How can I tell if my child is developing normally and meeting developmental milestones?

Developmental milestones, which are used to assess a child’s development, are a set of functional skills or age-specific tasks that most children can perform at a certain age. These milestones serve as guidelines to help determine if children are developing at a similar rate to children in the same age bracket. A number of complications, injuries and medical errors occurring before, during or after the time of birth can cause developmental disabilities and developmental delays. Children who suffered certain moderate to severe brain injuries may only be able to reach milestones through therapies and interventions. Other children with severe brain injuries may never reach certain milestones. Family members, caretakers, medical professionals, friends, and other people close to a growing child can monitor the child’s achievement of developmental milestones to help detect the presence of developmental delays.

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Developmental Milestones Based on Age

In this section, we’ll list the common developmental milestones children typically meet based on certain age brackets. The following lists of expectations and problems a developmentally delayed child may face is not exhaustive, and parents should never hesitate to speak with their child’s physician if they have any concerns.

I. Developmental Milestones at Two Months of Age and Older

  • Babies smile at people for the first time
  • Babies look at their parents
  • The baby can briefly calm himself or herself
  • Babies may bring the hands to the mouth
  • Babies make cooing sounds or gurgling sounds
  • Babies turn the head towards sounds
  • Babies begin to act bored by crying or getting fussy if activity doesn’t change
  • Babies begin to follow objects with the eyes and recognize people at a distance
  • Babies pay attention to faces
  • Babies can hold their heads up and push up on the arms when lying on the stomach
  • Babies make other movements with the arms and legs

If a baby is not meeting these developmental milestones, parents should talk to their physician about their baby’s development. Babies may have brain damage that causes intellectual and developmental delays if the following signs are present:

  • The baby has difficulty controlling his or her head when picked up
  • The baby has stiff or shaky arms
  • The baby has stiff or shaky legs
  • The baby has stiff legs that cross and look like scissors
  • The baby has problems sucking and feeding

II. Developmental Milestones at Four Months of Age and Older

  • Infants model certain movements and facial expressions, such as frowning and smiling, and smile at people
  • Infants enjoy playing with people and occasionally cry when the playing stops
  • Infants begin to babble
  • Infants copy sounds
  • Infants’ cries are different, depending on the reason for the cry (for example, showing hunger, pain, or being tired)
  • Infants express happiness or sadness to parents
  • Infants respond to affection.
  • Infants can use the eyes and hands together
  • Infants reach for toys with one hand
  • Infants’ eyes move from side to side as they follow moving objects
  • Infants watch faces closely and recognize familiar people at a distance
  • Infants push up on their elbows when lying on the stomach.
  • Infants hold their heads steady without support
  • Infants push down on their legs when their feet are on a hard surface
  • Infants may be able to roll over onto their backs from the stomach
  • Infants swing at toys in front of them and can shake toys when they’re holding them
  • Infants successfully bring their hands to their mouths

Beyond failures to meet the developmental milestones listed above, parents should speak to their baby’s physician if the baby exhibits the following:

  • The infant has poor head control
  • The infant doesn’t watch objects as they move
  • The infant doesn’t smile at people
  • The infant doesn’t bring items to his or her mouth
  • The infant doesn’t push up with his or her feet when placed on a hard surface
  • The infant has difficulty moving one or both eyes in all directions

III. Developmental Milestones at Six Months of Age and Older

  • Infants recognize familiar faces
  • Infants enjoy playing with people, especially parents
  • Infants respond to the emotions of others and often seem happy
  • Infants enjoy looking at themselves in the mirror
  • Infants respond to their name
  • Infants make sounds in response to sounds they hear
  • Infants put vowels together when babbling, such as “ah,” “eh,” and “oh,” and they like taking turns with their parents while making sounds
  • Infants show pleasure and displeasure by making sounds
  • Infants start to make consonant sounds, such as “m” and “b”
  • Infants look around at objects that are close
  • Infants continue to bring items to their mouths
  • Infants are curious, and they try to reach for objects that are out of reach
  • Infants begin to pass items from one hand to the other
  • Infants start to sit with no support
  • Infants roll over in both directions
  • Infants support their weight on their legs when standing (maybe also bouncing)
  • Infants rock back and forth and may crawl backward before crawling forward

The baby’s physician should be alerted if the baby reaches for items with only one hand while keeping the other in a fist, does not try to touch things that are within reach, does not show affection for parents or caregivers, does not respond to close sounds, has difficulty getting things to the mouth, does not make vowel sounds, does not roll over, doesn’t laugh or make squealing noises, has tight muscles and seems stiff, seems very floppy, and/or has problems eating and drinking.


