Milestones
Developmental milestones
Every child grows at their own pace. Use these guides to see which skills typically develop at each age, from first sounds to buttoning a coat.
How to use this page
- Step 1Pick an area: communication, feeding, fine motor, or self-care.
- Step 2Find your child’s age and see the skills that usually develop.
- Questions?If your child is missing several skills for their age, call us at (318) 775-4164.
Communication milestones
How children understand, talk, and connect with others.
UnderstandingTalkingSocial & play
Birth–6 months
Understanding
- Startles to loud sounds.
- Responds to voice and sound.
- Turns head toward a sound source.
- Recognizes familiar voices.
Talking
- Reflexive sounds (crying, burping, coughing, sneezing).
- Makes different sounds when happy or upset.
- Coos.
- Vocal play: squeals, clicks, growls, yells, and blowing “raspberries.”
- Begins using p, b, and m sounds with vowels.
- Laughs.
Social & play
- Social smile.
- Calms down when spoken to.
- Uses babbling to gain attention.
- Makes eye contact.
6–12 months
Understanding
- Responds to name.
- Understands “no.”
- Understands common words (e.g., mommy, ball, cup).
- Looks at familiar objects, pictures, or family members when named.
Talking
- Babbles long strings of sounds (e.g., ba-ba-ba).
- Early gestures emerge: reaching for “up,” waving bye-bye, and clapping.
- Uses gestures and sounds to gain attention.
- Tries to imitate different sounds.
Social & play
- Coos and squeals for attention.
- Babbles back and forth with caregiver.
- Smiles at self in the mirror.
- Plays games like peek-a-boo and pat-a-cake.
- Copies simple actions of others.
- Explores objects with hands and mouth.
- Plays alone (solitary play).
12–18 months
Understanding
- Understands 50+ words.
- Follows simple commands with gestures (e.g., “get the book”).
- Understands “come here” and “sit down.”
- Attends to an activity for about 2 minutes.
- Listens to simple stories.
Talking
- First words emerge around the first birthday.
- Uses at least 10 words by 18 months.
- New gestures emerge: pointing, high five, and shaking head.
- Uses sentence-like intonation (jargon).
- Points to objects, pictures, and people.
- Often tries to imitate new, simple words, mostly nouns.
- Speech is mostly hard to understand.
Social & play
- Brings objects to show an adult.
- Gains attention by vocalizing or pointing.
- Uses social words like “bye,” “hi,” “thank you,” and “please.”
- Shows affection.
- Imitates adult movements (e.g., sweeping).
- Uses a toy for its function (e.g., pushes a car).
- Simple pretend play (e.g., pretends to drink from a cup).
- Has toy preferences.
18–24 months
Understanding
- Understands 300+ words.
- Identifies several body parts.
- Understands familiar action words.
- Recognizes named familiar people and objects.
- Follows simple commands and understands simple questions.
- Understands early prepositions (e.g., “in” and “on”).
Talking
- Uses words more than gestures.
- Consistently imitates new words.
- Uses at least 50 words by 24 months.
- Names familiar objects, animal sounds, and actions.
- Uses words for more than requesting (e.g., labeling, protesting).
- Begins to use simple phrases.
- Uses intonation to ask yes/no questions.
- Answers simple “what’s this?” questions.
- Is understood 25–50% of the time by unfamiliar listeners.
Social & play
- Watches others play; play begins to extend beyond self.
- Symbolic play: uses one object to represent another (e.g., a remote as a microphone).
- Combines objects in play (e.g., eats from a bowl, then feeds a doll).
- Parallel play emerges around age 2.
2–3 years
Understanding
- Follows 2-step directions without gestures (e.g., “get the book and put it in the box”).
- Understands “one” and “all.”
- Understands new prepositions (e.g., under, off).
- Understands simple describing words (e.g., big).
- Understands early pronouns like “you,” “me,” and “he.”
- Identifies objects by function and sorts by category.
Talking
- Uses 2-word phrases often; 3- and 4-word phrases emerging.
- Has a word for almost everything.
- Uses plurals, past tense, pronouns, and basic prepositions.
- Asks simple questions (e.g., “Mommy? Eat cookie?”).
- Answers early WH questions.
- Uses at least 300 words by 36 months.
- Uses p, b, m, d, n, h, t, k, g, w, ng, f, and y sounds by 36 months.
- Is understood 50–75% of the time by unfamiliar listeners.
Social & play
- Attends to an activity for 6–7 minutes.
- Uses language for jokes, teasing, and pretending.
- Repairs conversations when not understood.
- Associative play emerges around age 3.
- Imaginative play (e.g., drinks from an imaginary cup).
- Participates in simple group activities.
3–4 years
Understanding
- Improved listening skills.
- Follows 3-step directions.
- Understands more complex sentences and negatives.
- Begins to understand when, why, and how.
- Understands quantity and spatial concepts (e.g., some, behind), same/different, and emotion words.
