Category:Developmental Milestones

Between birth and 1 year, the child is called an infant; between 1 and 3 years, the child is called a toddler; between 3 and 5 years, the child is called a preschooler or young child; between 6 and 11 years, the child is referred to as a schoolage child or older child; and between 12-18 years, the child is called an adolescent. The weight curve is the 50th percentile for all groups.

This developmental milestones chart includes normal expectations of developmental milestones for children, birth through adolescence, and information about the possible effects of maltreatment.

Below are some suggested uses:
 * Review the chart prior to interacting with children to prompt your recollection of common milestones and to help you identify potential developmental delays or concerns.
 * Copy the chart that corresponds to the age of the child, and use it to assess the child’s achievement of milestones and apparent delays. Highlight milestones they have reached, and work on those they have not. It may also be helpful to write down the date the milestones are reached, and put the chart in the baby book when all the milestones have been reached.

=Infants= Sensory-motor: physically explores environment to learn about it; repeats movements to master them, which also stimulates brain cell development

Attachment: baby settles when parent comforts; toddler seeks comfort from parent, safe-base exploration

Birth-1 year: learns fundamental trust in self, caretakers, environment

To connect with baby:
 * play together
 * do daily activities together
 * talk to baby
 * read to baby

Possible effects of maltreatment
 * Chronic malnutrition: growth retardation, brain damage, possibly mental retardation
 * Head injury and shaking: skull fracture, mental retardation, cerebral palsy, paralysis, coma, death, blindness, deafness
 * Internal organ injuries
 * Chronic illness from medical neglect
 * Delays in gross and fine motor skills, poor muscle tone
 * Language and speech delays; may not use language to communicate
 * Insecure or disorganized attachment: overly clingy, lack of discrimination of significant people, can’t use parent as source of comfort
 * Passive, withdrawn, apathetic, unresponsive to others
 * “Frozen watchfulness”, fearful, anxious, depressed
 * Feel they are “bad”
 * Immature play – cannot be involved in reciprocal, interactive play

To prevent SIDS:
 * keep puffy items out of baby's bed area, bassinet
 * put baby to sleep near you
 * have baby sleep on their back
 * do not let baby sleep on waterbed or sofa
 * do not allow smoking around your baby
 * keep temperature between 68 and 72 degrees
 * dress baby in layers
 * allow pacifier between 1-12 months, but not after 12 months

First Month
Physical Milestones:
 * 0-4 months 50-300 ml/day liquid elimination
 * 0-7 years PMI (point of maximum impulse of heart) located at 3rd or 4th intercostal space, just left of midclavicular line
 * 0-2 years respiration rate 24 to 34 respirations per minute
 * 0-1 years pulse rate 135 ± 3.1
 * 0-1 year blood pressure 90 ± 25 systolic, 61 ± 19 diastolic
 * 0-1 year pulse 70-180, respiration 30-40
 * 0-1 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
 * 0-1 year PaO2 85-100, PaCO2 35-45
 * 0-15 months eliminates automatically; may need up to 30 diapers a day as newborn
 * 0-2 1/2 years naps easily
 * rough, random, uncoordinated, reflexive movement
 * smell mommy's milk
 * hear a startling noise
 * can see 12-18 inches in front of him/her

Social/Behavioral Milestones:
 * 0-1 month Indefinitely gazing at surroundings, especially faces.
 * 0-1 month Listens to sounds, and can hear your voice.
 * 0-1 month Watches Mother's face when she feeds or talks to child.
 * crying when he needs something – respond gently and instantly
 * quiets when held – skin-to-skin contact is necessary for babies
 * they can feel your touch, likes your gentle handling

Mastered Skills (most can do):
 * Lifts head briefly when lying on tummy (allow baby time on back and stomach, attended, but not over-stimulated)
 * Responds to sound
 * Stares at faces

Emerging Skills (half can do):
 * Follows objects briefly with eyes
 * Vocalizes: oohs and aahs
 * Can see black-and-white patterns

Advanced Skills (a few can do):
 * Smiles, laughs
 * Holds head at 45-degree angle

If baby does not respond to sound, there may be developmental delay.

Second Month
Physical Milestones:
 * 2 months weight gain between 1 lb. 4 oz. and 1 lb. 12 oz.
 * 2 months height gain of 2 inches
 * 2 months a 1-inch increase of head circumference
 * 2 months closure of posterior fontanel
 * 2 months doll's eye reflex, dance reflex, grasp reflex (will try to grasp finger placed in open palm; attempting to remove finger causes tighter grip), and crawling reflex (making crawling motions when placed on abdomen) disappearing
 * 2 months hands are frequently open
 * 2 months less head lag
 * 2 months when on stomach, able to lift head about 45 degrees
 * 2 months decreased flexion of extremities while on stomach
 * holding head up for longer periods
 * tracking slowly moving object across field of vision with eyes
 * kick legs
 * move arms
 * strengthen muscles by spending time on stomach (do not leave baby alone with kids or pets)
 * holds head up for short periods
 * makes smoother movements

Sensory and Cognitive Milestones:
 * 2 months searches to locate sounds
 * 2 months head turns from side to side with auditory stimulation at the level of the ear
 * 2 months beginning to visually fix on close objects
 * 2 months crying becomes differentiated
 * 2 months vocalizes with coos and gurgling
 * 2 months vocal response to familiar voices
 * 2 months smiles, laughs in response to stimuli
 * connects during play
 * communicates better
 * notices his/her hands

Advanced Skills (a few can do):
 * Holds head steady
 * Can bear weight on legs
 * Lifts head and shoulders when lying on tummy (mini-pushup)

Third Month
Physical Milestones:
 * lifts head to 90 degree angle when on tummy, uses arms to prop
 * batting objects
 * likes moving body in water
 * Holds head steady
 * Visually tracks moving objects through midline
 * Blows bubbles

Social/Behavioral Milestones:
 * 3-4 months Spontaneous social smile.
 * 3-4 months Brings hands together and watches them.
 * 3-4 months Pulls cloths over face when playing.
 * 3-4 months Recognizes feeding bottle.
 * recognizing caregiver
 * play simple games
 * has improved communication (more signals, such as grinning, squealing, or frowning)
 * Recognizes face (which they can clearly see), scent, and voice of caregiver(s)

Advanced Skills (a few can do):
 * Rolls over, from tummy to back
 * Turns toward loud sounds

Use a high voice and short words (parentese). Baby's smile is now real, not just a reflex. Baby has learned that smiling gets them interaction. If baby does not track objects, coo and gurgle, smile, and support head well, there may be a developmental delay. Problems can be treated if they are caught early on.

