Ages and Stages: 

How to Monitor Child Development

Checklists, milestones, birth–18 months, 18 months–2 years, 3–5 years, school age, if you have concerns, developmental screening, and takeaways.

Is my child’s development on track?

That’s a question parents, pediatricians, educators, and caregivers ask over and over again as children grow and change.

To help answer this important question, child development experts have created lots of different charts and checklists that can help you keep track of child development across several key domains:

  • physical development
  • cognitive development (thinking skills)
  • language development
  • social-emotional development

But before you put too much stock in a single checklist…

Know that you’re going to see some variation between the lists. Researchers at Boston Children’s Hospital looked at four of the best known child development checklists and found that they mention a total of 728 different skills and abilities.

More importantly, just 40 of those developmental milestones show up on all four checklists, which begs the question: Should you depend on a single checklist?

A good approach, these researchers suggest, is to start by talking to your child’s pediatrician or primary care provider. The measures that doctors use may be different from those that parents can find in print or online checklists.

Your child’s physician can screen your child for any developmental delays using validated screening tools at or in-between well visits.

It may also help to think of development as an individual progression, rather than as a list of boxes you should tick at certain prescribed intervals. If progress stops or seems to stop, it’s time to talk to your child’s healthcare provider.

If there is a delay, identifying it early can sometimes make a big difference for the child.

WHAT ARE DEVELOPMENTAL MILESTONES?

Milestones are the things a child can do by a certain age. Most children develop skills and abilities in roughly the same order, but the timeframes involved aren’t exact. They vary from child to child, just as hair and eye color do.

Milestones at a glance

Every child grows and develops at an individual pace. Here’s a quick look at some common milestones for each age period.

Birth to 18 months

During this period of profound growth and development, babies grow and change rapidly.

Doctors recommend that you speak to your baby a lot during this phase, because hearing your voice will help your baby to develop communication skills. Other suggestions include:

  • Short periods of tummy time to help strengthen your baby’s neck and back muscles — but make sure baby is awake and you’re close by for this playtime.
  • Respond right away when your baby cries. Picking up and comforting a crying baby builds strong bonds between the two of you.

Development table: Birth to 18 months

1-3 months 4-6 months 5-9 months 9-12 months 12-18 months
Cognitive Shows interest in objects and human faces

May get bored with repeated activities

 Recognizes familiar faces

Notices music

Responds to signs of love and affection

 Brings hands up to mouth

Passes things from one hand to the other

 Watches things fall

Looks for hidden things

 Has learned how to use some basic things like spoons

Can point to named body parts
Social & emotional Tries to look at you or other people

Starts to smile at people

 Responds to facial expressions

Enjoys playing with people

Responds differently to different voice tones

 Enjoys mirrors

Knows when a stranger is present

 May be clingy or prefer familiar people May engage in simple pretend games

May have tantrums

May cry around strangers
Language Begins to coo and make vowel sounds

Becomes calm when spoken to

Cries differently for different needs

 Begins to babble or imitate sounds

Laughs

 Responds to hearing their name

May add consonant sounds to vowels

May communicate with gestures

 Points

Knows what “no” means

Imitates sounds and gestures

 Knows how to say several words

Says “no”

Waves bye-bye
Movement/Physical Turns toward sounds

Follows objects with eyes

Grasps objects

Gradually lifts head for longer periods

 Sees things and reaches for them

Pushes up with arms when on tummy

Might be able to roll over

 Starts sitting up without support

May bounce when held in standing position

Rolls in both directions

 Pulls up into standing position

Crawls

 Walks holding onto surfaces

Stands alone

May climb a step or two

May drink from a cup

18 months to 2 years

During the toddler years, children continue to need lots of sleep, good nutrition, and close, loving relationships with parents and caregivers.

Doctors at Seattle Children’s Hospital offer this advice for creating a safe, nurturing space to maximize your child’s early growth and development:

  • Create predictable routines and rituals to keep your child feeling secure and grounded.
  • Toddler-proof your home and yard so kids can explore safely.
  • Use gentle discipline to guide and teach children. Avoid hitting, which can cause long-term physical and emotional harm.
  • Sing, talk, and read to your toddler to boost their vocabularies.
  • Watch your child for cues about the warmth and reliability of all caregivers.
  • Take good care of yourself physically and emotionally, because your child needs you to be healthy.

