Listens to simple stories, songs and rhymes.

Talking

• Say more words every month
• Uses some 1-2 word questions
• Puts 2 words together (e.g. “more cookie” “no juice”)
• Uses many different consonant sounds at the beginning of words.

Red Flags: Child Does NOT…

• Identify basic body parts
• Understand concepts in/out, on/off
• Point to pictures with 1 finger
• Say approximately 20 words consistently
• Use at least 4 consonant sounds (p,b,m,n,d,g,h,w)
• Pretend to feed doll
• Use at least 100 words (by 2)
• Combine two words
• Enjoy other children
• Put 2 pretend actions together

2 to 3 Years

Hearing and Understanding

• Understands differences in meaning (go/stop, big/little)
• Follows 2 requests (“get the book and put it on the table”)
• Listens to and enjoys hearing stories for longer periods of time

Talking

• Has a word for almost everything
• Uses 2-3 words to talk about and ask for things
• Uses k,g,f,t,d,n sounds
• Speech is understood by familiar listeners most of the time
• Asks for or directs attention to objects by naming them

Red Flags: Child Does NOT…

• Understand Who, What, Where Questions
• Create longer sentences combining 4-5 words
• Use some adult grammar (plural –s, possessive ‘s,-ed)
• Speech is understood 75% of the time
• Pretends with other children (e.g. have tea party)

3 to 4 Years

Hearing and Understanding

• Hears you when you call from another room
• Hears TV and radio at same loudness levels as the rest of the family
• Answers Wh questions including Why?

Talking

• Talks about activities at school or at friends’ house
• People outside family understand speech
• Uses a lot of sentences 4 words or more
• Talks easily without repeating syllables or words

Red Flags: Child Does NOT…

• Follow 3 part directions
• Use sentences with adult type grammar
• Tell a story
• Have speech that is understood by strangers most of the time
• Act out different roles with friends (e.g. going to a restaurant, play house)

4 to 5 Years

Hearing and Understanding

• Pays attention to a short story and answers questions about them
• Hears and understands most of what is said at home and at school

Talking

• Uses sentences that give lots of details
• Tells stories that stick to topic
• Communicates easily with children and adults
• Says most sounds correctly except l,r,s,z,v,ch,sh,th
• Says rhyming words
• Names some letters, #’s
• Uses similar grammar to adults

Red Flags: Child Does NOT…

• Answer questions correctly
• Has numerous errors in their speech that make them difficult to understand
• Cannot give his/her first and last name
• Does not talk about daily activities
• Having difficulty with learning readiness skills

Red Flags for Autism

• Insistence on sameness; resists change in routine/transition
• Severe language deficits (stops talking after developing normally)
• Difficulty expressing needs (gestures instead of using words)
• Echolalia
• Prefers to be alone
• Laughs, cries, shows distress for no apparent reason
• Tantrums- extreme distress for no apparent reason
• Difficulty mixing with other children
• May not like cuddly interaction
• Little/No eye contact
• Sustained Odd play (spins self/objects, lines things up)
• Inappropriate Attachment/Obsession with objects
• Apparent over/under sensitivity to pain
• No fear of danger

Over/Under Reactive to Sensory Input

Articulation Activities

Speech-Language Activities

Stuttering Help

Expected Milestones (by age) – able to:

0-3 Months

• Lift and hold head up when lying on tummy
• Turn head side to side when lying on tummy
• Open and close hands
• Push up on hands/arms when lying on tummy
• Move arms and legs symmetrically between right and left sides – bend and straighten arms and legs either reciprocally or together

4-6 Months

• Sit (often relying on support from his or her hands on the ground until 6 months old)
• Roll (from back to stomach and stomach to back)
• Prop up on forearms when lying on stomach
• Accept weight through both legs when standing with support
• Bring hands together at midline
• Play with/explore toys with hands
• Brings feet to mouth or grabs feet with hands

7-9 Months

• Reach for/lean towards toys in sitting without losing balance
• Pivots 90 degrees in sitting position
• Moves into sitting position from laying on tummy or back
• Creeps/Crawls on hands and knees with alternating leg movements
• Starting to pull up into standing
• Demonstrates more control when rolling, sitting, and scooting

10-12 Months

• Pivot 180 degrees in sitting position
• Pull up into standing from sitting
• Bounce in standing by flexing knees
• Cruise along furniture
• Stand alone
• Walks with a push toy (may start to walk independently around this age)
• Sit unsupported and able to maintain balance when turning head to look at objects
• Release objects from hand into a container with a large opening

