developmental appraisal

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DEVELOPMENTAL

APPRAISAL (DEVELOPMENTAL MILESTONE

OF A CHILD)

By: THESA MARIE L. BABA, RN



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

At Birth

Lies in fetal

position with

knees tucked up.

Unable to raise

head. Head falls

backwards if

pulled to sit.

Reacts to sudden

sound. Closeseye to bright

light. Opens eye

when held in an

upright position.

Bonds with

mother. Smiles at

mother.

Beginning to

develop concepts

e.g. becomes

aware of physical

sensations such

as hunger.

Explores using

his senses. Makeeye contact and

cry to indicate

need.

Cries vigorously.

Respond to high-

pitched tones by

moving his

limbs.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

3 Months

Pelvis is flat

when lying

down. Lower

back is still

weak. Back and

neck firm when

held sitting.

Grasps objects

placed in hands.

Turns head roundto have a look at

objects.

Establishes eye

contact.

Squeals with

pleasure

appropriately.

Reacts with

pleasure to

familiar routines.

Discriminatessmile.

Takes increasing

interest in his

surroundings.

Shows interest in playthings.

Understand cause

and effect e.g. if

you tie one end

of a ribbon to his

toe and the other

to a mobile, he

will learn to

move the mobile.

Attentive to

sounds made by

your voice.Indicates needs

with

differentiated

cries. Beginning

to vocalise.

Smile in

response to

speech.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

6 Months

Can lift head and

shoulders. Sits up

with support.

Enjoys standing

and jumping.

Transfers objects

from one hand to

the other. Pulls

self up to sit and

sits erect with

supports. Rolls

over prone to

supine. Palmer

grasp of cube.

Well established

visual sense.

Responds to

different tones of

mother. May

show 'stranger

shyness'. Takes

stuff to mouth.

Finds feet

interesting.

Understand

objects and know

what to expect of

them.

Understand'up' a

nd'down' and

make appropriate

gestures, such as

raising his arms

to be picked.

Double syllable

sounds such

as 'mama' and'd

ada'. Laughs in

play. Screams

with annoyance.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

9 Months

Sits unsupported.

Grasps with

thumb and index

finger. Releasestoys by dropping.

Wiggles and

crawls. Picks up

objects with

pincer grasp.Looks for fallen

objects. Holds

bottle. Is visually

attentive.

Apprehensive

about strangers.

Imitates hand-

clapping. Clings

to familiar adults.

Shows interest in

picture books.

Watches

activities of

others with

interest.

Babblestunefully.

Vocalises to

attract attention.

Enjoy

communicatingwith sounds.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

1 Year

Stands holding

furniture. Stands

alone for a second

or two, thencollapses with a

bump. Walks

holding one hand.

Bends down and

picks up objects.

P

ulls to stand andsits deliberately.

May walk alone.

Holds spoon. Points

at objects. Picks up

small objects.

Cooperates with

dressing. Wavesgoodbye.

Understands

simple

commands.

Demonstrate

affection.

Participate in

nursery rhymes.

Responds to

simple

instructions. Uses

trial-and-error to

learn about

objects.

Babbles 2 or 3words repeatedly.

Responds to

simple

instructions.

Understands

several words.

Uses jargon.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

15 Months

Can crawl up

stairs frontwards.

Kneels unaided.

Balance is poor.

Can crawl down

stairs backwards.

Builds 2 block

tower. Can placeobjects precisely.

Turns pages of

picture book.

Helps with

dressing.

Indicates soiled

or wet paints.

Emotionally

dependent onfamiliar adult.

Is very curious.

Can

communicate

needs. Jabbers

freely and loudly.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

18 Months

Squats to pick up

toys. Can walk

alone. Drinks

without spilling.

Picks up toywithout falling

over. Shows

preference for one

hand. Gets

up/down stairs

holding onto rail.Begins to jump

with both feet. Can

build a tower of 3

or 4 cubes and

throw a ball.

Plays alone near

familiar adult.

Demands

constantmothering.

Drinks from a

cup with both

hands. Feeds self

with a spoon.

Attains bowel

control. Tries to

sing. Imitates

domestic

activities.

Enjoys simple picture books.

Explores

environment.

Knows the

names of parts of his body.

Uses 'Jargon'.Uses many

intelligible

words. Repeats

an adult's last

word. Jabberingestablished.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

2 Years

Can kick large

ball. Squats with

ease. Rises

without using

hands. Builds

tower of six

cubes. Able to

run. Walks up

and down stairs

2 feet per step.Builds tower of

6 cubes. Turns

picture book

pages one at a

time.

Throws tantrum if

frustrated. Can

put on shoes.

