SPEECH, LANGUAGE, AND FINE MOTOR DEVELOPMENTAL NORMS

Please refer to the following comprehensive checklists as necessary: 

Charts and Parental Guidance for Developing Speech and Language Skills

OT Developmental Milestone Checklists

SPEECH AND LANGUAGE DEVELOPMENT

0 to 3 months 

• Startles at loud sounds.
• Quiets or smiles when you talk.
• Seems to recognize your voice; quiets if crying.
• Making cooing sounds. 
• Cries change for different needs. 
• Smiles at people. 

4 to 6 months 

• Moves his/her eyes in the direction of the sound. 
• Responds to changes in your tone of voice. 
• Notices toys that make sounds.
• Pays attention to music.
• Coos and babbles when playing alone or with you.
• Makes speech-like babbling sounds, like pa, ba, and mi.
• Giggles and laughs. 
• Makes sounds when happy or upset. 

7 to 12 months 

• Turns and looks in the direction of sounds. 
• Looks when you point. 
• Turns when you call his/her name. 
• Understands words for common items and people - words like cup, truck, juice, and daddy.
• Starts to respond to simple words and phrases, like “No,” “Come here,” and “Want more?” 
• Plays games with you, like peek-a-boo and pat-a-cake.
• Listens to songs and stories for a short time.
• Babbles long strings of sounds like, mimi, upup, or babababa.
• Uses sounds and gestures to get and keep attention. 
• Went to objects and shows them to others. 
• Uses gestures like waving bye, reaching for “up”, and shaking his/her head no.
• Imitates different speech sounds. 
• Says 1 or 2 words, like hi, dog, dada, mama, uh-oh. This will happen around their first birthday, but sounds may not be clear. 

12 to 24 months

• Points to a few body parts when you ask. 
• Follows 1-part directions, like “Roll the ball” or “Kiss the baby”
• Responses to simple questions, like “Who's that?” or “Where's your shoe?” 
• Listens to simple stories, songs, and rhymes.
• Points to pictures in a book when you name them.
• 6Uses a lot of new words. 
• Starts to name pictures in books. 
• Asks questions, like “What’s that?”, “Who’s that?”, and “Where’s kitty?” 
• Puts 2 words together, like “more apple,” “no bed,” and “mommy book.” 

2 Year Olds (24 to 35 months) 

• Follows 2-step directions, like “Get the book and put it on the table.” 
• A child’s expressive vocabulary increases to about 300 words.
• A child understands about 400 words.
• Understands opposite words (go-stop and big-little). 
• A child should be able to tell you his/her name on request. A child should be beginning to understand number concepts, like “Give me one block.”
• Listens to and enjoys hearing stories for longer periods of time. 
• Has a word for almost everything (people, places, things, and actions).
• Uses 2-3 words to talk about and ask for things. 
• Familiar listeners understand your child's speech. 
• Plays pretend or make-believe games. 
• Talks in short conversations. 
• Produces p, b, m, d, n, h, t, k, g, w, ng, f, and y accurately in words (McLeod & Crowe, 2018). 

3 Year Olds (36 to 47 months) 

• Understands words for some colors and shapes.
• Responds when you call from another room.
• Answer simple “who?”, “what?”, “where?”, and “why?” questions. 
• Uses pronouns like I, you, me, we, and they. 
• Uses plural sounds like toys, birds, and buses. 
• A child understands 1,500 to 2,000 words and presents an expressive vocabulary of 1,000 words.
• A child understands complex sentences, like “When we go to the store, we will buy ice cream for a snack.” 
• A child uses past tense markers, pronouns and plurals.
• A child may have disfluencies (the repetition of sounds, syllables, words, or phrases without great effort or the use of unnecessary sounds like “um” or “ah”) in his/her speech. Some children do not go through this stage, but some do. If this happens, know that these disfluencies absent of struggle occur in the normal course of speech development. Please contact us and we’ll be happy to give you suggestions on how to handle it the best way for you and your child.
• A child listens and can be reasoned with verbally.
• Familiar and unfamiliar listeners understand your child's speech. 
• Uses many sentences that have 4 or more words. 
• Talks about what happened during the day. 
• Takes part in circle time or other group activities. 
• Plays with other children. 
• A child categorizes pictures of common objects, identifies colors, understands descriptive words and makes inferences.

