Important Milestones: Your Child, Birth to Five Years

From the moment your baby first enters the world, they are ready to learn. In fact, one of the most crucial time periods in a child’s development and learning is from birth to 5 years old.

“Eighty-five to ninety percent of a child’s brain develops by age five,” said Russell Horton, DO, a physician with Banner Health Center in Queen Creek, AZ. “This means your child is able to grow and develop new skills quickly—from thinking and speaking skills to social and emotional skills.”

As your newborn grows and develops, you’ll likely wonder, “When will they walk?” or “When will they talk?” These major achievements are called developmental milestones.

What are developmental milestones?

Developmental milestones are a set of skills or age-specific tasks that most children achieve by a certain age. Think of them as a checklist of what to expect around a particular age. These milestones can be broken down into four categories:

Social and emotional: child’s ability to express emotions effectively, follow rules and directions and form positive, healthy relationships
Speech and language: child’s ability to absorb and learn to speak language
Cognitive: child’s ability to think, learn and solve problems
Physical: child’s ability to learn large and fine motor skills, such as sitting up, crawling and walking

Why developmental milestones matter

By looking at the different milestones, you (as a parent), doctors and teachers can pick up on when development is not going according to plan.

Watching your child’s development is an amazing and unique experience. But these markers can give some parents a combination of excitement and anxiousness. You look forward to your baby’s first smile, their first steps and first words, but you also worry that they could be “falling behind” their peers.

The most frequently asked question on many parents' minds is typically, “Is my child developing normally?”

“It’s important to remember that growth and development can vary from child to child,” Dr. Horton said. One child may start walking at 10 months, while another child may start walking at 15 months. But, if you think your child is “falling behind” developmentally, these missed or delayed developmental milestones can be very concerning.

Updates to developmental milestones

With this context, it’s not surprising that many parents took notice when the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) made updates to developmental milestone guidelines. These guidelines, revised for the first time since their release in 2004, were updated to try and help capture more developmental delays earlier.

“Previous developmental milestones are based on what the 50th percentile of children could do at those ages,” Dr. Horton said. “The new guidelines raise this to the 75th percentile to hopefully avoid children falling through the cracks and delaying further interventions if there is a developmental delay.”

The earlier a child is identified with a developmental delay, the sooner they are eligible for early interventions, or programs to help them catch up with their peers. Early interventions mean better outcomes for your child.

Updated developmental milestone guidelines

According to the AAP and CDC, here is a brief overview of some of the major changes that were made in 2022:

Adding checklists for ages 15 months and 30 months. There is now a checklist for every well-child visit from 2 months to 5 years of age.
Identifying additional social and emotional milestones (e.g., smiles on their own to get your attention, age 4 months).
Removing vague language like “may” or “begins” when referring to certain milestones.
Removing duplicate milestones.
Providing new, open-ended questions to use in discussion with families (e.g., Is there anything that your child does or does not do that concerns you?).
Revising and expanding tips and activities for developmental promotion and early relational health.

Developmental skills by age

Regular well-baby and well-child visits during the first several years of life are critical to identify health, behavioral and developmental problems that could have long-lasting effects.

During your child’s regular check-ups, their doctor will spend time watching your child and talking with you to find out if your child is meeting normal developmental milestones. The visit will also include a physical examination, immunizations and tests for hearing, vision and other functions.

For general ranges on what developmental milestones are often expected during the first five years, check out these guidelines, or visit the CDC website for a more complete breakdown.

Birth to 6 months

Social and emotional: Recognizes familiar people, likes to look at themselves in a mirror and laughs
Speech and language: Takes turns making sounds with you, blows raspberries (sticks tongue out and blows) and makes squealing noises
Cognitive: Puts things in their mouth to explore, reaches for toys and closes lips to show they don’t want food
Physical: Rolls from tummy to back, pushes up with straight arms on tummy and leans on hands to support themselves when sitting

At 9 months*

Social and emotional: Shy, clingy around strangers, shows several facial expressions (i.e., happy, sad, angry), looks when you call their name and smiles and laughs when you play peek-a-boo
Speech and language: Makes lots of different sounds like “mama,” “baba” and “dada” and lifts their arms up to tell you they want to be picked up
Cognitive: Looks for objects when dropped out of sight and likes to bang two things together
Physical: Sits without support, moves things from one hand to the other and uses their fingers to “rake” food toward themselves

At 12 months (1 year)

Social and emotional: Plays games with you like peek-a-boo
Speech and language: Waves bye-bye, understands the word “no” and calls parents “mama” or “dada” or another special name
Cognitive: Puts items in a container and looks for things they see you hide, such as a toy under a blanket
Physical: Pulls up to stand, walks while holding onto things, drinks from a cup without a lid (as you hold it) and uses their thumb and pointer finger to pick up small bits of food

