Every time you bring your baby in the office for a well examination we will be checking your baby's development either through a series of questions or through direct observation. If you have a concern about a particular area of development we encourage you to share it your our physicians. Early detection of a delay is the best prevention. This section will walk you through the typical developmental milestones in areas of physical growth, cognitive development and speech development. Keep in mind these are rough guidelines and that there is some variation from baby to baby. For more information and videos, visit pathways.org

Also if your baby was born premature you need to adjust the time frame to account for the prematurity.

  • smiles to the sound of your voice
  • coos or vocalizes other than crying
  • begins to imitate some sounds
  • turns head to the direction of sound
  • sucks and swallows well during feeding
  • pushes up on arms when laying down
  • lifts and holds head up
  • pushes down on legs when feet are placed on a firm surface
Social Emotional
  • begins to develop a social smile
  • becomes more expressive with face and body
  • imitates some movements and facial expressions
Appropriate Toys
  • images or books with bright colors and high contrast patterns
  • break resistant mirror at the side of the crib
  • rattles
  • exposing to variety of music or singing to your baby
Alert Your Doctor If
  • doesn't seem to respond to loud sounds
  • doesn't follow objects with eyes by 2-3 months
  • doesn't smile by 3-4 months
  • has difficulty lifting head
  • stiff legs with little or no movement
  • still has Moro reflex after 4 months
  • doesn't bring objects to mouth by 4 months
  • seeks out speaker, localizes voice
  • understands own name
  • uses sounds to get attention
  • begins to use consonants sounds in babbling, e.g. "dada"
  • is eating solid pureed foods
  • reaches for nearby toy while laying on tummy
  • transfers one toy from one hand to the other
  • reaches both hands to play with feet
  • rolls both ways
  • sits up with some help
Social Emotional
  • enjoys social play
  • interested in mirror images
  • responds to other people's expressions of emotion and appears joyful often
Appropriate Toys
  • Unbreakable mirror
  • soft balls including some that makes pleasant sounds
  • musical toys such as bells, maracas, tambourines
  • baby books made of cloth and soft material
Alert Your Doctor If
  • unable to lift head up
  • poor head control
  • arches back and has stiff tight muscles
  • shows no affection for the person that cares for him
  • does not respond to sounds around him
  • doesn't smile by 5 months
  • does not actively reach for objects by 7 months
  • does not bear some weight on legs by 7 months
Additional Info
6 Month Handout
  • Increases variety of sounds and syllable combinations in babbling
  • Looks at familiar objects and people when named
  • Begins to eat junior foods and mashed table foods
  • sits well without help and reaches for toys while sitting
  • can get to sitting position from sitting
  • is starting to crawl
  • pulls up to a stand
  • starts to use the pincer grasp
  • bangs 2 cubes together
Social Emotional
  • explores objects in many different ways (shaking, banging, throwing and dropping)
  • looks for hidden objects
  • begins to use objects according to their function
  • turns pages of a book
  • starts to imitate other during play
  • starts to be shy and anxious around strangers
  • cries when mother or father leaves
Appropriate Toys
  • large building blocks
  • cardboard books with large pictures
  • push pull toys
  • paper tubes , empty boxes, old colorful magazines
  • large balls
  • toy telephones
Alert Your Doctor If
  • uses only one side of the body to move
  • inability to straighten back
  • will not put weight on legs
  • cannot display any movement while on the floor
  • Starts using "mama", "dada"
  • Responds to simple commands such as "come here"
  • Tries to imitate words
  • Babbles with inflection
  • Begins to use open cup
  • Finger feeds himself
  • Walks holding on to furniture
  • Stands momentarily without support
  • Gets from sitting to crawling
  • Puts objects in and out of containers
Social Emotional
  • Repeats sounds and gestures for attention
  • May be fearful in some situations
  • Shows preferences for toys
Appropriate Toys
  • Stacking toys
  • Containers with different size ball
  • Shape sorters
  • Musical toys
  • Music and singing
  • Cardboard books with colorful pictures
Alert Your Doctor If
