Paeds developmental milestones Flashcards
6 weeks gross motor skills
- Good head control- raises head to 45° when on tummy
- Stabilises head when raised to sitting position
6 weeks fine motor/vision skills
Tracks objects/face
6 weeks speech/language
Stills, startles to loud noises
6 weeks social
Social smile (visual problem if not)
6 months gross motor skills
- Sit without support, rounded back
- Rolls tummy (prone) to back (supine) (vice versa slightlv later)
6 months fine motor/vision
- Palmar grasp (5 months)
- Transfer hand to hand
6 months speech/language
- Turns head to loud sounds
- Understands “bye bye” / “no” (7m)
- Babbles (monosyllabic)
6 months social
- Puts objects to mouth (stops at 1 year)
- Shakes rattle
- Reaches for bottle / breast
9 months gross motor
- Stands holding on
- Straight back sitting (7 ½ m)
- Crawls
9 months fine motor/vision
- Interior pincer grip
- Object permanence
9 months speech/language
- Responses to own name
- Imitates adult sounds
- Says mama and dada
9 months social
- Stranger fear (6-9 mtns - 2 yrs)
- Holds and bites food (usually weaned after 6 mnths)
12 months gross motor
Walks alone (9-18m) 18m is threshold for worry (i.e. Duchenne’s MD, hip problems, cerebral palsy etc)
12 month fine motor/visual
- Neat pincer grip (10m)
- Casting bricks (should disappear by 18m – persistence
beyond this = abnormal) - Tower of 2 bricks
12 months speech/language
- Shows understanding of nouns (“where’s Mummy?”)
- 3 words (50% at 13m)
- Points to own body parts (15m), doll (18m)
12 months social
- Waves “bye bye”
- Hand clapping
- Plays alone if familiar person nearby
- Drinks from beaker with lid
18 months gross motor
- Runs (16m)
- Jumps (18m)
18 months fine motor/visual
- Tower of 4 bricks
- Drawing to and fro (15 m)
18 months speech/language
- Shows understanding of nouns (“show me the x”)
- 1 to 6 different words
18 months social
Imitates every day activities
2 years gross motor
- Runs tiptoe
- Walks upstairs, both feet on each step
- Throws ball at shoulder level
2 years fine motor/visual
- Draws a vertical line
- Tower of 8 blocks
- Puzzles: shape matching is >2 yr skill. Random effort <2 yr
- Turns several pages of book at a time
2 years speech/language
- Shows understanding of verbs (“what do you draw with, what do you eat with?”)
- 2 words joined together (50+ words)
2 years social
- Eats skilfully with spoon (21⁄2 years)
- Plays near others but with them
2.5 years gross motor
- Kicks ball
2.5 years fine motor/visual
Draws a horizontal line
2.5 years speech/language
- Shows understanding of prepositions in/on (“put the cat on the bowl”)
- 3 – 4 words joined together
3 years gross motor
- Hops on one foot for 3 steps (each foot)
- Walks upstairs, one foot per step; downstairs two feet per step
3 years fine motor/visual
- Draws a circle
- Builds bridge/train with bricks
- Single cut with scissors
- Puts Grittiths beads on a string
3 years speech/language
- Understands negatives (“which of these is NOT an animal?”)
- Understands adjectives (“which one is red?”)
3 years social
- Begins to share toys with friends Plays alone without parents
- Eats with fork and spoon
- Bowel control
3.5 years fine motor/visual
- Cuts pieces with scissors
3.5 years language
Understands comparatives (“which boy is bigger than this one?” while pointing to middle-sized boy! Or draw circles to illustrate point
4 years gross motor
Walks upstairs / downstairs in adult manner
4 years fine motor/visual
- Draws Cross, Square (4.5 yrs), Triangle / person (5 yrs)
- Builds bricks: 12 blocks tower, step, big step (5 years)
- Cuts paper in half with scissors
- Put small beads on a string
4 years speech/language
- Understands complex instructions (“Before you put x in y, give z to Mummy”)
- Uses complex narrative / sequences to describe events
4 years social
- Concern/sympathy for others if hurt
- Has best friend
- Bladder control (41⁄2 years)- referral if >5 years
- Engages in imaginative play, observing rules (41⁄2 to 5 years old)
- Eats skilfully with little help
- Handles knife (at 5 yrs)
- Dressing and undressing
Referral points
- doesn’t smile at 10 weeks
- cannot sit unsupported at 12 months
- cannot walk at 18 months
Fine motor: hand preference before 12 months is abnormal and may indicate cerebral palsy
Most common causes of gross motor problems: variant of normal, cerebral palsy and neuromuscular disorders (e.g. Duchenne muscular dystrophy)
Speech and language problems: always check hearing, other causes include environmental deprivation and general development delay