Developmental milestones in children

Age	Social/emotional skills	Language	Cognitive	Movement/physical development
2 months	Smile at people	Coos, gurgling sounds, turns head to sound	Pays attention to faces, follows objects with eyes	Hold head up, begins to push when lying on tummy
4 months	Likes to play with people, copies facial expressions like smiling or frowning	Babbles, cries in different ways to show hunger, pain, or being tired	Uses hands and eyes together e.g. while reaching for a toy; follows moving things, recognizes familiar people	Hold head steady unsupported, pushes legs down when on hard surface, may roll over from tummy to back, brings hands to mouth, holds toys
6 months	Recognizes if someone is a stranger	Responds to sounds by making sounds, responds to own name, begins to say consonant sounds (m,b)	Brings objects to mouth, tries to get objects that are out of reach, passes objects from one hand to another	Rolls over in both directions, begins to sit without support
9 months	Afraid of strangers, clingy to family members	Understands “no”, makes different sounds like “mamamama”, uses finger to point at objects	Plays peek-a-boo, picks up things between thumb and index finger (pincer grasp)	Stands with support, sits without support, pulls to stand, crawls
1 year	Shy or nervous with strangers, cries when parents leave, plays games like “pat-a-cake”	Responds to simple spoken requests, uses simple gestures like shaking head for “no” or waving “bye-bye”, says mama, dada	Explores things by shaking, banging, throwing, finds hidden things easily, looks at the right picture or thing when it’s named, drinks from a cup, follows simple directions	Pulls up to stand, walks holding on to furniture “cruising”, may stand alone, may take a few steps without holding on
18 months	May have temper tantrums, pretend play, explores alone with parent close by	Says several single words	Knows and names ordinary objects like spoon, phone, scribbles, follows one-step verbal commands	Walks alone, may walk up steps, can undress themselves, drinks from a cup, eats with a spoon
2 years	Copies adults and other children, shows more independence, shows defiant behavior, plays beside other children	Knows names of familiar people and body parts, says sentences with 2-4 words	Sorts shapes and colors, plays make-believe games, builds towers with 4 or more blocks, may show hand preference (left /right), follows 2 step instructions	Stands on tiptoes, kicks a ball, begins to run, walks up and down stairs holding on, draws straight lines or circles
3 years	Takes turns, shows concern for a crying friend, shows a wide range of emotions, dresses and undresses self, separates easily from parents	Follows 2 or 3 step instructions, says name,age; tals well enough for strangers to understand, carries on a conversation with 2-3 sentences	Plays with toys with moving parts, plays make-believe with dolls, animals and people, build towers with more than 6 blocks, does puzzles with 3 or 4 pieces	Climbs well, runs easily, pedals a tricycle, walks up and down stairs one foot at a time
4 years	Like to play with other kids, cooperates with other children	Knows basic grammar like correctly using “he” “she”, sings a song or recites a poem from memory, tells stories, can say first and last name	Names colors and numbers, understands the idea of counting, starts to copy capital letters,	Hops and stands on one foot for up to 2 seconds, pours, cuts with supervision, catches a bounced ball
5 years	Wants to please friends and be like them, mostly follows rules, is aware of gender	Speaks clearly, tells a simple story using full sentences,	Counts 10 or more things, can draw a person with at least 6 body parts, can print letters or numbers, draws a triangle and other geometric shapes	Stands on one foot for 10 seconds or longer, hops, may skip, uses fork and spoon, can use the toilet on their own

Enuresis, primary and secondary: Nocturnal enuresis is defined as nighttime bedwetting in children five years of age or older. Secondary enuresis is the occurrence of bed wetting in children who were previously continent at night, and is often seen due to stressors like new baby in the home, recent move, loss of a loved one etc. Management includes decreasing intake of fluids and water after dinner, avoiding caffeinated beverages in the evening and night, bed alarm (most sustained effect) , desmopressin and tricyclic antidepressants. Desmopressin (synthetic vasopressin) acts on the renal collecting duct and distal tubules to enhance reabsorption of water and thus decreases excessive nocturnal urine production.

Age	Social/emotional skills	Language	Cognitive	Movement/physical development
2 months	Smile at people	Coos, gurgling sounds, turns head to sound	Pays attention to faces, follows objects with eyes	Hold head up, begins to push when lying on tummy
4 months	Likes to play with people, copies facial expressions like smiling or frowning	Babbles, cries in different ways to show hunger, pain, or being tired	Uses hands and eyes together e.g. while reaching for a toy; follows moving things, recognizes familiar people	Hold head steady unsupported, pushes legs down when on hard surface, may roll over from tummy to back, brings hands to mouth, holds toys
6 months	Recognizes if someone is a stranger	Responds to sounds by making sounds, responds to own name, begins to say consonant sounds (m,b)	Brings objects to mouth, tries to get objects that are out of reach, passes objects from one hand to another	Rolls over in both directions, begins to sit without support
9 months	Afraid of strangers, clingy to family members	Understands “no”, makes different sounds like “mamamama”, uses finger to point at objects	Plays peek-a-boo, picks up things between thumb and index finger (pincer grasp)	Stands with support, sits without support, pulls to stand, crawls
1 year	Shy or nervous with strangers, cries when parents leave, plays games like “pat-a-cake”	Responds to simple spoken requests, uses simple gestures like shaking head for “no” or waving “bye-bye”, says mama, dada	Explores things by shaking, banging, throwing, finds hidden things easily, looks at the right picture or thing when it’s named, drinks from a cup, follows simple directions	Pulls up to stand, walks holding on to furniture “cruising”, may stand alone, may take a few steps without holding on
18 months	May have temper tantrums, pretend play, explores alone with parent close by	Says several single words	Knows and names ordinary objects like spoon, phone, scribbles, follows one-step verbal commands	Walks alone, may walk up steps, can undress themselves, drinks from a cup, eats with a spoon
2 years	Copies adults and other children, shows more independence, shows defiant behavior, plays beside other children	Knows names of familiar people and body parts, says sentences with 2-4 words	Sorts shapes and colors, plays make-believe games, builds towers with 4 or more blocks, may show hand preference (left /right), follows 2 step instructions	Stands on tiptoes, kicks a ball, begins to run, walks up and down stairs holding on, draws straight lines or circles
3 years	Takes turns, shows concern for a crying friend, shows a wide range of emotions, dresses and undresses self, separates easily from parents	Follows 2 or 3 step instructions, says name,age; tals well enough for strangers to understand, carries on a conversation with 2-3 sentences	Plays with toys with moving parts, plays make-believe with dolls, animals and people, build towers with more than 6 blocks, does puzzles with 3 or 4 pieces	Climbs well, runs easily, pedals a tricycle, walks up and down stairs one foot at a time
4 years	Like to play with other kids, cooperates with other children	Knows basic grammar like correctly using “he” “she”, sings a song or recites a poem from memory, tells stories, can say first and last name	Names colors and numbers, understands the idea of counting, starts to copy capital letters,	Hops and stands on one foot for up to 2 seconds, pours, cuts with supervision, catches a bounced ball
5 years	Wants to please friends and be like them, mostly follows rules, is aware of gender	Speaks clearly, tells a simple story using full sentences,	Counts 10 or more things, can draw a person with at least 6 body parts, can print letters or numbers, draws a triangle and other geometric shapes	Stands on one foot for 10 seconds or longer, hops, may skip, uses fork and spoon, can use the toilet on their own