Fourth Month

 * pushing up when on tummy
 * holding head up steadily
 * reaching for objects - improves hand-eye coordination
 * recognizing various family members
 * push up tummy and head with arms
 * baby can learn words in many languages and talking to them makes them feel important

Physical Milestones:
 * 4 months the average child should weigh 14 lb. height 25 in. (weight gain between 2 lb. 8 oz. and 3 lb. 8 oz. and a height gain of 4 inches from 2 months)
 * 4 months - 2 years 350-550 ml/day liquid elimination
 * 4 months a 2 inch increase of head circumference from 2 month old size
 * 4 months Moro reflex (If the infant's weight is removed by lifting it's body slightly and releasing suddenly. The infant should have a "startled" look, and fling it's arms out sideways with the palms up and the thumbs flexed.), tonic reflex (The tonic neck reflex is elicited when the head of a relaxed child, lying supine, is rotated to the side. The arm toward which the infant is facing extends straight away from the body with the hand partially open while the arm on the side away from the face is flexed and the fist is clenched tightly. Reversing the direction in which the face is turned reverses the position.), rooting reflex (If the cheek is stroked the infant will turn toward the side that was stroked and begin to make sucking motions with its mouth.), and Perez reflex disappearing
 * 4 months almost no head lag while in a sitting position
 * 4 months able to sit straight up if propped
 * 4 months able to raise head 90 degrees when placed on stomach
 * 4 months able to roll from tummy to back, and from back to one side
 * 4 months tries to reach objects with hands, but commonly overshoots
 * 4 months plays with rattle when placed in hands, but unable to pick it up if dropped
 * 4 months grasps rattle with both hands
 * 4 months able to place objects in mouth
 * 4-6 months Can bear weight on legs in a standing position

Sensory and Cognitive Milestones:
 * 4 months close vision well established
 * 4 months eye-hand coordination beginning
 * 4 months can make the consonant sounds: n, k, p, g, b
 * 4 months laughs out loud, smiles
 * 4 months anticipates feeding when able to see a bottle (if bottle-fed)
 * 4 months begins to show memory
 * 4 months demands attention by fussing
 * 4-5 months coos when talked to, curious and interested in environment

Advanced Skills (a few can do):
 * Imitates sounds: "baba," "dada"
 * Cuts first tooth
 * May be ready for solid foods

Fifth Month
Physical Milestones:
 * 5-9 months lower central incisors (2) [deciduous]
 * purposeful grasp
 * roll over
 * head lag disappears
 * reaches for objects
 * plays with hands and feet
 * exercises body by stretching, moving
 * may rock on stomach for pleasure or touch body
 * rolling over from back to front – encourage by using interesting object
 * holding onto objects
 * responding vocally
 * 5-6 months Brings objects to mouth (mouthing objects)
 * 5-6 months Rolls over in both directions
 * 5-7 months Sits without support
 * 5-8 months Transfers objects from hand to hand

Social/Behavioral Milestones:
 * 5 months Responsive to social stimuli; facial expressions of emotion
 * 5-6 months Puts everything in mouth (mouths objects).
 * 5-6 months Plays with toes and grasps feet.
 * 5-6 months Pats bottle with both hands when being fed.
 * 5-6 months Smiles or talks to image in mirror.
 * 5-7 months Separation anxiety begins

Cognitive Milestones:
 * Distinguishes between bold colors

Emerging Skills (half can do):
 * Recognizes own name
 * Turns toward new sounds

Making Your Home Child-Friendly
Get down to your baby's level and make your house child-friendly by securing what needs to be secured, and having areas and objects that are the right size for your child, as well as finding developmentally-appropriate activities and toys.

Sixth Month
Physical Milestones:
 * 6 months accommodation (pupil dilation for distant objects) present
 * 6 months the average child should weigh 18 lb. height 26 1/2 in.
 * 6 months should have doubled birth weight
 * 6 months height gain of 6 inches
 * 6 months a 3-inch increase of head circumference
 * 6 months able to lift chest and head while on stomach bearing the weight on hand
 * 6 months able to sit in a high chair with a straight back
 * 6 months beginning of teething
 * 6 months increased drooling
 * 6 months beginning of Landau reflex (when an infant is held in the prone position, the entire body forms a convex upward arc; gentle pressure on the head or gravity flexes the neck and hip, reversing the arc)
 * 6 months able to pick up a dropped object
 * 6-7 months Drags objects toward self by "raking" with hands
 * 6-7 months palmar grasp reflex disappears
 * 6-7 months Lunges forward or starts crawling
 * 6-8 months able to hold own bottle
 * 6 -12 months sleeps 10-12 hours per night & 20min. to 3 hours daytime naps

Sensory and Cognitive Milestones:
 * 6 months vision has improved to between 20/60 and 20/40
 * 6 months can localize sounds not made in a direct plane with the ear
 * 6 months prefers more complex auditory stimulation
 * 6 months starts to imitate sounds, babbles
 * 6 months sounds resemble one-syllable words
 * 6 months enjoys hearing own voice
 * 6 months makes sounds to mirror and toys
 * 6 months begins to fear strangers
 * 6 months recognizes parents
 * 6 months begins to imitate actions
 * 6 months realizes that if an object is dropped it is still there and just needs to be picked up (object
 * 6-9 months Jabbers or combines syllables

Mastered Skills (most can do):
 * Turns toward sounds and voices
 * Imitates sounds

Emerging Skills (half can do):
 * Is ready for solid foods

Seventh Month
Physical Milestones:
 * sits in “tripod”
 * 7-9 months Stands while holding onto something
 * 7-9 months Bangs objects together

Social/Behavioral Milestones:
 * 7-8 months Pats image of self in mirror.
 * 7-8 months Feeds self cracker.
 * 7-8 months Responds to name.
 * 7-12 months Waves goodbye
 * 7-10 months Starts to experience stranger anxiety

Eighth Month
Physical Milestones:
 * 8 months the average child should weigh 20 lb. height 27 in.
 * 8 months Says "mama" and "dada" to both parents (isn't specific)
 * 8-9 months Pulls self to standing, cruises
 * 8-10 months Picks things up with thumb-finger pincer grasp
 * 8-10 months Indicates wants with gestures
 * 8-10 months Crawls well, with belly off the ground
 * 8-12 months upper central incisors (2) [deciduous]
 * 8-12 months sit up strongly without support
 * 8-12 months creep and pull himself up
 * 8-12 months begin to use one hand more than the other
 * 8-12 months begin chopped foods
 * 8-12 months make sounds like da-da and ma-ma

Emerging Skills (half can do):
 * Points at objects
 * Searches for hidden objects

Ninth Month
Physical Milestones:
 * gets to and from sitting
 * crawls, pulls to standing
 * stooping and recovering
 * finger-thumb opposition
 * eye-hand coordination, but no hand preference
 * 9 months weight should increase by 2 lb. 4 oz. to 3 lb. 12 oz.
 * 9 months height gain of 1 ½ inches since 6 months old
 * 9 months bowel and bladder systems become more regulated
 * 9 months parachute reflex (If the child is held upright and the body is rotated quickly face forward as if falling. The arms are reflexively extended as if to break a fall to protect self from falling.) appears
 * 9 months can remain sitting for prolonged periods
 * 9 months may pull self to standing position
 * 9 months begins preference for dominant hand
 * 9 months has a pincer grasp between thumb and index finger
 * 9-12 months plantar reflex (if the sole of the foot is irritated with an object, the infant's toes will contract) disappears
 * 9-12 months neck righting reflex (the infant will rotate the truck in the direction in which the head of the supine infant is turned) disappears

Sensory and Cognitive Milestones:
 * 9 months development of depth perception
 * 9 months can respond to simple commands (understands simple instructions)
 * 9 months understands the meaning of no
 * 9 months may be afraid of being left alone
 * discriminates between parents and others
 * trial and error problem solving

