milestones pedia

8/13/2019 Milestones Pedia

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Melissa D. David

BSN2Y2-2

I. INFANTS AND TODDLERS

By 6 Months Making sounds other than crying

Rolling from stomach to back andback to stomach

Beginning to sit up

Grasping, reaching andtransferring toys from hand tohand

Reacting to sounds andresponding voices

Difficulty sucking

Not gaining height andweight

Not responding to sounds

and voices Not beginning to make

sounds other than crying

Stiff limbs/overalltightness

Weak limbs Not using hands to play

with toys

Not smiling in response toothers

By 12 Months Babbling with 6 – 7 differentconsonant sounds such as m or d

Imitating sounds and saying a fewwords

Responding to simple words such

as no and bye

Gesturing and vocalizing to

request

Creeping, crawling and cruising Sitting alone

Pulling to a stand

Picking up small objects andbanging objects on the table

Playing pat a cake or peek a boo Holding out objects to "show"

Feeding self small bits of cereal

Playing with caregivers

Exploring and touching a varietyof textures

Not imitating sounds

Not babbling different

sounds Not saying a few words

Not pointing and

vocalizing to request tomeet needs

Not responding to name

or to simple words such as ―bye‖ or ―no‖. Not standing, crawling and

sitting on own

Not picking up small

objects Not playing with parents,

siblings and toys

By 18 Months Responding to simple requestssuch as "give me the ball"

Listening to simple rhymes andsongs

Tasting foods with a variety oftextures

Imitating and saying a few words(10 – 15 words)

Jabbering in a way that sounds

Not responding to simplerequests

Not listening to stories orsongs

Not imitating and sayingwords

Not walking independently Not playing with toys and

caregivers



like language Walking without support

Playing in a typical way with toys

Showing affection Looking at books and turning

pages

Scribbling with a crayon Putting objects in container

Using a spoon with some spilling

and drinking from a cup

Not showing a variety ofemotions

Not scribbling or putting

objects in a container Not self-feeding

Avoiding textures

By 24 Months Using more words and puttingwords together

Showing interest in and playingwith a variety of toys

Pointing to a few pictures of

familiar people or objects and

body parts Obeying simple two part

commands Speech can be understood about

65% of the time

Running, jumping, climbing,kicking and throwing

Using crayon to make lines and

circular scribbles Building a 4 – 6 block tower and

putting pegs in a peg board Says ―no‖ often

Engaging in parallel and pretend

play Playing alone for a few minutes

Removing clothes

Not putting wordstogether

Not obeying simplecommands some of thetime

Not physically active

Not scribbling or buildingwith blocks Not showing interest in

toys and social or pretendplay

Not expressing affection Not beginning to undress

self Sensitive to or avoiding a

variety of textures

By 30 Months Using 3 —4 word sentencesfrequently

Answering simple questions suchas ―What is your name?‖ or

―Where are you going?‖ Following 2 step directions

Speech is understood by peopleoutside the family most of the

time Walking up and down stairs Building 8 block tower, snipping

with scissors, and placing square

pegs in a board Expressing emotions

Interest in playing with others but

may not share well

Not talking in simplesentences or answeringsimple questions

Speech is difficult to

understand Physically awkward or

clumsy or inactive Not feeding and dressing

self Not interested in social

play and playing with avariety of toys

Not expressing a variety ofemotions



Putting on some clothingindependently, feeding self withutensils, washing/drying hands

By 36 Months Has vocabulary of at least 300

words, expressively Is intelligible about 80% of the

time Relating experiences using short

grammatical sentences Climbing, catching, riding a trike,

jumping, going up and downstairs alone and running well

Actively playing with a variety oftoys including puzzles, books,

pegs, crayons and blocks Feeding self and dressing and

undressing with minimalassistance

Playing simple interactive gamesand enjoying playing with others

Beginning to obey simple rules

Limited vocabulary Difficult to understand Leaving endings off words

Not answering simplequestions or relatingexperiences

Not speaking in simple 4word sentences

Physically awkward or

clumsy or inactive Not playing with a variety

of toys Not obeying simple rules

Not interested in playingwith other children

II. PRESCHOOL

Physical Cognitive Social Emotional Possible effects of

maltreatment

Physically

active

Rule of Three:

3 yrs,

3 ft, 33 lbs.

Weight gain:

