PEDIATRIC MILESTONES
Gross Motor Fine Motor
Age
0 Flexor tone predominates
In prone, turns head to side
Automatic reflex walking
Rounded spine when held
sitting
4 mos Head midline
Head held when pulled to sit
In prone, lifts head to 90 and
lifts chest slightly
Turns to supine
7 mos Maintains sitting, may lean on
arms
Rolls to prone
Bears all weight, bounces
when held erect
Cervical lordosis
10 mos Creeps on all 4s
Pivot in sitting
Stands momentarily, cruises
Slight bow leg
Increased lumbar lordosis,
acute
LS angulation
14 mos Walks alone, arms in high
guard or midguard
Wide base, excessive knee and
hip flexion
Foot contact on entire side
Slight valgus of knees and feet
Pelvic tilt and rotation
Personal/Social Speech and Language
Hands fisted Habituation and some control of Cry
Grasp reflex state State dependent quieting and
State-dependent ability to fix and head turning to rattle or voice
follow bright objs
Hands mostly open Recognizes bottle Turns to voice and bell
Midline hand play consistently
Crude palmar grasp Laughs, squeals Responsive
vocalization
Blows bubbles, raspberries
Intermediate grasp Differentiates b/w familiar Uses 1-word and 2-consonant
Transfers cube from hand-to- person and stranger vowel combinations
hand Holds bottle
Bangs objects Looks for dropped object
Talks to mirror image
Pincer grasp, mature thumb to Plays peek-a-boo Shouts for attention
index grasp Finger feeds Imitates speech sounds
Bangs 2 cubes held in hands Chews with rotary movement Waves bye-bye
Uses mama and dada with
meaning
Inhibits behavior to no
Piles 2 cubes Uses spoon with over pronation Uses single words
Scribbles spontaneously and spilling Understands simple commands
Holds crayon full length in palm Removes a garment
Casts objects
18 mos Arms at low guard Emerging hand dominance
Mature supporting base and Crude release
heel strike Hold crayon butt end in palm
Seats self in a chair Dumps raisin from bottle
Walks backward spontaneously
2 yrs Begin running Hand dominance is usual
Walks up and down stairs Build 8-cube tower
alone Aligns cubes horizontally
Jumps on both feet in place Imitates vertical line
Places pencil shaft b/w thumb
and fingers
Draws with arm and wrist action
3 yrs Runs well Imitates 3-cube bridge
Pedal tricycle Copies circle
Broad jumps Uses overhand throw with AP
Walks up stairs alternating arm and motion
feet Catches with extended arms
hugging against body
4 yrs Walks down stairs alternating Handles a pencil by finger and
feet wrist action, like adults
Hops on one foot Copies a cross
Plantar arches developing Draws a froglike person with
Sits up from supine position s head and extremities
rotating Throws underhand
Cuts with scissors
5 yrs Skips, tiptoes Hand dominance expected
Balances 10 sec on each foot Draws man with head, body,
extremities
Throws with diagonal arm and
Imitates housework
Carries, hugs doll
Drinks from cup neatly
Pulls on garment
Uses spoon well
Opens door turning knob
Feeds doll with bottle or spoon
Toilet training usually begun
Toilet trained day and night
Pours from pitcher
Unbutton; washes and dries
hands and face
Parallel play
Can take turns
Can be reasoned with
Cooperative play-sharing and
interacting
Imaginative make-believe play
Dresses and undresses with
supervision distinguishing front
and back of clothing and
buttoning
Does simple errands outside of
home
Creative play
Competitive team play
Uses fork for stabbing food
Brushes teeth Self-sufficient in
Points to named body part
Identifies one picture Says no
Jargons
2-word phrases are common
Uses verbs
Refers to self by name
Uses me, mine
Follows simple directions
3-word sentences are usual
Uses future tense
Asks who, what, where
Follows prepositional
commands
Gives full name
May stutter; eager Identifies sex
of self
Recognizes 3 colors
Gives connected account of
experience
Asks why, when, how
Uses past tense, adjectives,
adverbs
Knows opposite analogies
Repeats 4 digits
Fluent speech
Disarticulation of some sounds
may persist
Gives name, age, address
 body rotation toileting Defines concrete nouns
Catches with hand Dresses s supervision except composition, classification, use
tying shoelaces Follows 3-part commands
Number concept to 10

6 yrs Rides bicycle Prints alphabet; letter reversal Teacher is important authority Shows mastery of grammar
Roller skates still acceptable Uses fork appropriately Uses proper articulation
Mature catch and throw of ball Uses knife for spreading
Plays table games

7 yrs Continuing refinement of Eats with fork and knife

skills Combs hair
Responsible for grooming