Talking
- Uses 1,000+ words.
- Uses 4–5+ word sentences.
- Expresses ideas and feelings and talks easily with others.
- Describes objects by color, size, and shape.
- Uses possessives (e.g., puppy’s ball), more verb forms, and pronouns.
- Answers who, why, where, how, and when questions.
- Answers “what would you do if…” questions.
- Uses l, j, ch, s, v, sh, and z sounds by age 4.
Social & play
- Cooperative play emerges around age 4.
- Takes turns and plays cooperatively.
- Pretends about less familiar events (e.g., going to the doctor).
- Begins dramatic play.
4–5 years
Understanding
- Understands most of what is said to them.
- Answers simple questions about a short story.
- Understands comparisons (e.g., big, bigger, biggest).
- Understands sequence words (e.g., first, middle, last).
- Understands time words (e.g., yesterday, today).
Talking
- Uses sentences with many details.
- Lists items in categories (e.g., foods, animals).
- Uses past tense.
- Says most sounds correctly; uses r, zh, and voiced th by age 5.
- Is understood 75–100% of the time by unfamiliar listeners.
Social & play
- Uses words to invite others to play.
- Uses language to resolve disagreements with peers.
- Tells stories that stay on topic.
5–6 years
Understanding
- Understands rhyming.
- Understands opposites, left/right, and early number concepts.
- Understands humor.
- Understands time sequences (first, second, third).
Talking
- Describes objects.
- Asks questions for information.
- Uses compound and complex sentences.
- Forms meaningful, grammatically correct sentences.
- Is understood by strangers.
- Retells a story accurately.
- Uses past and future tense correctly.
- Uses all speech sounds correctly by age 6.
Social & play
- Joins in and starts conversations.
- Uses imagination to tell stories.
- Cooperative play: makes group decisions, assigns roles, and plays fairly.
- Engages in complex imaginary play.
When should I be concerned?
Reach out if you notice any of these signs.
6 months
- Doesn’t respond to sounds
- Doesn’t laugh or squeal
9 months
- Limited babbling (e.g., bababa)
- Doesn’t show when happy or upset
12 months
- Doesn’t use gestures like pointing or waving
- Doesn’t respond to their name
- Doesn’t play back-and-forth games like peek-a-boo
15 months
- Has not used a first word
- Doesn’t point to things of interest to say “look”
18 months
- Doesn’t use at least 10–20 words
- Doesn’t understand simple directions
24 months
- Doesn’t use at least 50 words
- No word combinations
36 months
- Doesn’t use simple sentences
- Strangers have a hard time understanding them
Feeding milestones
Oral motor skills and the foods and textures to introduce at each age.
Birth–3 months
Feeding skills
- Feeding is reflexive; oral reflexes are present.
- Strong suck from breast or bottle; swallows well.
- Opens mouth in anticipation of bottle or breast.
- Uses a suckle-swallow pattern (tongue moves in and out).
- Coordinates suck-swallow-breathe during feeds.
- Explores toys with mouth.
Foods & textures
Breastmilk and/or formula provides all nutrition.
3–6 months
Feeding skills
- Suck becomes more voluntary; early reflexes fade.
- Sequences 20+ sucks before pausing, with no coughing or choking.
- Tongue and lips begin to move separately.
- Uses suckle and suck (tongue up and down) patterns.
- Improved lip closure.
- Develops a vertical munching pattern.
Foods & textures
Breastmilk and/or formula provides all nutrition.
6–9 months
Feeding skills
- Solids introduced; eats and drinks upright with minimal support.
- Holds bottle independently.
- Recognizes and anticipates food.
- Begins to self-feed finger foods.
- Better jaw and lip control; no liquid lost while sucking.
- Bites down on soft foods.
- Early rotary chewing begins; starts moving food to the side of the mouth.
- Removes food from a spoon with upper lip.
- Gag becomes less sensitive, allowing more foods.
Foods & textures
Breastmilk and/or formula provides most nutrition. Purees, soft solids, and cup drinking start at 6 months.
9–12 months
Feeding skills
- Feeds self with fingers.
- Moves food side to side with tongue.
- Lips close while chewing.
- Controlled, sustained bite on soft solids.
- Little liquid lost when drinking from a cup.
- Uses both lips to clear the spoon.
- Handles soft foods with more texture.
- Mastery of spoon feeding.
Foods & textures
Accepts more tastes and textures (smooth and lumpy mashed foods, dissolvable foods). By 12 months, handles lumps, chopped table foods, and easy-to-chew meats.
12–18 months
Feeding skills
- Starts using a rotary chew.
- Bites through hard, crunchy foods with a controlled bite.
- No longer suckles when drinking.
- Coordinates sucking, swallowing, and breathing with an open cup.
- Brings spoon to mouth with little spilling.
- May begin to show food preferences.
