2 months: social smile and lifts head; 4 months: rolls; 6 months: sits with support and transfers objects.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A 4-month-old infant cannot hold their head up and shows no social smile. The nurse recognizes this as:
Answer: B. Failing to achieve expected milestones (head control and social smile by ~2–4 months) is a developmental red flag warranting evaluation, not normal variation to ignore.
Question 2 of 5
A parent reports that their child can build a tower of two cubes, walks well, and uses about 10 words. Which age is most consistent with these findings?
Answer: B. Walking well, a two-cube tower, and roughly 10 words are classic 12- to 15-month milestones. A 6-month-old cannot walk, an 18-month-old typically stacks 3 to 4 cubes with more words, and a 3-year-old has far more advanced language and motor skills.
Question 3 of 5
A nurse is discussing toilet training readiness with the parent of a toddler. Which sign best indicates the child is developmentally ready to begin toilet training?
Answer: A. Readiness for toilet training is signaled by physiologic and developmental cues such as staying dry for about 2 hours, recognizing the urge to void or defecate, and being able to follow simple directions, usually around 18 to 24 months. Chronologic age alone, parental convenience, and sibling status are not reliable readiness indicators.
Question 4 of 5
A 9-month-old infant is at a well-child visit. Which is an expected developmental finding?
Answer: B. By ~9 months: sits without support, has a pincer grasp developing, pulls to stand, shows stranger anxiety, and may crawl. Walking independently (~12 months) and running (~2 years) come later.
Question 5 of 5
Which developmental milestone is expected of a typical 12-month-old?
Answer: B. At ~12 months, infants take first steps, say one to two words, and use a pincer grasp. Running and 2-word phrases come around age 2.
Keep the streak going with more questions like these, each with a full rationale.
What is developmental milestones by age?
They screen for normal development and detect delays early. Development proceeds cephalocaudal (head to toe) and proximodistal (center to periphery).
Key points to remember
- 2 months: social smile and lifts head; 4 months: rolls; 6 months: sits with support and transfers objects.
- 9 months: sits unsupported and crawls; 10 months: pincer grasp; 12 months: stands, says first words, walks with help.
- 15 months: walks independently; 2 years: runs, climbs stairs, and uses 2-word phrases.
- By age 2 a child should know about 50 words; by age 3 speech is mostly understandable to strangers.
- Birth weight doubles by about 5-6 months and triples by 12 months.
- The posterior fontanel closes by 2-3 months; the anterior fontanel closes by 12-18 months.
- Toddlers (1–3 years) show autonomy, parallel play, negativism and rituals; readiness for toilet training usually comes around age 2–3.
- Preschoolers (3–5 years) play together (associative play), use magical thinking and ask many questions; by 4 they hop and use scissors.
- School-age children (6–12 years) value rules, cooperative play and accomplishment, building a sense of industry.
Nursing priorities
- Use a standardized tool to screen development at well-child visits and plot growth.
- Assess head circumference, weight, length, and fontanels at each infant visit.
- Counsel parents on age-appropriate stimulation, play, and safety.
- Refer for early intervention promptly when a delay or red-flag finding is identified.
Labs & values
Patient teaching
- Provide tummy time while awake and always place infants on their back to sleep.
- Read and talk to children daily to support language; limit screen time in young children.
- Keep all well-child visits so growth and development can be tracked over time.
Red flags: report now
- No social smile by 3 months, not sitting by 9 months, or not walking by 18 months requires evaluation.
- Loss of previously acquired skills (regression) is reported and evaluated for a neurologic cause.
- A bulging fontanel (increased intracranial pressure) or a sunken fontanel (dehydration) is reported now.
- No words by 16 months or no two-word phrases by 2 years suggests a language delay that needs follow-up.
References
Clinical references for this topic
