Session 2: Developmental Milestones Flashcards
2 months Gross motor milestone (3)
- Head to 45 degrees
- Can lift head; Sustains head in ventral
- Active grasp
2 months fine motor milestone
Follows past midline and follows to midline
2 months social/emotional milestones (3)
- Laugh
- Vocalizes- vowel sounds “coos”
- Smiles spontaneously and responsively
4 weeks old developmental milestones (3)
- Lifts and turns head
- Reflex grasp
- Follows with eyes to midline
5 weeks old developmental milestones (3)
- Regards face
- Lifts head while prone
- Equal movements of extremities
3 months developmental milestones (6)
- Raise head above ventral plane + legs extended-up to 90 degree angle
- Will make hand contact and hold briefly
- Some head control
- Grabs rattle
- Follows past midline
- stop movement, appears to listen, turn toward sound
Red flags at 3 months old (3)
- No social smile
- Persistent fisting (cortical thumb; fisting of hands indicates hypertonicity)
- Failure to alert to visual/auditory stimuli
4 Months Development (6)
- No head lag (sit-head steady)
- Hands in midline; may have bald spot due to midline position
- May go from laughing to crying
- Follows to 180 degrees
- Turns to rattling sound
- Regards own hand
5 Months Development (3)
- Head erect and steady
- Begin to roll over: first from prone to supine
- Can be pulled to a standing position and can support weight
6 Months Development (7)
- No more head lag!
- Reaches for an object
- Turns to voice or rattling sound
- Transfer from hand to hand after learning to grasp
- May sit alone, but can roll especially from prone position
* SITS W/O SUPPORT - Feed self
- Work for toy out of reach (REACHING)
7 Months Normal Development (3)
- Pursue a pellet with raking (Raking object into palm with flexed fingers and proximal and distal thumb joints flexed) - cannot pick up
- Will respond to changes in facial expressions
- Pivot in prone position to go after an object
8 Months Normal Development (8)
- Go sitting position without help with back straight
- Stands if hands are held
- Repetitive constants: ma-ma baba
- Responds to name
- Separation anxiety
- Plays peek-a-boo in preparation
- Feeds self crackers
- Turns to voice
9 Months Normal Development (9)
- Sits without support, stands holding on
* pulls to stand - Imitates speech sounds
- May take steps with both hands held
- Pincer motion (thumb finger grasp)
- Wave bye-bye
- Object permanence - looking for an object when it disappears
- Becomes less dependent on presence of mother
- Feeds self
- Fine motor: takes 2 cubes and passes the cube (transfer)
Red flags between 6-12 months (4)
- Persistence of primitive reflexes after 6 months
- No babbling by 6 months
- No reciprocal vocalization by 9 months
- Inability to localize sound by 10 months
Normal development: 12 months (9)
- Responds to no
- Stands alone for 2 seconds
- Pincer without ulnar
- Games with ball
- Extend an object and release it into offered hand
- rise independently and take a step
- Bangs two cubes in hand
- imitates vocalizations/sounds and activities
- Babbling
Normal Development: 15 months (8)
- Walks alone/walks well
- Stoops to recover toy on floor
- Says 1 word besides “da-da” and “ma-ma”
- Jargon
- Put pellet into a small bottle
- Put 1 cube on top of another with demonstration
- Manages/drinks from cup
- Walks backwards
15 Months Fine motor (2)
- Scribble
2. Puts block in cup
Normal Development: 18 months (8)
- Says 3 words besides “ma ma” “da da”
- Walks backwards
- Imitates household chores (ex: sweeping)
- Scribbles
- Up stairs one at a time with 1 hand held
- Dump pellet(raisin) from bottle
- Stacks 2 blocks (tower 2 cubes)
- Lifts elbow
20 months development
Go down stairs one at a time with 1 hand held
Cognitive Development: 18 months
Can point to at least 1 body part
Knows 6 words total including mama dada
2 years old Normal Development (12)
- Speech should be understood
- Gains 5-6 pounds and 5 inches
- Head growth is 2cm
- Kicks ball forward
- Removes articles of clothing (not hat)
- Combines two words
- Mild lordosis with protuberant abdomen
- 8 more teeth to total 14-16
- Tower of 7 cubes
- Imitate circular strokes / horizontal lines
* Scribbling becomes nicer drawings - Empty trash cans and drawers
- Parallel play
Developmental Red Flags 15-24 months (6)
- No consonant production by 15 months
- No words
- Hand dominance before 18 months
- Not walking by 18 months
- Inability to walk up and down stairs by 24 months
- No two word sentences by 24 months (biggest risk factor for speech delay)
