Pediatric Developmental Milestones

Receptive Language – Does your child comprehend?

Age Milestone
12 months Your child should recognize the names of simple, common objects, familiar people, and action verbs.
18 months Your child should understand new words each week, identify pictures in a book, know a few major body parts, and identify some common objects.
2 years Your child should recognize many common objects and pictures when named. They should also be able to follow several simple directions.
3 years Your child should be able to listen to simple stories, follow a two step command, and understand the concept of taking turns.
4 years Your child should be able to correctly identify colors, understand “more” and “most”, and make inferences.
5 years Your child should understand time concepts, understand qualitative concepts, and understand “-er” as “one who does something”.
6 years Your child should understand passive voice tense, identify objects that don’t belong, and be able to order pictures from largest to smallest.

Expressive Language – How your child communicates; through words, gestures, etc.

Age Milestone
12 months Your child should use anywhere from one to three words.
18 months Your child should repeat some overheard words and begin to try to communicate with more words than gestures.
2 years Your child should join words into phrases such as “more ball” or “bye mama”.
2½ years Your child should begin to use short phrases 3-4 words in length.
3 years Your child should have a vocabulary of approximately 1000 words and be about 75% intelligible.
3½ years Your child should be able to name pictures in a book, tell how an object is used, and use possessives.
4 years Your child should be about 95% intelligible, even to unfamiliar listeners.
4½ years Your child should be able to respond to “where” questions and complete analogies.
5½ years Your child should be able to repeat sentences, use adjectives to describe objects, use past tense forms of verbs (-ed), and describe similarities.
6½ years Your child should be able to define words, rhyme words, and repair grammatical errors.

SPEECH SOUNDS – At what age a particular speech sound should be mastered?

Age Milestone
3 m, n, h, p, f, w, b, and d
4 k, g, and t
5 j and v
7 ing, l, s, r, ch, z, th, and sh

FINE MOTOR DEVELOPMENT (Occupational Therapy)

Use this chart as a guideline. If your child is unable to do multiple tasks under his or her age range, then an OT referral might be necessary.

Age Milestone
7-12 months • Able to pick up small objects using thumb and finger/fingers
10 months • Pokes and/or points with index finger
12-18 months • Holds crayon with whole hand, thumb up
2 years • Holds crayon with thumb and all fingers, forearm turned so thumb is pointing down
• Puts on shoes, socks, and shorts; takes off shoes and socks
• Can use a spoon independently, keeping it upright
• Can draw and copy a vertical line
2½-3 years • Strings large beads
• Snips paper with scissors
• Rolls clay/playdoh into “snake”
• Can draw and copy a horizontal line
3-3½ years • Able to complete simple puzzles
• Can build a tower of nine small blocks
• Can get himself dressed/undressed independently; only needs help with buttons; still confuses front/back for clothes, • and right/left for shoes
• Can feed self with little or no spilling
• Drinks from a cup/glass with one hand
3½-4 years • Can pour his own drink from a pitcher (if not too heavy)
• Can place small pegs into small holes
• Able to string small beads
• Can hold a pencil with a “tripod grasp” (3 fingers), but moves forearm and wrist to write/draw/color
4-4½ years • Can use scissors to follow and cut both straight and curved lines
• Can manage buttons, zippers, and snaps completely
• Can draw and copy a cross (one vertical and one horizontal intersecting lines)
4½-5 years • Can hold fork using his fingers
• Can feed self soup/cereal with little or no spilling
• Folds paper in half, making sure the edges meet
• Puts a key in a lock and opens it
5 years • Can get dressed completely by himself, and usually tie shoelaces
• Cuts square, triangle, circle, and simple pictures with scissors
• Uses a knife to spread food items (jelly, peanut butter, mayo etc.), uses a dull knife to cut soft foods
• Able to draw and copy a diagonal line
• Uses a “tripod grasp” on writing utensils (thumb & tips of 1st two fingers) and uses fingers only to write/draw/color
5½-6 years • Can build a five block “bridge”
• Sufficient hand coordination to cut out complex pictures, accurately following the outline
• Able to copy a sequence of letters or numbers correctly
6 years • Able to complete complex, jigsaw type puzzles