1-2 months

Social:

• regards face, mutual gaze
• spontaneous smile: first few weeks (inborn behavior, not in response to external stimuli, often unilateral)
• “quiet alert state”- increasing periods of visual attention and alertness
• reciprocal social smile by 2 months in response to external stimuli

• responds to sounds
• spontaneous soft cooing

• Head up in the prone position
• Hands become open, unfisted most of the time (2 months)

• Minimum expected weight gain from 2 weeks to 3 months is approx. 1 oz per day
• Typical total crying times are: 2 hours/day at 2 weeks progressing to a peak of 3 hours/day at 6 weeks and tapering to 1 hour/day by 3 months
• Head circumference increases by 5-6 cm in the first 3 months. This is the most rapid period of postnatal brain growth.

• laughs and squeals
• initiates smiling
• variety of facial expressions
• waves hands and arms at sight of a toy

Language:

• coos (long vowel sounds in musical fashion)
• responds to speech

• hands to midline
• rolling (first from front to back; back to front takes more coordination and usually seen at 5 months)
• bats at object (stethoscope) and may grab it
• holds onto a toy placed in hand
• in prone position, head up 90 degrees, holds self up on forearms

Did you know…?

• This is the age where babies start drooling a lot. (Also puts hands in mouth, which makes some parents misinterpret this as teething pain.)
• At this age, babies may sleep 5-6 hours at night
• Nap schedule: An infant at this age usually has 2-4 naps per day, gradually moving toward 2 naps at 6-9 months and consolidating to one long nap per day from 18-36 months.
• It is best to avoid overstimulation – babies still need help calming themselves.  For example, at least some feedings each day should take place in a quiet room with no distractions

• becomes very social at this age; initiates interactions with everyone

Language:

• monosyllabic babbling (sound units with a consonant and a vowel).  Also normal for this to start later, up to 10 months.

Fine Motor:

• Transfers object from hand to hand
• Raking grasp (palmar grasp)

• Bears weight on feet when held upright
• 5 months: Grasps and brings feet to mouth when lying supine
• 6 months: Crumples exam room paper, has more accurate reach, starting to sit with minimal support

Did you know?

• Good sleep schedules start at this age (See Good Sleep Patterns)
• Babies will say “da” before “ma,” which is why they say “dada” before “mama”

• Stranger anxiety (6-9 months).
• Finds a hidden object she has seen disappear: object permanence (e.g. protest when parents leave the room, follow dropped red yarn or thrown cheerio below horizon). 
• Gesture games: Pat-a-cake. Peek-a-boo (at this age, especially loves peek-a-boo because the game plays into the newfound understanding of object permanence)
• May select a transitional object (part of the developmental process of becoming independent, cuddly object substitutes for an absent parent.)

Transitional object:

Language:

•  “dada,” “mama” non-specific
• baby talk (jabbering): mixed varied sounds with inflections and gestures
• understands: name, “no,” familiar objects or people, “bye-bye”

Gross Motor:

• Moves forward somehow: crawling is the norm. Some find another way: creeping (pulling with arms), scooting
• Pulls to stand, gets to sitting position themselves
• 10 months: cruising

Fine Motor:

• eats finger foods
• bang 2 cubes together, clap hands
• uses scissorlike grasp (thumb and pad of index finger) = inferior pincer (see Development of Grasp)
• when reaching, anticipates the shape of the object

• Stranger anxiety reflects good attachment to caretaker

• watches and imitates older children and adults, single actions
• responds to name
• loves to run away and get caught

Language:

• 1-2 words plus “mama” and “dada”
• points at objects with index finger (first indicates want, soon after points for shared attention “look at what I am looking at”)
• understands simple requests, phrases and familiar objects
• imitates vocalizations

Fine Motor:

• releases block into cup
• refined pincer grasp (thumb and tip of index finger)

Gross Motor:

• takes few steps alone
• feeds self with hands
• drinks from a cup (not a sippy cup)

• starts imitating housework (sweeping, dusting)
• plays ball with examiner
• indicates wants with gesture

Language: 

• 3 words other than mama, dada.
• Follows simple commands (“give me your cup”)
• Talks to self while playing, understands function of objects, (pretends to talk on phone, brings comb to hair)

Fine Motor: 

• uses spoon (with spilling)
• starts scribbling
• tower of 2 blocks

Gross Motor: 

• stoops and recovers
• Walks with broad base, creeps up stairs
• Walks backwards

Did you know…?

