Charting Your Child's Healthy Development

The following charts describe many of the things your baby is learning between birth and 3 years, and what you can do to support your child in all areas of his development.  As you read, remember that children develop at their own pace and in their own way.  Understanding who your child is, what his strengths are and where he needs more support, is essential for promoting his healthy development.  If you have questions regarding your child's development, ask your health care provider.


0 to 2 Months

What's going on:

What you can do:

Questions to ask yourself:

One of the most important tasks of the first 2 months is to help newborns feel comfortable in their new world. They are learning to regulate their eating and sleeping patterns and their emotions, which help them feel content, safe and secure.

• Observe carefully.  This will help you figure out what your baby's cries are telling you.

• Soothe your baby.  When you respond to your baby's cries and meet his needs, you let him know he is loved. You can't spoil a baby. In fact, by responding lovingly to his needs, you are helping him learn skills now that allow him eventually to soothe himself. You are also promoting a strong bond and healthy brain development.

• What soothes your baby? How do you know?

• What most distresses him?

Newborns use their gestures (body movements), sounds and facial expressions to communicate their feelings and needs from day 1. They use different cries to let you know they are hungry, tired or bored. They ask for a break by looking away, arching their backs, frowning or crying. They socialize with you by watching your face and exchanging looks.

• Figure out what your baby is trying to tell you. Responding makes him feel important and tells him he is a good communicator. This builds a positive sense of self and a desire to communicate more.

• Talk and sing to your baby. Tell him about everything that's going on around him. Pay attention to the sights and sounds he likes. Find toys and everyday objects with different colors and textures and see which he likes best.

• How does your baby communicate with you?

• What kinds of interactions does he like best? How do you know?

• How does he let you know when he's had enough?

Even as newborns, babies can play in many ways. They can connect sounds with their sources, and love when you talk and sing to them. Play helps babies learn about the world around them. It is also an important way they connect with you, helping them to develop a strong attachment and promoting healthy social development.

• Offer your baby lots of different objects for him to look at, touch and even grip in his palms. He can focus best on things that are 8 to 12 inches away.

• Play "tracking" games by moving yourself and interesting objects back and forth. Eventually he will move his head from side to side. This helps strengthen his neck muscles as well as exercise his visual abilities.

• What experience does your baby seem to like best? (For example, talking with him; looking at toys or other objects; hearing the cat "meow.")

• What kind of toys grab your baby's attention? How does he let you know what he's interested in?

• What kind of play do you enjoy most with your baby?

2 to 6 months

What's going on:

What you can do:

Questions to ask yourself:

Babies are very interactive at this age. They use their new language and communication skills as they smile and coo back and forth, and enjoy babbling, starting with "ohs" and "ahs" and progressing to P's, M's, B's and D's. Your baby may babble and then pause, waiting for you to respond. They also love to imitate, which helps them learn new skills. For example, mom sticks out her tongue, baby imitates and mom does it again. This also teaches them about the back and forth of conversation.

• When your baby babbles, both talk and babble back, as if you both understand every word. These early conversations will teach her hundreds of words before she can actually speak any of them.

• Engage in back-and-forth interactions with gestures. For example, hold out an interesting object, encourage your baby to reach for it and then signal her to give it back. Keep this going as long as your baby seems to enjoy it.

• How does your baby let you know what she wants and how she's feeling?

• How do you and your baby enjoy communicating with each other? What do you say or do that gets the biggest reaction from her?

Babies this age love to explore. They learn from looking at, holding and putting their mouths on different objects. At about 3 months, babies begin to reach for things and try to hold them. Make sure all objects are safe. A toy or anything else you give her shouldn't fit entirely in her mouth.

• Introduce one toy at a time so your baby can focus on, and explore, each one. Good choices include a small rattle with a handle, a rubber ring, a soft doll and a board book with pictures.

• Lay your baby on her back and hold brightly colored toys over her chest within her reach. She'll love reaching up and pulling them close. You will start to see what most interests her.

• What kind of toys or objects does your baby seem most interested in? How do you know?

