Gross motor, fine motor and vision, hearing and speech, social
Mnemonic
Four domains, and the limit ages matter more than the averages:
| Age | Gross motor | Fine motor and vision | Speech and hearing | Social |
|---|---|---|---|---|
| 6 weeks | Head control developing | Fixes and follows | Startles | Smiles |
| 6 months | Sits with support | Palmar grasp, transfers | Babbles | Puts objects in mouth |
| 9 months | Sits unsupported, crawls | Pincer grip developing | “Mama”, “dada” non-specific | Stranger anxiety |
| 12 months | Walks with support, cruises | Mature pincer grip | 1 to 2 words | Waves bye-bye |
| 18 months | Walks steadily | Tower of 3 bricks, scribbles | 6 to 10 words | Feeds with spoon |
| 2 years | Runs, stairs two feet per step | Tower of 6 | 2 word phrases | Parallel play |
| 3 years | Stairs one foot per step, tricycle | Tower of 9, copies a circle | 3 word sentences | Interactive play |
| 4 years | Hops | Copies a cross | Full sentences | Plays with others |
Red flags (limit ages): no smile by 10 weeks, not sitting by 9 months, not walking by 18 months, no words by 18 months, no 2 word phrases by 2.5 years.
“Any regression at any age is a red flag”, regardless of the milestones already reached.
Expansion
Four domains: gross motor, fine motor and vision, hearing and speech and language, social and behavioural.
| Age | Gross motor | Fine motor | Speech | Social |
|---|---|---|---|---|
| 6 weeks | Head lag on pulling to sit | Fixes and follows | Startles to sound | Social smile |
| 6 months | Sits with support, rolls | Palmar grasp, transfers | Babbles | Stranger awareness beginning |
| 9 months | Sits unsupported, crawls | Pincer grip developing | “Mama” non-specific | Stranger anxiety |
| 12 months | Walks with support, cruises | Mature pincer grip | 1 to 2 words | Waves, plays peek-a-boo |
| 18 months | Walks steadily, climbs stairs | Scribbles, tower of 3 | 6 to 20 words | Feeds with spoon |
| 2 years | Runs, kicks a ball | Tower of 6 | Two word phrases | Parallel play |
| 3 years | Tricycle, stairs alternating | Tower of 9, copies a circle | Short sentences | Interactive play, dry by day |
| 4 years | Hops | Copies a cross | Full sentences | Cooperative play |
Red flags requiring referral: no social smile by 8 weeks, not sitting by 9 months, not walking by 18 months, no words by 18 months, no two-word phrases by 2 years, and any regression of previously acquired skills, which is always abnormal.
Distinguish global delay (all domains) from isolated delay, which points to a specific cause such as deafness or cerebral palsy.