Social/Behavioral Milestones:
 * 9 months Socially interactive
 * 9-10 months May not want to be left by mother.
 * 9-10 months Puts hands around cup.
 * 9-11 months Plays games (i.e., pattycake and peek-a-boo) with caretakers
 * 9-11 months Shows shyness, fear of strangers, and clings to familiar persons.
 * 9-11 months Says "mama" and "dada" to the correct parent

Emerging Skills (half can do):
 * Drinks from a sippy cup
 * Eats with fingers

Tenth Month
Physical Milestones:
 * 10 months the average child should weigh 22 lb. height 29 in.
 * 10-11 months Stands alone for a couple of seconds
 * 10-12 months upper lateral incisors (2) [deciduous]

Language Milestones:
 * 10-11 months Says 2-3 words besides "mama" and "dada"
 * Imitates familiar words
 * Recognizes words as symbols for objects: Car - points to garage, cat - meows

Advanced Skills (a few can do):
 * Puts objects into a container

Eleventh Month
Social Milestones:
 * solitary play

Mastered Skills (most can do):
 * Cruises (walks while holding onto furniture)

Advanced Skills (a few can do):
 * Says one word besides "mama" and "dada"
 * Stoops from standing position

=Toddlers=

Twelfth Month
Physical Milestones:
 * 1-2 years pulse rate 105 ± 1.8
 * 1-2 year blood pressure 96 ± 27 systolic, 65 ± 27 diastolic
 * 1-2 year pulse 80-140, respiration 28-32
 * 1-2 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
 * 1-2 year PaO2 85-100, PaCO2 35-45
 * 12 months the average child should weigh 23 lb. height 30 in.
 * 12 months weight should have tripled since birth and height should have increased by 50% over birth length
 * 12 months the head circumference should equal that of the chest
 * 12 months the anterior fontanelle (the front soft spot on the head) should be almost closed
 * 12 months the average child should have 6 teeth; lower lateral incisors (2) [deciduous] & anterior molars (4) [deciduous]
 * 12 months - 2 1/2 years sleeps 10-12 hours night
 * 12 months needs 6-8 diapers a day minimum
 * 12 months may recognize when he has wet or soiled himself
 * 12 months may walk a wide-legged gait, but may prefer crawling
 * 12 months may walk with the support of one hand
 * 12 months may stack blocks and try to build a tower out of two blocks
 * 12 months turns through pages of a book by flipping many at a time
 * 12 months can sit down without help
 * 12 months may get to a standing position from a squat, pivot a quarter of the way around, and lower himself to a sitting position
 * 12 months may become a very picky eater, and become more negative, especially at meals and naptime
 * 12 months may give attention to people and objects
 * 12 months may have renewed fear of strangers and strange situations
 * 12-15 months walk alone or with a little help
 * 12-15 months lower himself from a standing to a sitting position
 * 12-15 months hold a cup to drink from
 * 12-18 months learns bowel control
 * 12-18 months Babinski sign (when the lateral aspect of the sole of the relaxed foot is stroked, the great toe is flexed) disappears
 * 12-24 months voids liquid waste 8+ times a day
 * 12-24 months Landau reflex disappears

Social/Behavioral Milestones:
 * 12 months Cooperative with dress.
 * 12 months Holds arm or leg out.
 * 12 months Gives toys upon request.
 * 12 months Drinks from cup without help.

Sensory and Cognitive Milestones:
 * 12 months follows a fast moving object
 * 12 months has control over response to sounds
 * 12 months searches for objects that are hidden, but unable to consider alternative locations
 * 12 months may develop attachment to a toy or object
 * 12 months experiences separation anxiety and may cling to parents
 * 12 months may make brief exploratory journeys away from parents in familiar settings
 * beginning of symbolic thinking
 * points to pictures in books in response to verbal cue
 * object permanence
 * some may use single words
 * receptive language more advanced than expressive language

Language Milestones:
 * 12 months comprehends several words
 * 12 months can say mamma, papa and at least two other words
 * 12 months comprehends simple commands
 * 12 months tries to imitate animal sounds
 * 12 months associates names with objects
 * 12-15 months say a few words
 * 12-15 months combines two words such as "daddy bye-bye"

Social/Behavioral Milestones:
 * 12 months Waves good-bye and plays pat-a-cake
 * 12 months Gives a toy when asked
 * 12 months Pints to his or her toes, eyes, and nose
 * 12 months Brings object from another room when asked

Emotional Milestones:
 * 12-18 months: “terrible twos” may begin; willful, stubborn, tantrums
 * 12-36 months: mastery of body and rudimentary mastery of environment (can get other’s to take care of him)

Mastered Skills (most can do):
 * Imitates others' activities
 * Indicates wants with gestures

Emerging Skills (half can do):
 * Takes a few steps
 * Says one word besides "mama" and "dada"

Advanced Skills (a few can do):
 * Walks alone
 * Scribbles with a crayon
 * Says two words besides "mama" and "dada"

Thirteenth Month
Mastered Skills (most can do):
 * Uses two words skillfully (e.g., "hi" and "bye")
 * Bends over and picks up an object

Emerging Skills (half can do):
 * Enjoys gazing at his reflection
 * Holds out arm or leg to help you dress him

Advanced Skills (a few can do):
 * Combines words and gestures to make needs known
 * Rolls a ball back and forth

Fourteenth Month
Physical Milestones:
 * 14 months the average child should weigh 24 lb. height 31 in.

Mastered Skills (most can do):
 * Eats with fingers
 * Empties containers of contents
 * Imitates others

Emerging Skills (half can do):
 * Toddles well
 * Initiates games
 * Points to one body part when asked
 * Responds to instructions (e.g., "give me a kiss")

Advanced Skills (a few can do):
 * Uses a spoon or fork
 * Matches lids with appropriate containers
 * Pushes and pulls toys while walking

Fifteenth Month
Physical Milestones:
 * more complex motor skills
 * Plays with ball
 * Walks backward
 * 15-18 months show a little cooperation at being dressed
 * 15-18 months walk alone
 * 15-18 months use a spoon
 * 15-18 months fit a peg into its proper hole

Language Milestones:
 * 15-18 months have a five to ten word vocabulary

Social/Behavioral Milestones:
 * 15 months Feeds self.
 * 15 months Uses a spoon, but is messy.
 * 15 months Imitates mother in household duties.
 * learns through imitating complex behaviors
 * knows objects are used for specific purposes

Emerging Skills (half can do):
 * Scribbles with a crayon
 * Runs
 * Adopts "no" as his favorite word

Advanced Skills (a few can do):
 * "Helps" around the house
 * Puts his fingers to his mouth and says "shhh"

Sixteenth Month
Mastered Skills (most can do):
 * Turns the pages of a book
 * Has temper tantrums when frustrated
 * Becomes attached to a soft toy or other object

Emerging Skills (half can do):
 * Discovers the joy of climbing
 * Stacks three blocks
 * Learns the correct way to use common objects (e.g., the telephone)
 * 16-19 months Uses spoon and fork

Advanced Skills (a few can do):
 * Takes off one piece of clothing by himself
 * Gets finicky about food
 * Switches from two naps to one

Seventeenth Month
Mastered Skills (most can do):
 * Uses six words regularly
 * Enjoys pretend games
 * Likes riding toys

Emerging Skills (half can do):
 * Feeds doll
 * Speaks more clearly
 * Throws a ball underhand

