Monitoring Developmental Milestones: Key to Early Detection and Treatment of Childhood Developmental Problems


Being in the profession, while working with children and parent community, the common challenge faced by most of the mental health professionals is the concern of early detection in developmental delay. Developmental milestones are various sets of skills, or to say; they are age-specific tasks that a child requires to perform at a certain age. These are commonly taken as the measure to understand the healthy growth of the child by the paediatricians and other medical professionals. The developmental delay, thus, is a major symptom of different pervasive developmental disorders among children, such as Autism, Asperger syndrome, Attention deficit hyperactivity disorder, Mental retardation, Sensory-motor integration disorder, etc.

As the proverb says, “Prevention is better than cure” it is truly important to detect the very first sign of delay in the normal developmental milestone of the baby to ensure timely treatment, prevention to further malfunction, and proper training. The early the detection of the problem, the better will be the treatment. In this regard parents’ role, who are the foremost caregiver of the baby, is crucial. As parents are always the first point of contact for every child, it is essential for the parents to know and understand the normal developmental milestones for a baby at every stage of development so that even the slightest deviation can never be missed. The below mentioned developmental milestones at different stages of life till pre-school years are normal for children, and delay in any of them at any stage is definitely a matter of concern and need to be immediately reported to the medical professionals.

However, before starting with age-specific developmental milestones, it is necessary to know about different types of developmental skills upon which these milestones are based. There are mainly six types of skills that form the plinth to personality. These are:

Gross motor skill- associated with muscle movement, body positioning, balancing, etc.

Fine motor skill- associated with muscular flexibility, holding things, gripping, drawing, writing, etc.

Language skill- babbling, speaking, using body language and gestures meaningfully, etc.

Cognitive skill- thinking, remembering, learning, problem-solving, etc.

Emotional and Social skill- facial recognition, social smile, separation cry, interacting, socializing, playing in groups, etc.

Sensory skill- associated with the sensation of vision, hearing, touching, taste buds and smell.

Based on the above-mentioned skills, the age-specific developmental milestones for children are, thus, summarized below:

Birth to 2 months- begins smiling, sucking own hand, looking at caregivers, attending sounds made, making sounds (at least trying) by own self, try touching/holding things, recognizing familiarity, try holding head up, reacting to uncomfortable things, etc.

By four months- babbling, mood tantrums, give signals of a different emotional state through crying or smiling/laughing, respond to affection, try reaching out to familiarity, holds head unsupported, pushing legs, attend to moving objects, etc.

By 6 months- facial recognition from known to stranger, respond to sound by making sounds meaningfully, reciprocate hearing own name, shows curiosity about things, try exploring by putting it in mouth, passing things or toy from one hand to the other, sit without support, roll from one side to other, rocks back and forth, crawling, etc.

By 9 months- afraid of strangers, separation cry, clingy with familiar adults (degree varies), understand “No” or affectionate appreciation, try saying “Papa/Mamma/Dada”, using finger to point on things, watching path when things fall, playing peek-a-boo, tend to pick up things, stand by holding, etc.

By 12 months- sit without assistance, walk holding on to things or people, stands momentarily without support, walk 2/3 steps without support, put things in containers, try imitate scribbling, poke with index finger, increased attention to speech, try imitate words, explore objects more often, imitate gestures, find hidden things easily, feel shy or anxious, enjoy playing with others, self finger feeding, etc.

By 18 months- frequent meaningful temper tantrums to communicate emotions, playing simple pretention (eg. Feeding a doll), saying several words, pointing at what is needed, knowing use of simple daily things (eg. Brush, comb, etc.), pointing to body parts, walking alone, pull things/can hand things over to other while walking, drink from cup, eat with spoon (though in messy way), etc.

By 2 years- scribble spontaneously, build block towers, can use one hand frequently than the other, point to object or picture as named, use simple sentences, begin sorting shapes and colors, make-believe play begins, emotional intimacy with others, awareness of self-start developing, demonstrate increasing independent gestures and behaviors, etc.

By 3 to 4 years- hops and stands on one foot, climbing stairs without support, kick and throw toys/balls, copies simple shapes, draws meaningfully and independently (though mostly stick figures), understand simple concepts, speaks clear sentence, narrate stories/events, can name shape/color/body part and many other simple things, recall things, engages in fantasy play, etc.

By 4 to 5 years- can try swimming, write simple numbers and alphabets unassisted, begin caring for own toilet needs, saying name/address/phone number/date and many other simple things correctly, can count numbers, peer pleasing/sharing behavior, sing/dance/act/rhyme for others, showing more overall independent behavior, etc.

However, the given milestones are just the basic guiding steps for parents to understand if the child is developing normally or not. In case, any delay is observed, immediate consultation with the medical professional will help parents to get the best guidance on treatment (if required at all). Tracking developmental pattern of own child will always help parents to connect with the child better to cater the need, and even if any concern arises regarding child health, this monitoring will help early detection and treatment that in turn will ensure effective prevention and cure.

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