• How do you and your baby most enjoy playing together? Why?

Babies have greater control over their bodies. By 4 to 6 months, they may be able to roll both ways, becoming better at reaching and grasping and will begin to sit with assistance. They also begin wanting to explore their food and help feed themselves. Touching and tasting different foods is good for learning and for building self-confidence.

• Place your baby in different positions—on her back, stomach, and sitting with support. Each gives her a different view and a chance to move and explore in different ways.

• Let your baby play with your fingers and explore the bottle or breast during feedings. As she grows, let her handle finger foods and help hold the spoon.

• How does your baby use hr body to explore? Which positions does she like the best and least?

• How would you describe your baby's activity level? Does she like/need to move around a lot or is she more laid-back?

6 to 9 months

What's going on:

What you can do:

Questions to ask yourself:

Babies this age are big communicators. They use many sounds, gestures and facial expressions to communicate what they want. Their actions are their communications. They may be starting to put consonants and vowels together to form words like "dada" and "mama."

• Talk a lot with your baby. For example, label and narrate. "You're eating a big banana!" Give her time to respond.

• Respond to her communications. See how long you can keep a back-and-forth conversation going. For example, she makes a sound, you imitate it, she makes another sound and so on.

• How does your baby let you know what she wants; what she's feeling and thinking?

• What, if anything, do you find frustrating about understanding your baby's communications? Why?

As her brain grows, your baby will start to imitate others, especially you. This leads to the development of lots of new skills. Babies this age can also use toys in more complex ways. For example, instead of just holding a plastic cup, a baby this age may use it to pour water in the bathtub.

• Give your baby time to take in what you did and then copy you. Push a button on the jack-in-the-box, then wait for your baby to do it before you dot it again. This teaches your baby cause and effect. Seeing that she can make things happen builds her self-confidence and makes her want to take on new challenges.

• Provide a variety of safe toys for the bath—containers, rubber toys, plastic bath books, plastic ladles. These will encourage your baby to explore and experiment with different ways to use objects. Of course, never leave your baby alone in the bath.

• How have you seen your baby imitate?

• What kind of play does your baby most enjoy? What does this tell you about her?

Babies' motor skills are advancing by leaps and bounds at this stage. But all babies grow at their own rate. Many babies at this age can roll over both ways, scoot, crawl and even stand. Their motor skills allow them to make the ideas in their head happen, for example, getting the ball that rolled away.

• Encourage your baby to use her body to get what she wants. If she's showing you with her sounds and gestures that she wants the toy that is out of reach, don't just get it for her. Help her get it for herself by bringing it close enough for her to grab. This builds her confidence.

• Create an environment that is safe for exploration. Make sure only safe objects are within your baby's grasp, and that anything she might use to pull herself up to her feet is sturdy and fastened down to the floor or wall. This kind of baby-proofing of your house also will reduce conflicts between you and your baby.

• How does your baby sue her body—to explore, to express her feelings?

• What do you need to do to make your home safer for your "little explorer?"

9 to 12 months

What's going on:

What you can do:

Questions to ask yourself:

Babies this age are very good at expressing their feelings with their gestures, sounds and facial expressions. They can engage in "conversations," for example, handing things back and forth to you, imitating each other's sounds and actions. They also understand "cause and effect"—that they can make something happen: "if I cry, Mom will come."

• Help your baby handle her feelings. Comfort her when she cries, acknowledge when she's frustrated and help her calm down and try again. This helps your child manage her very strong feelings and develop self-control.

• Engage in "circles" of communication with your baby. Keep it going as long as she's engaged. If she reaches for a book, ask "Do you want that book?" Wait until she responds, and then hand it to her. See what she does with it and join her without taking over. These "conversations" help boost her overall development—social, emotional, language, intellectual and even motor.

• How would you describe your baby's personality? In what ways are you and your baby alike and different?

• How does your baby let you know what she wants; what she's thinking and feeling?