Advanced Skills (a few can do):
 * Dances to music
 * Sorts toys by color, shape, or size
 * Kicks ball forward

Eighteenth Month
Physical Milestones:
 * 18 months fontanelle closes
 * 18 months the average child should have 12 teeth
 * 18 months the average child should weigh 26 lb. height 32 1/2 in.
 * 18 months growth slows
 * 18 months the child is physically able to control sphincter muscles, but the child may not be psychologically ready to use the toilet
 * 18 months there are usually two bowel movements per day; after breakfast and after supper, there may be a third in the midmorning standing at the side of the crib or playpen
 * 18 months able to run with a lack of coordination
 * 18 months falls frequently
 * 18 months able to jump in place
 * 18 months able to get onto chairs without assistance
 * 18 months can build a tower of 4 blocks
 * 18 months can turn the pages of a book two or three at a time
 * 18 months abdomen protrudes, arms and legs lengthen
 * 18 months fine muscle coordination begins to develop
 * 18 months big muscles become well developed
 * 18 months Throws a ball overhand
 * 18-24 months eliminates liquid waste every 2-3 hours
 * 18-24 months canines (4) [deciduous]
 * 18-24 months good control with a spoon
 * 18-24 months throw a ball into a box
 * 18-24 months build a high tower with blocks
 * 18-24 months may start toilet training
 * 18-24 months Can walk down stairs

Sensory and Cognitive Milestones:
 * 18 months understands and able to identify common objects through pointing
 * 18 months frequently imitates
 * 18 months able to take off some clothing items; gloves, shoes & socks
 * 18 months begins to feel a sense of ownership identifying people and objects by saying "my"

Language Milestones:
 * Strings two words together in phrases
 * 18 months can say 10 or more words
 * 18 months uses words such as "more" to make wants known
 * 18-24 months say short sentences

Social/Behavioral Milestones:
 * 18 months Drinks without much spilling.
 * 18 months Can take off clothes.
 * Will "read" board books on his own
 * Scribbles well

Emotional Milestones:
 * 18-36 mo: feel pride when they are “good” and embarrassment when they are “bad”
 * 18-36 mo: Can recognize distress in others – beginning of empathy
 * 18-36 mo: are emotionally attached to toys or objects for security

Emerging Skills (half can do):
 * Brushes teeth with help

Advanced Skills (a few can do):
 * Takes toys apart and puts them back together
 * Shows signs of toilet training readiness

Nineteenth Month
Mastered Skills (most can do):
 * Runs
 * Throws a ball underhand
 * Enjoys helping around the house

Emerging Skills (half can do):
 * Understands as many as 200 words
 * Recognizes when something is wrong (e.g., calling a dog a cat)

Advanced Skills (a few can do):
 * Washes and dries own hands with help
 * Points to picture or object when you call it by name
 * May know when she needs to pee

Twentieth Month
Physical Milestones:
 * Feeds doll
 * Takes off own clothes
 * Dumps an object in imitation, such as throwing garbage away
 * 20-21 months Can walk up stairs (but probably not down)

Emerging Skills (half can do):
 * Learns words at a rate of ten or more a day

Advanced Skills (a few can do):
 * May start exploring body
 * Draws a straight line
 * Names several body parts

Twenty-first Month
Mastered Skills (most can do):
 * Able to set simple goals (e.g., deciding to put a toy in a certain place)

Emerging Skills (half can do):
 * Kicks ball forward
 * Stacks six blocks

Advanced Skills (a few can do):
 * Names simple picture in a book

Twenty-second Month
Mastered Skills (most can do):
 * Kicks ball forward
 * Follows two-step requests (e.g., "Get your doll and bring it here")

Emerging Skills (half can do):
 * Does simple puzzles
 * Draws a straight line
 * Names several body parts

Advanced Skills (a few can do):
 * Puts on loose-fitting clothes
 * Might be ready for a big bed
 * Understands opposites (e.g., tall vs. short)

Twenty-third Month
Mastered Skills (most can do):
 * Names simple picture in a book
 * Uses 50 to 70 words

Emerging Skills (half can do):
 * Opens doors
 * Sings simple tunes
 * Takes more of an interest in playing with other kids

Advanced Skills (a few can do):
 * Talks about self (likes, dislikes)
 * Asks "why?"

Twenty-Fourth Month
Physical Milestones:
 * 2-12 1/2 years respiration rate 20 to 26 respirations per minute
 * 2-3 years pulse rate 93 ± 1.0
 * 2-3 year blood pressure 95 ± 24 systolic, 61 ± 24 diastolic
 * 2-3 year pulse 80-140, respiration 28-32
 * 2-3 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
 * 2-3 year PaO2 85-100, PaCO2 35-45
 * 2-3 1/2 years learns bladder control
 * 24 months the average child should have 16 teeth
 * 24 months the average child should weigh 28 lb. height 34 1/2 in.
 * 2 years average female weight 26.4 lb. height 34 in.
 * 2 years average male weight 28.6 lb. height 34 in.
 * 2 years the circumference of the head should have increased to about 20 inches
 * 2 years the circumference of the growing chest should be larger than that of the head
 * 2 years the height is roughly half the total height the child will attain as an adult
 * 2 years the percent of (male) adult value of thigh 37%, calf 42%, foot 52%, upperarm 40%, forearm 47%, hand 54%
 * 2 years protruding abdomen less noticeable
 * 2 years may be psychologically ready for toilet training
 * 2 years may be bowel trained and may have daytime bladder control
 * 2 years can run with better coordination, while the stance may remain wide
 * 2 years can kick ball without loosing balance
 * 2 years can pick up objects while standing without losing balance
 * 2 years can build a tower of 7 blocks
 * 2 years can browse through a book one page at a time
 * 24-27 months able to turn a door knob and open door
 * 24-30 months posterior molars (4) [deciduous]
 * 2-3 years Lordosis and protuberant abdomen of toddler disappear
 * 2-10 years 500-1000 ml/day liquid elimination

Sensory and Cognitive Milestones
 * vision fully developed
 * vocabulary has increased to about 300 words
 * can organize phrases of 2 to 3 words
 * able to communicate needs such as thirst, hunger, need to use the restroom
 * increased attention span
 * able to clothe self in simple apparel

Language Milestones:
 * Identifies body parts
 * Carries on 'conversation' with self and dolls
 * Asks "what's that?" And "where's my?"
 * Uses 2-word negative phrases such as "no want".
 * Forms some plurals by adding "s"; book, books
 * Has a 450 word vocabulary
 * Gives first name, holds up fingers to tell age
 * Combines nouns and verbs "mommy go"
 * Understands simple time concepts: "last night", "tomorrow"
 * Refers to self as "me" rather than by name
 * Tries to get adult attention: "watch me"
 * Likes to hear same story repeated
 * May say "no" when means "yes"
 * Talks to other children as well as adults
 * Solves problems by talking instead of hitting or crying
 * Answers "where" questions
 * Names common pictures and things
 * Uses short sentences like "me want more" or "me want cookie"
 * Matches 3-4 colors, knows big and little
 * 2 word phrases
 * uses more complex toys and understands sequence of putting toys and puzzles together

Social/Behavioral Milestones:
 * 2 years Helps dress self.
 * 2 years Less messy when eating.
 * 2 years Washes and dries hands.
 * Imitation, parallel, and symbolic play