IV. Developmental Milestones at Nine Months of Age and Older

  • Babies may be afraid of strangers, and they are clingy with familiar adults
  • Babies have favorite toys
  • Babies understand the word “no”
  • Babies make different sounds, such as “mamamama” and “babababa”
  • Babies point at things and copy the sounds and movements of others
  • Babies’ eyes move in the path of something as it falls
  • Babies look for items that they see people hiding, and they can play peek-a-boo
  • Babies continue to put items in their mouths
  • Babies can smoothly move objects from one hand to another
  • Babies can pick very small items such as cereal with their thumbs and index fingers
  • Babies can get into a sitting position and sit with no support
  • Babies pull to stand and can hold onto something to stand
  • Babies can crawl

A discussion with the child’s physician is very important if the aforementioned milestones are not being met, and this is critical if the baby drags a hand and leg while crawling, cannot sit by himself or herself, cannot bear weight on his or her legs while using support, doesn’t babble, does not play games involving back and forth play, doesn’t look where a parent is pointing, and doesn’t move toys back and forth between hands.


V. Developmental Milestones at One Year of Age and Older

  • Developmental Milestones at One Year of Age and OlderBabies are shy with strangers and cry when their parents leave
  • Babies show fear in certain situations
  • Babies have favorite items and people, and may give a parent a book when they want to hear a story
  • Babies repeat sounds or actions to get attention
  • Babies put out an arm or leg to assist with getting dressed
  • Babies play games such as pat-a-cake
  • Babies respond to simple requests
  • Babies make gestures, such as shaking their heads “no” or waving goodbye
  • Babies make sounds that have more changes in tone and sound more like speech
  • Babies say their parents’ names (mama or dada) and make exclamations, such as saying “uh oh!”
  • Babies try to copy the words their parents use
  • Babies can easily find hidden objects
  • Babies explore things by banging and shaking or throwing them, and they bang two things together
  • Babies look at the correct object when it is named
  • Babies begin to use objects correctly, such as a comb for their hair and a cup for drinking, and they can put things into and take things out of a container
  • Babies copy the gestures of others
  • Babies can release objects from their hands without help
  • Babies poke items with their index fingers
  • Babies follow simple directions, such as when a parent tells them to pick up a toy
  • Babies get into a sitting position by themselves
  • Babies are able to pull themselves up to stand, and they can walk around
  • Babies may take a few steps and stand with no assistance

Parents should take their children to see the physician if they are not meeting these developmental milestones. This is particularly important if one-year-olds don’t crawl, can’t stand with support, don’t search for items they see being hidden, don’t say words such as “mama,” are not learning gestures such as waving goodbye, and/or do not point at objects or people.


VI. Developmental Milestones at 18 Months of Age

  • Toddlers enjoy handing items to others as part of play, and they play games of pretend, such as feeding a doll
  • Toddlers show affection to familiar people and may be afraid of strangers
  • Toddlers may have temper tantrums
  • Toddlers may cling to parents in unfamiliar situations
  • Toddlers point at things to show other people something interesting, as well as to show people what they want and get attention
  • Toddlers like to explore alone, but with parents nearby
  • Toddlers say several single words
  • Toddlers say no and shake their heads
  • Toddlers understand the use of common items, such as a telephone, brush, or spoon
  • Toddlers point to one body part
  • Toddlers enjoy scribbling on things
  • Toddlers are able to follow simple verbal commands without any gestures, such as sitting when their parents ask them to
  • Toddlers can walk alone, and may be able to walk up steps and run
  • Toddlers drag toys while they walk
  • Toddlers can help undress themselves
  • Toddlers can drink from a cup and eat with a spoon

A parent should be concerned when these age-appropriate developmental milestones are not met. It is especially concerning if children:

  • Cannot drink from a cup without help
  • Cannot feed themselves finger foods
  • Cannot grasp items using the thumb and index finger
  • Cannot manipulate small items such as putting blocks in and taking them out of a bucket
  • Cannot sit, walk, or crawl
  • Don’t point to objects or people
  • Don’t know the purpose of familiar items
  • Cannot copy other people
  • Are not learning new words or babbling
  • Have jerky or stiff arms and legs
  • Throw their heads back and severely arch their back in response to stimulation
  • Have feeding problems and excessive drooling
  • Have floppy arms or legs
  • Walk in the scissor gait
  • Do not respond to certain things, such as touch, sound, or sights
  • Do not show affection or fear

