Child Development
Development is the gaining of skills in all aspects your child's life.
There are different areas of development:
- Movement skills (gross motor) Jump to Section
- Hand skills (fine motor) Jump to Section
- Visual skills (response to what they can see) Jump to Section
- Speech, language and hearing Jump to Section
- Social skills, emotions and behaviour Jump to Section
You may be concerned about your child's development in just one of these areas, more than one, or all of these areas. All children are different and develop at different rates, so there is a range of ages when they learn these skills.
However, there are certain ages by which most children will have developed a certain skill. These are called developmental milestones. If your child has not met their milestone, it may be of concern and it is important to seek advice (please see individual sections for further details).
In the UK, babies and young children are offered routine health and development reviews at the following times:
Please share any concerns and seek advice and help early if:
- You are concerned about the way your child moves, acts, learns, speaks or plays.
- Seek advice urgently if you think that your child has lost skills that they once had (sometimes called regression).
A range of different services and professionals offer help and advice if you are worried about your child's development:
- Health visitor
- Early learning teacher in your child's nursery or your child's childminder.
- GP
You may be referred to different members of the multidisciplinary child development team depending on what your concern is:
- Community Paediatrician - a doctor who specialises in the health and development of children.
- Physiotherapist - a therapist who supports with physical movement skills.
- Occupational therapist - a therapist who supports skills required for activities of daily living and hand skills (fine motor).
- Speech & Language therapist (SALT) - a therapist who supports with speech, language, communication, understanding and safe swallow.
- Dietitian
- Psychologist - a qualified individual who is able to support aspects of your child's learning and behaviour.
- Children & Adolescent Mental Health Services (CAMHS) - services that support children and young people with difficulties with their emotional or behavioural wellbeing.
- Children's social services - can provide additional support for families who have needs beyond healthcare and education needs.
- Local education services - such as Portage (a home visiting educational service) to support preschool children requiring additional support with their developmental skills).
Further information on your child's developmental milestones and routine reviews
General information about child development
The NHS website - NHS (www.nhs.uk)
Movement
Your child's movement skills refer to their control or their head, limbs and body, sitting, crawling, walking, running, jumping and hopping.
The typical sequence of developing these skills as as follows with average ages:
Note: there is a range of normal ages at which children may acquire these skills. Please see following section on when you should be concerned.
The pattern of movement development from being immobile to walking may also vary. Most children achieve walking via crawling (80%), others bottom-shuffle and others commando crawl (with their tummy on the floor), some just stand up and walk.
Bottom shuffling children tend to walk later than those who crawl on all fours.
How can I help?
For your baby:
- Lay your baby on their tummy for short periods daily when they are awake (NOT asleep) and put some toys near them. This helps develop their head, neck and upper body strength.
- As your baby's muscle strength increases, support them to sit up and use toys to encourage them to roll and reach.
- Provide lots of safe space for your baby to move and explore under supervision.
- Support your baby in an upright position on their feet and put them close to things that will encourage them to pull themselves up on safely.
For your toddler/child who is close to or able to walk:
- Provide lots of space for your child to move and explore under supervision.
- Provide toys that your child can push or pull safely and balls for them to kick, roll and throw.
- Encourage your child to run and explore in a safe space - as your child gets older and their confidence grows, this may include supporting them to climb up and down stairs safely, climb on play equipment or ride a bike.
- Note - baby bouncers and walkers do not help your baby learn to balance or walk.
When should I be concerned?
- Delay in learning skills at certain ages e.g. poor head control (not holding their head up) at 4 months; not sitting unsupported by 9 months and/or not walking a few steps independently by 18 months.
- Appears very stiff, with tight muscles.
- Appears very floppy, like a rag doll.
- Moves asymmetrically (unevenly) - one side of their body or arms or legs moves differently or appears weaker than the other side.
- Repetitive jerking, twitching or writhing movements of their body or limbs.
- Walking suddenly becomes very unsteady (having previously been steady), or remains very unsteady within 6 months of learning to walk.
