Patient Education: Developmental Milestones

Part of the joy of being a parent is watching your child develop. Although every child develops differently, the following are guidelines you can use to track your child’s progress, adapted from "Caring for Your Baby and Young Child, Birth to Age 5" by Steven Shelov, M.D., American Academy of Pediatrics.

By the End of the Third Year (12-36 Months)

MOVEMENT MILESTONES

• Climbs well
• Walks up and down stairs, alternating feet
• Kicks ball
• Runs easily
• Pedals tricycle
• Bends over easily without falling

HAND AND FINGER SKILL MILESTONES

• Makes vertical, horizontal and circular strokes with pencil or crayon
• Turns book pages one at a time
• Holds pencil in writing position
• Screws and unscrews jar lids, nut and bolts
• Turns rotating handles

LANGUAGE MILESTONES

• Follows a two or three-component command
• Recognizes and identifies almost all common objects and pictures
• Understands most sentences
• Understands physical relationships (on, in, under)
• Uses four or five word sentences
• Can say names, age and gender
• Uses pronouns (I, you, me, we, they) and some plurals (cars, dogs)
• Strangers can understand most of his or her words

COGNITIVE MILESTONES

• Makes mechanical toys work
• Matches an object in his hand or room to picture in a book
• Plays make-believe with a doll, animals or people
• Sorts objects by shape and color
• Completes puzzles with three or four pieces
• Understands concept of "2"

SOCIAL MILESTONES

• Imitates adults and playmates
• Spontaneously shows affection for familiar playmates
• Can take turns in games
• Understands concept of "mine" and “his/hers"

DEVELOPMENTAL HEALTH WATCH
If a child displays any of the following signs they should be referred to his or her pediatrician.

• Frequent falling and difficulty with stairs
• Persistent drooling or very unclear speech
• Difficulty manipulating small objects
• Inability to copy a circle by age 3
• Inability to communicate in short phrases
• No involvement in pretend play
• Failure to understand simple instructions
• Little interest in other children
• Extreme difficulty separating from primary caretaker

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