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What Are Pediatric Milestones in Childhood Development?

Stages of Pediatric Developmental Milestones

Developmental milestones in children are sets of tasks that most children can do at a certain age. Pediatricians, clinicians, and parents use these to see how a child is developing, and sometimes the absence of a milestone can be a warning that requires attention.

Pediatric milestones can be represented in social and emotional development, language and communication skills, as well as cognitive or physical ability. While the absence or late occurrence or a milestone doesn’t necessarily represent a developmental delay, it often is a warning sign worth looking into. Take a look at these important child development milestones and what they might mean for you and your child.

Types of Pediatric Milestones

The behavioral or physical skills seen in children as they grow or develop are grouped into categories and age ranges. There is some overlap between the characterization of actions and the time they are expected to be seen, and most importantly – these are just guidelines. It’s not time to immediately panic if one of these is not happening, as every child develops differently:

*Please note that these are basic guidelines and not a comprehensive list.

Achieving Pediatric Milestones

Social and emotional:

  • 0-6 Months old: Smiling, crying, eye contact, awareness of surroundings, laughing, imitation of simple facial expressions.
  • 6-12 Months old: Mirror recognition, understanding strangers vs. acquaintances, responsive anger, anxiety or shyness, favoritism towards people or objects, disruptions or tantrums.
  • 12-24 Months old: Simple games, frustration with communication, the assertion of independence, temper tantrums, playing with other children, imitation of actions (both peers and adults).
  • 24-48 Months old: Expressing wider ranges of emotion, separating from parents or caregivers easier, sharing toys or showing caring actions, conflict resolution, tantrums based on behavioral changes towards them, cooperative play, confusing reality, and their imagination.


  • 0-6 Months Old: Vocalizing pleasure/displeasure, laughing, coos, babbling, making noises when talked to.
  • 6-12 Months Old: Gesturing or pointing, attempts to repeat words, first words, “mama or dada” type words with meaning, babbling.
  • 12-24 Months Old: Beginning of linear speech recognition, vocabulary creation, multiple word labels, simple word imitation, asking for food or toys, using pronouns such as “mine”, short phrases.
  • 24-48 Months Old: Verbalizing spatial concepts (in/on), sureness of pronouns, using descriptors, asking simple questions, beginning use of plurals and tenses, expressing ideas or feelings, repeating sentences.


  • 0-6 Months Old: Anticipatory behavior such as expecting a bottle, noticing changes in volume or brightness, discerning objects placed close to them, seeing colors, facial expressions in response to environmental change, recognizing familiar tastes.
  • 6-12 Months Old: Staring at objects, understanding living vs. inanimate things, understanding size differences, enjoying looking at pictures, manipulating objects, responding with gestures/sounds, understanding object permanence.
  • 12-24 Months Old: Identification and grouping of objects, imitation of actions/language in adults, explorative learning, understanding self vs. others, responsive communication, matching object with uses, responding to simple directions.
  • 24-48 Months Old: Sorting objects by shape or size, asking “why” for information, acknowledging past vs. present, learning by observation or instruction, maintaining an attention span for 10+ minutes, seeking additional information than given.


  • 0-6 Months Old: Holding head up without support, developing smooth movements with arms and legs, pushing down on legs, rolling over, bringing hands to mouth/face, holding and shaking objects, beginning to sit up while supported, rocking back and forth.
  • 6-12 Months Old: Crawling, sitting up without support, moving into new positions, beginning to stand or pull to stand, first steps, standing alone.
  • 12-24 Months Old: Walking unsupported, pulling objects while walking, drinking/eating from dishes, climbing without support, throwing things, drawing, kicking objects, standing on tiptoes.
  • 24-48 Months Old: Climbs well, can pedal a tricycle, runs easily, can walk up stairs, hops or stands on one foot, can catch slow-moving objects, can serve and segment their own food, practices fine motor skills to develop them.

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These actions may be obvious among your child or it may take time to recognize them. Additionally, the time ranges are broad; a child might be quick or slow to an independent skill while tracking well with all others. However, it is important to have an idea of what constitutes a common delay or a warning sign.

When There’s No Cause for Alarm

It is important to understand that the ‘normal’ age and the average age of these milestones are different things, and nothing is finite. Physical milestones such as rolling over, crawling, and walking are gradually developed processes. Thus, if you can link one delay to another, it might make sense.

Additionally, your child might have a different rate at which they develop expressive vs. receptive language – and they might focus on what comes easiest to them first. Mostly, worrying too much about the bottom of these age ranges for any pediatric milestone is going to lead to unnecessary stress. However, if your child is missing the upper limits of them, it might be time to consult your pediatrician.

When There are Warning Signs:

  • 0-6 Months: Doesn’t respond to loud noises, doesn’t track objects with eyes, doesn’t smile or recognize people, cannot bring objects to mouth, crosses eyes frequently.
  • 6-12 Months: Stiff or tight musculature, floppy like a rag doll, showing little affection for parents or caretakers, non-responsive to sounds, cannot sit alone, does not reach for objects, cannot crawl, no use of single words, no babbling.
  • 12-24 Months: Cannot walk by 18 months, no sentences by 24 months, no imitations of actions, does not understand simple functions around the house (toilets, utensils, etc.), cannot follow simple instructions.
  • 24-48 Months: Frequent falling, difficulty with stairs, does not understand simple instructions, little interest in playing with peers, cannot communicate in short phrases, won’t separate from parents or caregiver, cannot trace while drawing, ignoring peers, resists sleeping or bathroom behaviors, can’t separate self vs. others, cannot form sentences.

Child on a tricycle

While there are a number of things that may be warning signs, it is most concerning when a child exhibits multiple of them or it is clear that a deficiency is present past an expected age. Regardless of your fears and suspicions, the most beneficial thing you can do for your child is to have them seen by a pediatrician or other licensed clinician. From there, if something needs to be addressed, it is time for therapy and other behavioral frameworks.

What Parents Should Do

At Ally Pediatric Therapy, we have decades of experience in helping children who are behind in pediatric milestones. We know that it can be tough to self-assess your child without stress, which is why we work hand-in-hand with top pediatricians and specialists in each of our clinics.

If you are looking to make sure your child has the best chance at a healthy developmental path, please reach out today. We’d love to work together for a brighter tomorrow.