Child developmental milestones can be separated into four major domains:
- Gross motor
- Fine motor
- Language
- Personal and social
TOM TIP: The best way to learn developmental milestones is to play with children and test their milestones. Try to find children who are developing normally at the ages of 6 months, 1 year, 18 months, 2 years, and 3 years. This will give you a good reference point when assessing new children. There will always be an element of rote learning, but this becomes easier when you can think back to a specific child at a specific age.
Gross Motor
Gross motor refers to the child’s development of large movements, such as sitting, standing, walking and posture. Development in this area happens from the head downwards:
- 4 months: Able to support their head and aligned with the body.
- 6 months: Can keep their trunk supported on their pelvis (e.g., maintain a sitting position) but often without the balance to sit unsupported at this stage.
- 9 months: Sit unsupported. Start crawling. Can keep their trunk and pelvis supported on their legs (e.g., maintain a standing position) and bounce on their legs when supported.
- 12 months: Stand unsupported and begin cruising (walking whilst holding onto furniture).
- 15 months: Walk unaided.
- 18 months: Squat and pick objects up from the floor.
- 2 years: Run. Kick a ball.
- 3 years: Climb stairs one foot at a time. Stand on one leg for a few seconds. Ride a tricycle.
- 4 years: Hop. Climb and descend stairs like an adult.
Fine Motor
Fine motor refers to the child’s precise and skilled movements, visual development, and hand-eye coordination.
Early Milestones:
- 8 weeks: Fixes their eyes on an object 30 centimetres in front of them and attempts to follow it. Prefers faces rather than an inanimate objects.
- 6 months: Palmar grasp of objects (wraps thumb and fingers around the object).
- 9 months: Scissor grasp of objects (squashes it between thumb and forefinger).
- 12 months: Pincer grasp (with the tip of the thumb and forefinger).
- 14 – 18 months: They can clumsily use a spoon to bring food from a bowl to their mouth.
Drawing Skills:
- 12 months: Holds a crayon and scribbles.
- 2 years: Copies vertical line.
- 2.5 years: Copies horizontal line.
- 3 years: Copies circle.
- 4 years: Copies cross and square.
- 5 years: Copies triangle.
Tower of Bricks:
- 14 months: Tower of 2 bricks.
- 18 months: Tower of 4 bricks.
- 2 years: Tower of 8 bricks.
- 2.5 years: Tower of 12 bricks.
- 3 years: Can build a 3 block bridge or train.
- 4 years: Can build steps.
Pencil Grasps:
- Under 2 years: Palmar supinate grasp (fist grip).
- 2-3 years: Digital pronate grasp.
- 3-4 years: Quadrupod grasp or static tripod grasp.
- 5 years: Mature tripod grasp.
Others:
- 3 years: Can thread large beads onto a string. Can make cuts on the side of paper with scissors.
- 4 years: Can cut paper in half using scissors.
Language
Language refers to the child’s development of understanding and using speech and language to communicate. There are two components:
- Expressive language
- Receptive language
Expressive language milestones:
- 3 months: Cooing noises.
- 6 months: Makes noises with consonants (starting with g, b and p).
- 9 months: Babbles, sounding more like talking but not saying recognisable words.
- 12 months: Says single words in context (e.g., “mama”, “dada”, “bye-bye” or “hi”).
- 18 months: Has around 5 – 10 words.
- 2 years: Combines 2 words. Around 50+ words total.
- 2.5 years: Combines 3 – 4 words.
- 3 years: Using basic sentences.
- 4 years: Tells stories.
Receptive language milestones:
- 3 months: Recognises parents and familiar voices and gets comfort from these.
- 6 months: Responds to tone of voice.
- 9 months: Listens to speech.
- 12 months: Follows very simple instructions.
- 18 months: Understands nouns (e.g., “show me the spoon”).
- 2 years: Understands verbs (e.g., “show me what you eat with”).
- 2.5 years: Understands propositions (plan of action) (e.g., “put the spoon on/under the step”).
- 3 years: Understands adjectives (e.g., “show me the red brick” and “which one of these is bigger?”)
- 4 years: Follows complex instructions (e.g., “pick the spoon up, put it under the carpet and go to mummy”).
You can also think of receptive language in terms of the number of key words:
- 18 months: 1 key word (e.g., “show me the spoon”).
- 2 years: 2 key words (e.g., “show me the spoon and the cup”).
- 3 years: 3 key words (e.g., “put the spoon under the step”).
- 4 years: 4 key words (e.g., “put the red spoon under the step”).
Personal and Social
Personal and social refers to the child’s development of skills in interacting, communicating, playing and building relationships:
- 6 weeks: Smiles.
- 3 months: Communicates pleasure.
- 6 months: Curious and engaged with people.
- 9 months: They become cautious and apprehensive with strangers.
- 12 months: Engages with others by pointing and handing objects. Shares interest. Waves bye-bye. Claps hands.
- 18 months: Imitates activities, such as waving, clapping or using a phone.
- 2 years: Extends interest to others beyond parents, such as waving to strangers. Plays next to but not necessarily with other children (parallel play). Engages in pretend or imaginative play (e.g., feeding a teddy).
- 3 years: They will seek out other children and play with them. Dry by day. Bowel control.
- 4 years: Has a best friend. Dry by night. Dresses self. Imaginative play.
Red Flags
There are certain red flags for things that would suggest there is a problem:
- Lost developmental milestones
- Not holding an object by 6 months
- Not sitting unsupported by 9 months
- Not standing independently by 12–15 months
- Not walking by 15 months in girls or 18 months in boys
- Not running by 2 years
- No words by 18 months
- No interest in others by 12 months
Performing a Developmental Assessment
During the initial part of the assessment, try to develop rapport with the child so they engage with you. Make it a game and fun, and give plenty of praise when the child succeeds in a task. Remember and use their name. Children generally enjoy showing what they can do. If they are shy or don’t want to engage, try using the parent to encourage them. If they do not wish to engage, the last resort is to talk to their parent about the milestones.
Start by making a visual estimate of the rough age of the child and observing what they are doing before asking them to do something different. Test milestones that you think the child should be able to achieve at that age, and work your way up until they cannot complete the task. For example, if they look about 2 years old and you want to assess fine motor skills, start with a tower and see how many bricks they can build, then challenge them to make a train, then a bridge, then steps, and so on. When they fail at a task, move on to assessing a different ability (e.g., drawing).
TOM TIP: When talking to the child, encourage them in a way that lets the examiner know you have noticed certain key milestones, such as “that is a really good pincer grip”, “you built a tower of six bricks, that is great” and “that is really good walking”.
Last updated October 2025
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