Early Child Development

Early Child Development

Accomplishments, Difficulties, and Concerns in the Early Years

As a parent, it may be helpful to know what types of accomplishments and difficulties are expected as part of normal child development. This can help you determine when you may need to be concerned about your child’s mental health. 

The American Academy of Pediatrics recommends that all children get a developmental screening. A developmental screening tells if a child is learning basic skills when they should be. When a developmental problem is recognized early, children can get the help they need to grow, learn, and reach their full potential.

Developmental Screenings

During the developmental screening, your child’s pediatrician carefully watches as your child plays, talks, moves, and interacts with others.

Although every child is different, the information below explains what can generally be expected for your child from birth to age five.

Birth to Six Months

Children are working hard to observe and interact with their world. They are learning to comfort themselves, sleep at regular times, let their caregivers know when they need something and adjust to family routines.

Accomplishments

By six months, most children:

  • Sleep through the night
  • Have regular daily schedules
  • Roll over
  • Sit with help
  • Reach for items out of reach
  • Babble and coo
  • Support themselves on their legs with help
  • Look for dropped objects
  • Eat cereals and strained foods
  • Show strong interest in others, particularly their caregivers
Expected Difficulties
  • Common illnesses, such as colds or fevers that upset sleep schedules
  • Crying
  • Irregularities in development in different areas
  • Sibling jealousy
Possible Concerns
  • Medical illnesses
  • Infant colic
  • Not growing or gaining weight as expected
  • Not making any sounds or babbling
  • Significant delays in motor development

Six to Twelve Months

Children are exploring their world through movement, while still paying close attention to their caregivers’ whereabouts. Children have established sleeping, eating, and play time routines, and have begun to show their personalities.

Accomplishments

By twelve months, most children:

  • Walk holding on to furniture
  • Pull to a standing position
  • Play simple games (for example, peek-a-boo or patty-cake)
  • Wave bye-bye
  • Say small words (for example, mamma, dada, juice, or baba)
  • Show interest in books
  • Scribble with a crayon
  • Respond to simple commands or requests
  • Can sip from a cup with a lid
  • Can pick up small objects easily
Expected Difficulties
  • Minor interruptions in sleep schedules due to common illnesses or teething
  • Minor bumps and bruises because of greater activity
  • More separation fears, particularly separation from primary caregivers
  • More interested in activity than food
  • Fussiness related to food choices
  • Messy eating
  • Acting out when objects are taken away
Possible Concerns
  • Accidents that cause serious injury
  • Significant delays in development, such as:
    • Lack of verbal activity
    • Inability to sit without help
    • Inability to support themselves on their legs with help
    • Extreme disinterest in social interactions
  • Lots of feeding problems, resulting in poor growth

Twelve Months to Three Years

Children’s language, movement, and independence are growing rapidly during this time. They are typically very knowledgeable and demanding of their wants and needs.

Accomplishments

By three years, most children:

  • Speak and are understood most of the time
  • Can carry on a simple conversation
  • Help dress themselves (for example, pull up their own pants or put on their own shirt)
  • Feed themselves without help
  • Show their preferences for friends and activities
  • Can throw a ball and participate in simple games
  • Jump, run, and climb on play equipment
  • Participate in activities with other children for short periods of time
  • Draw simple shapes
  • Play by themselves for short periods of time
  • Have begun toilet training
Expected Difficulties
  • Interruptions in sleep schedules, due to common illnesses, teething, vacations, etc.
  • Tantrums that occur at embarrassing times for parents (for example, when in public or when with in-laws)
  • Occasional hyperactivity and distractibility
  • Minor aggressive behavior, particularly when the child is frustrated
  • Minor disrespect to parents or other adults
  • Messy eating
  • Picky eating
  • Occasional irritability and arguing, particularly when tired or hungry
  • Not wanting to use the toilet
  • Occasional toileting accidents
  • Stuttering
Possible Concerns
  • Significant delays in development, such as:
    • Limited verbal ability
    • Excessive tantrums involving self-injurious behaviors
    • Extreme disinterest in social interactions
    • Excessive activity placing the child at risk for injury

Three to Five Years

Children are moving away from being completely focused on themselves and moving more towards playing with others. As they show their independence and explore their surroundings, they are also dependent and rely on the safety of a “home base.” Their sometimes-challenging behavior is a result of exploring boundaries and developing relationships with other children.

Accomplishments

By five years, most children:

  • Have begun some form of formal education
  • Show interest in academic skills (for example, writing their own name, recognizing letters, or counting)
  • Speak fluently
  • Have some friends
  • Participate in family routines
  • Become occupied with imaginary play
  • Can run, jump, throw a ball, and climb play equipment easily
  • Use words to control their own behaviors and the behaviors of others
  • Show concerns about issues related to injury, loss, or death
  • Show that they care about others' feelings
Expected Difficulties
  • Arguing in an effort to influence parents and others
  • Bedtime struggles
  • Minor fears
  • Times of high energy and activity level
  • Not paying attention, particularly during activities that they do not like to do
  • Sibling arguments
  • Not listening to parents
  • Lying from time to time, particularly to get out of trouble
  • Occasional crying or angry outbursts associated with frustration or disappointment
Possible Concerns
  • Significant delays in development, such as:
    • Delayed language development
    • Persistently poor peer relationships
    • Poor coordination
  • Inability to form friendships
  • Persistent aggression
  • Self-injurious behaviors
  • Persistent disobedience and rebelliousness
  • Fears that result in the avoidance of age-appropriate activities (for example, school or friendships)
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