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 Fourth Year (3-4 years)

MOVEMENT MILESTONES

• Hops and stands on one foot
• Goes up stairs and down stairs without support
• Kicks ball forward
• Throws ball overhand
• Catches bounced ball most of the time
• Moves forward and backward with agility

HAND AND FINGER MILESTONES

• Copies square shapes
• Draws a person with two to four body parts
• Uses scissors
• Draws circles and squares
• Begins to copy some capital letters

LANGUAGE MILESTONES

• Understands the concepts of "same" and "different"
• Speaks in sentences of five or six words
• Speaks clearly enough for strangers to understand
• Tells stories

COGNITIVE MILESTONES

• Correctly names some colors
• Understands the concept of counting and knows a few numbers
• Approaches problems from a single point of view
• Begins to have a clearer sense of time
• Follows three-part commands
• Recalls part of a story
• Understands the concept of “same” and “different”
• Engages in fantasy play

SOCIAL MILESTONES

• Interested in new experiences
• Cooperates with other children
• Plays "mom" or "dad"
• Dresses and undresses
• Negotiates solutions to conflicts

EMOTIONAL MILESTONES

• Imagines that many unfamiliar images may be "monsters"
• Views self as a whole person involving body, mind and feelings
• Often cannot distinguish between fantasy and reality

DEVELOPMENTAL HEALTH WATCH
Refer the child to a pediatrician if he/she displays any of the following signs:

• Cannot throw a ball overhand
• Cannot jump in place
• Cannot grasp a crayon between thumb and fingers
• Has difficulty scribbling
• Shows no interest in interactive games
• Ignores other children
• Does not engage in fantasy play
• Resists dressing, sleeping, using the toilet
• Lashes out without any self control when angry or upset
• Cannot copy a circle
• Does not use "me" and "you" appropriately
• Speech is not fully understood by strangers

« 3 years