4 Year Olds (48 to 59 months) 

• Pays attention to short stories and answer simple questions about them. 
• Understands words that involve sequencing (first, next, last) and time (yesterday, today, tomorrow). 
• Follows classroom directions.
• Names some letters and numbers.
• Says rhyming words. 
• Tell simple stories in a logical order. 
• Communicates easily with other children and adults. 
• Produces l, j, ch, s, v, sh, and z accurately in words (McLeod & Crowe, 2018). 

5 Years Old (60 to 72 months)

• Follows 2-step classroom directions in the sequence given. 
• Listens to and understands short stories read aloud. 
• Understands what is taught in class. 
• Tries new words, can define age-appropriate vocabulary words, and formulate sentences with given words.
• Seeks information through why, what, and how questions.
• Explains the rules of a game or activity to others.
• Retells a story and talks about events. 
• Speaks clearly and is understood in most situations. 
• Understands time/sequence concepts and basic math operations.
• Recites address and phone number.
• Identifies money.
• Understands that words are made up of sounds. 
• Identifies and labels uppercase and lowercase letters. 
• Knows that some words have the same sounds in them like sun, soup, and sand. 
• Recognizes words by sight. 
• Draws a picture that tells a story. Labels and writes about the picture. 
• Participates appropriately in conversations. 
• Produces r, zh, and voiceless and voiced th accurately in words (McLeod & Crowe, 2018).
  

FINE MOTOR SKILL DEVELOPMENT

0 to 2 months

• Has a strong grasp; Opens and closes fists.
• Brings hand to, or near mouth.
• Arm stretch out and hands open.
• Scratches fingers along blanket or clothing.
• Looks toward outstretched hand. 

3 to 5 months

• Holds a toy when placed in hand.
• Uses arms to purposely swing at toys. 
• Brings hand to mouth consistently. 
• Pushes up onto elbows/forearms when on tummy. 

6 months 

• Consistently, purposeful reach using vision to guide movement. 
• Transfers object hand to hand. 
• Finger feeds large foods (e.g. biscuit). 

7 to 9 months 

• Plays using arms (Peek-A-Boo; So Big!). 
• Index finger use to “poke”. 
• Raking cereal with fingers to grasp.
• Purposeful grasp and release of objects into containers. 
• Grasp on thumb side of hand. 

10 to 12 months 

• Grasps with thumb and 2 fingers. 
• Pincer grasp develops; picking up cereal/objects with thumb and index finger. 
• Imitates tool use (e.g. brushing hair, using a toothbrush). 
• Uses hands to push, squeeze, and rotate. 
• Removes socks. 
• Stacks blocks; may not balance them. 

12 to 18 months 

• Removes peg from a pegboard. 
• Puts rings on a ring stand. 
• Scribbles with a crayon using whole hand. 
• Begins to stack small blocks. 
• Turns pages of a book. 
• Self feeds using hands or utensils. 
• Points with index finger. 
• Brings hands to midline for use. 

18 to 24 months

• Stacks 2-6 small blocks. 
• Can turn door knobs. 
• Completes 3 piece puzzle. 
• Starts to snip with scissors. 
• Opens and closes twist-on lids. 
• Can string large beads. 
• Uses spoon. 
• Imitates stroke on paper with whole arm movements. 

3 Year Olds (36 to 47 months) 

• Copies vertical and horizontal lines using thumb and fingers more.
• Cuts paper in half. 
• Beginning to cut in wide lines. 
• Strings beans onto lace. 
• Sorts objects based on color, size, etc. 
• Fastens (and possibly unfastens) large buttons. 

4 Year Olds (48 to 59 months) 

• Copies circle, cross, X, and square using emerging 3 or 4 finger grasp. 
• Fastens and unfastens large buttons. 
• Shows interest in coloring. 
• Cuts along a line. 
• Completes a 4 or 5 piece puzzle. 
• Uses fork correctly. 

Dresses and Undresses (except for fasteners). 

5 Years Old (60 to 72 months)

• Shows hand dominance. 
• Grasps pencil maturely (using 3 or 4 fingers to move utensil with hand rather than with whole arm). 
• Copies a triangle. 
• Cuts out a circle. 
• Can draw a person with several body parts. 
• Colors inside the lines.