VII. Developmental Milestones at 2 Years of Age

  • Toddlers copy other people
  • Toddlers get excited when other children are around
  • Toddlers show increasing independence
  • Toddlers begin to include other children in play (i.e., playing games of chase)
  • Toddlers show defiant behavior
  • Toddlers can point to items when they are named
  • Toddlers know the names of familiar people
  • Toddlers can speak in two to four-word sentences, and repeat words they overhear
  • Toddlers follow simple instructions
  • Toddlers use one hand more than the other
  • Toddlers build towers of four blocks or more
  • Toddlers play make-believe games that are simple
  • Toddlers complete rhymes and sentences in books that are familiar
  • Toddlers begin to sort shapes and colors
  • Toddlers find items, even when hidden under two or three layers
  • Toddlers can stand on tip toes and throw and kick a ball
  • Toddlers can run and climb onto and off of furniture
  • Toddlers can walk up and down stairs while holding onto something
  • Toddlers develop fine motor skills and can make or copy straight lines and circles

Parents should speak with their child’s physician if the developmental milestones listed above are not met. Seeking help from a physician is particularly important if children:

  • Cannot walk steadily
  • Do not know what to do with common items such as a brush
  • Do not copy the actions of others or follow simple instructions
  • Have legs that cross like scissors when walking
  • Do not lift arms to show a desire to be picked up
  • Have floppy arms or legs
  • Do not show affection towards parents
  • Fail to develop a mature heel-toe walking pattern after several months of walking
  • Walk only on their toes
  • Cannot use two-word sentences or follow simple instructions

VIII. Developmental Milestones at 3 Years of Age

  • Developmental Milestones FAQsChild copies adults and friends
  • Child shows affection for friends and shows concern for a crying friend
  • Child understands the concepts of “mine,” “his,” or “hers,” as well as “in,” “on,” and “under”
  • Child shows a wide range of emotions and may get upset when there are major changes in his or her routine
  • Child separates easily from his or her parents
  • Child can get dressed and undressed alone
  • Child can follow instructions that only have two or three steps
  • Child can name most familiar items
  • Child knows his or her name, age, sex, and friends’ names
  • Child talks well enough that strangers can understand him or her
  • Child can carry on a conversation using two or three sentences
  • Child is able to use the buttons, levers, and moving parts on toys
  • Child puts together puzzles with three or four pieces
  • Child understands what “two” means
  • Child can turn book pages one at a time
  • Child can copy a circle with a pencil or crayon
  • Child screws and unscrews jar lids and turns door handles
  • Child builds towers that have many blocks
  • Child can easily climb, run, and pedal a tricycle
  • Child walks up and down the stairs, placing one foot on each step

If these developmental milestones are missed by a three-year-old child, parents should speak with their physician as soon as possible. A physician visit is especially important if the child:

  • Frequently falls down
  • Has a lot of drooling
  • Has difficulty with speech
  • Has difficulty manipulating small objects
  • Cannot communicate in short phrases
  • Does not understand simple instructions
  • Does not make good eye contact
  • Has limited interest in toys and other children

IX. Developmental Milestones at 4 Years of Age

  • Children enjoy doing new activities
  • Children become more and more creative with make-believe games, including playing “Mom” and “Dad”
  • Children would rather play with other children than alone
  • Children cooperate with other children
  • Children talk about their interests
  • Children know basic rules of grammar
  • Children can tell stories, sing songs, or recite short poems from memory
  • Children can say their full names
  • Children understand the idea of counting and can name some numbers and colors
  • Children are beginning to understand the time
  • Children know the concepts of “same” and “different”
  • Children can use scissors and draw a person that has two to four body parts
  • Children can copy some capital letters
  • Children can speak about what is going to happen next in a book
  • Children can play board and card games
  • Children catch a bounced ball most of the time and can hop and stand on one foot for up to two seconds
  • Children can pour liquids and mash their own food

The four-year-old child’s physician should be alerted if the child is not meeting these developmental milestones. It is especially concerning if:

  • Children cannot throw a ball
  • Children cannot jump in place
  • Children show no interest in interactive games
  • Children don’t use sentences of more than three words
  • Children cannot grasp a crayon between the thumb and forefinger
  • Children cannot stack four blocks or more
  • Children cannot copy a circle
  • Children do not use “me” or “you” correctly
  • Children lash out without any self-control when upset or angry

X. Developmental Milestones at 5 Years of Age

  • The child wants to please and be like his or her friends
  • The child is more likely to agree with rules
  • The child is aware of gender
  • The child shows concern and sympathy for others
  • The child enjoys dancing, singing, and acting
  • The child knows what is real and what is make-believe
  • The child can be demanding at times and cooperative at other times
  • The child shows independence, such as visiting a neighbor alone
  • The child speaks very clearly and can tell a story using full sentences
  • The child can count ten or more items
  • The child can speak in future tense
  • The child can say his or her full name and address
  • The child can draw a person having at least six body parts
  • The child can copy a triangle and other shapes
  • The child can print some letters and numbers
  • The child knows about everyday items, such as food and money
  • The child can stand on one foot for more than ten seconds and can hop and skip
  • The child can do a somersault, swing, and climb
  • The child can use a fork, spoon, and sometimes a knife
  • The child is able to use the toilet on his or her own

If these milestones are not met, parents and child should visit the child’s physician. A visit is particularly important if the child has trouble taking off clothing, cannot wash or dry the hands independently, cannot build a tower of six to eight blocks, and/or has trouble holding a crayon.