13-15 Months

• Play in tall kneeling position
• Walk independently
• Squat down to the floor to pick up toy and returns to standing without losing balance
• Stack objects
• Creep up stairs on hands and knees
• Creep backwards down steps without support from adult or rail

16-18 Months

• Walk fast and walk backwards
• Walk up 4 steps with support from wall/rail or adult
• Walk down stairs with only 1 finger support from an adult

19-24 Months

• Run on level surfaces without losing balance
• Stand on a line with one foot in front of the other
• Walk sideways (both directions – leading with each foot)
• Walk on a line without stepping off
• Jump forward off of 2 feet at least 4 inches without losing balance
• Jump up off of 2 feet at least 2 inches
• Jump down from step 7 inches high

2 Years

• Stand on 1 foot with hands on hips for 3 seconds
• Walk up 4 steps, placing 1 foot on each step, using wall or rail for support
• Walk down 4 steps without support (from wall/rail or adult)
• Walk on tiptoes
• Jump forward 24 inches with a 2-footed take off
• Jump down from stable objects at least 18 inches high

3-4 Years

• Stand on 1 foot with hands on hips for 5 seconds
• Walk up 4 steps, placing 1 foot on each step without support (from wall/rail or adult)
• Hop on 1 foot
• Run with arms moving back and forth, pushing off of balls of feet

5-6 Years

• Stand on 1 foot for 10 seconds with steady balance without swaying side to side
• Imitate the body movements (arm and leg motions) of another person
• Perform 3 sit-ups in 30 seconds
• Gallop
• Skip
• Jump forward 36 inches off of 2 feet
• Jump and turn around 180 degrees

7-8 Years

• Perform 5 sit-ups in 30 seconds
• Perform 8 push-ups in 20 seconds
• Perform jumping jacks with smooth, continuous, and coordinated movements
• Walk with heel-to-toe pattern on a line without stepping off
• Hop side to side on 1 foot quickly
• Catch and throw various sizes of balls

Resources:

Peabody Developmental Motor Scales – 2^nd Edition

Bruininks-Oseretsky Test of Motor Proficiency – 2^nd Edition

Gross Motor Activities

Expected Milestones (by age) – able to:

Birth to 6 Months

• Closes fingers in tight grasp around finger
• Brief grasp and release of rattle
• Head alignment
• Mutual finger play
• Hands to mouth
• Feet to mouth

6-10 Months

• Grasping cube first with palm then fingers and thumb opposed
• Pincer grasp (10 months)
• Pokes
• Claps
• Holds a bottle at midline
• Holds a rattle/shakes
• Pushes up on arms while lying on tummy and shifts weight from one arm to the other
• Starts to roll over (both directions)
• Sits independently
• Creeps/crawls on hands hand knees with reciprocal movements

By 12 Months

• Removes socks by pulling
• Releases cube voluntarily
• Easily grasps small cubes
• Transfers cube from one hand to another
• Starting to turn pages in a hard cover book
• Drops and picks up a toy

2-3 Years

• Pronated grasp (palm down)
• Forearm moves as a unit
• Imitates vertical lines then horizontal lines
• By 3 years can draw a circle
• Feeding self with spoon and then fork
• Snipping with scissors
• Drink from an open cup
• Opens a screw on lid

3-4 Years

• Static tripod grasp
• Hand moves as a unit
• Traces
• Coloring simple pictures
• Developing skill to manipulate toys
• Puts on socks and shoes
• Finger isolation and opposition
• Copies a cross
• Stacks 10 cubes
• Build a train or bridge with cubes
• Strings beads
• Lacing
• Cutting

4-5 Years

• Develops dynamic tripod grasp
• More precise finger skillS
• Copies a square and drawing a person
• Buttoning
• Copies diagonal lines
• Tracing capital letters
• Writing some letters in name
• Cutting on a line and some shapes
• Hand dominance established
• Holds fork with standard position

Red Flags

• Keeps hand or hands fisted, thumb in palm
• Unable to prop self up on hands
• Unable to pick up toys
• Keeps head turned to one side
• Not exploring/reaching
• Grasp seems weak
• Frequently switches hands (5 years)
• Neglect of one side of body or limb
• Unusual movements/arching
• Extended crying

Fine Motor Activities