Thanks to their new memory skills, babies this age know that when you leave, you still exist. This is a very important skill, but can lead to difficulty when leaving. This is why babies often protest at bedtime and cry out for you in the middle of the night. They try to get you to dome back by gesturing, crying and calling out.

• Play hide-and-seek games like peek-a-boo. Disappearing and reappearing games like this help your baby learn to cope with separation and feel secure that you always come back.

• Be positive when leaving her. Go to her at night to reassure her you are still there but don't pick her up and rock her back to sleep. Falling asleep in your arms makes it more difficult to soothe herself back to sleep if she wakes up again at night. When saying "goodbye," tell her you will miss her, but that you will return. Make sure she has something that gives her comfort, like her "blankie" or favorite stuffed toy.

• How does your baby handle it when you leave? What makes it easier?

• What's hardest for you about being away from your child? Being aware of your own feelings is very important.

Babies this age doe things over and over again because that's the way they figure out how things work, and doing things repeatedly builds their self-confidence. It also strengthens the connections in their brains. Their ability to move in new ways (crawl, stand, even walk) makes it easier to explore and helps them make new discoveries, such as finding their favorite book under the chair.

• Be your child's learning partner and coach. Observe her closely to see what she can do. Then help her take the next step. For example, encourage her to  put one more block on her tower or to try and fit the cube into a different hole.

• Follow your child's lead. The more she directs the play, the more invested she is and the more she will learn.

• What are your baby's favorite activities? What does this tell you about her?

• What does your baby do well? What does she find challenging? How can you be a partner in helping her face these challenges?

12 to 18 months

What's going on:

What you can do:

Questions to ask yourself:

Toddlers are great communicators. They are learning new words every day, and use them, along with their gestures, to let you know what they are thinking and feeling. For example, they take your hand, walk you to the shelf and point to what they want and say, "Book."

Toddlers understand a lot more than they can say. By 12 months they will probably follow a 1-step instruction such as "Go get your shoes." By 18 months they will likely follow 2- and even 3-step directions.

• Encourage your child to use his words, sounds and gestures to communicate, even if you think you know what he wants.

• Play games that include instructions and see how many he can follow.

• Read with your toddler. It helps him learn new words and concepts. It also helps him develop a love of books and reading.

• How does your child communicate what he wants; what he's thinking and feeling?

• How does your child like to read with you? What are his favorite books?

Toddlers are beginning to do pretend play, a major developmental milestone. They continue to imitate what they see around them, for example, using a child-size broom to sweep the floor. But now, they are beginning to understand symbols and ideas—not just concrete things they can see and feel. For example, they begin to use objects in new and creative ways. A spoon can become an airplane or a toothbrush. Pretend play helps develop important intellectual skills and creativity.

• Offer toys that represent objects in your toddler's world, such as a play kitchen with plastic food, a mini-grocery cart or a toy telephone. Join in his play; help him develop his own stories by letting him be the director.

• Give your child different objects and watch the many ways he uses them.

• What kind of play does your child enjoy most? How do you see him pretending?

• What kind of play do you most/least enjoy with your toddler? Why?

During this stage of development, toddlers' motor skills are taking off. They begin to walk and run, which opens up a whole new world of exploration for them, and a whole new world of watchfulness for you. As you try to keep your toddler safe, remember that while they understand "Stop!" or "Don't touch!" they don't have the impulse control yet to stop themselves the next time the temptation appears. Since they are better at doing things rather than stopping what they are doing, "Walk slowly" works better than "Don't run."

• Create lots of low, safe places in your home where your child can crawl under furniture, cruise around a coffee table or stand on his own. Help a child who's walked up the stairs to get down safely.

• Think of ways to divert your child away from a forbidden object so you don't have to say "no" all day long. If he's fixated on the TV remote, maybe a toy with buttons and twisty knobs could be a substitute.

• How does your child use his motor skills? Is he a very active child who uses his whole body, or des he prefer to explore with his finders and hands?

• How is your child's need for physical activity the same or different from yours? How does this affect you and your relationship with your child?

