Ages and Stages_ How to Monitor Child Development

1. Ages and Stages: How to
Monitor Child
Development
● Checklists
● Milestones
● Birth–18 months
● 18 months–2 years
● 3–5 years
● School age
● If you have concerns
● Developmental screening
● Takeaway

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Is this child’s development on track?
That’s a question parents, pediatricians, educators, and caregivers ask over
and over again as children grow and change.
To help answer this important question, child development experts have
created lots of different charts and checklists that can help you keep track of
child development across several key domains:

3. ● physical development
● cognitive development (thinking skills)
● language development
● social-emotional development
But before you put too much
stock in a single checklist…
Know that you’re going to see some variation between the lists. Researchers
at Boston Children’s Hospital looked at four of the best known child
development checklists and found that they mention a total of 728 different
skills and abilities.
More importantly, just 40 of those developmental milestones show up on all
four checklists, which begs the question: Should you depend on a single
checklist?
A good approach, these researchers suggest, is to start by talking to your
child’s pediatrician or primary care provider. The measures that doctors use
may be different from those that parents can find in print or online checklists.
Your child’s physician can screen your child for any developmental delays
using validated screening tools at or in-between well visits.

4. It may also help to think of development as an individual progression, rather
than as a list of boxes you should tick at certain prescribed intervals. If
progress stops or seems to stop, it’s time to talk to your child’s healthcare
provider.
If there is a delay, identifying it early can sometimes make a big difference for
the child.
WHAT ARE DEVELOPMENTAL MILESTONES?
Milestones are the things a child can do by a certain age. Most children
develop skills and abilities in roughly the same order, but the timeframes
involved aren’t exact. They vary from child to child, just as hair and eye color
do.
Milestones at a glance
Every child grows and develops at an individual pace. Here’s a quick look at
some common milestones for each age period.
TOOLS FOR REVIEWING YOUR CHILD’S DEVELOPMENT

5. The Centers for Disease Control and Prevention (CDC) has created a free
app to help you keep up with the many ways your child is growing and
changing. You can download it here for Android devices or here for Apple
devices.
Birth to 18 months
During this period of profound growth and development, babies grow and
change rapidly.
Doctors recommend that you speak to your baby a lot during this phase,
because hearing your voice will help your baby to develop communication
skills. Other suggestions include:
● Short periods of tummy time to help strengthen your baby’s neck and
back muscles — but make sure baby is awake and you’re close by for
this playtime.
● Respond right away when your baby cries. Picking up and comforting a
crying baby builds strong bonds between the two of you.
Development table: Birth to 18 months

6. 1-3
months
4-6
months
5-9
months
9-12
months
12-18
months
Cognitive Shows
interest
in objects
and
human
faces
May get
bored
with
repeated
activities
Recogniz
es
familiar
faces
Notices
music
Respond
s to signs
of love
and
affection
Brings
hands up
to mouth
Passes
things
from one
hand to
the other
Watches
things fall
Looks for
hidden
things
Has
learned
how to
use
some
basic
things
like
spoons
Can
point to
named
body
parts

7. Social
and
emotiona
l
Tries to
look at
you or
other
people
Starts to
smile at
people
Respond
s to facial
expressi
ons
Enjoys
playing
with
people
Respond
s
differentl
y to
different
voice
tones
Enjoys
mirrors
Knows
when a
stranger
is
present
May be
clingy or
prefer
familiar
people
May
engage
in simple
pretend
games
May
have
tantrums
May cry
around
strangers

8. Languag
e
Begins to
coo and
make
vowel
sounds
Becomes
calm
when
spoken
to
Cries
differentl
y for
different
needs
Begins to
babble or
imitate
sounds
Laughs
Respond
s to
hearing
their
name
May add
consona
nt
sounds
to vowels
May
communi
cate with
gestures
Points
Knows
what “no”
means
Imitates
sounds
and
gestures
Knows
how to
say
several
words
Says
“no”
Waves
bye-bye

9. Moveme
nt/Physic
al
Turns
toward
sounds
Follows
objects
with eyes
Grasps
objects
Gradually
lifts head
for longer
periods
Sees
things
and
reaches
for them
Pushes
up with
arms
when on
tummy
Might be
able to
roll over
Starts
sitting up
without
support
May
bounce
when
held in
standing
position
Rolls in
both
direction
s
Pulls up
into
standing
position
Crawls
Walks
holding
onto
surfaces
Stands
alone
May
climb a
step or
two
May
drink
from a
cup

10. 18 months to 2 years
During the toddler years, children continue to need lots of sleep, good
nutrition, and close, loving relationships with parents and caregivers.
Doctors at Seattle Children’s Hospital offer this advice for creating a safe,
nurturing space to maximize your child’s early growth and development:
● Create predictable routines and rituals to keep your child feeling secure
and grounded.
● Toddler-proof your home and yard so kids can explore safely.
● Use gentle discipline to guide and teach children. Avoid hitting, which
can cause long-term physical and emotional harm.
● Sing, talk, and read to your toddler to boost their vocabularies.
● Watch your child for cues about the warmth and reliability of all
caregivers.
● Take good care of yourself physically and emotionally, because your
child needs you to be healthy.
Development table: 18 months to 2 years

