Development: Milestones

Question 1

What 4 functional areas can developmental milestones be separated into?

Answer 1

1) Gross motor

2) Vision and fine motor

3) Hearing, speech and language

4) Social, emotional and behavioural

Question 2

Developmental milestones must be considered in regards to their ‘median age of acquisition’ and the ‘limit age’.

What does this refer to?

Answer 2

Median age of acquisition: when half of a standard population of children achieve that level.

Limit age: by which they should have been achieved.

Question 3

What is the median age and limit age of walking?

Answer 3

Median - 12 months

Limit - 18 months

Question 4

What does gross motor refer to?

Answer 4

The child’s development of large movements, such as sitting, standing, walking and posture.

Development in this area happens from the head downwards.

Question 5

Give the gross motor development milestones and their average age

Answer 5

Newborn:
- Limbs flexed
- Symmetrical pattern, marked head lag on pulling up.

2-3 months:
- Almost no head lag when pulled to sit
- Lifts head and chest when prone

6 months:
- Rolls from back to front
- When held, stands and sit with a straight back
- Bears most of own weight

6-9 months:
- Sits without support
- Stands holding onto furniture

8-9 months:
- Crawling

10-12 months:
- Stands without support
- Crawls, bottom shuffles or ‘bear-walks’
- Cruises along furniture (walking whilst holding on)
- May walk unsteadily

15 months:
- Walks without support

18 months:
- Walks steadily, stopping safely
- Squats to pick up a toy
- Climbs stairs holding a hand or a rail

2 years:
- Runs safely
- Throws a ball overhand
- Walks up and down stairs, both feet on each step

30 months:
- Jumps on 2 feet
- Kicks a ball

3 years:
- Walks backwards and sideways
- Rides a tricycle
- Catches a large ball with arms outstretched

5 years:
- Hops
- Catches a ball
- Heel-toe walking
- May ride a bike

Question 6

What is the limit age for sitting without support?

Answer 6

9 months

Question 7

At what age do children typically begin crawling?

Answer 7

8-9 months

Question 8

At what age do children typically begin walking unsteadily?

Answer 8

12 months

Question 9

What is the limit age for walking unsteadily?

Answer 9

18 months

Question 10

At what age do children typically begin walking steadily?

Answer 10

15 months

Question 11

At what age do children typically begin running?

Answer 11

2-2.5 years

Question 12

What are fine motor skills?

Answer 12

Fine motor refers to a the child’s development of precise and skilled movements, and also encompasses their visual development and hand-eye coordination.

Question 13

Give the early fine motor development milestones and their average age

Answer 13

6 weeks:
- Follows moving object or face by turning the head (fixing and following)

4 months:
- Reaches out for toys

4-6 months:
- Palmar grasp

7 months:
- Transfers toys from one hand to another

10 months:
- Mature pincer grip

16-18 months:
- Makes marks with crayons

Question 14

What is the limit age for following a moving object or face by turning the head (fixing and following)?

Answer 14

3 months

Question 15

What is the limit age for reaching out for toys?

Answer 15

6 months

Question 16

What is a palmar grasp of an object?

Answer 16

wraps thumb and fingers around the object

Question 17

What are the fine motor development milestones regarding tower brick building and the average age?

Answer 17

Tower of three – 18 months

Tower of six – 2 years

Tower of eight or a train with four bricks – 2.5 years

Bridge (from a model) – 3 years

Builds steps (after demonstration) – 4 years

Question 18

What are the fine motor development milestones regarding pencil skills and the average age?

Answer 18

Line – 2 years

Circle – 3 years

Cross – 3.5 years

Square – 4 years

Triangle – 5 years

Question 19

What are the 2 components of langauge?

Answer 19

Expressive & receptive

Question 20

What are the expressive language development milestones and their average age?

Answer 20

Newborn: Cries

6-8 weeks : Cooing noises

3 months: Laughs & vocalises

6 months: Makes noises with consonants (starting with g, b and p)

9 months: Babbles, sounding more like talking but not saying any recognisable words. Imitates adult sounds.

12 months: Says single words in context, e.g. “Dad-da” or “Hi”

18 months: Has around 5 – 40 words. Tries to sing.

2 years: Speaks over 200 words, understands many more. Joins words together.

2.5 years: Continually asks questions.

3 years: Using basic sentences. Can name 2 or 3 colours.

4 years: Tells stories and talks fluently. Enjoys jokes.

5 years: Fluent in speech and mostly grammatically correct. Interested in reading and writing

Question 21

At what age do children typically start cooing?

Answer 21

6-8 weeks

Question 22

At what age do children typically start laughing?

Answer 22

3 months

Question 23

What are the receptive language development milestones and their average age?

Answer 23

3 months: Recognises parents and familiar voices and gets comfort from these

6 months: Responds to tone of voice

9 months: Listens to speech

12 months: Follows very simple instructions

18 months: Understands nouns, for example “show me the spoon”

2 years: Understands verbs, for example “show me what you eat with”

2.5 years: Understands propositions (plan of action), for example “put the spoon on / under the step”

3 years: Understands adjectives, for example “show me the red brick” and “which one of these is bigger?”

4 years: Follows complex instructions, for example “pick the spoon up, put it under the carpet and go to mummy”

Question 24

What do personal and social developmental milestones refer to?

Answer 24

Refers to the child’s development of skills in interacting, communicating, playing and building relationships.

Question 25

What are the social, emotional and behavioural development milestones and their average age?

Answer 25

6 weeks: Smiles responsively

6-8 months: Puts food in their mouth

10-12 months: Waves bye-bye, plays peek-a-boo

12 months: Drinks from a cup with two hands

18 months: Holds spoon and gets food safely to mouth

18-24 months: Symbolic play

2 years: Toilet training: dry by day. Pulls off some clothing.

2.5-3 years: Parallel play. Interactive play evolving. Takes turns.

Question 26

What is the limit age for smiling responsively?

Answer 26

8 weeks

Question 27

What is the limit age for symbolic play?

Answer 27

2-2.5 years

Question 28

List some developmental milestone red flags

Answer 28

• Lost developmental milestones
• Not able to hold an object at 5 months
• Not sitting unsupported at 12 months
• Not standing independently at 18 months
• Not walking independently at 2 years
• Not running at 2.5 years
• No words at 18 months
• Not smiling at 10 weks
• No interest in others at 18 months

Question 29

What is global developmental delay?

Answer 29

Refers to a child displaying slow development in all developmental domains.

Question 30

What are some conditions that can cause global developmental delay?

Answer 30

1) Down’s syndrome
2) Fragile X syndrome
3) Fetal alcohol syndrome
4) Rett syndrome
5) Metabolic disorders

Question 31

What are some conditions that can cause gross motor delay?

Answer 31

1) Cerebral palsy
2) Ataxia
3) Myopathy
4) Spina bifida
5) Visual impairment

Question 32

What are some conditions that can cause fine motor delay?

Answer 32

1) Dyspraxia
2) Cerebral palsy
3) Muscular dystrophy
4) Visual impairment
5) Congenital ataxia (rare)

Question 33

What are some causes of language delay?

Answer 33

1) Specific social circumstances, for example exposure to multiple languages or siblings that do all the talking

2) Hearing impairment

3) Learning disability

4) Neglect

5) Autism

6) Cerebral palsy

Question 34

What are some causes of personal and social delay?

Answer 34

1) Emotional and social neglect
2) Parenting issues
3) Autism