Child Development: Is My Child Normal?

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Mom and Baby The number one reason that parents contact myself and the various therapists at North Shore Pediatric Therapy is to find out whether or not their children are developing and progressing at a normal rate. When should my child crawl? When should she start speaking? At what age should he be walking? These are all questions that we find ourselves answering on a daily basis. Parents often are not privy to this information. If only children would come with an instruction manual. Each child develops at a different rate, which is found to be dependent upon several factors including environmental influence (exposure to a variety of experiences) to genetic predisposition. That being said, there are stages of development that every child will reach in a hierarchical order. The main areas of development include a child’s motor ability and his or her language functioning. Language functioning can then be broken down into two main areas: receptive language, which is the child’s ability to listen to and follow auditory demands, and expressive language, which is the ability to provide comprehensive responses. Below is a chart for the major stages of motor and language development along with typical ages in which the child should reach the stage.

Motor Development

Motor Skill

Expected Age of Achievement

Head erect and steady when held

Six weeks

Lifts self up by arms when prone

Two months

Rolls from side to side

Two months

Rolls from back to side

Four months

Sits alone

Seven months

Crawls

Seven months

Stands alone

Eleven months

Walks without assistance

Twelve months

Walks up stairs with assistance

Sixteen months

Jumps up and down

Twenty three months

 Language Development

 Receptive Language (listening and responding to information)

Age of Child

Speech/Language Behavior Observed

 
Zero to three months    Turns head to caregiver and smiles when spoken to  
Four to six months    Responds to word “no” and responds to changes with tone of voice   
Seven to twelve months    Listens when spoken to, recognizes names of objects, first word 
Two to three years    Understand two part commands and understand contrasting words   
Three to five years    Understand most of what they hear  
 
 
 Expressive Language (communicating needs and wants)

Age of Child

Speech/Language Behavior Observed

 
Zero to three months    Make sounds indicating pleasure, cry differently to express needs   
Three to six months    Laugh, babble, mimic sounds  
Nine to twelve months   First words, repeat sounds, use most consonant and vowel sounds   
Twelve to fifteen months    Gesture and speak ‘no’, ask for help with gestures and sounds  
Fifteen to eighteen months    Use 10-20 words, 20-25 percent of speech is intelligible by others  
Eighteen to twenty four months    Use three word sentences, 50-70 percent of speech is intelligible  
Two to three years    400 word vocabulary, word for almost everything, answer “what” questions   
Three to four year olds    900-1000 word vocabulary, use pronouns correctly, use three to six word sentences   
Four to five years old    1,500-2,500 word vocabulary, use six to eight word sentences   
 
The above charts are what we know to be the stages of development with regard to children’s receptive and expressive language and motor functioning. Typically, children will reach the target behaviors within the ages given. However, development is variable for many children and not every child will reach the various stages at the same time.
 If your child is not demonstrating the motor or language behaviors that should be present at his or her age, there are several things you should do. First, do not panic. Ask your pediatrician about your concerns. If you continue to have concerns, have an evaluation by a psychologist, occupational therapist, or speech/language therapist in order to determine if there are possible delays and what type of therapy may be warranted. A lot of parents ask me: won’t my child develop those skills eventually? Many children may often “catch up” with their development; however, the concern would be at what cost? How did the child’s delays impact him or her socially or emotionally? What was the impact with his or her academic performance? Parents often know instinctually when there is something atypical about their child. If you are watching other children at the playground or at play-dates doing things that your child is not (that you feel they should be) and you have any concern at all, it can’t hurt to ask a professional. Be proactive! Do not wait until it is too late to get the assistance your child needs most. Research has shown that the earlier intervention is applied, the more successful it can be. The goal of the therapies would be to ensure the child reaches his or her potential with no long term consequences.
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