This document discusses typical developmental milestones in fine motor skills, visual coordination, hearing, speech, social skills, scribbling, drawing, and toilet training from birth to age 6. It provides details on the ages that children typically develop abilities like grasping objects, following moving objects with their eyes, pointing, scribbling lines and shapes, speaking first and multiple words, and gaining bladder and bowel control.

1. Growth & DevelopmentGrowth & Development
((ΙΙΙΙΙΙ))
Dr. Eva GauchanDr. Eva Gauchan
LecturerLecturer
Paediatric DeptPaediatric Dept

2. Development - Fine motorDevelopment - Fine motor
 Co - ordination of eyesCo - ordination of eyes
 Hand – eye coordinationHand – eye coordination
 Hand – mouth coordinationHand – mouth coordination
 Skills for manipulation with handsSkills for manipulation with hands

3. Test objectsTest objects
• Red ring on red string
(6.5 cm diameter)
• Pen torch
• Red cubes (1"x1")
• Pellet
• Cup with handle
• Spoon
• Book with thick pages
• Red pencil or crayon
• Red ball (5.0 cm d)

4. Tests objectsTests objects
•• PaperPaper
•• Wooden blocksWooden blocks
•• DollDoll
•• MirrorMirror
•• Temple bell / rattleTemple bell / rattle

5. Shopping Cart
Blocks/Balls
Window House
Standard Toy Set

6. Eye co-ordinationEye co-ordination
 Newborn - turns head & follows lightNewborn - turns head & follows light
 4 weeks- regards lighted torch or a red4 weeks- regards lighted torch or a red
ring kept at a distance of 20-30 cmring kept at a distance of 20-30 cm
 6 weeks – follows object side to side6 weeks – follows object side to side

7. Eye co-ordinationEye co-ordination
 2-3 months – follows with steady eye2-3 months – follows with steady eye
movements and can converge & focus hismovements and can converge & focus his
eyeseyes
 3 months- converges upon fingers of3 months- converges upon fingers of
hands & begins to reach out for objects athands & begins to reach out for objects at
that distancethat distance

8.  4 months- macular fovea matures4 months- macular fovea matures
visual cortex differentiatesvisual cortex differentiates
accomodation ,mono-ocularaccomodation ,mono-ocular
fixationfixation
 4-6 months – binocular vision develops4-6 months – binocular vision develops

9. Visual distance:Visual distance:
 Birth: 20-30 cmBirth: 20-30 cm
 3-4 months: 0.6-1 m3-4 months: 0.6-1 m
 5-6 months: 1-1.6 m5-6 months: 1-1.6 m
 9 months: 3.3 m9 months: 3.3 m
 18 months: can follow with eyes small (318 months: can follow with eyes small (3
mm) object rolling at distance of 4 m awaymm) object rolling at distance of 4 m away

10. Hand – eye coordinationHand – eye coordination
 3 months - hand regard3 months - hand regard
 4 months – grasps red4 months – grasps red
dangling ringdangling ring

11.  5 months-Takes cube from table5 months-Takes cube from table
 Plays with toesPlays with toes

12. 6 months- Transfer object from6 months- Transfer object from
hand-to- handhand-to- hand
Hold feeding bottleHold feeding bottle
Bidextrous graspBidextrous grasp

13.  7 months – crude pincer grasp7 months – crude pincer grasp

14. 10 months – pincer grasp10 months – pincer grasp

15. 10 months-Poking with index10 months-Poking with index
fingerfinger

16. 12 months – Points to objects12 months – Points to objects
desireddesired

17. 12 months – fine pincer grasp12 months – fine pincer grasp

18.  12-15 months – make tower of 2 cubes12-15 months – make tower of 2 cubes

19.  18 months – make18 months – make
tower of 4 cubestower of 4 cubes
 18 months- Enjoys18 months- Enjoys
pictures from thepictures from the
booksbooks

20.  2 yrs – 6 cubes2 yrs – 6 cubes
 3 yrs – 10 cubes3 yrs – 10 cubes

21. Hand mouth coordinationHand mouth coordination
 5 months – Hand mouth approach5 months – Hand mouth approach

22.  12 months – feed with spoon with spilling12 months – feed with spoon with spilling
 15 month – feed with spoon without spilling15 month – feed with spoon without spilling
 18 month – feed with cup with slight spilling18 month – feed with cup with slight spilling