Mastered Skills (most can do):
 * Names at least six body parts
 * Half of speech is understandable
 * Makes two- to three-word sentences

Emerging Skills (half can do):
 * Talks about self
 * Arranges things in categories

Advanced Skills (a few can do):
 * Begins to understand abstract concepts (e.g., sooner and later)
 * Becomes attuned to gender differences
 * Learns to jump

Twenty-fifth Month
25-26 mo. Mastered Skills (most can do):
 * Stacks six blocks
 * Walks with smooth heel-to-toe motion

Emerging Skills (half can do):
 * Uses pronouns (e.g., I, me, you)
 * Washes and dries own hands

Advanced Skills (a few can do):
 * Speaks clearly most of the time
 * Draws a vertical line

Twenty-sixth Month
Mastered Skills (most can do):

Emerging Skills (half can do):

Advanced Skills (a few can do):

Twenty-seventh Month
27-29 mo. Mastered Skills (most can do):
 * Jumps with both feet
 * Opens doors

Emerging Skills (half can do):
 * Understands descriptions (e.g., big, soft)
 * Draws a vertical line

Advanced Skills (a few can do):
 * Starts to recognize ABC's
 * Balances on one foot

Twenty-eighth Month
Mastered Skills (most can do):

Emerging Skills (half can do):

Advanced Skills (a few can do):

Twenty-ninth Month
29-30 mo. Mastered Skills (most can do):
 * Brushes teeth with help
 * Washes and dries own hands
 * Draws a vertical line

Emerging Skills (half can do):
 * Draws a circle
 * Balances on one foot

Advanced Skills (a few can do):
 * Puts on a T-shirt
 * Names one color
 * Names one friend

Thirtieth Month
Physical Milestones:
 * 2 1/2 years the average child should have 20 teeth
 * 30 months the average child should weigh 32 lb. height 36 in.
 * 2 1/2 years average female weight 28.6 lb. height 351/2 in.
 * 2 1/2 years average male weight 30.8 lb. height 35 1/2 in.
 * 2 1/2 years has full set of baby teeth

Social/Behavioral Milestones:
 * 2 ½ years Helps put things away.
 * 2 ½ years Domestic make believe play.
 * 2 ½ years Toilet trained during the day.

Mastered Skills (most can do):

Emerging Skills (half can do):

Advanced Skills (a few can do):

Thirty-First Month
31-32 mo. Mastered Skills (most can do):
 * Recites own name
 * Draws a circle

Emerging Skills (half can do):
 * Puts on a T-shirt
 * Balances on each foot for a second
 * Recognizes ABCs
 * Brushes teeth by herself

Advanced Skills (a few can do):
 * Uses two adjectives
 * Draws a cross
 * Points to objects described by use

Thirty-Second Month
Mastered Skills (most can do):

Emerging Skills (half can do):

Advanced Skills (a few can do):

Thirty-Third Month
33-34 mo. Mastered Skills (most can do):
 * Names one color
 * Names one friend
 * Carries on a simple conversation

Emerging Skills (half can do):
 * Alternates feet going up and down stairs
 * Uses prepositions (e.g., on, in, over)
 * Speaks clearly most of the time (75 percent can be understood)
 * Stacks eight blocks

Advanced Skills (a few can do):
 * Is toilet trained during the day
 * Wiggles thumb
 * Expresses a wide range of emotions
 * Draws a stick figure

Thirty-Fourth Month
Mastered Skills (most can do):

Emerging Skills (half can do):

Advanced Skills (a few can do):

Thirty-Fifth Month
35-36 mo. Mastered Skills (most can do):
 * Describes how two objects are used
 * Uses three to four words in a sentence
 * Names two actions (e.g., skipping, jumping)

Emerging Skills (half can do):
 * Hops and skips
 * Follows a two- or three-part command
 * Separates fairly easily from parents
 * Rides a tricycle

Advanced Skills (a few can do):
 * Balances on each foot for three seconds
 * Gets dressed without help

Thirty-Sixth Month
Physical Milestones:
 * Physically active
 * Rule of Three: 3 yrs, 3 ft, 33 lbs.
 * Weight gain: 4-5 lbs per year
 * Growth: 3-4 inches per year
 * Physically active, can’t sit still for long
 * Clumsy throwing balls
 * Refines complex skills: hopping, jumping, climbing, running, ride “big wheels” and tricycles
 * Improving fine motor skills and eye-hand coordination: cut with scissors, draw shapes
 * 3– 3 ½ yr: most toilet trained
 * 3-4 years pulse rate 87 ± 0.7
 * 3-4 year blood pressure 99 ± 23 systolic, 65 ± 19 diastolic
 * 3-4 year pulse 80-120, respiration 24-28
 * 3-4 year temperature : 99.6F rectal, 98.6F oral, 97.4F axillary
 * 3-4 year PaO2 85-100, PaCO2 35-45
 * 3 years the average child should weigh 33 lb. height 38 in.
 * 3 years average female weight 30.8 lb. height 37 1/2 in.
 * 3 years average male weight 33 lb. height 37 1/2 in.
 * 3 years the percent of (male) adult value of thigh 44%, calf 47%, foot 58%, upperarm 47%, forearm 52%, hand 56%
 * 3 years during the 3rd year there is usually a weight gain of about 6 pounds
 * 3 years during the 3rd year there is usually a height gain of about 3 inches
 * 3 years should have daytime control over bowel and bladder functions and may have nighttime control as well
 * 3 years may stay dry all night
 * 3 years able to ride three wheel toys such as a tricycle or Big Wheel
 * 3 years improved balance
 * 3 years able to briefly balance on one foot
 * 3 years may walk up the stairs with alternating feet
 * 3 years can construct a block tower of 9 to 10 cubes
 * 3 years can easily place small objects in a small opening
 * 3 1/2 years the average child should weigh 35 lb. height 39 in.
 * 3 1/2 years average female weight 33 lb. height 38 1/2 in.
 * 3 1/2 years average male weight 35.2 lb. height 39 in.

Sensory and Cognitive Milestones:
 * 3 years able to completely clothe self, only requiring assistance with laces, buttons, and other fasteners in awkward places
 * 3 years attention span increasing
 * 3 years feeds self without difficulty
 * 3 years able to prepare uncomplicated meals
 * 3 years may experience an increase in imaginary fears
 * 3 years realization of own self and that of others
 * 3 years social encounters are acted out through play activities
 * 3 years both thought and behavior are egocentric
 * 3 years beginning to grasp the concept of time
 * 3 years decrease in separation anxiety for short periods of time
 * Ego-centric, illogical, magical thinking
 * Explosion of vocabulary; learning syntax, grammar; understood by 75% of people by age 3
 * Poor understanding of time, value, sequence of events
 * Vivid imaginations; some difficulty separating fantasy from reality
 * Accurate memory, but more suggestible than older children
 * Primitive drawing, can’t represent themselves in drawing till age 4
 * Don’t realize others have different perspective
 * Leave out important facts
 * May misinterpret visual cues of emotions
 * Receptive language better than expressive till age 4
 * Play: Cooperative, imaginative, may involve fantasy and imaginary friends, takes turns in games
 * Develops gross and fine motor skills; social skills; experiment with social roles; reduces fears
 * Wants to please adults
 * Development of conscience: incorporates parental prohibitions; feels guilty when disobedient; simplistic idea of “good and bad” behavior
 * Curious about his and other’s bodies, may explore body more
 * No sense of privacy
 * Primitive, stereotypic understanding of gender roles

Language Milestones:
 * Can tell a story
 * Has a vocabulary of nearly 1000 words
 * Has a sentence length of 4-5 words
 * frequently asks questions
 * speech is nearly constant regardless of the presence of an audience
 * Names at least one color
 * Understands "yesterday," "summer", "lunchtime", "tonight", "little-big"
 * Begins to obey requests like "put the block under the chair"
 * Knows his or her last name, name of street on which he/she lives and several nursery rhymes

Social/Behavioral Milestones:
 * 3 years Feeds self well.
 * 3 years Drinks with help.
 * 3 years Puts on socks.
 * 3 years Likes to help mother (set table & clean).
 * 3 years Sometimes shares things.

