As a paediatric Doctor and as a Mother, I know many parents wonder about what their child should be able to do and when. Since the pandemic, there have been many changes to healthcare systems in the UK and waiting times are difficult to navigate, particularly when you are worried about something.  A lot of parents send messages to me worried about what effect the pandemic has had on your baby/toddler, worried that your child isn’t doing what other babies/children are.
Raising children is hard work! There’s worry about their health and then there is also comparison, which we all do, however unconsciously. For the most part I tell parents not to compare their children to what other babies/toddlers/children are doing except for a few skills which I expect all children to acquire by a certain age. These skills are referred to development milestones and develop as your child grows from birth to 5-6 years.
As Paediatricians, we monitor when children get functional skills like eating, walking, talking so we can:
- Reassure parents
- Identify any problem areas that they need support with
4 key areas of development milestones
The key child developmental milestones fall into four categories:
- Gross motor skills (walking, jumping, running)
- Fine motor and vision skills (writing, pincer grip)
- Speech, language and hearing
- Social, emotional and behavioural
All milestones have a ‘median’ age for all milestones, meaning that we would expect 50% of all children of that age to have achieved this milestone by that age. Importantly, we have a limit age, meaning that we expect the skill to have been achieved by that age.
Take walking independently as an example. Most babies will take their first steps around their first birthday. However, the upper limit for this is 18 months. Therefore if your baby isn’t walking by 18 months old, you need to see a doctor for a detailed assessment and intervention as necessary. It doesn’t mean there is a problem, it just means we need to keep an eye on things. Your baby may walk a little later, for example at 20 months, and everything may well be okay. But sometimes it isn’t and these ‘limits’ help us identify children early.
Common child development milestones
These are just some of the common milestones in the first few years of your child’s life:
Six weeks old
By six weeks of age, your baby should be able to:
- Raise head when on tummy
- Have good head control
- Follow your face/toy
- Startle at loud noise
- Smile: this is a social smile, not because they find you funny (sorry folks!)
Six months old
By six months of age, your baby should be able to:
- Roll from their tummy onto their back
- Begin to sit with support (tripod sitting)
- Grab things with their hands
- Transfer toys from one hand to the other
- Turn their head to their name/noise
- Begin to babble
- Put toys/feet/your nose to their mouth
Nine months old
By nine months of age, your baby should be able to:
- Sit independently without support by now
- Begin to stand with support (they may begin to cruise too)
- Pick things with their thumb and index finger (pincer grip)
- Recognise and respond to their own name
- Hold and bite their food
- Develop stranger danger and object permanence: this means they cry when you leave room or if they don’t recognise a face
12 months old
Congratulation on your baby’s first birthday! They should be able to:
- Begin to walk independently
- Can put two brick on top of one another
- Throw objects
- Say mama/dada/: we expect most babies to say three words by around 12 months old
- Wave ‘bye-bye’ and understand Peekaboo
- Drink from a beaker cup
- Clap with their hands
Two years old
Your baby is now a toddler and should be able to:
- Run on their tip toes
- Walk up the stairs with two feet at a time
- Throw a ball (kick a ball at two and a half years old)
- Begin to draw a vertical line
- Turn pages in a book
- Say two-word sentences, e.g. Mama eat, I hungry
- Begin to eat with a spoon
Three years old
Your toddler should be able to:
- Walk up and down stairs
- Draw a circle
- Begin to use scissors
- Bead things through (pasta is great if you don’t have beads)
- Say three-word sentences, e.g. Mama, let’s go!
- Understand things are bigger/smaller and colours
- Start sharing with toys
- Play independently
- Eat with a fork and spoon
- Be dry by day (poop and pee between 3-4 years old)
Five years old
Where has your toddler gone?! Your child should now be able to:
- Run and walk up and down stairs like an adult
- Draw a cross/triangle/body part
- Cut pieces of paper
- Understand complex instructions, e.g. pick your shoes up, put in the cupboard and then wash your hands
- Dry by night (some children don’t achieve this until 8-9 years old)
- Can dress/undress some items of clothing
- Begin to do buttons and zips
This is a rough idea of what to expect and when. If there are concerns in more than one area, for example not walking (gross motor) and not talking (speech) then it is more likely to be significant and you should see a doctor as soon as you can. Isolate delays, such as using a fork or scissors, can be early indicators of dyspraxia.
Child development red flags
Importantly, there are factors in development that warrant timely assessment by a qualified healthcare professional. These are known as red flags.
Red flags that indicate your child needs a doctors assessment are:
- There is no social smile at six weeks old
- No head control by six weeks old
- Squinting/not reaching for things by six months old
- They are not sitting by nine months old or are very floppy
- They are not walking by 18 months old
- They have no words/babble by 18 months old
- They are not talking by two years old or understanding simple instructions
- REGRESSION: A loss of a skill or any regression is a serious concern and you should consult a healthcare professional urgently.
I have tried to cover all the important milestones in this article and I hope you found it useful! It’s important to say that please remember each child is unique and develops at their own pace and in their own way. Just because your child isn’t walking by 12 months old, or if your child is walking at 8 months old, doesn’t mean one is better than the other. Be kind with your words and think twice before saying “oh mine was born talking and walking.” It might make an already struggling parent, feel worse about their child.
If you have any questions, please feel free to pop them in the comments, get in touch via my Bloss profile, or ask an expert in The Clinic.
Leave a Comment
You must be logged in to post a comment.