Completely spoon

feeds and drinks

from cup. Is

aware of physicalneeds. Dry by

day.

Joins 2-3 words

in sentences.

Recognizes

details in

pictures. Uses

own name torefer to self.

Talks to self

continuously.

Speaks over two

hundred words,

and accumulate

new words veryrapidly.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

3 Years

Can jump off lower

steps. Can pedal and

steer tricycle. Goes

up stairs 1 foot per

step and downstairs

2 feet per step.

Copies circle.

Imitates cross and

draws man on

request. Builds

tower of 9 cubes.

Has good pencil

control. Can cut

paper with scissors.

Can thread large

beads on a string.

Plays co-

operatively .

Undresses with

assistance.

Imaginary

companions.Tries

very hard to please. Uses spoon

and fork.

Relates present

activities and past

experiences. Can

draw a person with

a head. Can sort

objects into simplecategories.

Constantly asks

questions. Speaks

in sentences. Talks

to himself when

playing.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

4 Years

Sits with knees

crossed. Ball

games skill

increases. Goesdown stairs one

foot per step.

Imitates gate with

cubes. Copies a

cross. Can turnsharp corners

when running.

Builds a tower of

10 cubes.

Argues with

other children.

Plans games co-

operatively.Dresses and

undresses with

assistance.

Attends to own

toilet needs.Developing a

sense of humour.

Wants to be

independent.

Counts up to 20.Asks meanings of

words.

Questioning at its

height. Draw

recognisablehouse.

Many infantile

substitutions in

speech. Uses

correct grammar

most of the time.

Enjoy counting

up to twenty by

repetition.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

5 Years

Skips. Well

developed ball

skills. Can walk

on along a thin

line. Skips on

both feet and

hops. Draws a

man and copies a

triangle. Gives

age. Can copy an

adult's writing.

Colors pictures

carefully. Builds

steps with 3-4

cubes.

Chooses ownfriends. Dresses

and undresses

alone. Shows

caring attitudes

towards others.Copes well with

personal needs.

Writes name.

Draws a detailed

person. Matches

most colours.

Understandsnumbers.

Fluent speech

with fewinfantile

substitutions in

speech. Talks

about the past,

present andfuture with a

good sense of

time.



AgePhysical

Development

Social and

Emotional

Development

Intellectual

Development

Language

Development

6 Years

Learns to skipwith rope.

Copies a

diamond. Knows

right from left

and number of

fingers. Ties

shoe laces.

Stubborn and

demanding.

Eager for fresh

experiences.

May be

quarrelsome withfriends.

Draws with

precision and to

detail.

Developing

reading skills

well. May writeindependently.

Fluent speech.

Can pronounce

majority of the

sounds of his

own language.

Talk fluently andwith confidence.



Child DevelopmentalMilestones



What are Developmental

Milestones?



Developmental milestones can

be described as a set of functional skills or age-specific

tasks that an average child isable to do when he reaches aspecific age.



W e make use of these

milestones to be sure that achild is developing at a

normal pace and is notsuffering from any growth-

related problems.



However, while making use of these

milestones, nurses should keep inmind that it is not necessary for a child to be able to do a specific task exactlywithin the age range mentioned . Some variations are bound to be there, as

every child is unique. It is only whenthe variations become too much that aneed for intervention is necessary.



Skills

The skills that are generally studiedin the growth and development charts

for babies

Basic Motor Skills

Using large muscle groups in sitting,standing, walking, running, balancing and

changing positions



Ad vanced Motor SkillsUsing hands to eat, draw, dress, play,

write and indulge in other things

Learning SkillsLearning to speak and use body

language as well as gestures for

communication, ability to understandothers



Cognitive and Thinking SkillsLearning, problem-solving and reasoning

Social SkillsInteracting with others, maintainingrelationships with family, friends and

teachers, learning to share and cooperateand responding to other people's feelings



