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 in Internal medicine at Nepal Police Hospital (previously clinical oncology). He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music and travelling.