Milestones of Childhood Development

Developmental Milestones

Developmental milestones reached, determine children's progress on the path of childhood development, which is of great interest to the parents and the child health professionals.

Knowledge of normal patterns of developmental process is important to help children achieve their optimal developmental potential.

Childhood development are described in four domains; gross motor, fine motor, cognitive also known as adaptive, and language – the communication skills.

Tabulated form of milestones works as an assessment tool

A child’s development at any specific age is an integrated whole.
Childhood development is a continuous process.
The sequence of skills achieved, during childhood development, always remains the same in all children.
The rate at which skills are achieved in various developmental domains of childhood varies from one child to another.
The delay in achievement of the developmental skills may be due to normal individual variations, or as a manifestation of a developmental disorder.
The rate of development of the skills helps assess the development process of a child.
Charting of milestones, like the growth charts, provides the baseline for evaluating the developmental delays or even possible regression of already achieved skills.

Children, in the early years of development, build up a store of knowledge about their environment. Motor skills are developed and mastered to get around, while language development is to communicate socially.

Role of nutrition and emotional support in child development

Children need to be in good physical and emotional health for optimal development. Provision of essential nutrition is important too for child growth.

Normal child growth and development of motor skills go hand in hand. Neonatal period and infancy are the periods of fast physical and brain growth. Maturation of a child’s various body systems also occur during these phases of life.

Adequate availability of iron and other nutrients is important for myelination of the brain cortex. The process of myelination of the brain is most active during the last 3 months of prenatal and first 2 years of postnatal life.

Inadequate dietary intake, insufficient interactions with caregivers, or both during this phase of life may alter experience-dependent processes that are critical to brain development and skills achievement of a child.

Developmental skills achievement charts

Expected developmental skills in the children of a particular age group are serially charted as developmental milestones.

Points to note while evaluating child's development:

Infants acquire competence in all developmental domains. Moreover, skills developed in one domain influence and are influenced by the skills developed in all the other domains.
Children progress through childhood development at their individual pace. It is therefore impossible to precisely specify the age at which a child should achieve a given skill.
Traditionally, these charts are only for the first 6 years of life.
The charts presented below show the internationally accepted average age at which a child should attain the specific developmental skills.

Milestones of Gross Motor Development Domain
(2 - 24 months)

Milestone

Holds head steady in sitting position

No head lag when pulled to sitting position

Brings hands together in midline

Neonatal asymmetric tonic reflex gone

Sits without support – initially short duration

Rolls back to stomach

Walks alone

Runs

Attainment Age (mo)

6.5

Implication

Allows more visual interaction

Muscle tone development

Self discovery: hands at this age

Gives ability to inspect hands in midline

Increases ability to explore

Truncal flexion, risk to fall

Exploration:can self control proximity to the parents

Caretaker’s supervision gets difficult

Milestones of Fine Motor Development Domain
(2 - 24 months)

Milestone

Grasp rattle

Reaches for object

Neonatal reflex-Palmar grasp gone

Transfer object from hand to hand

Thumb-finger grasp

Turns pages of book

Scribbles

Builds tower of 2 cubes

Builds tower of 6 cubes

Attainment Age (mo)

3.5

5.5

Implication

Object use

Visual motor coordination

Voluntary release

Comparison of objects

Able to explore small objects

Increasing autonomy

Purposeful visuomotor coordination

Use objects in combination

Requires visual, gross & fine motor coordination

For sequence of language skills development click here.

Milestones Provide Baseline to Evaluate Childhood Developmental Delays & Regression

Causes of delay in achieving developmental skills

May need correction for gestational age if the child was born premature
Idiopathic usually affects one domain of development and shows its catch up at a later date.
a.) Constitutional
b.) Familial
Specific Sensory deficit:
a.) Vision defect
b.) Hearing defect
Deprived child:
a.) Nutritional
b.) Emotional deprivation
c.) Both
Intellectual limitations
Hypotonic baby:
a.) Floppy baby
b.) Down’s syndrome
c.) Cerebral palsy, the hypotonic variety
Hypertonic child as in Cerebral palsy