- Only walk on tip toes
Where can I get help?
If you have concerns about your child's movements, speak with your health visitor or GP.
For more information
Hand Skills
Hand and finger skills include your child's ability to grasp, pick up and transfer objects, point, draw, write, get dressed and use cutlery.
The development of these skills also requires good vision, so these skills are considered together - please refer to the section on your child's vision.
What should my child be doing?
The typical sequence of developing these skills is as follow with average ages:
How can I help?
Provide your child with a range of age appropriate toys (such as blocks, crayons, books, puzzles) which encourage your child to use their hands - to reach for toys, hold them, pass them from hand to hand and play and use them)
When should I be concerned?
Delay in gaining key skills by certain ages
- Reaching for objects by 6 months
- Transferring toys from one hand to another by 8 months
- Using a pincer grip (first finger and thumb) to pick up small objects by 12 months.
- Does not use both hands equally when they are younger than 18 months (children should not become right or left handed until they are older than 18 months).
Where can I get help?
If you have any concerns about your child's hand skills, speak with your health visitor or GP.
For more information
Healthier Together - Hand Skills
Vision
Please see the following section for information about signs that may suggest your child has a problem with their vision and what you should do if you are concerned.
When does a child typically develop visual skills?
How can I help?
- Show your baby pictures of faces and colourful books and toys.
- Point out new things to your baby.
- Play peek-a-boo and hide and seek.
When should I be concerned about my baby's vision?
- Not fixing and following moving objects or faces by the age of 3 months.
- Not smiling responsively by 3 months of age.
- Appears to have a squint or unequal movements with their eyes after the age of 3 months (babies younger than this can sometimes appear to squint (eyes turning in)).
- Random or repetitive eye movements. Difficulties with development of fine motor skills may indicate a problem with vision, so please read this section also.
- If at any age you notice a white reflection in the pupil (dark centre circle) of the eye.
Where can I get help?
Speak with your health visitor or GP early if you may have any concerns about your baby's vision or eyes. They can help refer your baby to have a formal eye test.
For more information
Healthier Together - Eye Screening and Tests
Communicating & talking skills
What you need to know:
Communication skills are an essential part of your child's overall development. Your child needs to be able to to hear and understand what is being said to them and then use their verbal language skills to respond. In addition, they will learn to aid their communication using non-verbal skills such as body language, gestures, facial expressions and eye contact.
| Understanding | Language development | How else are they communicating? | |
| Newborns 0-3 months | your 1 month old can hear you and knows your voice | crying and making coo noises | from 6 weeks of age, your baby will startle with a loud noise. They will start to make eye contact with you when you to and feed them. They may smile. |
| Babies 3-12 months | from 6 months of age, they can tell how you are by feeling the tone of your voice and look on your face | In this period they will initially coo and laugh and play with sounds such as babbling (making repetitive sounds): 'ma-ma-ma-ma'. They will do this in a conversational manner where they will take turns with you to 'talk'. From 6 months, your baby will be vocalising tunefully, using different volumes and sounds e.g. ga-brrrr-le-dada-mmmm' From 9 months, they will be making longer sequence of sounds which might sound like normal speech often called jargon. |
From 3 months, your baby will turn their head to a sound and will quieten to a familiar voice. From 6 months your baby will be showing more emotion and copying your sounds, facial expressions and gestures. For example 'raspberries', laughing, squealing, growling and using gestures (e.g. putting their arms up when they want to be carried). |
