Physical

Babies’ physical development over the first year of life goes from a helpless newborn to a baby who, if not walking at age one, is nearly ready to walk. Normal development encompasses rolling from back to front, front to back, bringing hands and/or toys to the mouth, using a raking gesture and then a pincher grasp to self-feed, crawling, “cruising” (walking while holding onto furniture), standing alone, and finally to walking. While some babies walk at one year, if your child is not yet walking on his or her first birthday, don’t be alarmed.

Cognitive

Cognitive development over the first year is also rapid for normally developing babies. By the end of seven months, babies are exploring objects with their hands and mouths, finding partially hidden items, and struggling to reach objects out of reach. By the end of one year, normally developing babies find hidden objects easily, imitate gestures, and explore objects in several ways: banging, dropping, shaking them, for instance).

Social and Emotional

By three months, normally developing babies should begin to smile socially and become more expressive and communicative with their bodies and faces. Watching faces intently, babies this age are starting to put together what constitutes an expression of joy and one of displeasure. At seven months, babies enjoy social play and respond to others’ expressions of emotion. Around one year, babies may cry when their parent leaves, become shy with strangers, imitate others in play, and start testing parental responses to behavior. Babies at age one may repeat sounds or gestures to get attention and show preferences for specific toys and for certain people.

Language

During their first year, babies go from beginning to babble and imitate sounds around 3 months to using a few words (usually Mama and Dada) around one year. Somewhere in between that time, usually at the end of 7 months, babies will respond to their own names, use their voices to express joy or displeasure, babble chains of sounds, and begin to respond to “no.” By one year, babies try to imitate words, use simple gestures, pay increasing attention to speech, and respond to simple verbal requests. Babies may also use exclamations such as “Uh-oh!”

Because development happens on a continuum and no two babies are alike, there is room for deviation from the milestones (they are, after all, guidelines, not rules). Discuss any concerns you may have about your baby’s development with your pediatrician.

Physical

Physical development between ages 12 and 18 months encompasses movement, muscle development, and fine and gross motor skills. At around a year, typical development for the normally developing baby includes creeping on hands and knees, pulling self to a standing position, “cruising” (walking while holding onto furniture), and perhaps walking a step or two without support. Babies this age can put objects into a container and remover them, poke with their index finger, and may try to imitate scribbling.

By age two, development has increased significantly: a child will walk alone, carry toys while walking, kick a ball, and walk up and down stairs with support. He or she can scribble on his or her own, build a tower of 4 or more blocks, and may use one hand more than the other. Since these developments take place gradually, don’t be surprised if you suddenly realize your child has a new skill, or is missing one or two skills by age two. All children develop at different rates, and milestones are guidelines for normal development.

Cognitive

Cognitive development is rapid during this time as well. At around a year, babies are exploring objects by shaking, throwing, and dropping them, finding hidden objects, and beginning to use them for their intended use (drinking from a cup, listening to a telephone). These skills develop during the intervening year, and at age 2, babies can find objects that are hidden even under 2 or 3 layers, and begin to sort items by color or shape. Make-believe play develops during this time as well.

Social and Emotional

Babies at age 1 are anxious when a parent leaves, and are shy with strangers. They begin testing parental reactions to behaviors and to repeat gestures or sounds to get attention. On their way to reaching age two, however, they are becoming less shy and begin to see themselves as separate from others. They imitate others’ behavior and become more excited about being with other children.

Language

Language development is rapid between ages 12 and 18 months. Children who previously could use simple gestures and say a word or two are, by 18 months, developing a vocabulary of about 5 to 20 words (mostly nouns). At this age, babies are repeating a word or phrase over and over. Babies are on their way to recognizing the words for familiar object and people, and starting to follow simple instructions. Around 15 to 18 months, normally developing children say several single words and may use simple phrases.

Babies, of course, develop at different rates and no two are alike. Developmental milestones, then, are guidelines for development. Any concerns you may have about your child’s individual development should be discussed with your pediatrician.

Because ASD is diagnosed based on observation of behavior and not on a medical test, and symptoms are often first noticed by parents or caregivers, it is important to understand what is meant by childhood development.

Development encompasses the physical, cognitive, social and emotional, and language skills of children. Because these skills develop on a continuum, milestones are guidelines or approximations of where a child should be at a certain age.