At 15 months

Social and emotional: Copies other children while playing, shows you an object they like, clap when excited, hugs stuff animals or toys and shows you affection
Speech and language: Tries to say one or two words besides “mama” or “dada,” follows directions given with a gesture and words and points to ask for something
Cognitive: Tries to use things the right way like a phone and stacks at least two small objects like blocks
Physical: Takes a few steps on their own and uses their fingers to feed themselves food

At 18 months**

Social and emotional: Points to show you something interesting, puts hands out for you to wash, looks at a few pages in a book with you and helps you dress themselves
Speech and language: Tries to say three or more words besides “mama” or “dada” and follows one-step directions without any gestures
Cognitive: Copies you doing chores and plays with toys in a simple way like pushing a toy car
Physical: Walks without holding on to anyone or anything, scribbles, drinks from a cup without a lid and may spill a little, eats with their fingers, tries to use a spoon and climbs off and on a couch or chair.

At 2 years**

Social and emotional: Notices when others are hurt or upset and looks at your face to see how you react in a situation
Speech and language: Points to things in a book, says at least two words together, points to at least two body parts and uses more gestures, like blowing a kiss
Cognitive: Holds something in one hand while using the other hand, tries to use switches and knobs and plays with more than one toy at the same time
Physical: Kicks a ball, runs, walks up a few stairs with or without help and eats with a spoon

At 2 ½ years (30 months)*

Social and emotional: Plays next to other children and sometimes plays with them, shows you what she can do saying, “Look at me!” and follows simple routines when told, like picking up toys when you say, “It’s time to clean up.”
Speech and language: Says about 50 words, says two or more words with one action word, names things in a book and says words like “I,” “me” or “we”
Cognitive: Uses things to pretend, shows simple problem-solving skills, follows two-step instructions and knows how to recognize at least one color
Physical: Uses hands to twist things, takes some clothes off, jumps off the ground with both feet and turns book pages, one at a time, when you read

At 3 years

Social and emotional: Calms down within 10 minutes after you leave and notices other children and joins them to play
Speech and language: Talks with you in conversation using at least two back-and-forth exchanges, asks “who,” “what,” “where” or “why” questions, says what action is happening in a picture or book, says first name and talks well enough for others to understand
Cognitive: Draws a circle when you show them how and avoids touching hot objects
Physical: Strings items together, like large beads, puts on some clothes themselves and uses a fork

At 4 years

Social and emotional: Pretends to be something else during play, asks to go play with children, comforts others who are hurt, avoids danger, likes to be a helper and changes behavior based on where they are, such as a playground or library
Speech and language: Says sentences with four or more words, says some words from a song or story, talks about at least one thing that happened during the day and answers simple questions
Cognitive: Names a few colors, tells what comes next in a well-known story and draws a person with three or more body parts
Physical: Catches a large ball most of the time, serves themselves food or pours water, unbuttons some buttons and holds crayons or pencils between fingers and thumb

At 5 years

Social and emotional: Follows rules or takes turns, sings, dances or acts for you and does simple chores at home
Speech and language: Tells a story they heard or made up with at least two events, answers simple questions about a story after you read or tell them, keeps a conversation going with more than three back-and-forth exchanges and uses or recognizes simple rhymes
Cognitive: Counts to 10, names some numbers between 1 and 5 when you point to them, uses words like “yesterday” or “morning,” pays attention for 5 to 10 minutes during activities, writes some letters in their name and names letters when you point to them
Physical: Buttons some buttons and hops on one foot

These guidelines are also available in an infographic format on bannerhealth.com for easy reference.

What if my child is not reaching developmental milestones?

As a general rule, trust your instincts. If you have a concern about your child’s development, talk to their pediatrician or health care provider. If your child is developmentally delayed, the sooner you get a diagnosis, the better your child’s progress will be.

“The good news is that delayed development is treatable,” Dr. Horton said. “But, if we are going to treat any delays, it means that we need to diagnose as soon as possible and start early interventions.”

If the doctor doesn’t seem concerned, but you are, persist in asking questions, such as, “Why aren’t you concerned?” “When would you be worried?” “What can I do at home to help in this area of development?”

“Parents should never be shy about asking their pediatrician or health care provider if they are concerned about development,” Dr. Horton said. “This should be a discussion, not a simple checking of boxes.”

If your concerns persist, you can also contact your state’s early intervention program for a free developmental evaluation. No referral is required.

For additional resources regarding developmental milestones and delays, visit:

Developmental Milestones or Indicadores del desarrollo (CDC)
CDC’s Milestone Tracker App (Download for free on iOS and Android)
Bright Futures Guidelines (AAP)
National Head Start Association, Find a Location

For parenting-related articles, check out:

* Your child is due for a general developmental screening with their health care provider, so schedule an appointment.

** Your child is due for a general developmental screening and/or autism screening with their health care provider, so schedule an appointment.

Salud del niño Paternidad

Have you listened?

Birth to 5 Years: Updates to Your Child’s Developmental Milestones