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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


  • 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?”)


  • 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.


  • 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


  • 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?


  • 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


  • 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



Peabody Developmental Motor Scales – 2nd Edition

Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition

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

parents resource page

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

What are Milestones?

Milestones are specific skills which 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 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.