Developmental Milestone Infographics

Developmental Milestones - 2 Months

Developmental Milestones - 4 Months

Developmental Milestones - 6 Months

Developmental Milestones - 9 Months

Developmental Milestones - 1 Year

Developmental Milestones - 18 Months (1 1/2 Years)

Developmental Milestones - 2 Years

Developmental Milestones - 3 Years


Birth Injuries and Developmental Delays

Many children with cerebral palsy and intellectual and developmental delays (I/DD) are diagnosed shortly after birth. In other children, it may take a few years to detect and diagnose developmental and intellectual delays. For any child experiencing these delays, early diagnosis is critical. Without timely intervention, the child may miss the opportunity to participate in valuable early treatments and therapies.

Brain injuries that cause permanent brain damage often occur during labor and delivery, shortly before birth, or after delivery during the neonatal period. Oxygen deprivation, hypoxic-ischemic encephalopathy (HIE), and brain bleeds are conditions that can cause brain damage in a baby. Both brain bleeds and HIE can cause cerebral palsy and developmental and intellectual disabilities.

Many parents struggle with the question of whether their child is developing normally, especially if the pregnancy or labor and delivery were abnormal, risky, or traumatic. Parents should never hesitate to speak with their child’s physician. Research shows that 70 – 80% of all disabilities in children are detected by parents.

Neonatal Brain Damage, Birth Injury and Developmental Disabilities

When a baby experiences brain damage during or near the time of delivery, the damage can cause cerebral palsy, hypoxic-ischemic encephalopathy (HIE), and periventricular leukomalacia (PVL). These conditions often cause a child to have intellectual and developmental delays, but a child also can have intellectual and developmental delays and disabilities without a diagnosis of one of these conditions.

Some problems during or near the time of delivery that can cause brain damage include:

Failure to quickly deliver a baby by C-section when the baby is in trouble is a common cause of birth trauma, oxygen deprivation, and resultant neonatal brain damage. In addition, a baby may be poorly managed in the hospital after birth, and this can cause problems such as infection, oxygen deprivation, hypoxic-ischemic encephalopathy (HIE), and kernicterus. Failure to properly manage a baby with breathing problems can cause the baby to have overventilation problems and/or long-term oxygen deprivation, which can lead to serious brain damage.


Legal Help for Birth Injury and Developmental Delays

Trusted Detroit, Michigan Birth Trauma Attorneys

Children diagnosed with intellectual and developmental disabilities (I/DD) often go on to require specialized care throughout their entire lives. Therapy, special education programs, treatments, adaptive equipment, assistive technology, and other special care needs will allow your loved one to live a fuller, more equal life. If a medical professional’s error caused your loved one’s intellectual and developmental disabilities, you are likely entitled to compensation to afford these resources. We encourage you to contact Reiter & Walsh, P.C. today for a free legal consultation. During your case review, our team of birth injury attorneys, nurses, and professionals will:

  • Determine if negligence caused your loved one’s injuries
  • Identify the negligent party
  • Inform you of your legal options

Reiter & Walsh, P.C. is one of the only law firms in the United States exclusively handling birth trauma cases. We focus solely on helping families like yours obtain the resources they need, and our niche focus allows us to win even the most medically and legally complex birth trauma cases. To begin your free case review with our Detroit, Michigan birth injury attorneys, please contact Reiter & Walsh ABC Law Centers in any of the following ways:

Free Case Review  |  Available 24/7  |  No Fee Until We Win

Call our toll-free phone line at 888-419-2229
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Related Resources


Sources:
  • Gerber, R. Jason, Timothy Wilks, and Christine Erdie-Lalena. “Developmental milestones: motor development.” Pediatrics in Review 31.7 (2010): 267-277.
  • Miller G. Diagnosis and classification of cerebral palsy. In: UpToDate. Hoppin, ED (Ed), UpToDate, Waltham, MA, 2013.
  • “Developmental Milestones.” cdc.gov. Web. 18 Dec. 2013.