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Milestones

Milestone Red flags

Scharf et al. (2016) compiled a table that shows the red flags during the development of a child 1. The table below is extracted from their work.

Time Period Language/Cognitive Motor Social-Emotional
Neonatal period Infant does not respond to loud sounds. Muscle tone too low to feed. Caregiver shows indifference or disinterest in infant.
2 months Does not alert to voice. Cannot raise head when prone. Lack of looking at faces/lack of fixation.
4 months No cooing or gurgling sounds. Unable to bring hands to midline. Lack of smiling.
6 months Lack of turning toward voices. Does not pass object from one hand to another. No smiling, laughing, or expression.
9 months Lack of babbling with consonants. Inability to sit. Lack of rolling. Absence of back-and-forth smiles and vocalizations in “conversation.”
12 months Child does not respond to name. Does not understand “no”. Does not stand or bear weight on legs when supported. Indifferent or resistant attachment to caregiver. Does not look where caregiver points.
15 months Does not use words such as mama and papa/dada. No pincer grasp. Absence of proto-imperative pointing (point to desired object).
18 months Not using at least 6 words. Inability to walk independently. Absence of proto-declarative pointing (point to show interest) or showing gestures.
24 months Lack of words and two-word meaningful sentences. Inability to follow simple commands. Inability to walk well. Does not imitate actions or words of caregivers. Poor eye contact.
36 months Inability to use three-word sentences. Frequent falling or difficulty with stairs. Lack of pretend play.
4 years Unclear speech. Does not answer simple questions. Inability to use pronouns. Does not jump in place. Ignores other children.
5 years Inability to rhyme. Inability to recognize shapes, letters, colors. Resists dressing, sleeping, using the toilet. Does not draw pictures, a square, or a cross. Poor balance. Unusually fearful, sad, shy, angry. Does not distinguish between real and make-believe.
6–12 years Cannot retell or summarize a story with beginning, middle, and end. Does not skip or hop on one foot. Does not write name. Does not name friends. Cannot recognize feelings in others.
Any age Loss of previously acquired skill.

Milestones to Track Child Development

The following milestones are excerpted from Scharf et al. (2016) for reference1. The table below outlines developmental milestones for children aged 0–5 years, covering gross motor, fine motor, self-help, problem solving, social/emotional, receptive language, and expressive language domains.

There are also review papers about detailed discussions about motor milestones and cognitive milestones234.

  1. Scharf RJ, Scharf GJ, Stroustrup A. Developmental milestones. Pediatrics in review 2016; 37: 25–37; quiz 38, 47. ↩↩

  2. Wilks T, Gerber RJ, Erdie-Lalena C. Developmental milestones: Cognitive development. Pediatrics in review 2010; 31: 364–367. ↩

  3. Gerber RJ, Wilks T, Erdie-Lalena C. Developmental milestones: Motor development. Pediatrics in review 2010; 31: 267–76; quiz 277. ↩

  4. Gerber RJ, Wilks T, Erdie-Lalena C. Developmental milestones 3: Social-emotional development. Pediatrics in review 2011; 32: 533–536. ↩

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