| Toddlers 1-3 years | Initially, your child will have a better understanding of what is being said to them compared to what they can actually say. Commonly, they will respond to their own name and understand 'no' from 12 months of age. They will then start to understand simple instructions like 'get your shoes' by 18 months. Your child will learn a lot of new words by listening to adults. |
Gradually, their babbling or jargon will start to include real words. At 15 months old, they might be able to say a few words. From 18 months onwards, your child's ability to learn new words explodes to include familiar objects and people, body parts and animal noises. You might have difficulty understanding them initially, especially when they mix babbling with real words, but their speech should start to get clearer from 2 years onwards. By 2 years of age, your toddler might be able to say 'I', 'you' and 'me' and use sentences with 2-3 words e.g. 'Mummy drink'. At 3 years , your child will be able to use sentences of 3-5 words and start asking 'why' to pretty much everything. They will know their name, age and colours. Strangers will probably be able to understand your child most of the time. |
As their language is just developing, they might use a variety of gestures and noises to help their communication, such as: - to ask for something (ey contact pointing) - to let you know what they think (shake head and push spoon away when they have had enough food) - to demonstrate understanding (nod, eye contact etc.) As your child learns to talk, they will start copying how adults talk in conversation. So their voice may go up at the end of a question, or they might start frowning and wagging a finger if they are telling you off. At 3 years old, they will start learning how to take turns when speaking and you might be able to have a chat with them. |
| Preschool 3-5 years | At 3 years of age, they will understand most things you say and will follow instructions with 2-3 steps about familiar things e.g. 'go to your bedroom and get your jumper' By 5 years of age, they will enjoy jokes and riddles. |
At 3 years old, your child might be able to tell a simple story such as what has really happened during the day. Initially they will need help to put thing in the correct order e.g. Child: 'I go to shop' Parent: 'and what did we buy at the shop?' Child: 'bread' Later, as their imagination develops, they will start telling 'made up' stories. By 4 years of age, your child will speak in longer sentences of around 5-6 words. Other people will understand what she/he is saying most of the time. By 5 years of age, they should be talking fluently. They will understand jokes. |
Talk with your child, naming and talking about everything and anything.
From counting out loud, the steps as you walk down the stairs, to telling them what piece of clothing you are folding when you are doing the laundry. Even if you think your child doesn't understand, talking about what is happening in your daily lives will increase the number of words your child hears. Repetition does help.
Build your child's communication skills by:
- Noting and commenting on their interest e.g. 'wow, what is that?'
- Giving them time to respond back to you e.g. pause whilst looking them in the eye.
- Actively listening to what they have to say.
- Model the correct answer. whilst ignoring what was wrong e.g. if they say whilst looking at a bus 'look, bus', you would respond "yes it is a bus"
- Build on what they have said e.g. look it's red bus, what else is red?
- Sing to them
- Start reading to them at an early age. Link the words to the pictures in the book and alson in your own lives. As they get older, pointing to the words as you say them helps them understand the link between written and spoken words to develop their skills in literacy.
For more information
BabyCentre UK - Through the eyes of a child: 2-3 year old
Hearing
NHS - Hearing tests for children
Emotions, Behaviour & Play
What you need to know:
This refers to the development of your child's personality and how they form relationships with people they they interact with. They will mostly learn from this from play and also by watching you and how you interact with people in various situations, e.g. if they see you are angry and shout at them, then they will learn to shout when they are angry, whilst if they see you pause to calm yourself and then try to explain the situation then they will learn to deal with challenging situations in a more positive manner.
What might my child be doing?
