Dr. Saul Greenberg MD FRCP(C)
2401 Yonge St. #206
Toronto, Ontario M4P 3H1
Tel: 416-485-4419  Fax: 416-485-2936

Child Development

This describes the usual pattern of development that you may expect to see your baby undergo in the first five years.  Keep in mind that every baby is different and some babies skip steps or learn things in a different order.  This does not mean your baby has a problem, but if your baby differs greatly from these guidelines, you may wish to mention it to your pediatrician at your next well child visit.  The information here is organized by the usual ages at which well checks are done and includes developmental milestones from the four basic categories:  gross motor, visual and fine motor, language, and social development. 

Click on a specific age to jump to that section.

2 weeks
1 month
2 months
4 months
6 months
9 months
1 year
15 months
18 months
2 years
3 years
4 years
5 years

At two weeks your baby is returning to birth weight after an initial period of weight loss.  Most babies sleep a lot during this time.  Your baby should sleep on her back, not on her tummy or side.  The back is the safest position for preventing SIDS (crib death), one of the most common causes of death in the first year of life.  In order to promote gross motor development, make sure that she spends some supervised time during the day playing on her tummy.  This will also help keep the back of her head from becoming flattened from lying face up all the time.

By one month of age, your baby is more alert, with definite wakeful periods and less of the groggy, semi-alert state that is common earlier in the first month.  His head control is improving, with the ability to raise his head slightly and, possibly, to turn his head from side to side when lying on his tummy.  He holds his hands in tight fists most of the time.  His vision and hearing are gradually improving with age.  At one month, his best seeing distance is about one and a half feet away.  He probably recognizes your face when sitting in your lap and is able to follow an object that moves from his side to midline (directly in front of him) with his eyes.  If he startles in response to loud noises, that's a good sign that he can hear. 

By two months, your baby is able to lift her upper chest off the table when lying on her tummy and she is able to lift her head up and look around.  Her fists are not closed so tightly any more.  She may occasionally be tracking objects and movements past midline with her eyes.  She is becoming more social, smiling in response to being talked to or stroked, and she recognizes your face and voice.  Within the next month, she will be cooing (making soft “ooh” and “aah” sounds).  Soon, she will be discovering her hands, staring at them, and holding them together.  By now, you should be getting pretty good at sensing your baby’s cues and using your intuitive and empathetic skills to tune in to her needs and various modes of alertness.  Try to encourage her to use her multiple sensory and motor modalities, such as vision, sound, touch, and movement, to explore the world.  Mobiles and mirrors are great stimulation.

Some four month-olds are rolling over, but others wait until about five months of age to roll.  Now your baby can push his chest off the table, supporting his weight on his wrists when lying on his tummy.  He reaches with both arms for things that interest him, using his hands to grasp and play with small hand toys such as rattles.  You often hear him laughing and making happy, squealing sounds.  He can follow you with his eyes as you walk around the room, and turn toward your voice when you talk to him.  He really enjoys looking at his surroundings.  Soon he will transfer toys from hand to hand and start making “raspberry” sounds (spitting sounds) with his lips.

At six months of age, your baby may be able to maintain a sitting position, at least briefly.  She is transferring toys from hand to hand and playing with her feet, possibly getting them into her mouth.  She reaches for objects with one hand and can pick things up using a "raking" motion.  She is starting to use hard consonant sounds like "ba", "ga", or "da".  This is referred to as babbling, and is a good sign that your child is hearing.  Since she is soon going to be independently mobile, starting to crawl and pulling up to stand on furniture, now is the time to be sure your house is child proof.  Install electrical outlet guards and child proof latches.  Move dangerous chemicals such as those found in drain cleaners and dishwashing detergents out of your baby’s reach.  Some houseplants are poisonous, so move them up high, too.

At nine months, your baby has probably been crawling for about a month and should be able to stand, with something to hold onto.  Many nine month-olds are pulling up to stand, and some are taking steps holding onto furniture (cruising).  He may be able to pick up small objects with his finger and thumb (the "pincer grasp"), hold his bottle, and may be able to throw objects.  His is babbling more (using “dada” and “mama”, but not necessarily specifically for you), and playing social games such as peek-a-boo, pat-a-cake, or waving bye-bye with you.  It’s a good age to talk a lot to your child, and to read to him.  This gives him a good speech model and encourages language development.