Development table: 18 months to 2 years

18 months 24 months
Cognitive May identify familiar things in picture books

Knows what common objects do

Scribbles

Follows single-step requests like “Please stand up”

 Builds towers from blocks

May follow simple two-part instructions

Groups like shapes and colors together

Plays pretend games
Social & emotional May help with tasks like putting away toys

Is proud of what they’ve accomplished

Recognizes self in mirror; may make faces

May explore surroundings if parent stays close by

 Enjoys play dates

Plays beside other children; may start playing with them

May defy directions like “sit down” or “come back here”
Language Knows several words

Follows simple directions

Likes hearing short stories or songs

 May ask simple questions

Can name many things

Uses simple two-word phrases like “more milk”
Movement/Physical Can help in getting dressed

Begins to run

Drinks well from a cup

Eats with a spoon

Can walk while pulling a toy

Dances

Gets seated in a chair

 Runs

Jumps up and down

Stands on tip-toes

Can draw lines and round shapes

Throws balls

May climb stairs using rails to hold on

3 to 5 years old

During these pre-school years, children grow more and more independent and capable. Their natural curiosity is likely to be stimulated because their world is expanding: new friends, new experiences, new environments like daycare or kindergarten.

During this time of growth, the CDC recommends that you:

  • Keep reading to your child daily.
  • Show them how to do simple chores at home.
  • Be clear and consistent with your expectations, explaining what behaviors you want from your child.
  • Speak to your child in age-appropriate language.
  • Help your child problem solve when emotions are running high.
  • Supervise your child in outdoor play spaces, especially around water and play equipment.
  • Allow your child to have choices about how to interact with family members and strangers.

Development table: 3 to 5 years

3 years 4 years 5 years
Cognitive Can put together a 3-4 part puzzle

Can use toys that have moving parts like buttons and levers

Can turn door knobs

Can turn book pages

 May be able to count

Can draw stick figures

May be able to predict what will happen in a story

May play simple board games

Can name a few colors, numbers, and capital letters

 Draws more complex “people”

Counts up to 10 things

Can copy letters, numbers, and simple shapes

Understands the order of simple processes

Can say name and address
Social and emotional Shows empathy for hurt or crying children

Offers affection

Understands “mine” and “yours”

May get upset if routines are changed

Can get dressed

Knows how to take turns

 May play games that have roles like “parent” and “baby”

Plays with, not just beside, other kids

Talks about their likes and dislikes

Pretends; may have trouble knowing what’s real and what’s pretend

 Is aware of gender

Likes to play with friends

Sings, dances, and may play acting games

Switches between being compliant and being defiant

Can tell the difference between made-up and real
Language Talks using 2-3 sentences at a time

Has the words to name many things used daily

Can be understood by family

Understands terms like “in,” “on,” and “under”

 Can talk about what happens in daycare or at school

Speaks in sentences

May recognize or say rhymes

Can say first and last name

 May tell stories that stay on track

Recites nursery rhymes or sings songs

May be able to name letters and numbers

Can answer simple questions about stories
Movement

Physical

 Can walk up and down steps with one foot on each stair

Runs and jumps with ease

Catches a ball

Can slide down a slide

 Can hammer a peg into a hole

Walks backwards

Climbs stairs confidently

Can hop

Pours liquids with some help

 May be able to somersault

Uses scissors

Hops or stands on one foot for about 10 seconds

Can swing on swingset

Goes to the bathroom in the toilet

 

School-age development

During the school years, children gain independence and competence quickly. Friends become more important and influential. A child’s self-confidence will be affected by the academic and social challenges presented in the school environment.

As kids mature, the parenting challenge is to find a balance between keeping them safe, enforcing rules, maintaining family connections, allowing them to make some decisions, and encouraging them to accept increasing responsibility.

Despite their rapid growth and development, they still need parents and caregivers to set limits and encourage healthy habits.

Here are some things you can do to ensure that your child continues to be healthy:

  • Make sure they get enough sleep.
  • Provide opportunities for regular exercise and individual or team sports.
  • Create quiet, positive spaces for reading and studying at home.
  • Limit screen time and monitor online activities carefully.
  • Build and maintain positive family traditions.
  • Talk to your children about consent and setting boundaries with their bodies.

