DEVELOPMENTAL MILESTONES

0-3 MONTHS • Child looks at caregiver’s face while being held • Child grips caregiver’s finger when it’s placed in his or her hand • Child nurses or drinks a bottle without milk leaking out from around his or her mouth • Child is able to be soothed by primary caregiver when all basic needs have been met (child is fed, has a dry diaper, and is not in pain) RED FLAGS (should be brought to the attention of your doctor): • Child’s eyes do not focus on caregiver’s face when he or she is held 3-6 MONTHS • Child tracks a nearby moving object (such as a toy or book) with his or her eyes • Child brings hands together at the middle of his or her body • Child reaches for a toy with his or her arm and hand • Child becomes visibly excited and/or may open his or her mouth in anticipation when he or she sees bottle, breast, or food RED FLAGS (should be brought to the attention of your doctor): • Child does not bring his or her hands together at the middle of his or her body 6-9 MONTHS • Child uses all of his or her fingers to pick up a small piece of food (such as a Cheerio, Puff, etc.) to place it in his or her mouth during a meal or snack • Child releases a held toy or piece of food on purpose • Child shows affection or excitement at seeing a familiar person • Child responds to his or her own name by looking in the direction of the person who called him or her RED FLAGS (should be brought to the attention of your doctor): • Child does not use both arms or hands equally (i.e. has a preferred arm or hand) 9-12 MONTHS • Child puts objects in a container (such as an open shape sorter or toy box) during play • Child uses his or her pointer finger to point toward desired items or to interact with a toy • Child plays with a toy with both hands (such as using both hands to place a ring on a ring stacker, holding both sides of an open book, etc.) • Child feeds himself or herself almost all solid foods during snack or meal • Child plays simple social games with caregiver (such as peek-a-boo) RED FLAGS (should be brought to the attention of your doctor): • Child does not turn to look when his or her name is said (name may be repeated once or twice)

12-18 MONTHS • Child picks up small objects using his or her thumb and pointer finger • Child stacks 2-3 blocks during play after caregiver demonstration • Child drinks from a straw cup instead of a bottle during meals • Child follows simple 1-step instructions (such as “come here,” “get down,” “hand me that,” etc.) RED FLAGS (should be brought to the attention of your doctor): • Child does not attempt to pick up small pieces of food to feed himself or herself 18-24 MONTHS • Child holds a utensil (i.e. spoon, marker, chalk) with whole hand • Child attempts to scribble directly on an image instead of all over the page after caregiver demonstration • Child uses both hands to pull apart toys (such as pop beads, Duplo Legos, etc.) • Child dips a spoon into a thick, sticky food (such as yogurt, oatmeal, etc.) and places the spoon in his or her mouth • Child mimics actions he or she regularly sees from caregivers (such as putting a baby doll in bed, holding a toy phone up to his or her ear, etc.) during play RED FLAGS (should be brought to the attention of your doctor): • Child does not appear to understand or follow simple 1-step instructions • Child is not willing to try unfamiliar foods due to specific, consistent preferences related to foods’ texture, flavor, smell, or temperature

• Child holds a utensil (i.e. spoon, marker, chalk) with his or her thumb and 2-4 additional fingers • Child snips along the edge of a piece of paper with scissors following caregiver demonstration and with supervision for safety • Child draws circular scribbles on paper after caregiver demonstration • Child begins and may master toilet training, but continues to need assistance to wipe thoroughly • Child engages in make-believe play (such as pretending a plastic banana is a toy phone, placing blocks in a bowl to stir his or her “food,” etc.) RED FLAGS (should be brought to the attention of your doctor): • Child melts down when it’s time to transition to a new activity, place, or person • Child is not willing to try unfamiliar foods due to specific, consistent preferences related to foods’ texture, flavor, smell, or temperature