One to Six Months Old



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

1 month

old

Lifts head

Responds to

soundStares at faces

Follows

moving objects

by eyesMake cooing

sounds

Can see

patterns inblack and

white and their

contrasts

Smiles

Laughs

Holds head at45 degree

angle



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

2 months

old

Make gurgling

and cooing

soundsFollows moving

objects by eyes

Holds head up for

short periods

Smiles

Laughs

Holds head at45 degree

angle

Smoother

movements

Keeps head

steady

Bears weighton legs

May lift head

and shoulder

in a pushup-like position



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

3 months old Laughs

Keeps head steady

Recognizes mom's face

and can know her by

her scent

Squeals and make

gurgling and cooing

sounds

Recognizes mom's

voice

Do mini-pushups

Listens and turns

toward loud sounds

Can bring hands

together

May try to bat at

toys

Rolls over

4 months old Keeps head up and

steady

Can bear weight on

legs

Make cooing sounds in

response to your talk

Can grasp a toy

Reaches out to

touch or grab

objects

Rolls over

Imitates sounds

and speech made

by you such as

papa, mama

First tooth may

show up

May be ready for

solids



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

5 months old Understands

differences in bold

colors

Rolls over Plays with own hands

and feet

Recognizes and

turns to look at the

source of new

soundsRecognizes own

name

May sit without

support for a moment

or two

Puts objects in mouth

Stranger anxiety may

begin

6 months old Turns to look at the

source of sounds and

voicesImitates sounds

Blows bubbles

Rolls in both directions

Reaches for

objects and puts

them in mouthSits without support

Ready for solids

May start crawling or

lunge forward

May jabber trying to

combine syllables

May try to drag

objects toward

himself



Seven Months

to One Year Old



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

7 months old Sits without support

Makes sweeping motion

to reach for things

Babbles

Combines syllables

to form word like

sounds

Crawls or lungesforward

Stands with

support or while

holding something

Waves to saygoodbye

Bangs objects to

produce sounds

8 months old Uses 'mama' or 'dada'

to parents, notnecessary the right one

Crawls

Passes object from

hand to hand

Stands with

support or whileholding something

Masters crawling

Points at objects

Pulls self to standing

position and tries to

cruise with support of

walls or furniture

Picks things up using

'pincer grasp' or using

thumb and finger

Tries to express himself

using gestures



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

9 months old Combines syllables to

form word like sounds

Stands with support or

while holding something

Picks things up using

'pincer grasp' or

using thumb and

finger

Tries to cruise with

support of walls or

furniture

Bangs objects

together

Plays infant games

with small rhymes

Says 'dada' and

'mama' to the right

parent

10 months old Waves to say goodbye

Picks things up using'pincer grasp' or using

thumb and finger

Masters crawling

Explores and cruises

Says 'dada' and

'mama' to the rightparent

Responds to own

name

Understands 'No'

Expresses himself

using gestures

Drinks from a cup

Stands alone withoutsupport for a couple

of seconds

Puts objects in a

container and pull

them out



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

11 months old Says 'dada' and 'mama'

to the right parent

Plays infant games with

small rhymes

Stands alone withoutsupport for a couple of

seconds

Imitates what others

are doing

Puts objects in a

container and pull

them out

Understands simple

sentences and

instructions

Drinks from a cup

Learns one word

besides 'mama'

and 'dada'

Stoops whilestanding

12 months old

or One year

old

Imitates what others are

doing

Jabbers and makesounds that are like

words

Expresses himself

using gestures

Learns one word

besides 'mama' and

'dada'Takes a few steps

Understands simple

sentences and

instructions and

responds to them

Scribbles with

crayon

Masters walkingLearns two words

besides 'mama'

and 'dada



One Year to One and a

Half Year Old



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

13 months

old or just

one year old

Learns to use two

words besides 'mama'

and 'dada' well

Stoops while standing

to pick up objectsStands without support

Finds gazing at his

reflection funny and

amusing

Drinks from a cup

Plays hide-and-seek or peek-a-boo

Uses combination of

words and gestures

to express himself

Tries to lift heavy

things

Rolls a ball back and

forth like to play

'Catch and throw'