 

Development table: School-age

6-8 years 9-11 years 12-14 years 15-17 years
Cognitive Can complete instructions with 3 or more steps

Can count backward

Knows left and right

Tells time

 Can use common devices, including phones, tablets, and game stations

Writes stories and letters

Maintains longer attention span

 Develops views/opinions that may differ from parents

Grows awareness that adults aren’t always correct

Understands figurative language

Ability to think logically improves yet prefrontal cortex is not yet mature

 Internalize work and study habits

Can explain their positions and choices

Continues to differentiate from parents
Social and emotional Cooperates and plays with others

May play with kids of different genders

Mimics adult behaviors

Feels jealousy

May be modest about bodies

 May have a best friend

Can see from another person’s perspective

Experiences more peer pressure

 May become more independent from parents

Displays moodiness

Increased need for some privacy

 Increased interest in dating and sexuality

Spends more time with friends than family

Growth in ability to empathize with others
Language Can read books at grade level

Understands speech and speaks well

 Listens for specific reasons (pleasure, learning)

Forms opinions

Can take brief notes

Follows written instructions

Draws logical inferences based on reading

Can write about a main idea

Can plan and give a speech

 Can use speech that isn’t literal

Can use tone of voice to communicate intentions; i.e. sarcasm

 Can speak, read, listen, and write fluently and easily

Can have complex conversations

Can speak differently in different groups

Can write persuasively

Can understand proverbs, figurative language, and analogies
Movement/Physical Can jump rope or ride a bike

Can draw or paint

Can brush teeth, comb hair, and complete basic grooming tasks

Can practice physical skills to get better at them

 May experience signs of early puberty like breast development and facial hair growth

Increased skill levels in sports and physical activities

 Many females will have started periods

Secondary sex characteristics like armpit hair and voice changes continue

Height or weight may change quickly and then slow down

 Continues to mature physically, especially boys

 

What to do if you’re concerned

If you’re wondering whether some aspect of a child’s development may be delayed, you have several options.

First, talk to your child’s pediatrician and ask for a developmental screening. The screening tools used by doctors are more thorough than online checklists, and they may give you more reliable information about your child’s abilities and progress.

You can also ask your pediatrician for a referral to a developmental specialist like a pediatric neurologist, occupational therapist, speech/language therapist, or a psychologist who specializes in evaluating children.

If your child is under the age of 3, you can reach out to the early intervention program in your state.

If your child is 3 or older, you can speak to the special education director at the public school near your home (even if your child isn’t enrolled at that school) to ask for a developmental evaluation. Make sure you write down the date and director’s name so you can follow up if necessary.

It’s really important that you act right away if you suspect a developmental delay or disorder, because many developmental issues can be addressed more effectively with early intervention.

What happens in a developmental screening?

During a screening, the healthcare provider may ask you questions, interact with your child, or conduct tests to find out more about what your child can and cannot yet do.

If your child has a medical condition, was born early, or was exposed to an environmental toxin like lead, the doctor might conduct developmental screenings more often.

TALKING TO PARENTS ABOUT MILESTONES

If you’re a caregiver or educator who needs to discuss a possible delay with parents, the CDC recommends that you approach the topic in a clear, compassionate way. You may find these tips helpful:

  • Talk about milestones often, not just when you’re worried about a delay.
  • Use good listening skills. Allow parents to speak uninterupted, and repeat their concerns so they’ll know you’re paying close attention.
  • Consider having a colleague at the meeting to take notes.
    Be aware that parents may respond emotionally. Family and cultural issues may shape parents’ reactions.
  • Share any notes or records you’ve kept to document the child’s progress.
  • Encourage contact with their family pediatrician.
  • Follow up, making sure you share good news as well as concerns.

The takeaway

Babies, toddlers, and school-age children develop new skills and abilities in a steady progression as they get older. Every child develops at an individual pace.

Using developmental milestone checklists may be helpful for parents and caregivers who want to be sure that a child is growing in healthy ways. But it’s also important to keep all well child appointments, as development is screened at each of these.

If you’re concerned about the possibility of a missed milestone, your child’s doctor can discuss it with you and can conduct a developmental screening as needed to provide a clearer picture. You can also connect with developmental specialists, early intervention programs, and special education programs in local schools to have a child evaluated.

Strong parent-child bonds, good nutrition, adequate sleep, and a safe, nurturing environment at home and school will help ensure that children have the best chance of developing as they should.

HEALTHLINE NEWSLETTER

Last medically reviewed on December 9, 2019

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

 

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