4-5 lbs per year

Growth: 3-4

inches

per year

Physically

Ego-centric,

illogical,

magicalthinking

Explosion of

vocabulary;learning syntax,

grammar;understood by75% of

people by age 3

Poorunderstanding

of time,

Play:

imaginative, mayinvolve fantasy

and imaginary

friends, takes

turnsin games

and fine motor

skills; social

skills;

experiment withsocial roles;

reduces fears

Self-esteem

based on

what otherstell him

or her

Increasingability to

controlemotions; lessemotional

outbursts

Increasedfrustration

tolerance

Poor muscle tone, motor

coordination

Poor pronunciation,

incomplete sentences

Cognitive delays; inabilityto concentrate

Cannot play cooperatively;lack curiosity, absent

imaginative and fantasy

play

Social immaturity: unable to

share or negotiate with



active,

can’t sit stillfor

long

Clumsythrowing

balls

Refines

complex

skills:hopping,

jumping,

climbing,

running, ride

“bigwheels” and

tricycles

Improving

finemotor skills

and

eye-hand

coordination:cut

with scissors,draw shapes

3 – 3 ½ yr:

most

toilet trained

value, sequence

of events

Vivid

imaginations;

somedifficulty

separatingfantasy

from reality

Accuratememory, but

more

suggestible than

older

children

Primitivedrawing, can’t

represent

themselves indrawing till age

4

Don’t realizeothers have

different perspective

Leave out

important facts

May

misinterpret

visual cues ofemotions

Receptive

language betterthan expressive

till age 4

Wants to pleaseadults

Development of

conscience:incorporates

parental prohibitions; feels

guilty when

disobedient;

simplistic idea of“good and bad”

behavior

Curious about his

andother’s bodies,

maymasturbate

No sense of privacy

Primitive,

stereotypicunderstanding of

gender roles

Better delaygratification

Rudimentary

sense ofself

Understands

concepts

of right and

wrong

Self-esteem

reflects

opinions of

significantothers

Curious

Self-directedin many

activities

peers; overly bossy,

aggressive, competitive

Attachment problems:

overly clingy, superficial

attachments, show littledistress or over-react when

separated from caregiver

Underweight from

malnourishment; small

stature

Excessively fearful,

anxious, night terrors

Reminders of traumaticexperience may trigger

severe anxiety, aggression, preoccupation

Lack impulse control, littleability to delay gratification

Exaggerated response

(tantrums, aggression) toeven

mild stressors

Poor self esteem,

confidence; absence of

initiative

Blame self for abuse,

placement

Physical injuries; sickly,

untreated illnesses

Eneuresis, encopresis, selfstimulating behavior –

rocking, head-banging



III. SCHOOL AGE

Physical Cognitive Social Cognitive Possible effects of

maltreatment

Slow, steady

growth:3 -4 inches per year

Use physicalactivities

to develop

gross

and finemotor skills

Motor & perceptual

motor skills

better

integrated

10-12 yr:

puberty begins for

some

children

Use language as

acommunicationtool

Perspectivetaking:

5-8 yr: can

recognize

others’ perspectives,

can’t assume

the role ofthe other

8 – 10 yr:

recognize

difference between

behavior and

intent; age10-11 yr: can

accurately

recognize and

considerothers’

viewpoints

Concrete

operations:

Accurate perception ofevents; rational,

logical

thought;

concretethinking; reflect

upon self

and attributes;understands

concepts of

space, time,dimension

Friendships are

situationspecific

Understands

conceptsof right and

wrong

Rules relied uponto

guide behavior

and play, and provide

child with

structure

and security

5-6 yr: believe

rules can be changed

7-8 yrs: strict

adherenceto rules

9-10 yrs: rulescan be

negotiated

Beginunderstanding

social roles;

regards

them asinflexible; can

adapt behavior to

fitdifferent

situations;

practices socialroles

Self esteem

based onabilityto perform

and produce

Alternative

strategies for

dealing with

frustrationand

expressing

emotions

Sensitive to

other’s

opinionsabout

themselves

6-9 yr: have

questions

about

pregnancy,intercourse,

sexual

swearing,look for

nude pictures

in books,magazines

10-12 yr:

games with

peeing,sexual activity

(e.g., strip

poker,truth/dare,

boy-girl

relationships,flirting, some

Poor social/academic

adjustment in school: preoccupied, easilyfrustrated, emotional

outbursts, difficulty

concentrating, can beoverly reliant on teachers;

academic

challenges are threatening,

cause anxiety

Little impulse control,

immediate gratification,inadequate coping skills,

anxiety, easily

frustrated, may feel out of

control

Extremes of emotions,

emotional numbing; olderchildren may “self-

medicate” to avoid

negative emotions

Act out frustration, anger,

anxiety with hitting,

fighting, lying, stealing, breaking objects,

verbal outbursts, swearing

Extreme reaction to perceived danger (i.e.,

“fight, flight, freeze”

response)

May be mistrustful of

adults, or overly solicitous,

manipulative

May speak in unrealistically

glowing terms abouthis parents



Can rememberevents

from months, or

years

earlier

More effectivecoping skills

Understands

how his behavior affects

others

Takes on moreresponsibilities at

home

Less fantasy play,more

team sports, board

games

Morality: avoid punishment; self

interested

exchanges

kissing,

stroking/rubbing,

re-enacting

intercourse

with clotheson)

Difficulties in peerrelationships; feel

inadequate

around peers; over-

controlling

Unable to initiate, participate in, or complete

activities, give up quickly

Attachment problems: maynot be able to trust,

tests commitment of foster

and adoptive

parent with negative

behaviors

Role reversal to please parents, and take care of

parent and younger siblings

Emotional disturbances:

depression, anxiety,

post traumatic stress

disorder, attachment problems, conduct disorders

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