Child Development

Your Child’s Development – Important Milestones: Birth – 36 months

Babies and children develop at their own pace, so it’s impossible to tell exactly when your child will learn a given skill. The developmental milestones listed below will give you a general idea of the changes you can expect, but don’t be alarmed if your own baby’s or child’s development takes a slightly different course.

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Social and Emotional
  • Begins to develop a social smile
  • Enjoys playing with other people and may cry when playing stops
  • Becomes more expressive and communicates more with face and body
  • Imitates some movements and facial expressions
Movement
  • Raises head and chest when lying on stomach
  • Supports upper body with arms when lying on stomach
  • Stretches legs out and kicks when lying on stomach or back
  • Opens and shuts hands
  • Pushes down on legs when feet are placed on a firm surface
  • Brings hand to mouth
  • Takes swipes at dangling objects with hands
  • Grasps and shakes hand toys
Vision
  • Watches faces intently
  • Follows moving objects
  • Recognizes familiar objects and people at a distance
  • Starts using hands and eyes in coordination
Hearing and Speech
  • Smiles at the sound of your voice
  • Begins to babble
  • Begins to imitate some sounds
  • Turns head toward direction of sound
Developmental Health Watch Alert your child’s doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range:
  • Does not seem to respond to loud noises
  • Does not notice hands by 2 months
  • Does not follow moving objects with eyes by 2 to 3 months
  • Does not grasp and hold objects by 3 months
  • Does not smile at people by 3 months
  • Cannot support head well by 3 months
  • Does not reach for and grasp toys by 3 to 4 months
  • Does not babble by 3 to 4 months
  • Does not bring objects to mouth by 4 months
  • Begins babbling, but does not try to imitate any of your sounds by 4 months
  • Does not push down with legs when feet are placed on a firm surface by 4 months
  • Has trouble moving one or both eyes in all directions
  • Crosses eyes most of the time (occasional crossing of the eyes is normal in these first months)
  • Does not pay attention to new faces, or seems frightened by new faces or surroundings
  • Experiences a dramatic loss of skills he or she once had
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Social and Emotional
  • Enjoys social play
  • Interested in mirror images
  • Responds to other people’s expressions of emotion & appears joyful often
Cognitive
  • Finds partially hidden object
  • Explores with hands and mouth
  • Struggles to get objects that are out of reach
Language
  • Responds to own name
  • Begins to respond to “no”
  • Can tell emotions by tone of voice
  • Responds to sound by making sounds
  • Uses voice to express joy and displeasure
  • Babbles chains of sounds
Movement
  • Rolls both ways (front to back, back to front)
  • Sits with, and then without, support on hands
  • Supports whole weight on legs
  • Reaches with one hand
  • Transfers object from hand to hand
  • Uses hand to rake objects
Vision
  • Develops full color vision
  • Distance vision matures
  • Ability to track moving objects improves
Developmental Health Watch Alert your child’s doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.
  • Seems very stiff, with tight muscles
  • Seems very floppy, like a rag doll
  • Head still flops back when body is pulled into sitting position
  • Reaches with one hand only
  • Refuses to cuddle
  • Shows no affection for the person who cares for him or her
  • Doesn’t seem to enjoy being around people
  • One or both eyes consistently turn in or out
  • Persistent tearing, eye drainage or sensitivity to light
  • Does not respond to sounds around him or her
  • Has difficulty getting objects to mouth
  • Does not turn head to locate sounds by 4 months
  • Does not roll over in either direction (front to back or back to front) by 5 months
  • Seems impossible to comfort at night after 5 months
  • Does not smile on his or her own by 5 months
  • Cannot sit up with help by 6 months
  • Experiences a dramatic loss of skills he or she once had
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Social and Emotional
  • Shy or anxious with strangers
  • Cries when mother or father leaves
  • Enjoys imitating people in his play
  • Shows specific preferences for certain people and toys
  • Tests parental responses to his actions during feedings
  • Tests parental responses to his behavior
  • May be fearful in some situations
  • Prefers mother and/or regular caregiver over all others
  • Repeats sounds or gestures for attention
  • Finger-feeds himself
  • Extends arm or leg to help when being dressed
Cognitive
  • Explores objects in many different ways (shaking, banging, throwing, dropping)
  • Finds hidden objects easily
  • Looks at correct picture when the image is named
  • Imitates gestures
  • Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)
Language
  • Pays increasing attention to speech
  • Responds to simple verbal requests
  • Responds to “no”
  • Uses simple gestures, such as shaking head for “no”
  • Babbles with inflection (changes in tone)
  • Says “dada” and “mama”
  • Uses exclamations, such as “Oh-oh!”
  • Tries to imitate words
Movement
  • Reaches sitting position without assistance
  • Crawls forward on belly
  • Assumes hands-and-knees position
  • Creeps on hands and knees