Foods & textures
Solid foods become the main source of nutrition, cut to an appropriate size.
18–24 months
Feeding skills
- Self-feeds at most meals.
- Biting, chewing, and lip closure are efficient for most foods.
- Uses a mature, adult chewing pattern.
- Swallows solids with no loss of food.
- Drinks from an open cup with little spilling.
- Eats table foods with mixed textures.
Foods & textures
Handles most food textures but may have preferences.
2–3 years
Feeding skills
- Fine-tunes all feeding skills.
- Feeds self and uses a fork.
Foods & textures
Should manage most textures without difficulty by age 3.
Fine motor milestones
How little hands learn to grasp, let go, draw, and cut.
Grasping small objects
Like a Cheerio
- 3 monthsNo attempt
- 6 monthsRakes and touches the object
- 7 monthsInferior scissors grasp
- 8 monthsScissors grasp
- 9 monthsInferior pincer grasp
- 10 monthsPincer grasp
- 12 monthsFine pincer grasp
Grasping larger objects
Like a toy block
- 3 monthsGrasps on contact; wrist bent
- 4 monthsPrimitive squeeze grasp
- 4–5 monthsMoving toward a palmar grasp
- 5 monthsPalmar grasp
- 6 monthsRadial-palmar grasp
- 7 monthsRadial-palmar grasp, wrist straight
- 9 monthsRadial-digital grasp
Pencil grasp
Holding crayons and pencils
- 1–1½ yearsPalmar-supinate grasp (fist)
- 2–3 yearsDigital-pronate grasp
- 3½–4 yearsStatic tripod grasp
- 4½–6 yearsDynamic tripod grasp
Letting go
Releasing objects
- 0–1 monthNo release; strong grasp reflex
- 1–4 monthsInvoluntary release
- 4–8 monthsPasses objects hand to hand
- 7–9 monthsLets go on purpose
- 10–14 monthsDrops items into a container (may rest hand on it)
- 12–15 monthsPrecise release into a small container
Scissor skills
Cutting
- 2–3 yearsInterested in scissors; snips and opens/closes them
- 3–4 yearsCuts forward along a straight line and simple shapes
- 3½–4½ yearsCuts circles
Before scissors
Skills kids need first
- Opening and closing the hand
- Moving the thumb, index, and middle fingers separately and together
- Using both hands together
- Coordinating arm, hand, and eye movements
- Keeping the wrist, elbow, and shoulder steady
Children begin using both hands together around 12–18 months.
Self-care milestones
Dressing, toileting, self-feeding, and helping around the house.
Dressing & toileting
12 months
- Cooperates with dressing; pulls off shoes and socks
- Shows when soiled; may use the potty
- Regular bowel movements
18 months
- Pushes arms and legs through shirt and pants
- Wipes face with a napkin
- Uses a spoon to feed self
- Stays on the toilet when placed there
2 years
- Removes an unfastened coat
- Helps pull pants down
- Urinates regularly
2½ years
- Unbuttons large buttons
- Washes and dries hands
- Removes elastic-waist pants
- Tries to pull on socks (may need help)
- Puts on coat
- Regular toileting with occasional daytime accidents
- Tells someone they need to use the potty
- Uses the potty with few accidents (needs reminders)
3 years
- Puts on a shirt with little help
- Puts on shoes (no fasteners)
- Puts on socks
- Pulls down pants
- Zips and unzips a jacket once started
- Buttons large buttons
- Goes to the bathroom independently (may need help wiping)
3½ years
- Finds the front of clothing
- Unzips a jacket completely
- Unbuckles shoes or a belt
- Dresses with supervision (help with direction of clothing)
4 years
- Removes shirt independently
- Buckles shoes or a belt
- Zips a jacket
- Puts on socks and shoes correctly
- Laces shoes
- Tells front from back of clothing
- Uses the toilet independently: manages clothing, sits, and washes hands (may need help at night)
Self-feeding
Eating independently
- 5–7 monthsSpoon-fed by caregiver
- 6–8 monthsTries to hold bottle
- 6–9 monthsBrings small foods to mouth; plays with spoon
- 9–13 monthsFinger-feeds self
- 12–14 monthsUses a spoon (clumsy, lots of spilling)
- 15–18 monthsScoops food and brings it to mouth with a spoon
- 24–30 monthsInterested in using a fork; more skilled with a spoon
Household chores
Helping at home
- 13 monthsImitates chores they’ve seen, like cooking on a pretend stove
- 2 yearsPuts away toys when asked
- 3 yearsWith help, can dust, dry dishes, and clean up spills
- 4 yearsMakes a bowl of dry cereal and helps sort laundry
Source: Fleming-Castaldy, R. P., et al. (2017). TherapyEd’s National Occupational Therapy Certification Exam Review & Study Guide (8th ed.).
Have questions about your child’s development?
Milestones are general guidelines. If something doesn’t feel right, our team is here to help.