11. 18 months 24 months
Cognitive May identify familiar
things in picture books
Knows what common
objects do
Scribbles
Follows single-step
requests like “Please
stand up”
Builds towers from
blocks
May follow simple
two-part instructions
Groups like shapes and
colors together
Plays pretend games

12. Social and
emotional
May help with tasks
like putting away toys
Is proud of what
they’ve accomplished
Recognizes self in
mirror; may make
faces
May explore
surroundings if parent
stays close by
Enjoys play dates
Plays beside other
children; may start
playing with them
May defy directions like
“sit down” or “come
back here”

13. Language Knows several words
Follows simple
directions
Likes hearing short
stories or songs
May ask simple
questions
Can name many things
Uses simple two-word
phrases like “more milk”
Says the names of
familiar people

14. Movement
/Physical
Can help in getting
dressed
Begins to run
Drinks well from a cup
Eats with a spoon
Can walk while pulling
a toy
Runs
Jumps up and down
Stands on tip-toes
Can draw lines and
round shapes
Throws balls

15. Dances
Gets seated in a chair
May climb stairs using
rails to hold on
3 to 5 years old
During these pre-school years, children grow more and more independent and
capable. Their natural curiosity is likely to be stimulated because their world is
expanding: new friends, new experiences, new environments like daycare or
kindergarten.
During this time of growth, the CDC
Trusted Source
recommends that you:

16. ● Keep reading to your child daily.
● Show them how to do simple chores at home.
● Be clear and consistent with your expectations, explaining what
behaviors you want from your child.
● Speak to your child in age-appropriate language.
● Help your child problem solve when emotions are running high.
● Supervise your child in outdoor play spaces, especially around water
and play equipment.
● Allow your child to have choices about how to interact with family
members and strangers.
Development table: 3 to 5 years
3 years 4 years 5 years

17. Cognitive Can put
together a 3-4
part puzzle
Can use toys
that have
moving parts
like buttons and
levers
Can turn door
knobs
Can turn book
pages
May be able to
count
Can draw stick
figures
May be able to
predict what will
happen in a
story
May play simple
board games
Can name a few
colors, numbers,
Draws more
complex
“people”
Counts up to
10 things
Can copy
letters,
numbers, and
simple shapes
Understands
the order of
simple
processes

18. and capital
letters
Can say name
and address
Names many
colors
Social and
emotional
Shows empathy
for hurt or
crying children
Offers affection
May play games
that have roles
like “parent” and
“baby”
Plays with, not
just beside,
other kids
Is aware of
gender
Likes to play
with friends

19. Understands
“mine” and
“yours”
May get upset if
routines are
changed
Can get
dressed
Knows how to
take turns
Talks about their
likes and dislikes
Pretends; may
have trouble
knowing what’s
real and what’s
pretend
Sings, dances,
and may play
acting games
Switches
between being
compliant and
being defiant
Can tell the
difference
between
made-up and
real

20. Language Talks using 2-3
sentences at a
time
Has the words
to name many
things used
daily
Can be
understood by
family
Understands
terms like “in,”
“on,” and
“under”
Can talk about
what happens in
daycare or at
school
Speaks in
sentences
May recognize
or say rhymes
Can say first and
last name
May tell stories
that stay on
track
Recites
nursery
rhymes or
sings songs
May be able to
name letters
and numbers
Can answer
simple
questions
about stories

21. Movement/P
hysical
Can walk up
and down steps
with one foot on
each stair
Runs and
jumps with ease
Catches a ball
Can slide down
a slide
Can hammer a
peg into a hole
Walks
backwards
Climbs stairs
confidently
Can hop
Pours liquids
with some help
May be able to
somersault
Uses scissors
Hops or stands
on one foot for
about 10
seconds
Can swing on
swingset

22. Goes to the
bathroom in
the toilet
School-age development
During the school years, children gain independence and competence quickly.
Friends become more important and influential. A child’s self-confidence will
be affected by the academic and social challenges presented in the school
environment.
As kids mature, the parenting challenge is to find a balance between keeping
them safe, enforcing rules, maintaining family connections, allowing them to
make some decisions, and encouraging them to accept increasing
responsibility.
Despite their rapid growth and development, they still need parents and
caregivers to set limits and encourage healthy habits.
Here are some things you can do to ensure that your child continues to be
healthy:
● Make sure they get enough sleep.