Emotional Milestones:
 * Self-esteem based on what others tell him or her Increasing ability to control emotions; less emotional outbursts
 * Increased frustration tolerance
 * Better delay gratification
 * Rudimentary sense of self
 * Understands concepts of right and wrong
 * Self-esteem reflects opinions of significant others
 * Curious
 * Self-directed in many activities

Possible Effects of Maltreatment:
 * Poor muscle tone, motor coordination
 * Poor pronunciation, incomplete sentences
 * Cognitive delays; inability to concentrate
 * Cannot play cooperatively; lack curiosity, absent imaginative and fantasy play
 * Social immaturity: unable to share or negotiate with peers; overly bossy, aggressive, competitive
 * Attachment problems: overly clingy, superficial attachments, show little distress or over-react when separated from caregiver
 * Underweight from malnourishment; small stature
 * Excessively fearful, anxious, night terrors
 * Reminders of traumatic experience may trigger severe anxiety, aggression, preoccupation
 * Lack impulse control, little ability to delay gratification
 * Exaggerated response (tantrums, aggression) to even mild stressors
 * Poor self esteem, confidence; absence of initiative
 * Blame self for abuse, placement
 * Physical injuries; sickly, untreated illnesses
 * Eneuresis, encopresis, self stimulating behavior – rocking, head-banging

=Young Children=

Fourth Year
Physical Milestones:
 * 4-5 years pulse rate 84 ± 0.7
 * 4 years the average child should weigh 37 lb. height 40 1/2 in.
 * 4 years average female weight 35.2 lb. height 40 in.
 * 4 years average male weight 37.4 lb. height 40 1/2 in.
 * 4 years the percent of (male) adult value of thigh 48%, calf 53%, foot 62%, upperarm 54%, forearm 56%, hand 60%
 * 4 years muscle width, arm + calf 8.2cm
 * 4 years weight gain of about 6 pounds during the 4th year
 * 4 years the height should be double their length at birth
 * 4 years improved balance
 * 4 years hops on one foot without losing balance
 * 4 years throws a ball overhand with coordination
 * 4 years skillfully cuts out a picture using scissors
 * 4 years may not be able to tie shoelaces
 * 4 years dry though night
 * 4-6 years average child weighs 44 lb. height 44 in.
 * 4 1/2 years the average child should weigh 39 lb. height 41 1/2 in.
 * 4 1/2 years average female weight 37.4 lb. height 41 1/2 in.
 * 4 1/2 years average male weight 39.6 lb. height 42 1/2 in.

Sensory and Cognitive Milestones: Language Milestones:
 * 4 years tries to be very independent
 * 4 years increased aggressive behavior
 * 4 years readily discloses personal family matters to others
 * 4 years imaginary playmates are common
 * 4 years increased comprehension of time
 * 4 years able to distinguish between two objects based on simple criteria (such as size, weight, and so forth)
 * 4 years less egocentric behavior
 * 4 years believes that their thought and emotions are causative events
 * 4 years lack moral concept of right and wrong
 * 4 years rebellion is common if expectations are excessive
 * Has a vocabulary of nearly 1500 words
 * Has sentence length of 4-5 words
 * Uses past tense correctly
 * Points to colors red, blue, yellow and green
 * Identifies triangles, circles and squares
 * Understands "In the morning", "next", "noontime"
 * Can speak of imaginary conditions such as "I hope"
 * Asks many questions, asks "who?" And "why?"
 * The age when the child will ask the most questions
 * May use words outside their comprehension
 * May begin using vulgar terms, depending on their exposure (can be reduced or eliminated if adults in the home do not use it either)
 * Learns and sings simple songs

Social/Behavioral Milestones:
 * 4 years Dresses self unassisted.
 * 4 years Can button clothes.
 * 4 years Washes and dries hands and brushes teeth unassisted.
 * 4 years Understands taking turns.

Fifth Year
Physical Milestones:
 * 5-6 years pulse rate 79 ± 0.6 and respiratory rate may decrease
 * 5 years the average child should weigh 42 lb. height 43 in.
 * 5-9 years early Lordosis disappears
 * 5-9 begins to lose baby teeth; first permanent teeth begin to erupt, permanent teeth then appear at a rate of 4 teeth per year from 7-14 years
 * 5-12 Slow, steady growth: 3-4 inches per year
 * 5-12 Use physical activities to develop gross and fine motor skills
 * 5-12 Motor & perceptual motor skills better integrated
 * 5 years average female weight 39.6 lb. height 42 1/2 in.
 * 5 years average male weight 41.8 lb. height 43 1/2 in.
 * 5 years the percent of (male) adult value of thigh 54%, calf 57%, foot 66%, upperarm 57%, forearm 60%, hand 64%
 * 5 years muscle width, arm + calf 8.5cm
 * 5 years increased coordination
 * 5 years skips, jumps, and skates with good balance
 * 5 years able to maintain balance while standing on one foot with eyes closed
 * 5 years able to tie own shoelaces
 * 5 years increased skill with simple tools and writing utensils
 * 5 1/2 years average female weight 41.8 lb. height 44 in.
 * 5 1/2 years average male weight 44 lb. height 44 1/2 in.

Sensory and Cognitive Milestones:
 * 5 years increasingly responsible
 * 5 years decreased aggressiveness
 * 5 years some fears from earlier childhood are disappearing
 * 5 years able to accept the validity of others view and perspective, but may not understand it
 * 5 years increased mathematical skill
 * 5 years does not hesitate to question others, including parents
 * 5 years there is a strong identification with the parent of the same sex
 * 5-8 yr: can recognize others’ perspectives, can’t assume the role of the other
 * 5-12 years Use language as a communication tool
 * 5-12 years Concrete operations: Accurate perception of events; rational, logical thought; concrete thinking; reflect upon self and attributes; understands concepts of space, time, dimension
 * 5-12 years Can remember events from months, or years earlier
 * 5-12 years More effective coping skills
 * 5-12 years Understands how his behavior affects others

Language Milestones:
 * Has a vocabulary of around 2000 words
 * Has a sentence length of 5-6 words
 * Defines objects by their use (you eat with a fork) and can tell what objects are made of
 * Knows spatial relations like "on top", "behind", "far" and "near"
 * Knows the names of the primary colors and may know the names of many more
 * Knows her address
 * Identifies a penny, nickel and dime
 * Knows common opposites like "big/little"
 * Understands "same" and "different"
 * Counts ten objects
 * Asks questions for information
 * Distinguished left and right hand in herself
 * Can compose sentences with all parts of speech
 * Questions are less superficial, addressing meaning and purpose
 * Uses all types of sentences, for example "let's go to the store after we eat"

