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SNAPSHOTS Developmental Milestones Chart UPDATED Aug 2014 PDF
SNAPSHOTS Developmental Milestones Chart UPDATED Aug 2014 PDF
SNAPSHOTS Developmental Milestones Chart UPDATED Aug 2014 PDF
© Compiled by Dr. Debbi Andrews, Division Director, 2009. Amended by D. Andrews and C. Dosman, August 2014.
*Milestone ages approximate the 50th percentile.
‡ Sector heading mnemonic created by P. MacPherson, Class of 2012, University of Alberta Faculty of Medicine and Dentistry.
Development: trends, delays and disabilities
Sector Gross Motor Fine Motor Speech / Language Cognitive / Problem Solving Social / Emotional
Domains/ Posture Tool use Communication Intellect Self-awareness
skills/processes Change of position Dexterity Words and symbols (semantics) Thinking Empathy
Ambulation Precision Grammar (syntax) Remembering Relationships
Strength Bi-manual coordination Pragmatics Categorising Emotional regulation
Balance Articulation/voice/fluency Problem-solving
Coordination Analysis/synthesis
Trends Primitive reflexes to volitional Primitive reflexes to volitional Primitive reflexes to volitional Implicit memory before explicit Bonding: parent>child
movement movement (grasp) movement (suck) Specific>general>specific Attachment: child >parent
Cephalo-caudal Proximal to distal (whole hand to Proximal to distal (back of throat to Increased # of dimensions attended to Increasing social circle: self
Proximal to distal fingertips) lips, tongue, teeth) simultaneously >primary caregiver >extended
Flexor to extensor Effortful to automatic Understanding before speaking (rec "Trial & error" to mental rehearsal family >peers >broader
Postural reflexes fade as balance Unilateral to bimanual coordination before exp) Concrete (sensory, hands-on) to abstract community >country & culture
increases Inc'ing length of utterance Inc'd use of executive functions >world
Single mvts to sequences Inc'ing complexity of syntax Inc'd length of attention span
Effortful to automatic “Metas” “Metas”
Examples of devt’l Cerebral palsy DCD Devt’l language disorders Mental retardation (intellectual impairment) Autism spectrum disorders
disorder in sector Muscular dystrophies Dysgraphia Language-based learning Learning Disabilities Reactive attachment disorder
DCD disability (dyslexia)
Dysarthria/Stuttering
Examples of adult Paresis/paralysis Paresis/paralysis Aphasias Dementia Mental health disorders
functional loss in Apraxia Specific stroke syndromes Post concussion personality
sector changes
Adult disability Walking Feeding Speaking "Mental functions" = Adaptive functioning (eg self-
(mostly based on Dressing Hearing -Adaptive functioning (eg self-care, health & care, social skills
loss of previously "unable to walk even with approp. Elimination (toileting req'd for bowel safety, social skills common, simple
normal function, therapy, medication & devices; OR or bladder functions) "unable to speak/understand even transactions) "unable to perform mental
per Canada requires an inordinate amount of with approp. therapy, medication & -Memory functions* even with approp.
Revenue ) time to walk, even with approp. "unable to do task even with approp. devices; or requires an inordinate -Problem-solving, goal-setting, and judgment therapy, medication & devices;
therapy, medication & devices" therapy, medication & devices; OR amount of time to OR requires an inordinate
Vision: acuity in requires an inordinate amount of speak/understand, even with "unable to perform mental functions* even amount of time to do task, even
both eyes 20/200 time to do task, even with approp. approp. therapy, medication & with approp. therapy, medication & devices; with approp. therapy, medication
(6/60) or less OR therapy, medication & devices" devices" (hearing specifies "in a OR requires an inordinate amount of time & devices"
greatest diameter quiet setting") to do task, even with approp. therapy,
of field of vision in medication & devices"
both eyes is 20
degrees or less.
Who assesses MD MD MD MD MD
PT OT SLP Psychologist Psychologist
Audiologist Optometrist or Ophthalmologist Mental health therapist
RED FLAGS! Persistent primitive reflexes Lack of transfer at 7 mos Problems with feeding and/or Lack of developmentally appropriate Emotional dysregulation
Abnl tone or mvt patterns at any Using one hand exclusively at any swallowing response to visual stimuli Abnormal attachment patterns
REGRESSION age, spasticity, hypotonia, absent age Parents suspect hearing loss, Immature play (like younger child) (over-clingy, indiscriminate)
(loss of skills) & DTRs Delayed self care (ADLs) at 4 years babbling stops at > 6 mos, lack of Stereotypic play; lack of pretend Limited social smiling and shared
PARENTAL Asymmetry Delayed printing at school entry response to sound (check hearing!) School failure (either for specific subjects like enjoyment by 6 mos
CONCERN are Poor head control at 5 mos No single words by 15 mos reading or math or generalised) Limited gestures like pointing,
red flags at any Not sitting independently with No combos by 24 mos response to name, joint attention
age hands-free at 8 mos Stutter past 3 ½ yrs (or earlier if by 12 mos
Not rolling back-front, not taking anxiety/mannerisms) Always check vision and hearing if any Limited social imitative play by 18
weight well through the legs when Idiosyncratic speech, disordered concerns—can be assessed as young as mos (eg imitating housework)
held at 9 mos sequence of development newborn Limited pretend play (eg feeding
Not walking by 18 mos Poor intelligibility for age doll) by 24 mos
No friends at school-age
© Compiled by Dr. Debbi Andrews, Division Director, 2009. Amended by D. Andrews and C. Dosman, August 2014.
*Milestone ages approximate the 50th percentile.
‡ Sector heading mnemonic created by P. MacPherson, Class of 2012, University of Alberta Faculty of Medicine and Dentistry.