Developmental Milestones: What to Track and When to Ask for an Evaluation

Milestones are the skills most children develop by a certain age, such as smiling, walking, talking and playing with others. Tracking them helps you notice early if your child might need extra support. But milestones are a guide, not a race. Children develop at different speeds, and missing one milestone on its own is rarely a cause for alarm.

The four areas to watch

• Communication: babbling, understanding words, talking and using gestures
• Movement: sitting, crawling, walking, running and using hands
• Play and thinking: exploring, copying, pretend play and solving simple problems
• Social and emotional: smiling, sharing attention, playing with others and managing feelings

Milestones by age

The skills below are ones that most children, around three out of four, can do by each age.

By 6 months

• Laughs and makes squealing sounds; takes turns making sounds with you
• Knows familiar people; likes to look at themselves in a mirror
• Rolls from tummy to back; reaches for and grabs toys

By 12 months

• Waves bye-bye; calls a parent “mama”, “dada” or a similar special name
• Plays games like peek-a-boo; looks for things they see you hide
• Pulls up to stand; walks holding onto furniture

By 18 months

• Tries to say three or more words besides “mama” or “dada”
• Points to show you something interesting; copies you doing chores
• Walks without holding on; tries to use a spoon

By 2 years

• Says at least two words together, such as “more milk”
• Points to things in a book when you ask; notices when others are hurt or upset
• Kicks a ball; runs; plays with more than one toy at once

By 3 years

• Talks with you in conversation using at least two back-and-forth exchanges
• Notices other children and joins them to play
• Draws a circle when shown how; puts on some clothes by themselves

By 4 to 5 years

• Tells stories and talks about their day in sentences
• Pretends to be something else during play, such as a teacher or a superhero
• Follows rules or takes turns in simple games; hops on one foot

Individual variation is normal

Some children walk early and talk late; others do the opposite. Children who were born early may reach milestones later, and doctors usually use their “corrected” age until about age 2. Children growing up with more than one language may mix languages or say fewer words in each one, but they should reach overall communication milestones on time. Speaking more than one language does not cause speech delay.

When to ask for an evaluation

Speak to your paediatrician or a developmental specialist if:

• Your child is not meeting several milestones for their age
• Your child is behind in social communication, such as pointing, sharing attention or responding to their name
• Your child is behind in more than one area, such as speech and movement
• You have a strong feeling that something is not right, even if you cannot explain why

Loss of skills: do not wait

If your child loses a skill they once had, such as words, eye contact, play or walking, ask for a prompt medical review. Loss of skills is never a normal part of development. It can occur in autism, but it can also point to hearing problems, seizures or other medical conditions that need investigating.

Tips for tracking

• Use a milestone checklist or app every few months, and keep notes and short videos.
• Take your notes to every routine check-up.
• Remember that early support, such as speech therapy, can start before any diagnosis is made.

How FXMed can help

Alongside developmental support, good sleep, nutrition and digestive health help every child do their best. Our Autism Support program works alongside your child’s paediatrician, therapists and school. It does not aim to cure or change autism. It focuses on the physical health issues, such as digestion, nutrition and sleep, that can make everyday life harder.

This article is for general education and does not replace advice from your own doctor or care team. If you are worried about your child’s development or health, please speak to a qualified professional.