Social/Behavioral Milestones:
 * 5 years Independent and self sufficient. Dresses and undresses self. Ties shoelaces. Uses knife and fork.
 * 5-6 yr: believe rules can be changed
 * 5-12 Friendships are situation specific
 * 5-12 Understands concepts of right and wrong
 * 5-12 Rules relied upon to guide behavior and play, and provide child with structure and security
 * 5-12 Begin understanding social roles; regards them as inflexible; can adapt behavior to fit different situations; practices social roles
 * 5-12 Takes on more responsibilities at home
 * 5-12 Less fantasy play, more team sports, board games
 * 5-12 Morality: avoid punishment; self interested exchanges

Emotional Milestones:
 * 5-12 Self esteem based on ability to perform and produce
 * 5-12 Alternative strategies for dealing with frustration and expressing emotions
 * 5-12 Sensitive to other’s opinions about themselves

Possible Effects of Maltreatment of Children Ages 5-12
 * Poor social/academic adjustment in school: preoccupied, easily frustrated, emotional outbursts, difficulty concentrating, can be overly reliant on teachers; academic challenges are threatening, cause anxiety
 * Little impulse control, immediate gratification, inadequate coping skills, anxiety, easily frustrated, may feel out of control
 * Extremes of emotions, emotional numbing; older children may “self-medicate” to avoid negative emotions
 * Act out frustration, anger, anxiety with hitting, fighting, lying, stealing, breaking objects, verbal outbursts, swearing
 * Extreme reaction to perceived danger (i.e., “fight, flight, freeze” response)
 * May be mistrustful of adults, or overly solicitous, manipulative
 * May speak in unrealistically glowing terms about his parents
 * Difficulties in peer relationships; feel inadequate around peers; over-controlling
 * Unable to initiate, participate in, or complete activities, give up quickly
 * Attachment problems: may not be able to trust, tests commitment of foster and adoptive parent with negative behaviors
 * Role reversal to please parents, and take care of parent and younger siblings
 * Emotional disturbances: depression, anxiety, post traumatic stress disorder, attachment problems, conduct disorders

=Older Children=

Sixth Year
Physical Milestones:
 * 6-7 years pulse rate 76 ± 0.6
 * 6 years average female weight 44 lb. height 45 1/2 in.
 * 6 years average male weight 46.2 lb. height 45 1/2 in.
 * 6 years the percent of (male) adult value of thigh 58%, calf 62%, foot 70%, upperarm 62%, forearm 63%, hand 66%
 * 6 years muscle width, arm + calf 8.8cm
 * 6-7 years first molars (4) [permanent]
 * 6 1/2 years average female weight 46.2 lb. height 46 1/2 in.
 * 6 1/2 years average male weight 48.4 lb. height 47 in.

Language Milestones:
 * At six years the vocabulary has increased to over 2100 words
 * At six years readily composes sentences of 6 to 8 words

Emotional Milestones:
 * 6-9 years has questions about the human body

Seventh Year
Physical Milestones:
 * 7 years PMI located 5th or 6th left intercostal space at the midclavicular line or slightly medial to it
 * 7-8 years pulse rate 75 ± 0.7
 * 7 years average female weight 48.4 lb. height 47 1/2 in.
 * 7 years average male weight 50.6 lb. height 48 1/2 in.
 * 7 years the percent of (male) adult value of thigh 63%, calf 65%, foot 73%, upperarm 66%, forearm 67%, hand 69%
 * 7 years muscle width, arm + calf 9cm
 * 7-8 years incisors (8) [permanent]
 * 7-10 years average child weighs 62 lb. height 52 in.
 * 7 1/2 years average female weight 52.8 lb. height 49 in.
 * 7 1/2 years average male weight 52.8 lb. height 49 in.

Social Milestones:
 * 7-8 years strict adherence to rules

Eighth Year
Physical Milestones
 * 8-9 years pulse rate 73 ± 0.7
 * 8 years average female weight 55 lb. height 50 in.
 * 8 years average male weight 55 lb. height 50 in.
 * 8 years the percent of (male) adult value of thigh 66%, calf 70%, foot 76%, upperarm 69%, forearm 70%, hand 72%
 * 8 years muscle width, arm + calf 9.3cm
 * 8 1/2 years average female weight 59.4 lb. height 50 1/2 in.
 * 8 1/2 years average male weight 59.4 lb. height 51 in.

Cognitive and Sensory Milestones:
 * 8–10 years recognizes difference between behavior and intent; age

Ninth Year
Physical Milestones
 * 9-10 years pulse rate 70 ± 0.6
 * 9 years average female weight 63.8 lb. height 52 in.
 * 9 years average male weight 61.6 lb. height 52 in.
 * 9 years the percent of (male) adult value of thigh 72%, calf 74%, foot 81%, upperarm 72%, forearm 73%, hand 75%
 * 9 years muscle width, arm + calf 9.6cm
 * 9-10 years bicuspids (8) [permanent]
 * 9-12 years childish appearance of face disappears
 * 9 1/2 years average female weight 68.2 lb. height 53 in.
 * 9 1/2 years average male weight 66 lb. height 53 in.

Social Milestones:
 * 9-10 years rules can be negotiated

Tenth Year
Physical Milestones
 * 10-12 yr: puberty begins for some children
 * 10-11 years pulse rate 67 ± 0.6
 * 10 years average female weight 72.6 lb. height 54 1/2 in.
 * 10 years average male weight 70.4 lb. height 54 in.
 * 10 years the percent of (male) adult value of thigh 75%, calf 79%, foot 84%, upperarm 77%, forearm 78%, hand 80%
 * 10 years muscle width, arm + calf 10cm


 * 10-16 years (female) growth rate increase
 * 10 1/2 years average female weight 77 lb. height 56 in.
 * 10 1/2 years average male weight 74.8 lb. height 55 in.

Cognitive and Sensory Milestones:
 * 10-11 years can accurately recognize and consider others’ viewpoints

Emotional Milestones:
 * 10-12 years interested in boy-girl relationships; may reenact what they see

Eleventh Year
Physical Milestones
 * 11-12 years pulse rate 67 ± 0.6
 * 11 years average female weight 81.4 lb. height 57 in.
 * 11 years average male weight 77 lb. height 56 1/2 in.
 * 11 years the percent of (male) adult value of thigh 80%, calf 82%, foot 87%, upperarm 81%, forearm 81%, hand 82%
 * 11 years muscle width, arm + calf 10.3cm
 * 11-14 years average female weight 101 lb. height 62 in.
 * 11-14 years average male weight 99 lb. height 62 in.
 * 11-15 years 700-1400 ml/day liquid elimination
 * 11 1/2 years average female weight 85.8 lb. height 58 1/2 in.
 * 11 1/2 years average male weight 83.6 lb. height 58 in.