• It is important to have daily routines with consistent mealtimes and bedtime rituals
• Confrontations don’t work; avoid saying “no” to unwelcome behavior - instead use distraction and diversions
• Food fads (child eating only certain things) are common and harmless
• Self feeding is very important

• Symbolic (pretend) play – e.g. feeding a doll 
• Still imitating housework – likes to clean, put things in order.
• Loves the process of switching between opposites and changing their mind, such as filling/emptying; opening/closing; get up/get down; turning on and off lights

Language: 

• 6-10 words
• knows 5 body parts

Fine motor: 

• scribbles spontaneously
• self feeding with cup and spoon
• tower of 3-4 blocks
• turns pages 2-3 pages at a time
• removes some clothing

Gross motor: 

• climbing
• walks up stairs with help (2 feet per step)
• kicks ball by running into it
• throws ball overhead without falling

Did you know…?

• Rapprochement occurs at this age (18-24 mos), due to increasing sense of separateness.  Can rapidly alternate between extreme independence and extreme clinginess.

Language Emerges

Social: 

• parallel play (very excited by other children)
• put on at least one article of clothing

Language: 

• 2 word sentences (needs a verb)
• minimum 50 word vocabulary – need this to start combining words
• points to 6 body parts
• uses personal pronouns “I, me, mine”
• understandable by strangers 50% of the time

Gross Motor: 

• walks up and down stairs without help (two feet per step)
• kicks ball (draws back leg to kick ball instead of running into ball)
• jumps off bottom step (with hand held)

Fine Motor: 

• Copies vertical line (2.5 years)
• Turns doorknobs, unscrews lids
• Turns page one at a time
• Tower of 6-7 cubes
• Uses spoon well

Did you know…?

• At this age, a child starts to learn if they are a boy or a girl
• A rich language environment is most important to language development.  Bilingualism should not delay language development.

Link to gender identity

Language Delay – ddx includes hearing loss, global DD, psychosocial deprivation, chronic illness, acute stressors, autism spectrum, elective mutism

Link:       http://familydoctor.org/online/famdocen/home/children/parents/special/common/442.html

Bilingualism- children raised in bilingual households have a slight delay in expressive language up to about 2 years of age while they are learning to put the components of language together.  After that, children are able to switch from one language to another in context and have a combined vocabulary that meets the usual expectations.

3 years

Social:

• interactive play (has progressed from parallel play at earlier ages)
• fantasy play and role-playing (more complex with roles, costumes, props)
• knows full name, age, gender
• Undresses completely, dresses partially (needs help with buttons and correct shoe)

Language:

• Can understand and tell simple stories
• 3 word phrases
• Minimum 250 words vocabulary
• Is understandable by strangers 75% of the time
• Names 2 colors
• Uses plural nouns
• Understands prepositions (“on,” “in,” “under”)

Fine Motor:

• copies circle
• builds tower of 9-10 cubes
• can unbutton
• thumb wiggle

Gross Motor:

• rides tricycle
• goes up stairs with alternating feet (down the stairs two feet on each step)
• balances on one foot 2 seconds

LINK TO: Emergence of Handedness

LINK TO: Night Terrors

• learning concepts of “taking turns” and what is “fair” (not really sharing)
• tells “tall tales” (not lying, but reality testing not in place)
• oedipal phase: may have strong attachment to parent of the opposite sex
• gender identity further develops – knows expected, gender-specific behavior for play activities, toy preferences, language, and body posture
• sexual curiousity: this is the age of playing “house” and “doctor”
• understands the concept of “same” and “different” – starts to notice racial differences between people and develop expectations based upon them

Language:

• speaks in 4-5 word sentences, can tell a story
• vocabulary is > 1000 words
• pretty much 100% intelligible to strangers but some hesitation is normal
• names 4 colors

Fine Motor:

• copies cross
• copies square at 4.5 years
• can button
• draws person with 2-4 parts

Gross Motor:

• goes up and down stairs with alternating feet
• can stand on 1 foot for 3-4 seconds
• hops on one foot
• running is well-controlled; can start, stop, and turn

5 years

• dresses and undresses self without help (except tying shoe laces, zippers)
• can be taught address, phone number, where mother and father work
• cooperative team play

Language:

• can print some letters, including first name

Fine Motor:

• draws person with 10 parts
• copies triangle

• stands on one foot for 10 seconds
• skips with alternating feet