Red flags in evaluating infant motor development: abnormal movement patterns (2)
- Increased tone: spasticity
- Early rolling (1 month)
- Pulling directly to stand at 4 months
- W-sitting
- Persistent toe walking
- Hand dominance prior to 18 months (hemiparesis)
* *Don’t want this because it means the other side is weak
Red flags in evaluating infant motor development: motor development (4)
- No rolling to prone to supine by 7 months
- No rolling supine to prone by 9 months
- No unsupported sitting by 10 months
- No independent steps by 18 months
Important Fine Motor Milestones (5)
- Tower of 8 cubes: 2.5 years old
- Thumb wiggle: 2.5 years old
- Copies circle: 3-3.5 years old
- Person with 6 parts: 4.5 years
- Copies square by 5 years but can start as early as 4.5 years
Gender identity at 2 years old
Knows male or female
Gender identity at 3-4 years old
Show sex typed preference
Gender identity at 5-6 years old
Notion of how male or female should dress
Language Overview (4)
Language is a sequential acquisition in following pattern:
- Emergence of words and basic vocabulary
- Transition from one word to word and phrase combinations
- Transition from single to complex sentences
- Most importantly, language acquisition is influenced by biological factors as well as child’s rearing environment
How Language Develops
Baby’s earliest communication is to attract attention from parents and others in the environment
Receptive Vocabulary
Refers to words an individual understands and which greatly increases in second year (can understand ~75 words at 1 year old)
*Ex: you coo and they coo back
Spoken Vocabulary
Begins when the infant utters its first word occurring at approximately 10-15 months of age (what they say)
Receptive Vocabulary from Birth-3 months (2)
- Attends to voices/sounds
2. Prefers parental voice, may orient to voice by turning eye
Expressive Vocabulary from Birth-3 months (3)
- Has different cries
- Vocalizes (coos, gurgles)
- Reciprocal vocalization
Receptive Vocabulary from 3 months-6 months (3)
- Works to localize vocalization sound
- Enjoys toys that make noise
- Responds to name at 6 months
Receptive Vocabulary: 6-9 Months (2)
- Looks to family members when named
2. Begins to understand words
Expressive Vocabulary: 6-9 Months (3)
- Vocal play
- Babbles with a string of syllables with intonation
- Uses mama and dada nonspecific
Receptive Vocabulary: 9 months - 1 year (3)
- Understands verbal cues and peek-a-boo
- Looks when name is called
- 70 words at 12 months
Expressive Vocabulary: 9 months- 1 year (4)
- Uses mama and dad specific
- Imitates
- Waves bye bye
- Reaches to be picked up
Receptive vocabulary: 12-15 months
Follow one step direction
Expressive vocabulary: 12-15 months
Shakes head and uses 3-6 words
Receptive Vocabulary 15-18 months
points to objects
picture at 18 months
Expressive Vocabulary 15-18 months (2)
- Repeats words
2. Says no
Receptive Vocabulary: 18-24 months (2)
- Follows two step directions
2. Enjoys simple stories
Expressive Vocabulary: 18-24 months (3)
- Language explosion
- Up to 50 words with average fo 200 words by age 2 years
- 50% intelligible
Receptive Vocabulary: 24-30 months (2)
- 2 step directions
2. Able to point to different actions
Expressive Vocabulary: 24-30 months (3)
- Less jargon
- Simple questions
- Joins in songs
Receptive Vocabulary: 30-36 months
- 2-3 step directions
2. Identifies colors
Expressive Vocabulary: 30-36 months
- Uses 900-1,000 words
2. Speech is 75% intelligible by age 3 years
Receptive Vocabulary: 36-48 months
Points to objects by category
Expressive Vocabulary: 36-48 months
5-6 word sentences by age 4
When to refer…(5)
- When recommended by screening tool
- Delay in language development > 1 year old
- Speech noticeably unintelligible
- Positive hearing loss
- Presence of an obvious medical problem
* Early intervention programs are mandated by law
Where to refer…(4)
- Audiologist/ENT for hearing related issues
- Early intervention ( less than 3 years old)
- Contact local school districts or health departments for available services (3 years or older)
- American Speech Language and Hearing Association
Other Language Concerns
Stuttering (repetition/pauses/eye blink)
- *This is normal for preschooler (2-5 years)
- Refer if the child is 6 or older, embarrassed, interferes with communication, parents very concerned, or if it lasts more than 6 months
Types of Play (3)
- Solitary play: infancy
- Parallel play: toddler
- Preschooler: cooperative play, dramatic presented play,rough and tumble pray