Physical

Physical development encompasses actions such as rolling over, sitting, crawling, standing without support, walking (forward and backward), running, jumping on one leg, climbing stairs, carrying objects, and throwing and catching a ball. Obviously, these skills build on each other over time.

Cognitive

Cognitive development encompasses how the brain processes information. Starting at about 6 months, babies explore things with their hands and look for hidden objects. This progresses to imitating gestures and experimenting with how their actions affect objects. Testing parental reaction to their actions, beginning to follow directions, sorting colors and shapes, playing make-believe and pretend games, and solving puzzles are all cognitive skills.

Social and Emotional

Social and emotional development is measured by things such as baby’s smiles, reaction to tone of voice, imitation of others, a sense of “mine” and “yours,” taking turns during play, being excited to be around other children, becoming independent in doing things like dressing oneself, negotiating solutions to problems, and developing a sense of oneself as a whole: body, mind, and emotions.

Language

Language development encompasses first coos and babbling, then the “telegraphic” language of toddlers that is often two-word sentences, repeating words, recognizing names, understanding what is said and being able to follow directions, using pronouns correctly, and ultimately being able to speak so that anyone outside of the family can understand.

Development Varies

Talk to your child’s healthcare provider about what is appropriate development for your child’s age. Not all children develop exactly alike, and there is room for variation within the guidelines. Not meeting certain developmental milestones does not automatically mean your child has a delay or disorder. For more information on developmental guidelines, visit the Centers for Disease Control’s page here.

Physical Development

A child’s physical growth is easy to measure with simple tools; his or her physical development requires observation by parents, caregivers, and health care practitioners.  Physical development encompasses many things depending on the child’s age: rolling from back to front and front to back, holding one’s head up, sitting alone, standing with or without support, crawling, walking, climbing stairs, throwing a ball, and imitating scribbling are all examples of a child’s physical development.

Cognitive Development

Cognitive development also encompasses a variety of skills and abilities.  Whether a child will search for an object hidden while he is looking, or while he is not looking, is a measurement of cognitive development.  A child’s problem-solving skills (does she move a stool to the counter in order to reach an object?) and ability to understand concepts such as “two” are examples of how cognitive development is measured.

Social and Emotional

A child’s social and emotional development is vital. Expressing joy or displeasure, being able to understand when another’s facial expressions or tone of voice indicate joy or displeasure, smiling, laughing, waving, and maintaining eye contact are all measurements of social and emotional development. For older children, the ability to play cooperatively and collaboratively and to take turns are other developmental milestones.  Playing make-believe games is another example of emotional and social development.

Language

Babies are hard-wired for language, and, if developing appropriately, will coo and make other noises from birth. Around one year, normally developing children can use a word or two; by age two, short subject + verb sentences and repeating words are signs of normal development.  The extent to which a child uses language to express him- or herself as appropriate for his or her age is measured in language development assessments.

These definitions should serve as a starting point for understanding what is measured in developmental assessments. Your child’s health care practitioner can offer more detailed explanations of both what each term refers to and where you child should be developmentally at his or her age.

Physical

Children at this age continue to develop muscles and motor skills, both large and fine. While at age 48 months, a normally developing child can stand on one foot for up to 5 seconds, that length of time increases to 10 seconds by 60 months. The ability to hop well develops during this time, and children progress from going up and down stairs without support to going up and down stairs using alternate feet. Fine motor skills like copying shapes and being able to print some letters progress, and by age 60 months most children can draw a person with a body. Children learn to use silverware at the table during this time, and, by 60 months, usually can tend to their own bathroom and dressing and undressing needs.

Cognitive

Cognitive development during this stage includes moving from being able to correctly name some colors to being able to name at least four. An increased sense of time develops as well, and fantasy and make-believe play continue and become more elaborate. Children also develop a sense of what everyday objects are and how they are used, and, by the end of 60 months, can count 10 or more objects.

Social and Emotional

Children begin to be able to distinguish between fantasy and reality during this time, and begin to view themselves as whole beings. As such beings, their desire to be around and to please friends develops. By the end of 60 months, children are more likely than before to agree to rules as they become more independent. By the end of 60 months children are aware of gender. While increasingly cooperative, children will still sometimes be demanding during this stage as they become more independent.

