COLLEGE OF NURSING
L.L.R.M MEDICAL COLLEGE MEERUT
TEACHING PRACTICE ON
DEVELOPMENTAL
MILESTONES
PREPARED BY
MR. ADESH MISHRA
M.Sc (N) 1ST YEAR
College of Nursing ,L.L.R.M
Medical college ,Meerut
DEVELOPMENT
• Development refers to the maturation of the functions and acquisition of
various skills for optimal functioning of an individual.
MILESTONE
MILESTONE
• Developmental milestones are a set of goals or markers that a child is
expected to achieve during maturation.
COMMON PATTERN OF DEVELOPMENT
• CONTINUOUS PROCESS
• DEPENDS ON THE FUNCTIONAL MATURATION
OF THE NERVOUS SYSTEM
• CEPHALOCAUDAL DIRECTION
• UNIVERSAL
• APPEARING REFLEXES
DOMAINS OF DEVELOPMENT
1. GROSS MOTOR
2. FINE MOTOR
3. PERSONAL,SOCIAL AND GENERAL
UNDERSTANDING
4. LANGUAGE
5. VISION AND HEARING
GROSS MOTOR
AGE MILESTONE
3 MONTH NECK HOLD
5 MONTH ROLLS OVER
6 MONTH SIT IN TRIPOD POSITION
8MONTH SIT WITHOUT SUPPORT
9 MONTH CRAWLING
10 MONTH CREEPING
11 MONTH WALK WITH SUPPORT
12 MONTH WALK INDEPENDENTLY BUT FALL
2 YEAR RUN WELL, KICK A BALL, UP/DOWN STAIR- 2 STEP
3 YEAR RIDE A TRICLE , UP STAIR -1 STEP
4 YEAR HOPING, DOWN STAIR- SINGLE STEP
5 YEAR SKIPPING
FINE MOTOR
AGE MILESTONES
4 MONTH BIDEXTROUS – REACHING OUT FOR OBJECTS WITH BOTH
HANDS
6 MONTH UNIDEXTROUS – REACHING OUT FOR OBJECTS WITH ONE
HAND , TRANSFER OBJECT
9 MONTH IMMATURE PINCER GRASP
12 MONTH PINCER GRASP MATURE
15 MONTH IMITATES SCRIBBLING ,TOWER OF 2 BLOCKS
18 MONTH SCRIBBLES, TOWER OF 3 BLOCKS
2 YEAR TOWER OF 6 BLOCKS
3 YEAR TOWER OF 9 BLOCKS, COPY CIRCLE
4 YEAR COPY CROSS, BRIDGE WITH BLOCKS
5 YEAR COPY TRIANGLE
SOCIAL AND ADAPTIVE MILESTONES
AGE MILESTONES
2 MONTH SOCIAL SMILE
3 MONTH RECOGNIZE MOTHER
6 MONTH STRANGER ANXIETY , RECOGNIZE STRANGER
9 MONTH WAVES BYE-BYE
12 MONTH COMES WHEN CALLED, PLAY SIMPLE GAME
15 MONTH JARGON
18 MONTH COPIES PARENTS TASK
2 YEAR ASK FOR FOOD, DRINK, TOILET
3 YEAR SHARE TOYS, KNOWS FULL NAME, GENDER
4 YEAR PLAY COOPERATIVELY IN A GROUP
5 YEAR DRESS AND UBDRESS
LANGUAGE MILESTONES
AGE MILESTONES
1 MONTH ALERT TO SOUND
3 MONTH COOS ( MUSICAL VOWEL SOUND )
4 MONTH LAUGH LOUD
6 MONTH MONOSYLLABLES ( BA ,DA, PA
9 MONTH BISYLLABLES (MAMA, PAPA ,DADA )
12 MONTH 1-2 WORDS WITH MEANING
18 MONTH 8-10 WORDS
2 YEAR 2-3 WORD SENTENCES AND USES TERMS I, ME, YOU
3 YEAR ASK QUESTIONS
4 YEAR SAYS SONG OR POEM ,
5 YEAR ASK MEANING OF WORDS
Developmental Red Flags
DOMAIN RED FLAGS
GROSS MOTOR Not sitting by 9 months, not walking by 18 months
FINE MOTOR Persistent fisting after 3 months
LANGUAGE No babbling by 12 months, no words by 18 months
SOCIAL No social smile by 3 months, lack of eye contact
Denver Developmental Screening Test
Domain Description Examples
Personal-Social Child's ability to Smiling, feeding self,
interact with people playing
Fine Motor-Adaptive Hand-eye coordination, Grasping objects,
problem-solving stacking blocks
Language Hearing, Babbling, speaking
understanding, and words, following
speaking commands
Gross Motor Large muscle Sitting, standing,
movement walking, jumping
RECAPTULIZATION
• DOMAINS OF DEVELOPMENT
1. GROSS MOTOR
2. FINE MOTOR
3. PERSONAL, SOCIAL AND GENERAL UNDERSTANDING
4. LANGUAGE
5. VISION AND HEARING
SUMMARY
• Developmental milestones are a set of observable skills or abilities that children
typically achieve as they grow, providing a framework for parents, caregivers,
and professionals to monitor healthy development. These milestones are
generally categorized into four main areas: physical (including both gross and
fine motor skills such as rolling, crawling, walking, and using utensils), social
and emotional development (building relationships, expressing feelings, and
interacting with others), and communication and language (progressing from
babbling and first words to full sentences and conversation)
CONCLUSION
• Developmental milestones are
skills or behaviors that most children can do by a certain age
. They include physical, social, emotional, cognitive, and language abil
ities, such as walking, talking, smiling, and waving. Developmental mi
lestones are used to track a child's progress and identify any potential
delays or problems. They should be assessed regularly by parents and
health care providers
.
BIBLIOGRAPHY
• Book references:
• Dutta, Parul (2015). Paediatric nursing (4th ed., pp. 119-125). Jaypee
Brothers Medical Publishers.
• Hockenberry, M. J., & Wilson, D. (2019). Wong's essentials of pediatric
nursing (11th ed., pp. 24-28). Elsevier.
• Gupta, P., & Menon, P. S. N. (2020). Essential pediatrics (10th ed.,
pp.56-78 ). CBS Publishers & Distributors.
• Ghai , k. vinod (2024). Essential pediatrics (10 th edition, pp- 22-32
) CBS Publishers & Distributors.
• Sharma Rimple (2018), Paediatric nursing ( 3rd ed., pp. 48-55), Jaypee
Brothers Medical Publishers.
•Thank you