| Emotions | Behaviour | Play | |
Newborns 0-3 months |
from 6 weeks of age, your baby will smile back when their main carer smiles at them | Your one month old will know your voice and by 6 weeks of age they will recognise you and respond to your voice and smile | in the early days, your face is the most interesting thing to your baby They might also like looking at toys with contrasting colours e.g. black and white |
| Babies 3-12 months | Your baby is starting to show more emotion and can laugh, smile, show excitement when happy or grimace with frustration when denied what they want. From 9 months old, your baby might show signs of separation anxiety where they might cry when away from their carer and stranger anxiety when they get upset around people they don't know. |
Your baby knows your voice and has a stronger attachment to you. By 6 months, they know other people can also look after them and can recognise and enjoy spending time with them. |
At 6 months they will start to show enjoyment when you play with them e.g. tickling, playing peek-a-boo, singing to them etc. From 6 months your baby will explore objects by reaching to grab them and tasting them. |
| Toddlers 1-3 years | Your toddler is going through a lot of emotions without knowing how to express it. This may come out as tempers tantrums when they don't know how to put into words that they are feeling frustrated, sad, angry etc. | From 2 years old, separation anxiety should settle, as your toddler will understand that you will come back when you leave them. | At 12 months of age your toddler will love to explore their surroundings with you close by, e.g., by crawling towards a cupboard and pulling out all the hidden items in it. From 18 months of age, they might start to do 'pretend play' where they will pretend to drink from a toy cup, or put a phone to their ear and start talking. At 2 years old they will start playing games with other children and having friends. |
| Preschool 3-5 years | At 5 years old, children develop a sense of awareness such as worrying about not being liked and knowing how to be funny in order to make people laugh. | By 4 years old you child might enjoy tricking you such as pretending to be asleep | By 4 years old they understand how to share and take turns and their imagination becomes quite dramatic in their play e.g. playing mums and dads. |
How can I help?
- give your child lots of hugs and kisses to provide your child with a sense of comfort, safety and confidence.
- being nearby when they are trying new things out, to help them develop their independence and self-confidence.
- play together and give them your full attention when doing so by smiling at them, giving eye contact, e.g. messy play, outdoor play, art-based play and roleplay.
- if changing your child's activity is regularly met with protests, try giving successive warnings to your child that an activity is going to stop imminently e.g. 'we are going to turn off the TV in 10 minutes', followed by 'we are going to turn off the TV in 5 minutes/when the cartoon ends'.
- be you child's role model on how you would like them to behave with others e.g. if you have a child who interrupts persistently - be mindful of actively listening to the and allowing them to finish what they want to say before getting your own point across or focusing on something else. If you have a child who snatches - be mindful of asking for things politely and not grabbing things yourself.
- be more aware of how you speak to your child - if you are struggling with a child who says 'no' to everything - try to avoid using the word 'no' yourself and explain in short sentences why you are not giving permission now and when you would reconsider their request. Tell them what you would to do as opposed to telling them what no to do e.g. say 'please use kinds hands' instead of 'don't hit!' or try saying 'please use your quiet voice' instead of 'don't shout!'
- encourage your child's imagination by reading together, telling stories, singing songs etc.
When should I be concerned?
When your baby:
- Cries persistently without you being able to settle them
- Doesn't appear to like cuddles
- Doesn't pay attention to faces
- Doesn't smile back from 6 weeks old
By 2-3 years old, when your toddler:
- Seems to be in their 'own world' with very little interest in their general surroundings
- Can be very particular and infatuated about certain things
- When they persistently and continuously can not listen or pay attention to adults requests/instructions
By 4-5 years old, when your pre-schooler:
- Seems to be in their 'own world' with very little interest in their general surroundings
- Can be very particular and infatuated about certain things
- When they persistently and continuously can not listen or pay attention to adults requests/instructions
By 4-5 years old, when your pre-schooler:
- doesn't look you in the eye to communicate with you
- isn't interested in other children
- doesn't do any pretend or imaginative play
- enjoys obsessive, repetitive things e.g. lining things up, wanders around aimlessly, throws things
- does not have a strong bond with their carers. Things that you may notice could include; not looking for comfort when upset, but will expect you to approach them, not appearing to enjoy praise for doing a good job, not running up to you after a period of separation, when they have routines that are near impossible to break or have purposeless rituals that they must do in order for them not to have a meltdown, etc.
You should be concerned at any age if your child stops doing what they were previously able to do.
Where can I get help?
If you think you are having trouble with your child's behaviour and emotions or finding it difficult to know how to play with them, discuss your concerns with a professional like a health visitor, GP, or a nurse/school teacher who can provide advice and consider what support might be appropriate.
For more information
NHS - Autistic Spectrum Condition (ASC)
Healthier Together - Fussy Eaters, Tantrums and Sleep