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6 weeks of age

Gross motor

• Head control- Head is held at level with body in ventral suspension ( 0- 3 months)
• Moros reflex

Fine motor and vision

• Stares at bright object
• Follows horizontally to 90 degree

Hearing and speech

• Startle response-Stills to sound

Social behaviour

• Smiles ( 0 – 10 weeks)
• Turns to regard observers face

Warning signs at 6 weeks

• No visual fixation or following to bright light
• Failure to respond to sound
• Asymmetrical neonatal reflex
• Excessive head lag
• Failure to smile( by 10 weeks)

6 to 8 months of age

Gross motor

• Holds head at 90 degrees in ventral suspension ( 3 months)
• Bears weight on legs ( 3- 7 months)
• In prone lifts up on forearms( 6 months)
• Downward parachute ( 4- 6 months)
• Sits with support ( 4- 6 months)
• Sits without support ( 5- 8 months)
• Can be pulled to sit( 3 ½ to 6 months)
• Crawls( 9- 10 months)

Fine motor and vision

• Reaches out to grasp ( palmar grasp- 3 to 6 months)
• Transfers objects and mouths objects ( 4 ½ to 8 months)
• Fixes vision on small objects ( 5 to 8 months)
• Follows fallen objects/ toys ( 5 to 8 months)

Hearing and speech

• Turns to sound (3 months)
• Vocalises (4 to 6 months)
• Laughs (2- 5 months)
• Responds to name ( 4 to 8 months)
• Distraction hearing test
• Social behaviour and play
• Puts everything to mouth ( 4- 8 months)
• Hand and foot regard( 4- 8 months)
• Plays peek a boo ( 6 to 10 months)

Warning signs

• Hand preference
• Fisting
• Squint
• Persisting of primitive reflexes ( moros/ stepping/ asymmetrical tonic neck reflex)

9 months of age-

Gross Motor

• Crawls
• Sits steadily unsupported

Fine Motor and vision

• Pincer grasp
• Bangs 2 cubes together

12 months old

Gross motor

• Gets to sitting position ( 6 to 11 months)
• Pulls to standing position ( 6 to 10 months)
• Walks holding furniture (7- 13 months)
• Walks alone ( 12- 15 months)

Fine motor and vision

• Points with index finger
• Throws objects ( 9 – 15 months)
• Pincer grasp (9- 14 months)
• Holds two bricks and bangs together ( 7 – 13 months)

Hearing and speech

• Turns to sound of name
• Uses ‘Mama’ and ‘Dada’ ( 11- 20 months )
• Understands several words
• Distraction hearing test

Social behaviour and play

• Drinks from a cup ( 10 – 16 months)
• Indicates wants ( 10 – 15 months)
• Plays ‘ Pat a cake’ ( 8-1 months)
• Waves good bye( 8- 13 months)

Warning signs at 12 months

• Unable to sit or bear weight
• Persistence of hand regard
• Absence of babbling and cooing

18 months old

Gross motor

• Walks backwards ( 12- 22 months)
• Carried toys while walking
• Climbs stairs ( 14- 22 months)
• Climbs onto chair

Fine motor vision

• Delicate pincer grasp ( 10- 18 months)
• Scribbles ( 12- 24 months)
• Turns pages
• Build tower of 3 – 4 bricks( 16- 24 months)
• Hearing and speech
• Jabbers continuously
• Utters 3 or more words( 10-21 months)
• Points to eyes, nose and mouth ( 14- 23 months)
• Obeys simple instructions ( 15 month- 2 ½ years)

Social behaviour and play

• Holds spoon and tries to put in mouth( 14 months- 2 ½ years)
• Explores environment ( 13- 20 months)
• Takes off shoes and socks ( 13- 20 months)
• Indicated toilet needs

Warning signs at 18 months

• Inability to stand without support
• Inability to understand simple commands
• No spontaneous vocalisation
• No pincer grasp

2 ½ years old

Gross motor

• Climbs and descends stairs
• Jumps in place ( 21 months – 3 years)
• Kicks ball( 15- 24 months)

Fine motor and vision

• Picks up objects
• Imitates vertical line ( 18 months – 3 years)
• Builds tower of 8 blocks ( 21 months – 3 ½ years)

Hearing and speech

• Gives name
• Hearing test- Speech discrimination test
• Social behaviour and play
• Plays alone
• Eats with spoon and fork without spilling
• Puts on clothes
• Dry throughout day

Warning signs at 2 ½ years

• Unable to speak in short sentences
• Unable to understand speech

3 years old

Fine motor

• Runs
• Climbs stairs one step at a time
• Pedals tricycle( 21 months- 3 years)
• Stand on one foot for few seconds ( 22 months – 3 ½ years)
• Fine motor and vision
• Copies circle ( 2 ½ years – 3 ½ years)
• Threads beads
• Matches 2 colours

Hearing and speech

• Uses 4 word sentences
• Gives full name, sex , age( 2 ½ years – 4 years)

Social behaviour and play

• Eats with knife and fork
• Goes to toilet alone
• Dresses independently
• Washes and dries hands ( 20 months- 3 ½ years)
• Separates from mother (2- 4 years)

4 years old

Gross motor

• Hops on one foot
• Climbs ladder
• Stands on one foot for 5 seconds( 2 ½ years to 4 ½ years)
• Walks heel to toe (3 ½ years – 5 ½ years)

Fine motor and vision

• Copies cross and square
• Imitates bridge of 3 blocks
• Draws man with 3 parts

Hearing and speech

• Counts till 10
• Gives full name and address
• Recognises colours

Social behaviour and play

• Shares toys
• Brushes teeth
• Dress without supervision ( 3 ½ years – 5 ½ years)

Warning signs

• Speech difficult to understand

5 years old

Gross motor

• Walks down stairs one foot per step
• Bounces and clothes ball ( 3 years- 5 ½ years)
• Walks backwards heel t toe ( 4 to 6 years)

Fine motor and vision

• Copies triangle (5 ½ years)
• Draws man with complete features ( 4 ½ years – 6 years)

Hearing and speech

• Speaks fluently
• Hearing test- audiometry

Social behaviour and play

• Comforts friends in distress
• Chooses friends
• Group play

Key messages

• Parents who are concerned that there is something wrong with their child are usually right
• History of loss of skills (regression) implies a progressive underlying cause for developmental delay.
• Almost all normal babies born around their expected due date smile by 8 weeks. Failure to do so should alert you to the possibility that there is a problem.
• Children not walking at 18 months have a 1 in 5 chance of having a significant problem.