Many one year-olds are beginning to walk unsupported.  Some children walk as early as ten months of age; others don’t take that first step until about 15 months.  As your child becomes more mobile, it is extremely important to supervise her around any body of water.  If you have a pool, it should be fully enclosed and equipped with self-closing gates.  Buckets of water and kiddie pools should be emptied when not in use.  REMEMBER, IT ONLY TAKES SECONDS AND JUST A FEW INCHES OF WATER TO DROWN.  Children also begin to say words at about one year of age, and she may be saying things that only she can understand ("jargonning").  She imitates your actions and may come when you call to her.  You can help her developmental progress by giving her plenty of opportunities to move around furniture on carpeted floors and by talking to her a lot.  Explain to her everything you’re doing with her.  Tell her what she is eating, playing with, or wearing.  Teach her body parts and animal sounds.  Reading to her provides an excellent speech model and teaches object permanence.  A rear-facing car seat is still required until she is over 20 pounds.

Most 15 month-olds are walking, running, and climbing, though a few aren't quite ready to walk yet.  These are usually children with cautious personalities.  They'll walk soon!  Your child can scribble and build a tower of two blocks, if shown how.  He is talking more, using several words and his jargonning is becoming more recognizable as real words.  He understands speech; follows simple commands, like, "Bring me your shoes"; and points to some body parts.  He soon will be able to use a spoon by himself.

At 18 months, coordination is improving.  Your child is running, climbing, and jumping, and may be able to kick or throw a ball.  She can build a tower of three blocks and can scribble independently.  Her speech is also improving.  Hopefully, she is using more single words, repeating words you say to her, and putting two words together.  She enjoys imitating housework (dusting or vacuuming with you) and can feed herself with a spoon or fork.

At two years of age, your child can kick a ball, throw overhand, climb stairs one at a time, and stack five or six blocks.  He imitates horizontal or circular strokes with a crayon, turns the pages of a book, and can take off a few items of clothing.  Most children are using at least 50 words by this age; putting words together to make short phrases; and using pronouns like "I", "me", and "you", though they don't use them correctly.  You can work on teaching him colors and counting.  He may be showing an interest in toilet training.  You can get him a potty seat and give positive reinforcement, but do not force it if he doesn't want to use the potty.  Most kids will be ready by about two and a half or three years of age.

At three years, many kids can pedal a tricycle, balance briefly on one foot, alternate feet ascending stairs, build a tower of nine cubes, copy a circle or cross, do simple puzzles, dress themselves partially, and recognize colors.  Your child can speak in clear sentences that are understandable to you and also to others, though there is often some minor stuttering at this age.  Being with other kids in a preschool setting often helps.  If stuttering becomes excessive, please call your pediatrician.  Teach your child the ABC song, work on counting, and keep reading to her.  At this age, she can also play in groups, sharing toys and taking turns.

At four years, children are developing the coordination to alternate feet descending stairs, hop, jump, stand on one foot for three to five seconds, climb a ladder, ride a tricycle, walk on tip-toes, hold a pencil with good control, build a tower of ten blocks, and play with puzzles.  Your child can copy figures such as a cross, a circle, and possibly a square.  He may have learned to wash and dry his hands and brush his teeth.  He can dress himself, including using zippers and buttons.  He enjoys the companionship of other children, plays cooperatively, and tells "tall tales".  Attending preschool helps him develop friendships and makes the transition to kindergarten easier.

At five years, your child is able to skip; walk on tip-toes; wash and dry her hands; brush her teeth; cut and paste; identify coins; name four or five colors; copy a triangle; tell a simple story; define at least one word, such as "ball", "shoe", "chair", or "dog"; and name the materials of which objects are made.  She can tie her shoes and may be able to write her first name.  She is beginning to understand right from wrong, fair from unfair, and the concept that games have rules.  She enjoys the companionship of other children and engages in make-believe play with domestic role-playing.  Children should participate in household chores, such as setting and clearing the table, and tidying up their own rooms.

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The information contained on this web site is not a substitute for direct examination and treatment by a physician. If any of this material is unclear or confusing, or if you have additional questions or concerns, please call the office at (416)485-4419.