Developmental Milestones
(By Prof. T.F. Leung)
Age in Gross Motor
month
3 No head lag when pulled to sit
Head and upper chest wall well up
when lying on abdomen
Lying on back with hands loosely
open
6 Sits with support
Rolls over from prone to supine and
then from supine to prone
Bears weight
9 Sits supported on the floor
Turns body to look sideways
Crawling or wriggling on abdomen
Steps purposefully on alternate feet
when handing outside
12 Walks holding to furniture
Pulls to standing position
May walk alone with uneven steps
18 Carries toys while walking
Walks backwards
Claims stairs
24 Runs safely on whole foot
Squats with complete steadiness to
rest
Walks upstairs and downstairs
holding on the rail or wall;2 feet to
a step
36 Jumps with 2 feet together
Walks alone upstairs using alternate
feet; downstairs 2 feet to a step
Stand on one foot(preferred) for
3-5s
48 Hops on preferred foot
Runs alone up and down stairs with
1 foot to a step
60 Stands on preferred foot with
arms folded
Walks easily on narrow line
Bends and touches toes without
flexing knee
Eye-hand coordination
Follows dangling toys at
15-25cmfrom face through
180˚ horizontally and
vertically from chest to brow
Hand regard and brings hands
together to midline
Reaches out for objects
Transfers objects(7m)
Moves eyes in unison
Uses whole hand to palmar
grasp
Goes for object with index
finger
Looks in correct direction for
falling or fallen toys
Inferior pincer grasp
Precise pincer grasp
Casts objects
Holds 2 cubes and bangs
together
Builds tower of 3 to 4 cubes
Scribbles
Shows hand preference
Builds tower of 6 cubes and
train without chimney
Circular and to and fro
scribble
Turns pages singly
Copies circles and imitates a
cross
Builds tower of 9 cubes and
bridges of 3 cubes using 2
hands
Draw person with hand and 2
or 2 part
Copies circles and crosses
Draws a person with head,
legs and trunk and usually
arms and fingers
Builds 3 steps with 6 cubes
Copies square and triangle
Draws recognizable man with
head, trunk, legs, arms and
other features
Hearing and Speech
Turns eyes or head towards
sound source
Startles and blinks with reflex eye
movement
Vocalize
Turns to source when hears
sounds at ear level
Vocalize tunefully to self and
others using simple syllables, e.g.
‘a-a’, ‘muh’
Turns to search and localize
faint sounds on either side
Understands no and Bye Bye
Babbles tunefully in syllables,
e.g. ‘dad-dad’ ,’ma-ma’
Turns to sound of name
Understands several words
Points to eye, nose and mouth
Says a few recognizable words
appropriately
Obeys simple instruction
Speaks simple phrases with 2
or more words
Uses 50 or more recognizable
words appropriately
Names familiar objects
Gives full name and sex, and
sometimes age
Carries on simple conversation
Identify primary colours
Gives home address and age
Asks Qs on meaning of words
Names 4 primary colours
Speaks fluently
Asks meaning of abstract words
Tells school experience
Personal-Social
Fixes eyes unblinkingly on
parent’s face when feeding
Smiles and gets excited to familiar
situation
Enjoys bathing and caring routines
Puts hand on bottle and pats it
when drinking
Still friendly with stranger but
occasional anxiety
Takes everything to mouth
Shows stranger anxiety
Puts hands around bottle or cup
when drinking
Plays 'peek-a-boo’
Shows object permanence
Waves good-bye
Drinks from cup
Indicates wants(not by crying)
Takes off shoes and socks
Holds spoon; starts to get food to
month
Indicate toilet needs
Lifts cup and drinks well without
spilling; feeds self with a spoon
competently
Defends own possessions
Resentful of attention to other
children by own familiars
Pulls pants down and up but
needs help with buttons
Washes hands but need adult
supervision with drying
Shows affection for younger sibling
Can dress and undress simple
clothing
Washes and dries hands and brushes
teeth
Dressed and undresses alone
Washes and dries face and hands
Appreciation meaning of time in
relation to daily programme
Child lying down (babies up to approx. 6 months old)
Procedure Observation Approx. age