=Adolescence=

Physical Milestones:
 * Youth acclimate to changes in body

Cognitive Milestones:
 * Formal operations: precursors in early adolescence, more developed in middle and late adolescence, as follows:
 * Think hypothetically: calculate consequences of thoughts and actions without experiencing them; consider a number of possibilities and plan behavior accordingly
 * Think logically: identify and reject hypotheses or possible outcomes based on logic
 * Think hypothetically, abstractly, logically
 * Think about thought: leads to introspection and self-analysis
 * Insight, perspective taking: understand and consider others’ perspectives, and perspectives of social systems
 * Systematic problem solving: can attack a problem, consider multiple solutions, plan a course of action
 * Cognitive development is uneven, and impacted by emotionality

Social Milestones:
 * Morality: golden rule; conformity with law is necessary for good of society

Emotional Milestones:
 * Psycho-social task is identity formation
 * Additional struggles with identity formation include minority or biracial status, being an adopted child, religious/social identity

Possible Effects of Maltreatment
 * All of the problems listed in school age section
 * Identity confusion: inability to trust in self to be a healthy adult; expect to fail; may appear immobilized and without direction
 * Poor self esteem: pervasive feelings of guilt, self-criticism, overly rigid expectations for self, inadequacy
 * May overcompensate for negative self-esteem by being narcissistic, unrealistically self-complimentary; grandiose expectations for self
 * May engage in self-defeating, testing, and aggressive, antisocial, or impulsive behavior; may withdraw
 * Lack capacity to manage intense emotions; may be excessively labile, with frequent and violent mood swings
 * May be unable to form or maintain satisfactory relationships with peers
 * Emotional disturbances: depression, anxiety, post traumatic stress disorder, attachment problems, conduct disorders

Twelfth Year
Physical Milestones
 * 12-13 years pulse rate 66 ± 0.6
 * 12 years average female weight 92.4 lb. height 60 in.
 * 12 years average male weight 88 lb. height 59 in.
 * 12 years the percent of (male) adult value of thigh 85%, calf 86%, foot 90%, upperarm 83%, forearm 84%, hand 85%
 * 12 years muscle width, arm + calf 10.7cm
 * 12-14 years canines (4) [permanent]
 * 12-15 years second molars (4) [permanent]
 * 12-18 years (male) growth rate increase
 * 12 1/2 years respiration rate 12 to 18 respirations per minute
 * 12 1/2 years the forehead becomes more prominent (caused by the growth of brow ridges and air sinuses), both jaws grow forward(lower more than upper)
 * 12 1/2 years average female weight 96.8 lb. height 61 in.
 * 12 1/2 years average male weight 94.6 lb. height 60 in.

Social Milestones:
 * 12–14: psychologically distance self from parents; identify with peer group; social status largely related to group membership; social acceptance depends on conformity to observable traits or roles; need to be independent from all adults; ambivalent about boy-girl relationships, behavior is exploratory

Emotional Milestones:
 * 12-14: self-conscious about physical appearance and early or late development; body image rarely objective, negatively affected by abuse; emotionally labile; may over-react to parental questions or criticisms; engage in activities for intense emotional experience; risky behavior; blatant rejections of parental standards; rely on peer group for support

Thirteenth Year
Physical Milestones
 * 13-14 years pulse rate 65 ± 0.8
 * 13 years average female weight 101.2 lb. height 62 in.
 * 13 years average male weight 99 lb. height 61 1/2 in.
 * 13 years the percent of (male) adult value of thigh 89%, calf 89%, foot 91%, upperarm 85%, forearm 86%, hand 87%
 * 13 years muscle width, arm + calf 11.3cm
 * 13-14 years (male) enlargement of voice box
 * 13 1/2 years average female weight 105.6 lb. height 62 1/2 in.
 * 13 1/2 years average male weight 105.6 lb. height 63 in.

Fourteenth Year
Physical Milestones
 * 14-15 years pulse rate 62 ± 0.7
 * 14 years average female weight 110 lb. height 63 in.
 * 14 years average male weight 112.2 lb. height 64 in.
 * 14 years the percent of (male) adult value of thigh 92%, calf 92%, foot 94%, upperarm 91%, forearm 91%, hand 91%
 * 14 years muscle width, arm + calf 12cm
 * 14-17 years (male) deepening of voice
 * 14 1/2 years average female weight 114.4 lb. height 63 1/2 in.
 * 14 1/2 years average male weight 118.8 lb. height 65 1/2 in.

Fifteenth Year
Physical Milestones
 * 15 years onward (male) 800-2000 ml/day liquid elimination
 * 15 years onward (female) 800-1600 ml/day liquid elimination
 * 15-16 years pulse rate 61 ± 0.9
 * 15 years average female weight 118.8 lb. height 63 1/2 in.
 * 15 years average male weight 125.4 lb. height 66 1/2 in.
 * 15 years the percent of (male) adult value of thigh 93%, calf 93%, foot 95%, upperarm 92%, forearm 92%, hand 93%
 * 15 years muscle width, arm + calf 12.5cm
 * 15-18 years average female weight 120 lb. height 64 in.
 * 15-18 years average male weight 145 lb. height 69 in.
 * 15 1/2 years average female weight 120 lb. height 64 in.
 * 15 1/2 years average male weight 132 lb. height 67 1/2 in.

Social Milestones
 * 15 – 17: friendships based on loyalty, understanding, trust; self-revelation is first step towards intimacy; conscious choices about adults to trust; respect honesty & straightforwardness from adults; may have deeper relationships

Emotional Milestones:
 * 15-17: examination of others’ values, beliefs; forms identity by organizing perceptions of ones attitudes, behaviors, values into coherent “whole”; identity includes positive self image comprised of cognitive and affective components

Sixteenth Year
Physical Milestones
 * 16-17 years pulse rate 61 ± 0.9
 * 16 years average female weight 120 lb. height 64 in.
 * 16 years average male weight 136.4 lb. height 68 1/2 in.
 * 16 years the percent of (male) adult value of thigh 93%, calf 94%, foot 95%, upperarm 95%, forearm 95%, hand 95%
 * 16 years muscle width, arm + calf 13.5cm
 * 16 1/2 years average female weight 120 lb. height 64 in.
 * 16 1/2 years average male weight 143 lb. height 69 in.

Seventeenth Year
Physical Milestones
 * 17-18 years pulse rate 60 ± 1.4
 * 17 years average female weight 120 lb. height 64 in.
 * 17 years average male weight 147.4 lb. height 69 1/2 in.
 * 17 years the percent of (male) adult value of thigh 97%, calf 97%, foot 97%, upperarm 97%, forearm 97%, hand 97%
 * 17 years muscle width, arm + calf 14.1cm
 * 17-25 years third molars (4) [permanent]
 * 17 1/2 years average female weight 120 lb. height 64 in.
 * 17 1/2 years average male weight 149.6 lb. height 70 in.

Eighteenth Year
Physical Milestones
 * 18 years average female weight 120 lb. height 64 in.
 * 18 years average male weight 151.8 lb. height 70 in.
 * 18 years the percent of (male) adult value of thigh 100%, calf 100%, foot 100%, upperarm 100%, forearm 100%, hand 100%
 * 18 years muscle width, arm + calf 14.4cm

=Adults=

Nineteen to Fifty Years

 * 19-22 years average female weight 120 lb. height 64 in.
 * 19-22 years average male weight 154 lb. height 70 in.
 * 23-50 years average female weight 120 lb. height 64 in.
 * 23-50 years average male weight 154 lb. height 70 in.