Paeds - Developmental milestones

Question 1

What gross motor skills should a child have at 6 weeks?

Answer 1

Good head control - Raises head to 45 degrees when on tummy
Stabilises head when raised to sitting position

Question 2

What gross motor skills should a child have at 6 months?

Answer 2

Sitting without support with a rounded back
Can roll from their tummy to their back (vice versa slightly later)

Question 3

Which comes first - rolling from tummy to back, or back to tummy?

Answer 3

Tummy to back

Question 4

What gross motor skills should a child have at 7.5 months?

Answer 4

Sitting with a straight back

Question 5

What gross motor skills should a child have at 9 months?

Answer 5

Standing holding on

Question 6

When is a child expected to be able to walk? When is it a red flag if a child is not walking? What are some possible causes for delayed walking?

BONUS: One cause is genetic - what is the mode of inheritance? One cause can be identified during a NIPE using which manoeuvres?

Answer 6

Between 9 and 18 months

Not walking by 18 months is a red flag. Possible causes of delayed walking include Duchenne’s Muscular Dystrophy, hip problems and cerebral palsy

BONUS: Duchenne’s MD is X-linked recessive. The Barlow and Ortolani manoeuvres can identify hip problems during a NIPE

Question 7

Which comes first, running or jumping? At what ages?

Answer 7

Running is first (16 months), then jumping (18 months)

Question 8

What gross motor skills should a child have at 2 years old?

Answer 8

Running tiptoe
Walking upstairs - both feet on each step
Throwing a ball at shoulder level

Question 9

What gross motor skills should a child have at 2.5 years old?

Answer 9

Kicking a ball

Question 10

What gross motor skills should a child have at 3 years old?

Answer 10

Hopping on one foot for 3 steps (both feet)
Walking upstairs one foot per step
Walking downstairs two feet per step

Question 11

When should children be able to use stairs?

Answer 11

2 years: Walk upstairs two feet per step

3 years: Walk upstairs one foot per step, walk downstairs two feet per step

4 years: Use stairs like an adult

Question 12

What gross motor skills should a child have at 4 years old?

Answer 12

Walking upstairs / downstairs in an adult manner

Question 13

What fine motor skills should a child have at 6 weeks?

Answer 13

Tracking objects / faces

Question 14

What fine motor skills should a child have at 6 months?

Answer 14

Transferring hand to hand

Question 15

What fine motor skills should a child have at 5 months?

Answer 15

Palmar grasp

Question 16

What fine motor skills should a child have at 9 months?

Answer 16

Inferior pincer grip
Object permanence

Question 17

When do children develop object permanence?

Answer 17

9 months

Question 18

What fine motor skills should a child have at 12 months? BONUS: What red flag should we look out for?

Answer 18

Stacking 2 bricks
Casting bricks - this should disappear by 18 months. Persistence beyond this is abnormal

Question 19

What fine motor skills should a child have at 10 months?

Answer 19

Neat pincer grip

Question 20

What fine motor skills should a child have at 18 months?

Answer 20

Stacking 4 bricks

Question 21

What fine motor skills should a child have at 15 months?

Answer 21

Drawing to and fro

Question 22

What fine motor skills should a child have at 2 years old?

Answer 22

Drawing a vertical line
Stacking 8 bricks
Attempting puzzles (matching shapes). Children under 2 years will try randomly
Turning several pages of a book at a time

Question 23

What fine motor skills should a child have at 2.5 years old?

Answer 23

Drawing a horizontal line

Question 24

What fine motor skills should a child have at 3 years old?

Answer 24

Drawing a circle
Building a bridge with bricks
Single cuts with scissors
Use Griffiths beads
Turn one page of a book at a time

Question 25

What fine motor skills should a child have at 3.5 years?

Answer 25

Cutting pieces using scissors

Question 26

What fine motor skills should a child have at 4 years old?

Answer 26

Drawing a cross Stacking 12 blocks Cutting paper in half Using small beads

Question 27

What fine motor skills should a child have at 4.5 years old?

Answer 27

Drawing a square Building steps using bricks

Question 28

What fine motor skills should a child have at 5 years old?

Answer 28

Drawing a triangle or person Building big steps with bricks

Question 29

What shapes should a child be able to draw, and at what ages?

