What are Milestones?
Milestones are specific skills that are mastered along a specific developmental sequence. These benchmarks help to tell if a child is developing as expected. Milestones are behaviors that emerge over time, forming the building blocks for growth and continued learning. Although there is a developmental variation amongst children, milestones should be met within a specific time frame. Failure to meet 1 or more milestones may be a “red flag” for a communication delay or disorder.
Speech and Language Milestones
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
Speech and Language Activities
Gross Motor Development Milestones
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:
Gross Motor Activities
Fine Motor Development Milestones
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
1-1.5 Year
- Fisted grasp on crayon
- Arm moves as a unit
- Rolling and then throwing a ball
- Stacks 2-3 cubes
- Putting toys in a container and dumping
- Scribbles
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