Paediatric development milestones Flashcards
When should you urgently refer a child?
They don’t smile at 10 weeks
Can’t sit unsupported at 12 months
Cannot walk at 18 months
Hand preference before 12 months
what fine motor problem needs urgent referral?
Hand preference before 12 months is abnormal and may indicate cerebral palsy
What are the common differential for a gross motor issue?
Variant of normal
Cerebral palsy
Neuromuscular disorder e.g. Duchenne’s
What should be checked if there is a speech and language issue?
hearing
causes of speech and language problems
Hearing
Environmental Deprivation
General developmental delay
Risk factors for cerebral palsy
HIE
preterm, low birth weight
what delayed motor milestones make cerebral palsy likely?
Not sitting by 8 months (corrected for gestational age)
Not walking by 18 months (corrected for gestational age)
Early asymmetry of hand function (hand preference) before 1 year (corrected for gestational age)
Persistent toe-walking
When do most children become toilet trained?
at or after 3 years
When should children be able to stand on one leg?
3 years
When should children be able to hop?
4 years
what is the limit for walking?
18 months
Quietens to parents voice
Turns towards sound
Squeals
3 months
Double syllables ‘adah’, ‘erleh’
6 months
Says ‘mama’ and ‘dada’
Understands ‘no’
9 months
Knows and responds to own name
12 months
Knows about 2-6 words (Refer at 18 months)
Understands simple commands - ‘give it to mummy’
12-15 months
Combine two words
Points to parts of the body
2 years
Vocabulary of 200 words
2½ years
Talks in short sentences (e.g. 3-5 words)
Asks ‘what’ and ‘who’ questions
Identifies colours
Counts to 10 (little appreciation of numbers though)
3 years
Asks ‘why’, ‘when’ and ‘how’ questions
4 years
by what age should they respond to their own name
1 year
motor milestones at 3 months
Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve
motor milestones at 6 months
Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back
motor milestones at 7-8 months
Sits without support (Refer at 12 months)
motor milestones at 9 months
Pulls to standing
Crawls
motor milestones at 12 months
Cruises
Walks with one hand held
motor milestones at 13-15 months
Walks unsupported (Refer at 18 months)
motor milestones at 18 months
Squats to pick up a toy
motor milestones at 2 years
Runs
Walks upstairs and downstairs holding on to rail
motor milestones at 3 years
Rides a tricycle using pedals
Walks up stairs without holding on to rail
motor milestones at 4 years
Hops on one leg
fine motor and vision milestones at 3 months
Reaches for object
Holds rattle briefly if given to hand
Visually alert, particularly human faces
Fixes and follows to 180 degrees
fine motor and vision milestones at 6 months
Holds in palmar grasp
Pass objects from one hand to another
Visually insatiable, looking around in every direction
fine motor and vision milestones at 9 months
Points with finger
Early pincer
fine motor and vision milestones at 12 months
Good pincer grip
Bangs toys together
number of bricks at 15 months
tower of 2
number of bricks at 18 months
tower of 3
number of bricks at 2 years
tower of 6
number of bricks at 3 years
tower of 9
drawing at 18 months
circular scribble
drawing at 2 years
copies vertical line
drawing at 3 years
copies circle
drawing at 4 years
copies cross
drawing at 5 years
copies square and triangle
book at 15 months
looks at book, pats page
book at 18 months
turns pages, several at a time
book at 2 years
turns pages, one at a time
social behaviour and play at 6 weeks
smiles
social behaviour and play at 3 months
laughs
enjoys friendly handling
social behaviour and play at 6 months
not shy
social behaviour and play at 9 months
shy
takes everything to mouth
feeding at 6 months
May put hand on bottle when being fed
feeding at 12-15 months
Drinks from cup + uses spoon, develops over 3 month period
feeding at 2 years
Competent with spoon, doesn’t spill with cup
feeding at 3 years
Uses spoon and fork
feeding at 5 years
Uses knife and fork
dressing at 12-15 months
Helps getting dressed/undressed
dressing at 18 months
Takes off shoes, hat but unable to replace
dressing at 2 years
Puts on hat and shoes
dressing at 4 years
Can dress and undress independently except for laces and buttons
play at 9 months
Plays ‘peek-a-boo’
play at 12 months
Waves ‘bye-bye’
Plays ‘pat-a-cake’
play at 18 months
Plays contentedly alone
play at 2 years
Plays near others, not with them
play at 4 years
Plays with other children