23. Skills for manipulation with handsSkills for manipulation with hands
 Birth – grasp reflexBirth – grasp reflex
presentpresent
 1-2 month-No grasp1-2 month-No grasp
reflexreflex
 3 months-hand3 months-hand
loosely openloosely open

24.  3-4 months – can3-4 months – can
hold objects withhold objects with
ulnar approachulnar approach
 5 months – radial5 months – radial
approachapproach

25. Handedness:Handedness:
 Newborn: no hand preferenceNewborn: no hand preference
 Hand preference marked 1Hand preference marked 1stst
two yearstwo years
 Hand preference established 3-4 yearsHand preference established 3-4 years
 True dominance develops by 10 yrsTrue dominance develops by 10 yrs

26. DressingDressing
 7 months: takes off socks7 months: takes off socks
 10 months: raises arms10 months: raises arms
 1 year- can indicate where hat goes,1 year- can indicate where hat goes,
tries to remove coat, tries to wear sockstries to remove coat, tries to wear socks
& shoes without success& shoes without success
 15 months- “NO” stage, dislikes15 months- “NO” stage, dislikes
dressingdressing
 18 months- Takes off pants, shoes,18 months- Takes off pants, shoes,
gloves ,socks, easy zips & big buttonsgloves ,socks, easy zips & big buttons
etc

27. 2 years- Puts shoes, socks and2 years- Puts shoes, socks and
pantspants

28. 3 years- Dress and undress except shoe lace3 years- Dress and undress except shoe lace

29. 5 years – Ties shoe5 years – Ties shoe
lacelace

30.  6 years- interested in dressing6 years- interested in dressing
 7 years- chooses own clothes7 years- chooses own clothes

31. ScribblingScribbling
 12 months – spontaneously scribbles12 months – spontaneously scribbles

32. Developmental stages of drawingDevelopmental stages of drawing
1-2 years: random scribble marks
simply as a sensorimotor activity

33. ScribblingScribbling
 15 months – imitate straight lines15 months – imitate straight lines

34. 2-21/2 years: controlled scribbling. The child
begins to develop some control of his fine motor
abilities, and the scribbles gain some direction
and control. After some experience with
controlled scribbling, a child may name his
picture a “motorcycle” or a “big wheel”,
although there appears to be no resemblance.
This is an intellectual accomplishment for the
child, an indication that he is taking his first
step toward being able to do representation
Developmental stages of drawingDevelopmental stages of drawing
(continued)(continued)

35. ScribblingScribbling
 2 yrs – draws2 yrs – draws
horizontal / verticalhorizontal / vertical
lineslines
 3 yrs – draws circle3 yrs – draws circle
 4 years-Draws4 years-Draws
rectangle / + (plus),rectangle / + (plus),
squaresquare
 5 years-Draws5 years-Draws
triangle & ”X” signtriangle & ”X” sign

36. Developmental stages of drawingDevelopmental stages of drawing
(continued)(continued)
2 1/2 -3 years: the face. The
next major development is for
the circle to become a face
3 ½ -4 years: arms and legs. The circle
“person” develops sticks arms and legs,
which protrude from the circle, or the
head; there is no body yet
4 years: the body. The human figure
begins to acquire a body. Gradually
more and more body parts are added
(hands, feet, hair, ears, etc.)

37. Developmental stages of drawingDevelopmental stages of drawing
(continued)(continued)
5 years: the floating house: First
“house” drawings usually resemble a
face, with windows placed like eyes
and door like a mouth. These first
houses are usually somewhere in the
middle of the paper and seem to be
floating in space
5 ½ - 6 years: the house on a bottom
line. The bottom of the paper is used
as a baseline and the house rests on it

38. Developmental stages of drawingDevelopmental stages of drawing
(continued)(continued)
5 ½ -6 years: a baseline supports
the house. A baseline appears
within the drawing and the house
rests on it
6 -7 years: two-dimensional drawing.
The baseline begins to take on the
quality of a horizon, which indicates
the child’s awareness of two-
dimensional space

39. Picture bookPicture book
 13 month – turn 2-313 month – turn 2-3
pages of bookpages of book
 24 months – turn24 months – turn
pages one at a timepages one at a time