Language

Language use is refined during this stage of development. Most children can be easily understood by strangers by around age 48 months, but their sentences may be short and basic grammar rules like verb tense incorrect. By the end of age 60 months, most children speak in sentences longer than 5 sentences (although many do before this age) and they can tell longer stories than at age 48 months. They begin to use future tense, can say their name and address, and can recall parts of stories.

Obviously, no two children will develop at the same rate and may develop certain skills while seeming to lag in other areas. Developmental milestones are guidelines to normal development. Check with your pediatrician if you have any questions or concerns about the rate at which your child is developing.

Physical

At age 2, normally developing children walk alone, can pull a toy behind them while walking, and carry toys while walking.  This independent walking develops into the ability to climb unassisted and then into the ability to climb by age 3. Walking develops into running and being able to bend over without falling.  Fine motor skills move from scribbling on one’s own to being able to make circular, side-to-side, and up-and-down, more deliberate, marks with a crayon, and being able to hold a pencil in a writing position. The height of block towers increases, and children move from being able to turn over a container to dump out its contents to being able to unscrew lids and turn rotating handles.

Cognitive

Make-believe play takes off during this year.  Normally developing children begin to play “pretend” around 24 months; this develops into playing make-believe games with dolls and stuffed animals.  During this stage children move from being able to find hidden objects to being able to sort them by shape or color, and matching items.  Concepts such as the idea of “two” are developing, as is the ability to work simple, 3 or 4 piece puzzles.

Social and Emotional

Around age 2, children may begin to show defiant behavior as they are becoming aware of themselves as independen beings.  At the same time, they get excited about the company of others, and separation anxiety increases, and then fades.  The concept of “mine” and of taking turns in games starts to develop and children start to display affection for familiar friends as well as to express a range of emotions.  These displays may make parents realize their child is turning into a “real” little person, and it is this social and emotional development that can be in turn frustrating and exhilarating to witness.  Children may become increasingly less flexible, objecting to major changes in routine as they become more independent and aware of likes and dislikes.

Language

Language development during this time is rapid as well.  Around age 2, children use telegraphic language:  simple phrases and 2-to-4 word sentences, repeating words they overhear and recognizing familiar names and objects.  The ability to follow simple instructions develops into being able to follow a 2-or 3-part command and an understanding of most sentences.  Pronoun use develops, and by the end of age 3, children can state their name, age, and sex.  Strangers can usually understand most of a child’s words by age 3.

No two children develop alike, and they may seem to lag in one area of development only to catch up later.  Developmental guidelines help to assess a major deviation from normal development, so if you have any concerns about your child’s development, check with your pediatrician.

Physical

At 36 months, children are a whirlwind of activity; movement and motor skills continue to develop and a child who was running and climbing at 36 months moves on to agile movement both forward and backward, throwing a ball overhand, and going up and down stairs without support. The ability to kick a ball continues to develop and evolves into being able to catch a bounced ball and to hop and stand on one foot. Fine motor skills develop, too: deliberate scribbling evolves into being able to draw a person with 2, 3, or 4 body parts and being able to copy some letters.

Cognitive

Thirty-six month-olds can match objects to pictures of them and complete 3 and 4 piece puzzles, which evolves into greater cognitive skills by age 4: beginning to have a sense of time, correctly naming some colors, and following 3-part commands. Ideas are starting to come together for children at this time, they are beginning to solve problems and to understand concepts such as “alike” and “different.” Make believe play continues, and children begin to engage in fantasy play around age 4.

Social and Emotional

Between the ages of 36 and 48 months, children develop more independence and a sense of self. By age 3, normally developing children separate easily from their parents and show affection for playmates. The concept of taking turns and of what is “mine” and “yours” is developing into the ability to cooperate with other children by the end of 48 months. Make believe play becomes fantasy play (children begin to pretend to be mom or dad, for example), and the difference between fantasy and reality may be blurred. The ability to negotiate solutions to problems and to express a wide range of emotions develops during this time.

Language

Just as a child’s sense of self is developing, so is his or her ability to express that selfhood. Children in this stage move from using 4 to 5 word sentences around age 3 to mastering grammar around age 4. Gradually, speech becomes clear enough for a stranger to understand and sentence length grows to 5 to 6 words. By age 4, normally developing children are telling stories of their own.

Children develop rapidly, but no two will develop at the same rate. Use developmental milestones as guidelines, and be sure to check with your pediatrician if you have any questions or concerns about the rate at which your child is developing.