• Child holds a utensil (i.e. spoon, marker, chalk) with his or her thumb and 2-3 additional fingers • Child draws the shape of a cross on paper after caregiver demonstration • Child completes a 4-6 piece interlocking puzzle • Child dresses himself or herself with assistance for fasteners and correct orientation (identifying which side is the front/back and top/bottom) • Child creates pretend play schemes where he or she takes on the role of a character (such as he is a firefighter putting out a pretend fire, she is a teacher showing her students what to do, etc.) RED FLAGS (should be brought to the attention of your doctor): • Child is unable to sequence through familiar dressing and grooming (i.e. tooth brushing, hand washing, etc.) tasks without step-by-step instructions • Child is not willing to try unfamiliar foods due to specific, consistent preferences related to foods’ texture, flavor, smell, or temperature

• Child consistently uses one dominant hand during drawing, coloring, eating, and other functional activities • Child copies the letters of his or her first name with good accuracy • Child cuts out simple shapes, managing paper and scissors independently and with supervision for safety • Child dresses himself or herself, including managing buttons, snaps, and zippers • Child collaborates with peers to create elaborate play scheme or game RED FLAGS (should be brought to the attention of your doctor): • Child hasn’t chosen a dominant hand or frequently switches back and forth between hands during coloring activities, drawing tasks, or meals • Child is not willing to try unfamiliar foods due to specific, consistent preferences related to foods’ texture, flavor, smell, or temperature

• Child uses his or her thumb, pointer finger, and middle finger to hold and use a writing utensil throughout a writing, coloring, or drawing activity • Child draws a recognizable person with at least 8 features • Child writes all uppercase and lowercase letters of the alphabet legibly • Child ties his or her shoes independently • Child can ask a peer to use a toy, and then wait for up to 5 minutes for his or her turn without becoming upset RED FLAGS (should be brought to the attention of your doctor): • Child has difficulty making and keeping friends

• Child sits to complete a 30 minute tabletop task (not involving a screen - tablet, phone, etc.) without cues to attend to activity or remain seated • Child can remember and complete a 5-6 step sequence to get ready for the day • Child can resolve a conflict with a peer without adult intervention RED FLAGS (should be brought to the attention of your doctor): • Child is unable to tie his or her own shoes • Child’s handwriting is much more difficult to read than his or her peers’ at the end of kindergarten

• Child writes all letters accurately, with no reversals • Child can read and complete tasks on a list (such as to complete homework assignments, simple chores, etc.) • Child can prepare himself or herself a simple 2-3 step snack (such as a peanut butter sandwich, cereal, etc.) and complete clean up independently RED FLAGS (should be brought to the attention of your doctor): • Child continues to reverse some letters (such as b/d, p/q) at end of 2nd grade

• Child writes all letters accurately, with no reversals • Child can read and complete tasks on a list (such as to complete homework assignments, simple chores, etc.) • Child can prepare himself or herself a simple 2-3 step snack (such as a peanut butter sandwich, cereal, etc.) and complete clean up independently RED FLAGS (should be brought to the attention of your doctor): • Child continues to reverse some letters (such as b/d, p/q) at end of 2nd grade

• Child sits to complete a 60 minute tabletop task (not involving a screen - tablet, phone, etc.) without cues to attend to activity or remain seated • Child can read the instructions and safely prepare a simple meal or snack using the microwave (such as Easy Mac, chicken nuggets, TV dinner, etc.) as well as complete clean up following RED FLAGS (should be brought to the attention of your doctor): • Child needs parent to continue to supervise the thoroughness of dressing and other self-care activities (i.e. bathing and drying off, tooth brushing, hair brushing, hand washing and drying)

• Child sits to complete a 60 minute tabletop task (not involving a screen - tablet, phone, etc.) without cues to attend to activity or remain seated • Child can read the instructions and safely prepare a simple meal or snack using the microwave (such as Easy Mac, chicken nuggets, TV dinner, etc.) as well as complete clean up following RED FLAGS (should be brought to the attention of your doctor): • Child needs parent to continue to supervise the thoroughness of dressing and other self-care activities (i.e. bathing and drying off, tooth brushing, hair brushing, hand washing and drying)

• Child can prepare a shopping list in order to purchase items needed for a meal using a recipe, a craft based on the given instructions, etc. • Child gathers all needed items to take to school and places them in his or her backpack • Child is able to cook simple dishes using the stove or oven safely (such as browning ground beef for spaghetti, boiling pasta, etc), but may occasionally have questions to ensure correct sequencing and/or safety RED FLAGS (should be brought to the attention of your doctor): • Child frequently forgets to complete school assignments or does not receive credit for completed assignments because he or she does not remember to turn them in, put his or her name on the paper, etc.

