Developmental Milestones for Infants - Ages and Stages

From the moment a baby is born, they are developing skills and connections that help them understand the world around them. This article explains what you can expect during that exciting first year.

The first year with baby is filled with wonder

Isn’t it remarkable that hospitals send helpless babies home with parents who have neither a clue nor an instruction manual? Oh, the worries that have plagued this mama’s mind since day one with my babies: Are they healthy? Are they on track? Am I doing enough? Too much? Am I even doing it right? You’ve likely heard the saying “Behind every great kid is a mom who’s pretty sure she’s screwing it all up.” (Preach, author unknown!)

Luckily, most parents get the hang of it before too long. And thankfully, there are some great resources that parents and pediatricians can use to help gauge whether children are progressing on schedule, and to intervene early if there are delays.

Jane Squires, Ph.D., is an expert in early childhood development and early identification of delays. She stresses the importance of involving parents in the monitoring of young children’s development. After all, who knows the child better? Squires is lead author of the Ages & Stages Questionnaires®, Third Edition (ASQ®-3). ASQ-3 is often used by pediatricians and child care centers, in conjunction with parents and caregivers, to screen young children for developmental delays.

Skills to watch for

What sorts of developmental milestones should parents notice, when it comes to typically developing infants during the first year? The Centers for Disease Control (CDC) gives us a breakdown on some noteworthy behaviors for most babies.

At 2 months: calms down when spoken to or picked up; looks at your face; smiles when you talk or smile to them; makes sounds other than crying; reacts to loud sounds; watches you as you move; looks at a toy for several seconds; holds head up when on tummy; moves both arms and both legs; opens hands briefly.

At 4 months: chuckles (not yet a full laugh) when you try to make them laugh; looks at you, moves, or makes sounds to get or keep your attention; makes sounds back when you talk; turns head towards the sound of your voice; looks at hands with interest; holds head steady without support when being held; brings hands to mouth; pushes up onto elbows/forearms when on tummy.

At 6 months: knows familiar people; likes to look at self in mirror; laughs; takes turns making sounds with you; makes squealing noises; puts things in their mouth to explore them; reaches to grab a toy they want; closes lips to show they don’t want more food; rolls from tummy to back; pushes up with straight arms when on tummy; leans on hands to support themselves when sitting.
At 1 year: waves “bye-bye”; calls a parent “mama” or “dada” or another special name; understands “no” (pauses briefly or stops when you say it); puts something in a container, like a block in a cup; looks for things they see you hide, like a toy under a blanket; pulls up to stand; walks, holding on to furniture; drinks from a cup without a lid, as you hold it; picks things up between thumb and pointer finger, like small bits of food.

In the event that delays are suspected, don’t panic! Early intervention is key. Identifying possible delays early gets you on the path to getting the supports in place to help your child achieve better outcomes. Discuss your child’s development and any concerns with your pediatrician. They’ll have lots of advice, as well as referral options for you to pursue additional resources if needed. You can also do some homework online. There are some great websites referenced at the end of this column and on the agesandstagesresearch.com webpage under parent resources.

How parents can help

Quality parent–child interaction makes a tremendous difference in supporting healthy development. Get down on the floor and play! Read to them. Cuddle. Make things together. Go places. Explore and identify new things. Narrate the trip through the grocery store aisles. Talk and sing. Make it a priority to be present and engaging. “It’s the most important thing that parents can do for their children,” says Squires.

Squires suggests some simple activities parents can try with their children:
With babies 1–4 months of age:

Sing baby simple songs with repeated phrases. The repetition helps baby learn and listen.
While baby lays on their back, hold a brightly colored toy above their head in line of vision, and move it slowly back and forth to see if their gaze follows the toy.
On a nice day, take baby outside on a nature walk, talking about the things you see. Baby will enjoy the sound of your voice and the stimulation of being outdoors and seeing new sights.
Sit baby on your lap and gently shake a rattle on one side and then the other. See if baby searches for the source of the noise.

With babies 4–8 months of age:

Give baby a spoon to grasp, hold, chew, bang on something, or drop.
Place an unbreakable mirror near baby for visual stimulation. Do they understand their reflection? Look in the mirror together and wave.
Place baby on tummy with favorite objects close but just far enough away to encourage reach and movement.
With baby facing you, change facial expressions (big smile, sticking out tongue, raising eyebrows, etc.). Give baby a turn to make faces and mimic what they do.

With babies 8–12 months of age:

Make a simple puzzle for baby by putting ping pong balls into a muffin pan or egg carton. Or, cut a round hole in the lid of a coffee can and let baby drop wooden clothespins or ping pong balls inside.
Play ball games. Roll a beach ball or nerf ball to baby and have a partner help them roll (or throw) it back to you.
Let baby make choices by offering two toys or foods and see which they pick. Encourage them to point or reach to show preference and express their likes or dislikes.
Say “Hi” or “Bye” and wave when entering or leaving a room, encouraging baby to imitate these early gestures.

With babies 12–16 months of age:

Tape a large piece of drawing paper to a table and show baby how to scribble with large crayons or paint with water.
When baby is learning to walk and holding on to furniture in room, arrange furniture with small spaces in between to encourage baby to step across the gaps using balance.
Show baby how everything has a name. Help them learn by repeatedly naming common objects, body parts, people, etc.
Let baby help you clean up! Play “feed the wastebasket” or “give this to Mommy or Daddy.”

Free screenings available

Parents have an opportunity to try an ASQ developmental screener for free online anytime at www.discoverasqstudy.com (no obligations; and no personal names or addresses are collected). Each questionnaire takes about 10–15 minutes to complete. Answer based on your observations of your child in natural environments, looking at communication, gross motor, fine motor, problem solving, and personal-social skills. You can see a copy of your child’s screening results by email and/or download at end of the session, and get targeted play and learning activities that fit your child’s age, as well as suggested resources if you have concerns about risk for delay.

Quiet the worries

Another saying I’ve heard is “worry doesn’t take away tomorrows troubles, it takes away today’s peace” (Randy Armstrong). Easier said than done, no doubt. But when parents can get a little encouragement in feeling more competent and confident in their caregiver roles, and when children can get additional support in reaching important milestones, it does help quiet the worries. Peace be with you, mama. You’ve got this!

Additional resources for parents:
Ages & Stages Questionnaires
www.agesandstages.com
www.discoverasqstudy.com

Centers for Disease Control and Prevention
www.cdc.gov/ncbddd/actearly/milestones
www.cdc.gov/ncbddd/childdevelopment/positiveparenting/toddlers.html
https://www.cdc.gov/ncbddd/actearly/concerned.html

American Academy of Pediatrics
https://www.healthychildren.org/english/ages-stages/baby

“We chose ASQ because it is easy to do, low cost, culturally sensitive, and it meets our purpose of basic screening for our children’s development. Our infant teachers base their curriculum on each individual child based on the ASQ.”

Kathy Bostic, Program Supervisor, Pinehurst Child Care Center