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PEDIATRIC DEVELOPMENTAL MILESTONES

18–24

Months

Fine/Gross Motor: uses 2 hands during play, makes 4-6 cube tower, walks up/down stairs while holding on, throws ball while standing, kicks ball forward, runs (stiffly)

Self-care: pushes arms/legs through openings in clothing, removes clothing, uses spoon (with spillage), drinks from cup (with spillage)

Speech: 25%-50% intelligible

Vocabulary: 50-300 words

Language: Uses 1, 2 and 3 word utterances, follows simple directions, engages in parallel play, protests by saying “no,” engages in simple pretend play, says things like “bye,” ‘hi,” “please,” and “thank you,” looks in appropriate place when asking a question (i.e. where’s mommy), answers where questions by pointing (i.e. where is the truck), answers “what’s this” questions regarding familiar objects, answers yes/no questions (might use head nod)

Literacy: recognizes certain books by their covers, listens to simple stories and songs, attends to a book of toy for about 2 minutes, pretends to read books, points to and labels pictures

2–2.5 Years

Fine/Gross Motor: walks up/down stairs (some support), catches large ball against chest, imitates vertical/horizontal/circular marks, strings large beads awkwardly, holds and snips w/ scissors, uses digital pronate grasp on writing utensil

Self-care: good use of spoon, beginning to use fork, helps pull down pants (with elastic waistband), sucks through straw, indicates need to use bathroom, washes hands, helps w/ bathing (may see resistance to grooming)

Speech: 50%-75%  intelligible

Vocabulary: 200-450 words

Language: says things like “bye,” ‘hi,” “please,” and “thank you,” talks to self during pretend play,

watches other children play and may join in their play, points to objects being described (i.e. what do you wear on your feet), responds to commands (i.e. show me your foot), recognizes family labels (i.e. mom, sister, etc.)

Literacy: holds a book correctly, begins to recognize logos, likes to listen to books for longer periods of time

2.5–3 Years

Fine/Gross Motor: walks up stairs (alternating feet w/ rail), jumps, runs, climbs, cuts 6” straight line, makes 8 cube tower, copies vertical/horizontal lines and circle

Self-care: unbuttons large buttons, helps to put on socks/coat/shirt, brushes teeth w/ help, zips/unzips w/ help to start, eating w/ minimal supervision

Speech: 50%-75% intelligible

Vocabulary: 450-1000 words

Language: requests permission for items or activities, begins to use language jokes and fantasies,  makes communication repairs when listener does not understand, engages in longer dialogues, carries on “conversation” with self and toys, looks for missing toys, holds up fingers to tell age, answers/understands “can you” questions, follows 2-step directions, responds to commands (i.e. show me your foot).

Literacy: holds a book correctly, begins to recognize logos, likes to listen to books for longer periods of time

3–3.5 Years

Fine/Gross Motor: balances on one foot for 3-5 seconds, walks down stairs (alternating feet), jumps over objects, throws ball and hits target, cuts out circle, uses static tripod grasp on writing utensil.

Self-care: puts on shoes w/o laces, zip/unzip completely, buttons/unbuttons, can find front of clothing, independent eating.

Speech: about 75% intelligible

Vocabulary: 1000-1200 words

Language: follows 2-step directions, takes turns during play, separates from caregiver easily, frequently practices conversation skills by talking to self, answers who, where, why, how questions.

Literacy: begins to pay attention to specific print (i.e. fist letter of name), talks about characters in a book, likes to “read” stories to self.

3.5–4 Years

Fine/Gross Motor: hops on one foot, gallops, catches bounced ball w/ 2 hands, colors w/in lines, cuts out square, copies cross/diagonal lines/square/name, completes up to 10-piece puzzle, ties single knot.

Self-care: supervision w/ toileting, puts on socks/shoes w/ correct orientation, supervision for teeth brushing.

Speech: about 75% intelligible

Vocabulary: 1200-1600 words

Language: expresses ideas and feelings, shows frustration if not understood, follows 2-step directions without help, begins dramatic play and acting out scenes, answers who, where, why, how questions, answers questions about function of objects (i.e. what do we use spoons for?), Understands simple “wh” questions, attends to name being called from another room.

Literacy: begins to pay attention to specific print (i.e. fist letter of name), talks about characters in a book, likes to “read” stories to self, identifies some letters, participates in rhyming games.

4–5 Years

Fine/Gross Motor: catches ball w/o trapping against body, stands on one foot for ~10 seconds, uses dynamic tripod grasp on writing utensil, draws stick figure, cuts w/ scissors.

Self-care: independent w/ toileting, assistance w/ washing hair and body thoroughly and for safety, ties/unties knots.

Speech: 75%-90% intelligible

Vocabulary: 1600-2500 words

Language: Follows 3-step directions without help, uses words to invite others to play, speaks of imaginary conditions, such as “what if,” answers “when” and “how many” questions, understands majority of things that are said at home/school.

Literacy: understands story sequence, understands the purpose/function of print.

5–6 Years

Fine/Gross Motor: runs w/ speed and endurance, skips proficiently, kicks w/ accuracy, hops on one foot ~15 times, writes first/last name, copies most lowercase and uppercase letters.

Self-care: ties shoes (assistance), manages fasteners on backs of clothes, combs hair, proficient use of knife

Speech: 90%-100% intelligible

Vocabulary: 2200-7000 words

Language: Asks meanings of words, likes to complete projects, asks questions for information, engages in cooperative play, follows 3-step directions.

Literacy: Recognizes letters and letter-sound matches, understands that print is left to right, retells simple stories, begins to write letters and some words, recognizes some words.