23. ● Provide opportunities for regular exercise and individual or team sports.
● Create quiet, positive spaces for reading and studying at home.
● Limit screen time and monitor online activities carefully.
● Build and maintain positive family traditions.
● Talk to your children about consent and setting boundaries with their
bodies.
Development table: School-age
6-8 years 9-11 years 12-14 years 15-17 years

24. Cognitive Can
complete
instructions
with 3 or
more steps
Can count
backward
Knows left
and right
Tells time
Can use
common
devices,
including
phones,
tablets, and
game
stations
Writes
stories and
letters
Maintains
longer
attention
span
Develops
views and
opinions
that may
differ from
parents’
ideas
Grows
awareness
that parents
aren’t
always
correct
Can
understand
figurative
language
Internalize
work and
study
habits
Can explain
their
positions
and
choices
Continues
to
differentiate
from
parents

25. Ability to
think
logically is
improving,
but
prefrontal
cortex is
not yet
mature
Social and
emotional
Cooperates
and plays
with others
May play
with kids of
different
genders
Mimics
adult
behaviors
May have a
best friend
Can see
from
another
person’s
perspective
Experience
s more
May
become
more
independen
t from
parents
Displays
moodiness
Increased
need for
Increased
interest in
dating and
sexuality
Spends
more time
with friends
than family
Growth in
ability to

26. Feels
jealousy
May be
modest
about
bodies
peer
pressure
some
privacy
empathize
with others

27. Language Can read
books at
grade level
Understand
s speech
and speaks
well
Listens for
specific
reasons
(like
pleasure or
learning)
Forms
opinions
based on
what’s
heard
Can take
brief notes
Follows
written
instructions
Can use
speech that
isn’t literal
Can use
tone of
voice to
communica
te
intentions;
i.e.
sarcasm
Can speak,
read, listen,
and write
fluently and
easily
Can have
complex
conversatio
ns
Can speak
differently
in different
groups
Can write
persuasivel
y

28. Draws
logical
inferences
based on
reading
Can write
about a
stated main
idea
Can plan
and give a
speech
Can
understand
proverbs,
figurative
language,
and
analogies

29. Movement/
Physical
Can jump
rope or ride
a bike
Can draw
or paint
Can brush
teeth, comb
hair, and
complete
basic
grooming
tasks
Can
practice
physical
skills to get
May
experience
signs of
early
puberty like
breast
developme
nt and
facial hair
growth
Increased
skill levels
in sports
and
physical
activities
Many
females will
have
started
periods
Secondary
sex
characterist
ics like
armpit hair
and voice
changes
continue
Height or
weight may
change
quickly and
then slow
down
Continues
to mature
physically,
especially
boys

30. better at
them
What to do if you’re concerned
If you’re wondering whether some aspect of a child’s development may be
delayed, you have several options.
First, talk to your child’s pediatrician and ask for a developmental screening.
The screening tools used by doctors are more thorough than online checklists,
and they may give you more reliable information about your child’s abilities
and progress.
You can also ask your pediatrician for a referral to a developmental specialist
like a pediatric neurologist, occupational therapist, speech/language therapist,
or a psychologist who specializes in evaluating children.
If your child is under the age of 3, you can reach out to the early intervention
program
Trusted Source

31. in your state.
If your child is 3 or older, you can speak to the special education director at
the public school near your home (even if your child isn’t enrolled at that
school) to ask for a developmental evaluation. Make sure you write down the
date and director’s name so you can follow up if necessary.
It’s really important that you act right away if you suspect a developmental
delay or disorder, because many developmental issues can be addressed
more effectively with early intervention.
What happens in a developmental
screening?
During a screening, the healthcare provider may ask you questions, interact
with your child, or conduct tests to find out more about what your child can
and cannot yet do.
If your child has a medical condition, was born early, or was exposed to an
environmental toxin like lead, the doctor might conduct developmental
screenings more often.
TALKING TO PARENTS ABOUT MILESTONES

32. If you’re a caregiver or educator who needs to discuss a possible delay with
parents, the CDC
Trusted Source
recommends that you approach the topic in a clear, compassionate way. You
may find these tips helpful:
● Talk about milestones often, not just when you’re worried about a delay.
● Use good listening skills. Allow parents to speak without interrupting
them, and repeat their concerns so they’ll know you’re paying close
attention.
● Consider having a colleague at the meeting to take notes.
Be aware that parents may respond emotionally. Family and cultural
issues may shape parents’ reactions.
● Share any notes or records you’ve kept to document the child’s
progress.
● Encourage contact with their family pediatrician.
● Follow up, making sure you share good news as well as concerns.
The takeaway

33. Babies, toddlers, and school-age children develop new skills and abilities in a
steady progression as they get older. Every child develops at an individual
pace.
Using developmental milestone checklists may be helpful for parents and
caregivers who want to be sure that a child is growing in healthy ways. But it’s
also important to keep all well child appointments, as development is
screened at each of these.
If you’re concerned about the possibility of a missed milestone, your child’s
doctor can discuss it with you and can conduct a developmental screening as
needed to provide a clearer picture. You can also connect with developmental
specialists, early intervention programs, and special education programs in
local schools to have a child evaluated.
Strong parent-child bonds, good nutrition, adequate sleep, and a safe,
nurturing environment at home and school will help ensure that children have
the best chance of developing as they should.
Last medically reviewed on December 9, 2019