1 Observe Posture, movements and any obvious anomalies

Hand regards, grasps feet 3–4m
Plays with toes 5m

2 Smile to baby Social responsive smile

Visual fixation and following of examiner’s face 4 – 6 wks

3 Talk to baby Vocalize in return 3m

Babbling 6m

4 Offer bright dangling Visual following from 4 wks

object (in midline) Reaches for objects 4m
Grasps dangling object 5m

5 Offer cube / toy Voluntary grasp 3m

Grasp longer, shakes it, etc. 5–6m
Hand transfer 6–7m
Mouthing cease by 12–15 m

6 Test hearing (if baby Startles, blinks, cries, quietens, reflex eye 0–3m
cooperative movements
Turns head to sound 4–7m

7 Locomotor assessment Observe for head lag

Put baby through: pull to sit, stand, prone, ventral
suspension

8 Physical examination

9 Take relevant history

(Given by KWH Dr. Soo MT)

Child sitting (babes in the latter part of infancy)
Procedure Observation Approx. age

1 Observe and listen Sits with head steady and back straight (slight 6–7m
support)
Unaided sitting 9m
Points to objects to indicate needs 10 – 11 m
Babbling 6m
Words 9 – 12 m

2 Smile and approach Social responsiveness 6m

Stranger anxiety 8m

3 First cube Reaches / grasps 4–5m

Transfers 6–7m
Mouthing cease by 12-15 m
Casting (present at 12 – 15 m) cease by 15-18 m

Second cube Drops 1st cube 6m

Hold 2nd cube (1 in each hand) 7m

Demonstrating clicking Imitates 10 m

Third cube Holds all 3 cubes 11 m

Ask for cube to be Tries but unable to release 10 m

released onto palm Releases successfully 11 – 12 m

4 Offer pellet / raisin and Remove cover in order to find pellet 9m

cove it just when baby Picks up pellet / raisin with finger-thumb 9m
reaches out opposition
Releases pellet /raisin into mouth 11 m

5 Talk to child (or ask Appropriate responses to: flying kiss, bye-bye about 12 m
parents)

6 Test near vision Fixates and follows 100s and 1000s

7 Test hearing (if child Turns head to look for sound source (an assistant
cooperative) will be required for distraction test

8 Locomotor assessment Put child through the following positions:

pull to stand, stand unaided, cruise
Observe for means of locomotion and gait:
walks when led about 12 m
 walks well unaided about 15 m

9 Physical examination

10 Take relevant history

(Given by KWH Dr. Soo MT)

Child sitting at table (about 15 m up)
Procedure Observation Approx. age

1 Observes and listen General observation (note the presence of napkin)

Spontaneous speech

2 Demonstrate Tower of 3 – 4 cubes 18 m

construction tasks with Train without chimney 2 yr
cubes Train with chimney 2 – 2½ yr
Bridge imitates / copies 3 – 3½ yr

3 Ask child to count Rote count 2+ yr

cubes Counts correctly about 3+ – 4 yr

Ask child to give 2 Gives correctly about 3+ – 4 yr

cubes

4 Paper and pencil task Note laterality

(put paper in front of Scribbles in imitation or spontaneously 18 m
child, put pencil at the Imitates circle 2 yr
centre of paper for child Copies circle 3 yr
to pick up, demonstrate Imitates cross 3 yr
drawings or shown Copies cross 4 yr
predrawn diagrams) Copies square 4½ yr
Copies triangle 5 yr
Copies diamond 6 yr
Draws a man from 3 yr

5 (Equipment: pencil, 8” doll, small cup, spoon & comb, picture book)
(If child talkative, try carrying on conversation with him to obtain samples of speech)

Demonstrate feeding Imitates action on own self 12 – 15 m

doll or combing doll’s imitates action on doll 18 – 21 m
hair

Lines items up, ask Identifies objects correctly in naming 18 m

child to identify Identifies objects correctly in response to use of about 2½ yr
objects

Ask child to name Names objects correctly from about 2 yr

objects or pictures Names pictures correctly from about 2½ yr

Ask child to tell His full name from about 3 yr

 His age (in yrs) from about 3½ yr

6 Test vision (If you are familiar with the tests)

7 Test hearing (If you are familiar with the tests)

8 Gross motor assessment

Ask child to walk Gait anomalies

Place small object on Stoops / squats to pick up object with help 15 – 18 m

floor and ask child to Motor anomalies
pick

Demonstrate standing Maintains for a few seconds 3 yr

on one foot

Demonstrate jumping Jumps correctly as demonstrated 2½ yr

with both feet together
on level ground

9 Physical examination

10 Take relevant history

(Given by KWH Dr. Soo MT)