Milestones

Each child develops at a different rate. It is still important to know if your child is meeting the milestones and norms compared to others at the same age. If an issue is caught and treated sooner rather than later, then the long-term effect of the disorder may be lower. Also, it a deficit is treated earlier, it is likely that progress will quicker than if you took the “wait and see” approach.

Here is a general guideline of developmental milestones to watch for in your child. If your child is not meeting several of these as he/she ages, then you may want to consult your child’s pediatrician and request a referral to Therapy Trails.

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Speech Therapy

  • Makes eye contact with adult

  • Alerts to sound and turns head to voice

  • Recognizes own name

  • Responds to “no” half of the time

  • Smiles in response to people or voices

  • Takes turns vocalizing

  • Vocalizes excitement and displeasure

Physical Therapy

  • Follows a moving object

  • Props up head and chest for a long time

  • Sits with support

  • Rolls from front to back

  • Shifts weight between arms when on stomach

The following information was compiled from How Does Your Child Hear and Talk from American-Speech Language Hearing Association, The Early Intervention Kit by Nancy Swigert, and the Peabody Motor Development Chart by M. Rhonda Folio and Rebecca Fewell:

0-6 Months ➜

Occupational Therapy

  • Tracks an object from midline to each side, when lying on back

  • Looks at hands for a short amount of time (~3 seconds)

  • Closes finger in tight grasp

  • Grasps rattle, other other objects and toys

  • Holds a small toy for 30 seconds

  • Extends arms up toward toy, when lying on back

  • Moves small toy a small amount while holding it

  • Picks up a small toy

  • Grasps and holds small block

Speech Therapy

  • Imitates gestures, facial expressions, and sounds

  • Responds to “no” most of the time

  • Vocalizes two syllable combinations (ex: “dada”)

  • Uses a variety of different consonants and vowels when babbling

  • Responds to simple requests (ex: “Come here”)

  • Moves toward or searches for named family member

Physical Therapy

  • Pulls to stand

  • Sits independently

  • Rolls from front to back, and back to front

  • Belly crawl

6-9 Months ➜

Occupational Therapy

  • Brings hands together to hold object, when sitting

  • Picks up 2 small blocks, holding both

  • Transfers small object to other hand

  • Bangs cup or other objects on table

  • Crumples paper

Speech Therapy

  • Plays “peek-a-boo” with adult

  • Waves “hi” and “bye”

  • Shows toys to others

  • Attends to speaker and pictures

  • Identifies some body parts

  • Recognizes the name of common objects

  • Understands simple actions

  • Imitates non-speech sounds (ex: animals), simple syllables (ex: “boo”), and familiar words

  • Says 1-2 words independently

Physical Therapy

  • Begins self-feeding

  • Can stand alone

  • Searches for hidden toys

9-12 Months ➜

Occupational Therapy

  • Closes hands together

  • Removes socks independently

  • Puts 3-7 small objects into open cup

  • Grasps objects using thumb and 1st & 2nd fingers

Occupational Therapy

Speech Therapy

  • Initiates turn-taking routines and games

  • Maintains attention to pictures

  • Follows 1-step commands

  • Identifies body parts and clothing items

  • Tries to sing with familiar song

  • Use exclamatory expressions (ex: “Uh oh”) and social words (ex: “hi/bye”)

  • Answers questions with one word

  • Has close to 50 words by 18 months

Physical Therapy

  • Stands and begins to walk unassisted

  • Sits on a small chair

  • Reaches for objects

12-18 Months ➜

Occupational Therapy

  • Opens book

  • Stirs spoon in cup

  • Puts 1 shape (or puzzle piece) into the correct hole

  • Makes at least 1 scribble on paper

  • Picks up 2 small blocks with 1 hand

  • Stacks 2-3 blocks

  • Places at least 2 shapes (or puzzle piece) into the correct hole

  • Holds marker with thumb and 1st finger

Occupational Therapy

18-24 Months ➜

Speech Therapy

  • Uses two toys together in pretend play

  • Follow commands such as “Sit down”, “Come here”, etc.

  • Identifies and names familiar objects and pictures

  • Understands meaning of action words

  • Follows 2-step commands

  • Uses 2-word phrases

  • Uses vocalizations AND gestures to request items

  • Uses own name

  • Uses and understands some simple pronouns

Physical Therapy

  • Jumps off bottom step

  • Walks up and down stairs with assistance

  • Begins to run more coordinated

Occupational Therapy

  • Turns pages in a book

  • Stacks 4-6 blocks

  • Places at least 3 shapes (or puzzle piece) into the correct hole

  • Draws a vertical line (up/down)

Occupational Therapy

2-3 Years ➜

Speech Therapy

  • Follows 2-step commands

  • Plays with other children

  • Understands simple colors and size

  • Understands simple prepositions (ex: on, in, under)

  • Answers “who, what, where” questions

  • Uses 2- and 3- word phrases

  • Sings songs

  • Speech is mostly understood (50% by age two, 75% by age three)

Physical Therapy

  • Runs well

  • Goes up and down stairs one at a time

  • Begins to catch a ball

Occupational Therapy

  • Removes a screw-on lid from bottle

  • Stacks up to 10 blocks

  • Cuts paper

  • Draws a horizontal line (side-to-side)

  • Folds paper

  • Strings beads

  • Builds a bridge using blocks

  • Draws a circle

Occupational Therapy

3-4 Years ➜

Speech Therapy

  • Understands some colors, shapes, & sizes

  • Follows 2-step directions without gestures/pointing

  • Uses pronouns (ex: “I, you, me,” etc. & plurals [ex: “cats”])

  • Asks and answers questions

  • Says these sounds: P, B, M, N, W, H, T, D, K, G, F, Y

  • Uses lots of 4+ word sentences

  • Speech is more than 75% understood

  • Takes turns ands plays with others

Physical Therapy

  • Rides a tricycle

  • Stands and hops on one foot

  • Kicks a ball

Occupational Therapy

  • Cuts paper into 2 pieces

  • Laces holes

  • Draws a cross

  • Traces lines

  • Holds marker with thumb and 1st finger, while other fingers are against palm

  • Buttons and unbuttons clothes

Occupational Therapy

4-5 Years ➜

Speech Therapy

  • Follows classroom directions

  • Answers “when” & “how many” questions

  • Understands words for order (ex: “first”) & time (ex: “yesterday”)

  • Names letters & numbers

  • Tells a short story

  • Speech is almost 100% understood

  • Engages in conversation appropriately

Physical Therapy

  • Climbs

  • Throws a ball overhanded

  • Stands on tiptoes

Occupational Therapy

  • Draws a square

  • Cuts out a circle and square

  • Connects dots when drawing

  • Folds paper in half

  • Colors between two lines

Occupational Therapy

5-6 Years ➜

Speech Therapy

  • Understands opposite concepts (ex: over/under)

  • Understands complex sentences

  • Follows 3-step commands

  • Retells simple stories

  • Uses approximately 7,000 words

  • Asks questions for information

  • Begins to say these sounds correctly: R, L

  • Engages in cooperative play (group decisions, playing fair, etc)

Physical & Occupational Therapy

  • Skips

  • Kicks a ball well

  • Dresses and undresses self

Occupational Therapy