Principles of development:
- Development proceeds from the head downward (cephalocaudal principle).
- Development proceeds from the center of the cody outward (proximodistal development).
- Development depends on maturation and learning.
- Development proceeds from the simple to the more complex.
- Growth and development is a sequential and continuous process.
- Growth and development proceed from the general to specific.
- There are individual rates of growth and development.
Keep in mind, these principles and remember what a child will be able to achieve at the end of a year and fill the missing gaps.
By 1 year: Walk, Scribble, Single words
- 2-3 months: Head holding, Social smile
- 4 months: Rolls over
- 6 months: Sits with support, Stranger anxiety, Smiles at mirror, Palmar grasp
- 9 months: Stands with support, Crawls, Pincer grasp (immature), Says dada/mama (non-specific)
- 12 months: Walks with support, Pincer grasp (mature), Says dada/mama (specific)
See how the development progresses from head to foot, from proximal to distal and from simple to complex in a sequential manner, i.e. head holding, then rolling over (shoulder and chest), sit (halfway to walk), crawl and then walk for gross motor; palmar grasp to pincer grasp for fine motor; and meaningless cooing/babbling to meaningful 1-2 words for speech.
By 2 years: Climb 2 steps, 2 parallel lines, 2 word sentence, Follow 2 step commands, Turn 2 pages of a book
- 15 months: Walks alone, 3-5 meaningful words
- 18 months: Runs, Climb stairs with support, 8-10 meaningul words
- 2 years: Climb stairs without support, 2-3 word sentence (e.g. I love you), Follow 2 step commands
By 3 years: Tricycle, Ready to go to school (alternate feet upstairs, dresses/undressess partially, knows full name and gender, copies a circle)
By 4 years: Hops/alternate feet downstairs, Copies cross and square, Knows colors, Becomes more social (co-operative play with friends, tells stories/poems, dressess/undresses fully)
By 5 years: Bicycle, Copies triangle, Skips, Shoe laces
Red flag signs
Typically, there is a 3-6 month range on either side of the development milestone, but this will vary depending upon the behavior.
- By 3 months: Persistent fisting, Failure to alert to environmental stimuli
- By 6 months: Poor head control, Failure to reach for objects, Absent ccoing, Absent smile (Normally achieved by 3 months + 3 months)
- By 10 months: Not sitting without support (Normally achieved by 7 months + 3 months)
- By 12 months: Persistence of primitive reflexes, Development of hand preference (Normally achieved at 18 months – 6 months)
- By 18 months: Not walking without support (Normally achieved by 15 months + 3 months), No single word with meaning (Normally achieved by 12 months + 6 months)
- By 30 months: No 2-3 word sentence (Normally achieved by 24 months + 6 months)
In general, wait for 3 months for milestones acquired in 1st year and 6 months for milestones acquired in 2 year to list it under the “red flag” signs.
is currently working as a medical officer at Nepal Police Hospital. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music and travelling.