  • Gets from sitting to crawling or prone (lying on stomach) position
  • Pulls self up to stand
  • Walks holding on to furniture
  • Stands momentarily without support
  • May walk two or three steps without support
  • Hand and Finger Skills
  • Uses pincer grasp
  • Bangs two objects together
  • Puts objects into container
  • Takes objects out of container
  • Lets objects go voluntarily
  • Pokes with index finger
  • Tries to imitate scribbling
Developmental Health Watch Alert your child’s doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.
  • Does not crawl
  • Drags one side of body while crawling (for over one month)
  • Cannot stand when supported
  • Does not search for objects that are hidden while he or she watches
  • Says no single words (“mama” or “dada”)
  • Does not learn to use gestures, such as waving or shaking head
  • Does not point to objects or pictures
  • Experiences a dramatic loss of skills he or she once had
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Social and Emotional
  • Imitates behaviors of others, especially adults and older children
  • More aware of herself as separate from others
  • More excited about company of other children
  • Demonstrates increasing independence
  • Begins to show defiant behavior
  • Separation anxiety increases toward midyear then fades
Cognitive
  • Finds objects even when hidden under two or three covers
  • Begins to sort by shapes and colors
  • Begins make-believe play
Language
  • Points to object or picture when it’s named for him
  • Recognizes names of familiar people, objects and body parts
  • Says several single words (by 15 to 18 months)
  • Uses simple phrases (by 18 to 24 months)
  • Uses 2 to 4 word sentences
  • Follows simple instructions
  • Repeats words overheard in conversation
Movement
  • Walks alone
  • Pulls toys behind her while walking
  • Carries large toy or several toys while walking
  • Begins to run
  • Stands on tiptoe
  • Kicks a ball
  • Climbs onto and down from furniture unassisted
  • Walks up and down stairs holding on to support
  • Hand and Finger Skills
  • Scribbles on his or her own
  • Turns over container to pour out contents
  • Builds tower of four blocks or more
  • Might use one hand more often than the other
Developmental Health Watch Alert your child’s doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.
  • Cannot walk by 18 months
  • Fails to develop a mature heel-toe walking pattern after several months of walking, or walks only on his toes
  • Does not speak at least 15 words
  • Does not use two-word sentences by age 2
  • By 15 months, does not seem to know the function of common household objects (brush, telephone, bell, fork, spoon)
  • Does not imitate actions or words by the end of this period
  • Does not follow simple instructions by age 2
  • Cannot push a wheeled toy by age 2
  • Experiences a dramatic loss of skills he or she once had
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Social and Emotional
  • Imitates adults and playmates
  • Spontaneously shows affection for familiar playmates
  • Can take turns in games
  • Understands concept of “mine” and “his/hers”
  • Expresses affection openly
  • Expresses a wide range of emotions
  • By 3, separates easily from parents
  • Objects to major changes in routine
Cognitive
  • Makes mechanical toys work
  • Matches an object in her hand or room to picture in a book
  • Plays make-believe with dolls, animals, and people
  • Sorts objects by shape and color
  • Completes puzzles with three or four pieces
  • Understands concept of “two”
Language
  • Follows a two-or three-part command
  • Recognizes and identifies almost all common objects and pictures
  • Understands most sentences
  • Understands placement in space (“on”, “in”, “under”)
  • Uses 4 to 5 word sentences
  • Can say name, age, sex
  • Uses pronouns (I, you, me, we, they) and some plurals (cars, dogs, cats)
  • Strangers can understand most of his or her words
Movement
  • Climbs well
  • Walks up and down stairs, alternating feet (one foot per stair step)
  • Kicks ball
  • Runs easily
  • Pedals tricycle
  • Bends over easily without falling
  • Hand and Finger Skills
  • Makes up-and-down, side-to-side, and circular lines with pencil or crayon
  • Turns book pages one at a time
  • Builds tower of more than six blocks
  • Holds pencil in writing position
  • Screws and unscrews jar lids, nuts, and bolts
  • Turns rotating handles
Developmental Health Watch Alert your child’s doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.
  • Frequent falling and difficulty with stairs
  • Persistent drooling or very unclear speech
  • Cannot build a tower of more than four blocks
  • Difficulty manipulating small objects
  • Cannot copy a circle by age 3
  • Cannot communicate in short phrases
  • No involvement in “pretend” play
  • Does not understand simple instructions
  • Little interest in other children
  • Extreme difficulty separating from mother or primary caregiver
  • Poor eye contact
  • Limited interest in toys
  • Experiences a dramatic loss of skills he or she once had
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Excerpted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5 by Steven Shelov, M.D. and Robert E. Hannermann, published by Bantam Books, a division of Random House, Inc., and The American Academy of Pediatrics. The appearance of the name American Academy of Pediatrics does not imply endorsement of any product or service.