• Child can prepare a shopping list in order to purchase items needed for a meal using a recipe, a craft based on the given instructions, etc. • Child gathers all needed items to take to school and places them in his or her backpack • Child is able to cook simple dishes using the stove or oven safely (such as browning ground beef for spaghetti, boiling pasta, etc), but may occasionally have questions to ensure correct sequencing and/or safety RED FLAGS (should be brought to the attention of your doctor): • Child frequently forgets to complete school assignments or does not receive credit for completed assignments because he or she does not remember to turn them in, put his or her name on the paper, etc.

• Child completes basic household chores (such as sweeping, mopping, wiping counters, washing dishes, etc.), but may still have occasional questions about correct products to use or where some things are stored • Child initiates and completes tasks that last 60-90 minutes • Child uses money and makes correct change when shopping in a store RED FLAGS (should be brought to the attention of your doctor): • Child has poor awareness of how his or her choices may be impacting himself or herself as well as others at times (such as staying up too late playing video games may lead to fatigue and a lower test score the next day, gossiping about one’s friends may lead to difficulty maintaining friendships, etc.). Disclaimer: These choices may still occur from time to time, but a typical 13-14 year old should be able to identify the cause of the unwanted consequence.

• Child completes basic household chores (such as sweeping, mopping, wiping counters, washing dishes, etc.), but may still have occasional questions about correct products to use or where some things are stored • Child initiates and completes tasks that last 60-90 minutes • Child uses money and makes correct change when shopping in a store RED FLAGS (should be brought to the attention of your doctor): • Child has poor awareness of how his or her choices may be impacting himself or herself as well as others at times (such as staying up too late playing video games may lead to fatigue and a lower test score the next day, gossiping about one’s friends may lead to difficulty maintaining friendships, etc.). Disclaimer: These choices may still occur from time to time, but a typical 13-14 year old should be able to identify the cause of the unwanted consequence.

• Child is trusted to take care of a younger sibling or family member for short periods of time as he or she demonstrates good safety awareness, forethought of potential needs, and can carry out the younger child’s schedule reliably as requested by the primary caregiver • Child completes all advanced self-care tasks (identifying if clothing is clean and seasonally appropriate for the day, if clothing needs to be ironed, flossing teeth, etc.) and many household tasks (sweeping prior to mopping, cleaning the bathroom with the correct products, laundering all clothing, etc.) RED FLAGS (should be brought to the attention of your doctor): • Child is not able to make purchases in a store from a list of needed items, and/or he or she is not able to keep his or her purchases within a given amount or budget.

• Child is trusted to take care of a younger sibling or family member for short periods of time as he or she demonstrates good safety awareness, forethought of potential needs, and can carry out the younger child’s schedule reliably as requested by the primary caregiver • Child completes all advanced self-care tasks (identifying if clothing is clean and seasonally appropriate for the day, if clothing needs to be ironed, flossing teeth, etc.) and many household tasks (sweeping prior to mopping, cleaning the bathroom with the correct products, laundering all clothing, etc.) RED FLAGS (should be brought to the attention of your doctor): • Child is not able to make purchases in a store from a list of needed items, and/or he or she is not able to keep his or her purchases within a given amount or budget.

• Child completes all advanced self-care tasks (identifying if clothing is clean and seasonally appropriate for the day, if clothing needs to be ironed, flossing teeth, etc.) and advanced household tasks (such as planning, shopping for, and cooking a meal; identifying when certain chores need to be completed that may be outside of his or her usual responsibilities; etc.) • Child problem-solves independently through complex scenarios and involves the correct people as appropriate (such as child knows to contact parents, police, and insurance company and can initiate these steps if he or she is involved in a car accident, etc.) RED FLAGS (should be brought to the attention of your doctor): • Child is not independent in planning for and executing all advanced daily tasks required for success at home, school, work, and meaningful community engagement