  • Difficulty getting to stand because of stiff legs or pointed toes
  • Only uses arms to get to standing
  • Cannot keep balance when in sitting position
  • Stiff arms or very flexed arms
  • Doesn't point to objects or pictures
  • Does not turn to name
  • Will not imitate waving of the hand or shaking of head
Additional Info
12 Month Handout
  • Uses 4-6 words
  • Starts to point at body parts
  • Starts to imitate less familiar words
  • Understands about 50 words
  • Walks with confidence
  • Walks up the stairs
  • Squats to pick up a toy
  • Helps getting dressed
  • Stacks 2 blocks
  • Starts to scribble
Social Emotional
  • Starts to use utensils with eating
  • Uses cup independently
  • Follows more complex directions
Alert Your Doctor If
  • Stiff legs
  • Unable to stand
  • Doesn't respond to name
  • Can say between 10-20 words
  • Points to 5-8 body parts
  • Runs
  • Throws objects from standing position without falling
  • Goes up the steps
Social Emotional
  • Starts to imitate caregivers in tasks like sweeping, dusting, cooking
  • Can build a tower of 3 blocks
  • Turns pages in books 2-3 pages at a time
Additional Info
18 Month Handout
  • Is using 2 word sentences
  • Is following 2 step directions
  • Knows about 50 words
  • Points to object or picture when it is named for him
  • Walks up and down steps without help
  • Can pull a toy while walking
  • Is able to carry toys while walking
  • Kicks a ball
  • Climbs on and off furniture
Social Emotional
  • Is happy to be around other children
  • Imitates behaviors of adults
  • Is sorting by shapes and colors
  • Imitates strokes with pencil
  • Builds tower of 7 blocks
  • Removes shoes and socks
Appropriate Toys
  • Blocks
  • Beginner jigsaw puzzles
  • Push and pull toys
  • Toy telephone
  • Child keyboard and other musical instruments
  • Stuffed animals
Alert Your Doctor If
  • Does not have at least 50 words by 2 years of age
  • Is not using 2 word sentences
  • Does not seem to know the function of some common household items (brush, telephone, spoon)
  • Does not follow simple instructions
Additional Info
2 Year Handout
  • Is using 3 words sentences
  • Uses plural, and past tense
  • Understands the concept of same and different
  • Can alternate feet when going up the stairs
  • Can begin to ride a tricycle
  • Jumps in place
  • Undresses completely
  • Dresses partially
Social Emotional
  • Starts to engage in group play
  • Starts to share with others
  • Starts to take turns
  • Knows name, age and sex
  • More independent
Appropriate Toys
  • Simple jigsaw puzzles
  • Crayons and paper
  • Building blocks
  • Dress up clothes
Alert Your Doctor If
  • Cannot jump in place
  • Has difficulty scribbling
  • Shows no interest in interactive games
  • Cannot stack 4 bloks
  • Ignores other children
Additional Info
3 Year Handout
  • Talks in full sentences
  • Speaks clearly enough for strangers to understand
  • Knows colors
  • Says songs from memory
  • Asks questions
  • Hops and stands on one foot for more than five seconds
  • Goes up and down the stairs without holding
  • Catches a bounced ball most of the time
  • Throws ball overhead
  • Copies square shapes
  • Draws a person with 2-4 body parts
  • Uses scissors
Social Emotional
  • Can tell a story
  • Engages in fantasy play
  • Plays with group of children
  • Interested in new experiences
Appropriate Toys
  • Paints, crayons
  • More complex puzzles
  • Books
  • Dress up clothes
  • Building toys
  • Board games
Alert Your Doctor If
  • Cannot grasp a crayon between thumb and fingers
  • Still cries when parents leave
  • Doesn't respond to people outside the family
  • Lashes out without any self control when angry or upset
  • Doesn't engage in fantasy play
  • Resists dressing and undressing
  • Uses full sentences
  • Says name and address
  • Can tell longer stories
  • Asks what a word means
  • Skips alternating feet
  • Jumps over low obstacles
  • Swings , climbs
  • Copies triangle and other shapes
  • Draws a person with body
  • Can print some letters
  • Uses fork and spoon
Social Emotional
  • Wants to please friends
  • Wants to be like the friends
  • Likes to sing and dance
  • Plays competitive games
  • Likes to help in household tasks
Alert Your Doctor If
  • Exhibits extremely fearful or timid behavior
  • Shows no interest in playing with other children
  • Does not use fantasy play
  • Does not express a lot of emotions
  • Cannot build a tower with 6-8 blocks
  • Cannot give name and age correctly
  • Cannot take off clothing
  • Cannot wash and dry off hands