Answer 29

15 months - To and fro 2 years - Vertical line 2.5 years - Horizontal line 3 years - Circle 4 years - Cross 4.5 years - Square 5 years - Triangle / person

Question 30

How many bricks should a child be able to stack, and at what age?

Answer 30

12 months - 2 bricks 18 months - 4 bricks 2 years - 8 bricks 3 years - Build a bridge or train 4 years - 12 bricks, build steps 5 years - Build big steps

Question 31

What speech and language skills should a child have at 6 weeks?

Answer 31

Stills and startles at loud noises

Question 32

What speech and language skills should a child have at 6 months?

Answer 32

Turns head to loud sounds Monosyllabic babbles

Question 33

What speech and language skills should a child have at 7 months?

Answer 33

Understands "bye bye" and "no"

Question 34

What speech and language skills should a child have at 9 months?

Answer 34

Responds to own name Imitates adult sounds

Question 35

What speech and language skills should a child have at 12 months?

Answer 35

Shows understanding of nouns (eg. "where's mummy?") 3 words

Question 36

What speech and language skills should a child have at 15 months?

Answer 36

Points to own body parts

Question 37

What speech and language skills should a child have at 18 months?

Answer 37

Points to body parts on a doll Shows understanding of nouns ("show me the [blank]") 1 to 6 different words

Question 38

What speech and language skills should a child have at 2 years old?

Answer 38

Shows understanding of verbs ("what do you draw with? What do you eat with?") 2 words joined together (50+ words)

Question 39

What speech and language skills should a child have at 2.5 years old?

Answer 39

Shows understanding of prepositions in/on ("put the cat on the bowl") 3-4 words joined together

Question 40

What speech and language skills should a child have at 3 years old?

Answer 40

Understands negatives ("which of these is NOT an animal?") Understands adjectives ("which one is red?")

Question 41

What speech and language skills should a child have at 3.5 years old?

Answer 41

Understands comparatives ("which boy is bigger than this one?")

Question 42

What speech and language skills should a child have at 4 years old?

Answer 42

Understands complex instructions ("before you put x in y, give z to Mummy") Uses complex narrative / sequences to describe events (eg. ask them to tell you what they did in school)

Question 43

How should a child's grasp of language develop?

Answer 43

7 months - Understands "bye bye" and "no" 12 months - Shows understanding of nouns ("where's Mummy?") 18 months - Shows understanding of nouns ("show me the [blank]") 2 years - Shows understanding of verbs ("what do you draw with, what do you eat with?") 2.5 years - Shows understanding of prepositions in/on ("put the cat on the bowl") 3 years - Understands negatives ("which of these is NOT an animal") and adjectives ("which one is red?") 3.5 years - Understands comparatives ("which boy is bigger than this one?") 4 years - Understands complex instructions ("before you put x in y, give z to Mummy")

Question 44

What social skills should a child have at 6 weeks? What do we need to worry about?

Answer 44

Social smile If not, there is concern about a vision problem

Question 45

What social skills should a child have at 6 months?

Answer 45

Puts objects to mouth (stops at 1 yr) Shakes rattle Reaches for bottle / breast

Question 46

When should a child normally have stranger fear?

Answer 46

Between 6-9 months and 2 years

Question 47

What social skills should a child have at 9 months?

Answer 47

Stranger fear Holding and biting food

Question 48

What social skills should a child have at 12 months?

Answer 48

Waves "bye bye" Hand clapping Plays alone if familiar person nearby (remember stranger fear is normal at this point) Drinks from beaker with lid

Question 49

What social skills should a child have at 18 months?

Answer 49

Imitates everyday activities

Question 50

What social skills should a child have at 2.5 years?

Answer 50

Eats skilfully with spoon

Question 51

What social skills should a child have at 3 years old?

Answer 51

Begins to share toys with friends Plays alone without parents (should not have stranger fear anymore) Eats with fork and spoon Bowel control

Question 52

What social skills should a child have at 4 years?

Answer 52

Concern / sympathy for others if hurt Has best friend Eats skillfully with little help Can dress and undress

Question 53

What social skills should a child have at 4.5 years?

Answer 53

Bladder control Engaged in imaginative play, observing rules (4.5 - 5 years)

Question 54

What social skills should a child have at 5 years old?

Answer 54

Handles knife