14 months

old

Feeds using fingers

Pull things out from jars

and empties containers

Imitates others

Walks well while

toddling

Makes and starts hisown games to play

Learns the names of

body parts and point

to them when the

name is said

Starts learning how to

use spoon or fork

Can find matching lidsof containers, pots

and pans according

to size and shape

Pushes and pulls toys

while walking



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

15 months old Plays with ball

Learns about five

words other than initial

vocabulary Can walk

backward

Can draw a dot and

a line

Masters running

'No' becomes his

favorite word

Can climb up stairs

Begins to learn with

household chores

Learns to put his

fingers to mouthand say 'shhh' to

indicate silence or

secrecy

16 months old Can turn the pages of

a bookHas toddler temper

tantrums Has favorite

toy or object to which

he becomes attached

Climbs well

Can stack up tothree blocks

Learns to use

common objects

such as telephone

Can take a piece or

two of clothes byhimself

May become picky

eater

Nap times reduce

from two to one



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

17 months old Vocabulary increases

and he learns to use

some words regularly

Loves to play pretend

games and riding toys

Understands and

responds to

directions May feed

dolls like a real

babySpeech becomes

clear

Dances when

music plays

Learns to sort toys

by color, shape or

sizeLearns to kick ball

to launch it forward

18 months old

or One and a

half year old

Loves to watch the

pictures or 'read' his

board books on his ownLearns to scribbles well

Can pedal his tricycle

Can put words

together to make

phrasesBrush teeth with

help

Can stack up to

four cubes together

Throws ball

overhand

Loves to pull toysapart and then put

them back together

Ready for toilet

training



One and a HalfYear to Two Years

Old



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

19 months old

or just one and

a half year old

Learns to use a spoon and

fork

Runs

Throws ball underhand

Speech becomes

clearer and about

half of it is

understandable

Recognizes troubleor that something is

wrong and may call

for help

Can brush teeth with

help and wash and dry

hands too

Can understand the

meaning of animal

names such as cat or

dog and point to its

picture

May recognize and tell

you when child needs to

go toilet

20 months old Will pretend a doll to be ababy and feed it

Can take off own clothes

with help

Can imitate actions just as

throwing garbage

Vocabulary increasesrapidly and learns 10

or more words a day

Can walk up stairs

Tries to find objects

that are hidden

May be curious abouthis genitals

Draws straighter lines

Knows the name of

many body parts and

can say them



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

21 months old Can walk up stairs

Loves to help with

household chores

Can follow simple goals

such as keeping a toy inits place

Kicks the ball and

can throw it

overhand

Makes block

towers

Can recognize the

picture of cat or

dog and say it

Can make tow-

word sentencessuch as go park or

want candy

Can walk down

stairs

22 months old Can kick a ball forward

Follows two-step

requests (get your doll

and bring it here)

Imitates others'

behavior

Can do simple

puzzles

Can draw a straight

line

Can identify

several body parts

Can put on

clothing

Might be ready for

a big bed

Understands

opposites (tall and

short)



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

23 months old Stack up to 4 blocks to

make a tower

Names simple pictures

in a book

Learns and uses about50 words

Uses two or three

word sentences

Sings simple tunes

Loves to play with

other kids

Walk down stairs

Expresses his likes

and dislikes and

talks about himself

Asks 'Why?'questions about

almost everything

24 months old

or two years

old

Can tell at least six

body parts in a doll

About half of what hesays is clear and

understandable

Can make short

sentences

Expresses his likes

and dislikes and

talks about himself Can arrange and

categorize things

Can walk down

stairs

Learns and

understands simple

abstract words andconcepts like

sooner and later

Understands

gender differences

Starts jumping



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

25 and 26

months old or

just two years

old

Dresses down on his

own

Know the names of

many body parts and

can say themBuilds tower of three or

four blocks

Washes and dries

hands by himself

Brushes teeth with

help

Dresses up on his

ownSpeech is

understandable most

of the time

Throws a ball

overhand

Speech is

understandable all

the time

Draws vertical line

27 and 28

months old

Speech is

understandable most of

the time

Dresses up on his own

Jumps up and down

Builds tower of

several blocks

Speech is

understandable all

the time

Draws vertical line

Can balance

himself on one foot



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

29 to 30

months old

or two and a

half yearsold

Washes and dries

hands by himself

Brushes teeth with

help

Draws a vertical

line

Speech is

understandableall the time

Can balance

himself on one

foot

Can put on T-

shirt

Can recognize

and say namesof colors

Known the

names of his

friends



Two and a Half toThree Years Old



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

31 and 32

months old or

just two and a

half years old

Can stack up to six

blocks to make a tower

Knows at least six body

parts by names

Throws ball overhand

Puts on a T-shirt on

his own

Can keep balance

on each foot for a

moment or twoLearns to brush

teeth on his own

Calls friend by

names

Washes and dries

hands on his own

Can use up to twoadjectives in one

sentence

33 and 34

months old

Can name colors

Can carry on

conversations using twoto three sentences at

once

Can name at least four

pictures in a book

Builds tower of up

to eight blocks

Starts usingprepositions in

sentences

Speech is clear

Toilet trained fully,

at least during the

dayWiggles thumb

Express many

emotions using

body language and

sounds



Age of

the Child

Common

Skills

Skills Still

Learning

Rare Skills

35 to 36

months old or

three years

old

Learn to use at least

two common objects

well

Uses sentences with

about four to fivewords.

Can describe everyday

actions such as jumping

and running

Can keep balance on

each foot for about

three seconds

Can follow more

complex commands

with tow or three

instructions such as

go to your room;

switch off the lights

and go to sleep.

Can stay without

parents for sometime

and do not cry and

wail for them

Learns to hop, skip

and jump.

Can draw a circle

Can dress up and

down on his own

developmental appraisal

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