MilestoneS
Communication
| Receptive | Expressive | Pragmatics/Social Language | |
|---|---|---|---|
| Birth-6 Months | Startles to loud sounds. Responds to voice and sound. Turns head towards a sound source. Recognizes familiar voices. | Reflexive vocalizations (crying, burping, coughing, sneezing). Makes different sounds when happy/upset. Cooing. Vocal play- squeals, clicks, growls, yells, blowing ‘raspberries.’ Begins using sounds p, b, m with vowels. Laughs. | Social smile. Calms down when spoken to. Uses babbling to gain attention. Establishes eye contact. |
| 6-12 Months | Responds to name. Understands ‘no.’ Understands common words (e.g., mommy, ball, cup). Looks at familiar objects, pictures, or family members when named. | Begins babbling- using long strings of sounds (e.g., ba-ba-ba). Early gestures emerge- reaching for “up,” waving bye-bye, and clapping. Uses gestures and sounds to gain attention. Tries to imitate different sounds. | Coos and squeals for attention. Babbles back and forth with caregiver. Smiles at self in mirror. Plays games like “peek-a-boo” and “pat-a-cake.” Copies simple actions of others. Manipulates and explores objects. Solitary play. |
| 12-18 Months | Understands 50+ words. Understands simple commands with gestures (e.g., ‘get the book’). Understands ‘come here’ and ‘sit down.’ Attends to an activity for about 2 minutes. Listens to simple stories. | First words emerge around first birthday. Uses at least 10 words by 18 months. New gestures emerge- pointing, high five, shaking head. Uses sentence-like intonation/jargon. Points to objects, pictures, people. Tries to frequently imitate new, simple words- uses mostly nouns. Produces mostly unintelligible speech. | Brings objects to show adult. Gains attention by vocalizing or pointing. Uses bye and other social words, such as “hi,” “thank you,” and “please.” Initiating affection. Imitates adult movements (e.g., sweeping). Begins self-play. Uses a toy for its function (e.g., push a car). Simple pretend play with self (e.g., pretends to drink from a cup). Has toy preferences. |
| 18-24 Months | Understands 300+ words. Identifies several body parts. Understands familiar action words. Recognizes named familiar people and objects. Follows simple commands and understands simple questions. Understands some early prepositions (e.g., ‘in’ and ‘on’). | Uses words more than gestures. Consistently imitates new words. Uses at least 50 words by 24 months. Names familiar objects, animal sounds, and verbs. Uses words for more than requesting (e.g., labeling, protesting). Begins to use simple phrases. Uses intonation to ask yes/no questions. Answers simple “what’s this” questions. Uses a variety of consonant sounds. Is understood 25-50% of the time by unfamiliar listeners. | Begins to observe others during play (onlooker play); play begins to extend beyond itself. Participates in symbolic play by using one object to represent another object (e.g., using the remote as a microphone). Combines objects during play (e.g., uses spoon to eat from bowl then feeds doll). Parallel play emerging around 2. |
| 2-3 years | Consistently follows 2-step commands (e.g., “get the book and put it in the box”) without gestures. Understands early quantity concepts “one” and “all.” Understands new prepositions (e.g., under, off). Understands simple descriptive concepts/adjectives (e.g., big). Understands early pronouns like “you,” “me,” “he.” Comprehends simple questions. Identifies common objects by function and sorts by category. | Engages in longer dialogues (frequently uses 2-word phrases; 3 and 4-word phrases emerging). Has a word for almost everything. Begins to use different word combinations (e.g., noun+verb). Uses plurals (e.g., ‘socks’), past tense verbs (e.g., jumped), pronouns (e.g., I), and basic prepositions (e.g., in). Asks simple questions (e.g., mommy? eat cookie?). Learns to answer early WH questions. Uses at least 300 words by 36 months. Should stop omitting final consonants by 36 months. Use the following sounds by 36 months- p b, m, d, n, h, t, k, g, w, ng, f, y. Is understood 50-75% of the time by unfamiliar listeners. | Attends to activity for 6-7 minutes. Begins to use language for jokes, teasing, pretending. Carries on “conversation” with self. Makes conversational repairs when listener does not understand. Associative play emerging (watching and imitating peers, but each child has their own focus) around 3. Participates in imaginative play (e.g., pretending to drink from an imaginary cup). More elaborate pretend/symbolic play. Participates in simple group activities. |