40. SocialSocial
●● 4 weeks –regards mother’s face4 weeks –regards mother’s face
●● 8 weeks-Social smile8 weeks-Social smile
●● 3 months- Smile when spoken to/Follow a3 months- Smile when spoken to/Follow a
person with eye / recognizes motherperson with eye / recognizes mother

41. 6 months- Smiles and vocalizes6 months- Smiles and vocalizes
mirror imagemirror image

42. ●● 7-9 months- liking ,disliking, fear of strangers7-9 months- liking ,disliking, fear of strangers
(stranger anxiety)(stranger anxiety)

43. 9-10 months- Wave bye, bye9-10 months- Wave bye, bye

44. 12 month- Stranger anxiety / concept of self12 month- Stranger anxiety / concept of self
plays simple ball gameplays simple ball game

45. 12 month- separation anxiety12 month- separation anxiety

46. 15-18 months-Domestic mimicry15-18 months-Domestic mimicry

47. 15-18 months-Domestic mimicry15-18 months-Domestic mimicry

48.  18 months- points to 3 parts of18 months- points to 3 parts of
the bodythe body
 2 years- Demand constant2 years- Demand constant
attentionattention

49. 2 yrs – Parallel play2 yrs – Parallel play

50. 2 yrs – Parallel play2 yrs – Parallel play

51. 2 yrs – Parallel play2 yrs – Parallel play

52. ●● 3 yrs- knows gender3 yrs- knows gender
handednesshandedness

53. 3-4 yrs :plays with peers3-4 yrs :plays with peers

54. HearingHearing
●● Birth : Startling/Birth : Startling/
Blinking /StopBlinking /Stop
cryingcrying
●● 3 months: Turns3 months: Turns
head towardshead towards
sound (level)sound (level)
●● 5 months: Turns5 months: Turns
head towardshead towards
sound below thesound below the
level of earlevel of ear

55.  6 -7 months:6 -7 months:
Response to nameResponse to name
Turns head towardsTurns head towards
sound at the levelsound at the level
of earof ear
 9 months: Turns9 months: Turns
head above level ofhead above level of
earear

56. Distance at which sounds can beDistance at which sounds can be
heard:heard:
 6 months- 45 cm6 months- 45 cm
 9 months- 1 m9 months- 1 m
 18 months- 2 m18 months- 2 m

57. SpeechSpeech
●● 3 months-Vocalizes when spoken to3 months-Vocalizes when spoken to
(cooing)(cooing)
●● 6 months- says ba, da, ka,ma6 months- says ba, da, ka,ma
●● 9 months – bisyllables (mama, baba)9 months – bisyllables (mama, baba)
●● 12 months-two words with meaning12 months-two words with meaning

58. ●● 18 months- 10 words with meaning18 months- 10 words with meaning
●● 2 years- 50 words with meaning2 years- 50 words with meaning
●● 21-24 months –spontaneously join 321-24 months –spontaneously join 3
words together to make sentenceswords together to make sentences
●● 36 months- tells a story36 months- tells a story

59. Toilet training/Bowel control:Toilet training/Bowel control:
 Birth: reflex actBirth: reflex act
 4 weeks: wakes up on passing stool4 weeks: wakes up on passing stool
 4 months -Gastrocolic reflex weakens4 months -Gastrocolic reflex weakens
 7 months- bowel movements irregular7 months- bowel movements irregular
 10 mo- can sit on toilet seat10 mo- can sit on toilet seat

60.  12 months: grunts after passing stool12 months: grunts after passing stool
 15- 18 mo : can walk to toilet15- 18 mo : can walk to toilet
 2 yrs : toilet trainable2 yrs : toilet trainable
 3 yrs : can postpone bowel movements3 yrs : can postpone bowel movements

61. Bladder control:Bladder control:
 Birth: reflex actBirth: reflex act
 4 weeks: cries when nappy wet4 weeks: cries when nappy wet
 40 weeks: dry for 2 hrs40 weeks: dry for 2 hrs
 24 months: dry by day24 months: dry by day
 30-36 months: dry by night30-36 months: dry by night
 4 yrs- dry by day & night4 yrs- dry by day & night