Toddler Milestones: When to Be Concerned

Below is a snapshot into developmental milestones at age 1 and 4. This is only a guide, and is meant help you identify when it might be time to talk with your pediatrician.
Milestones at 1 Year
Movement
- Gets to sitting position without assistance
- Crawls forward on belly by pulling with arms and pushing with legs
- Assumes hands-and-knees position
- Creeps on hands and knees supporting trunk on hands and knees
- Gets from sitting to crawling or prone (lying on stomach) position
- Pulls self up to stand
- Walks holding on to furniture
- Stands momentarily without support
- May walk two or three steps without support
Hand and Finger Skills
- Uses pincer grasp
- Bangs two cubes together
- Puts objects into container
- Takes objects out of container
- Lets objects go voluntarily
- Pokes with index finger
- Tries to imitate scribbling
Language
- Pays increasing attention to speech
- Responds to simple verbal requests
- Responds to “no”
- Uses simple gestures, such as shaking head for “no”
- Babbles with inflection
- Says “dada” and “mama”
- Uses exclamations, such as “oh-oh!”
- Tries to imitate words
Cognitive
- Explores objects in many different ways (shaking, banging, throwing, dropping)
- Finds hidden objects easily
- Looks at correct picture when the image is named
- Imitates gestures
- Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)
Social and Emotional
- Shy or anxious with strangers
- Cries when mother or father leaves
- Enjoys imitating people in play
- Shows specific preferences for certain people and toys
- Tests parental responses to his actions during feedings (What do you do when he refuses a food?)
- Tests parental responses to his behavior (What do you do if he cries after you leave the room?)
- May be fearful in some situations
- Prefers mother and/or regular caregiver over all others
- Repeats sounds or gestures for attention
- Finger-feeds himself
- Extends arm or leg to help when being dressed
Developmental Health Watch
Each baby develops in his own manner, so it’s impossible to tell exactly when your child will perfect a given skill. Although the developmental milestones listed in this book will give you a general idea of the changes you can expect as your child gets older, don’t be alarmed if his development takes a slightly different course. Alert your pediatrician if your baby displays any of the following signs of possible developmental delay in the eight-to twelve-month age range.
- Does not crawl
- Drags one side of body while crawling (for over one month)
- Cannot stand when supported
- Does not search for objects that are hidden while he watches
- Says no single words (“mama” or “dada”)
- Does not learn to use gestures, such as waving or shaking head
- Does not point to objects or pictures
Milestones at 4 years
Movement
- Hops and stands on one foot up to five seconds
- Goes upstairs and downstairs without support
- Kicks ball forward
- Throws ball overhand
- Catches bounced ball most of the time
- Moves forward and backward with agility
Hand and finger skills
- Copies square shapes
- Draws a person with two to four body parts
- Uses scissors
- Draws circles and squares
- Begins to copy some capital letters
Language
- Understands the concepts of “same” and “different”
- Has mastered some basic rules of grammar
- Speaks in sentences of five to six words
- Speaks clearly enough for strangers to understand
- Tells stories
Cognitive
- Correctly names some colors
- Understands the concept of counting and may know a few numbers
- Approaches problems from a single point of view
- Begins to have a clearer sense of time
- Follows three-part commands
- Recalls parts of a story
- Understands the concept of same/different
- Engages in fantasy play
Social and emotional
- Interested in new experiences
- Cooperates with other children
- Plays “Mom” or “Dad”
- Increasingly inventive in fantasy play
- Dresses and undresses
- Negotiates solutions to conflicts
- More independent
- Imagines that many unfamiliar images may be “monsters”
- Views self as a whole person involving body, mind, and feelings
- Often cannot distinguish between fantasy and reality
Developmental health watch
Because each child develops in his own particular manner, it’s impossible to tell exactly when or how he’ll perfect a given skill. The developmental milestones listed here will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if his development takes a slightly different course. Alert your pediatrician, however, if your child displays any of the following signs of possible developmental delay for this age range.
- Cannot throw a ball overhand
- Cannot jump in place
- Cannot ride a tricycle
- Cannot grasp a crayon between thumb and fingers
- Has difficulty scribbling
- Cannot stack four blocks
- Still clings or cries whenever his parents leave him
- Shows no interest in interactive games
- Ignores other children
- Doesn’t respond to people outside the family
- Doesn’t engage in fantasy play
- Resists dressing, sleeping, using the toilet
- Lashes out without any self-control when angry or upset
- Cannot copy a circle
- Doesn’t use sentences of more than three words
- Doesn’t use “me” and “you” appropriately
For a complete look at toddler basics, problem behavior, challenges and sleep issues, read the full article HERE.