| 3-4 Years | Improved listening skills. Follows three-step directions. Understands more complex sentences. Understands negatives in sentences. Begins to understand when, why, and how. Understands quantity concepts (e.g., some), spatial concepts (e.g., behind), same/different, and emotion words. | Uses more than 1,000+ words. Uses 4-5+ word sentences. Expresses ideas and feelings and communicates easily with others. Describes the use of objects and differentiates by color, size, shape). Uses possessive’s (e.g., puppy’s ball), more verb forms, and more pronouns. Answers more complex questions- who, why, where, how, when. Answers hypothetical questions (e.g., “what would you do if…”). Uses the following sounds by 4- l, j, ch, s, v, sh, z. | Cooperative play emerging around 4. Takes turns and plays cooperatively. Pretend play of less frequently experienced events (e.g., going to the doctor). Begins dramatic play. |
| 4-5 Years | Understands most of what is said to them. Answers simple questions following short story. Understands comparative and superlative adjectives (e.g., big, bigger, biggest). Understands sequence concepts (e.g., first, middle, last). Understands advanced time concepts (e.g., yesterday today). | Uses sentences with many details. Lists items in different categories (e.g., foods, animals). Uses past tense. Says most sounds correctly; uses the following sounds by 5- r, zh, voiced th. Is understood 75-100% of the time by unfamiliar listeners. | Uses words to invite others to play. Uses language to resolve disputes with peers. Tells stories that stay on topic. |
| 5-6 Years | Understands rhyming. Understands opposites, left/right, and early number concepts. Understands humor. Understands time sequences (first, second, third, etc.). | Describes objects. Asks questions for information. Uses compound and complex sentences. Formulates meaningful, grammatically correct sentences. Intelligible to strangers. Retells a story accurately. Uses past and future tense appropriately. Use all sounds appropriately by 6. | Joins in and starts conversations. Uses imagination to tell stories. Engages in cooperative play, such as making group decisions, assigning roles, and playing fairly. Engage in complex imaginary play. |
feeding
| Oral Motor/Feeding Skills | Appropriate Foods/Textures To Introduce | |
|---|---|---|
| Birth-3 Months | Feeding is involuntary and reflexive. Oral reflexes are present. Strong sucks from breast or bottle and swallows well. Responds to stimulation in and around the mouth and opens mouth in anticipation of bottle or breast. Uses a suckle-swallow pattern with the bottle or breast (tongue moves forward and backward/in and out). Tongue, jaw, and lips work as one unit. Coordinated suck-swallow-breathe pattern during feed (coordinates breath with 2-3 sucks of liquid before swallowing at birth). Explores toys orally. | Breastmilk and/or formula provides all of baby’s nutrition. |
| 3-6 Months | Baby’s suck becomes more voluntary. Early reflexes begin to fade. Sequences 20 or more sucks during feed before pausing to swallow/breathe (pauses are infrequent and there should be no coughing or choking). Baby’s tongue and lips begin to move separately. Uses a suckle (tongue moves in and out) and suck (tongue moves up and down) pattern with the bottle or breast. Improved lip closure. Baby develops reflexive vertical munching pattern due to phasic bite reflex. | Breastmilk and/or formula provides all of baby’s nutrition. |
| 6-9 Months | Introduction of solids. Can eat and drink in upright position with minimal support. Holds bottle independently. Recognizes and anticipates food. Begins to self-feed finger foods. Continues to use both suckle and suck patterns while drinking liquids. Refining jaw and lip control; liquid is no longer lost during sucking from bottle or breast. Can bite down on soft foods. Development of rotary chewing begins with less reflexive diagonal rotary chewing movements (tongue moves up and down in a munching pattern and begins to show lateralization (i.e., can move food from the center of the mouth to one side for chewing); jaw moves up and down and can move horizontally, but tongue doesn’t cross midline. Can remove food from spoon with upper lip. Less pronounced protective gag allows for diet expansion. | Breastmilk and/or formula continues to provide most of baby’s nutrition. Purees and/or soft solids and cup drinking introduced at 6 months. |
| 9-12 Months | Feeding self with fingers. Continues to use diagonal rotary chew pattern (more up and down movement of jaw during chewing). Increased tongue lateralization (full transfer of foods from side to side in mouth with tongue). Lips close during chewing. Uses controlled, sustained bite on soft solids. Minimal loss from mouth with cup drinking. Actively uses top and bottom lip to remove food from spoon. Tolerates soft foods with more texture well. Beginnings of tongue tip elevation during swallow initiation. Mastery of spoon feeding. | Increased acceptance of a variety of tastes and textures (e.g., smooth and lumpy mashed solids, easy dissolvable/meltable foods, soft, easy to swallow foods). At 12 months, baby should have no difficulty with lumps, coarsely chopped table foods, and some easily chewed meats. |
| 12-18 Months | Continues to refine eating and oral motor skills. Starts to use a rotary chew. Can bite through a hard, crunchy texture and use a controlled bite. No longer uses suckling pattern while drinking liquids. Coordinates sucking, swallowing, and breathing patterns with an open cup. Tongue tip elevation begins. Brings spoon to mouth with minimal spillage. May begin to show preferences/non-preference for foods. | Solid foods become baby’s primary nutrition source; cut to appropriate size. |
| 18-24 Months | Self feeds often at mealtime. Biting, chewing, and lip closure are efficiently established for chewing most foods. Uses mature, adult chewing pattern (diagonal, circular, and rotary movements). Swallows solid foods with easy lip closure and no loss of food. Drinks from cup independently with minimal spillage. Eats table foods with mixed textures. | Tolerates majority of food textures but may have preferences. |
| 24-36 Months | Independently moves toward fine tuning all feeding skills. Feeds self and uses fork. | Should be able to manage most textures without issue by 3. |
Fine motor
Grasping Small Objects grasping a larger object
| Age | Grasp of Pellet |
|---|---|
| 3 months | No attempt |
| 6 months | Raking and contacting object |
| 7 months | Inferior-scissors grasp |
| 8 months | Scissors grasp |
| 9 months | Inferior pincer grasp |
| 10 months | Pincer grasp |
| 12 months | Fine pincer grasp |
| Age | Grasp of Cube |
|---|---|
| 3 months | Grasp possible upon contact; wrist flexed |
| 4 months | Primitive squeeze grasp |
| 4-5 months | Progression towards palmar grasp |
| 5 months | Palmar grasp |
| 6 months | Radial-palmar grasp |
| 7 months | Radial-palmar grasp (wrist straight) |
| 9 months | Radial-digital grasp |
Release of small items pencil grasp scissor skills
| Age | Release |
|---|---|
| 0-1 months | No release, grasp reflex is strong |
| 1-4 months | Involuntary release |
| 4-8 months | Transfers object from hand to hand |
| 7-9 months | Volitional release |
| 10-14 months | Release item into container (clumsy- may rest hand on container) |
| 12-15 months | Precise release into a small container |
| Age | Writing tool grasp |
|---|---|
| 1-1 1/2 years | Palmar-supinate grasp |
| 2-3 years | Digital-pronate grasp |
| 3 1/2-4 years | Static tripod or static quadrupod grasp |
| 4 1/2-6 years | Dynamic tripod or dynamic quadrupod |
| Age | Scissor Skill |
|---|---|
| 2-3 years | Interest in scissors, holds and snips scissors, opens and closes scissors |
| 3-4 years | Manipulates scissors in forward motion, coordinates the lateral direction of scissors, cuts forward line and geometric shapes |
| 3 1/2- 4 1/2 years | Cuts circles |
Self-dressing/toileting
| Age | Self/Dressing/Toileting Skill |
|---|---|
| 12 months | Cooperates with dressing. Pulls off shoes/socks. Tells when soiled, may use the potty. Regular bowel movements. |
| 18 months | Pushes arms and legs through shirt/pants. Uses napkin to wipe face. Uses spoon to feed self. Stays on toilet when placed there. |
| 2 years | Removes coat (unfastened). Helps pull pants down. Urinates regularly. |
| 2 1/2 years | Unbuttons large button. Wash & dry hands. Remove elastic pants. Attempts to pull on socks (may need help getting on to foot). Puts on coat. Regular toileting-occasional daytime accidents. Tells someone they need to use potty. Uses potty with few accidents (needs reminders to go). |
| 3 years | Requires little assistance with putting on shirt. Puts on shoes (no fasteners). Puts on socks. Pulls down pants. Zip/unzip jacket (once started). Buttons large buttons. Goes to bathroom independently (may need help wiping). |
| 3 1/2 years | Identify front of clothing. Unzips zipper on jacket completely. Unbuckles shoe or belt. Dresses with adult supervision only (assist with direction of clothing). |
| 4 years | Removes shirt independently. Buckles shoes/belt. Zips jacket Independently puts on socks and shoes correctly Laces shoes Identifies front/back of clothing. Uses toilet independently-takes self, manages clothing, sits at toilet, washing hands (may need diaper or assistance at nighttime). |
progression of household chores
| Age | Task |
|---|---|
| 13 months | Child can imitate household chores he has seen, such as cooking on a pretend stove |
| 2 years | Child can put away toys after asked by parents |
| 3 years | When provided with help, child can: -dust -dry dishes -clean spills |
| 4 years | Child can fix themselves dry cereal and help sort laundry |