18 to 24 months

What's going on:

What you can do:

Questions to ask yourself:

Toddlers' vocabularies are growing by leaps and bounds. They are learning and saying many new words, and stringing words together such as "Dolly fall." Toddlers are very independent and eager to be in control. Among their favorite words are "Me" and "Mine!"

• Expand on what your child says. When she says "Dolly fall!" you can say "Yes, Dolly tumbled down to the floor." This helps you expand your child's language skills.

• Give your toddler ways to feel in control by giving choices among options that are all acceptable. Let her choose between the red or blue cup, and the pink or green shirt. Avoid asking her questions when only one option is okay: for example, do not ask, "Are you ready to go?" unless she can stay longer. Use language to help her predict what will happen. "In five minutes it will be time to go."

• What are your child's strengths in communicating? Where does she need help?

• How does your child express her thoughts and feelings? Is she more likely to use her words or actions?

Toddlers are developing self-control, but they still cannot stop themselves from doing something unacceptable, even after many reminders. They also don't yet understand the consequences of their actions.

• Help prevent tantrums or loss of control by heading them off at the pass. If you see your child getting frustrated, try to calm her down and suggest another activity before she starts hurling puzzle pieces. Help your obviously angry toddler avoid a fight with her friend by inviting them to pause for a snack.

• Use consequences that are directly connected to the behavior of your child. If she is pouring water on her high chair after being told not to, take her out of her high chair. Then offer other acceptable options such as water play in the bathtub or outside.

• What behavior do you find most difficult to handle? Why?

• How were you disciplined as a child? How do you think that influences how you discipline your child?

Toddlers are able to play and explore in more complex ways. They like toys that they can play with in many different ways such as blocks, cars and stuffed animals that lend themselves to imaginative play.

Toddlers love to move. In just a matter of months, children go from crawling to walking to practically running! Practicing their new moves strengthens the brain connections that help with coordination. Children learn a lot from active play. For example, they learn about gravity and up and down when they swing and go down the slide.

• Provide your child with objects and toys that lend themselves to imaginative play and join in with them. You will learn a lot about her thoughts and feelings and can help her expand her thinking. Sand, water, play dough and drawing materials are all good choices for children this age. They help develop your child's creativity and strengthen muscles that your toddler will use later in handwriting.

• Turn a walk into a learning opportunity. Point out big and small dogs in the park. Talk about the colors of the cars on the street. This kind of learning makes new ideas and concepts stick.

• What are some of the ways your child uses pretend play? What does this tell you about her?

• What do you most/least enjoy about playing with your toddler?

24 to 36 months

What's going on:

What you can do:

Questions to ask yourself:

Two-year-olds typically can speak between 200 and 250 words. By the age of 3 years, their vocabulary is much larger still and they are able to put together 3- and 4-word sentences. Despite all this word power, 2-year-olds often lack the verbal skills to describe their emotions. this can leave them feeling powerless and frustrated.

• Have lots of conversations with your child. This will boost his language skills, introduce him to the pleasure of conversation and make him feel important. Also, read with your child as often as you can.

• Let your 2-year-old know that you understand what he's experiencing by saying, for example, "I know that you are upset that you cant find your magic cape." Acknowledging his feelings will help calm him and make it easier for him to tackle the challenge.

• What does your child like to talk about? How do you and your toddler enjoy conversation together?

• How does your child manage difficult feelings and situations? What helps him cope?

Play is essential for the 2-year-olds. It builds all areas of his development. Through play, he interacts more with friends, uses pretend play to understand things in more complex ways, and learns important concepts such as big and small and up and down.

• Encourage pretend play and get involved. This will build a strong connection between you and your child, and can help encourage creativity. You can do this in many ways. For example, ask what will happen next in the story he is acting out. If he is "cooking," you might say, "What are you cooking? It smells good, can I have some?"

• Make plans for your child to spend some time with other children. He will learn about the pleasure of making friends. And the more opportunity he has to interact with peers, the more he will learn about how to get along well with others.

• What kind of play does your child most enjoy? How do you know? What does this tell you about him?

• How does our child use his imagination? What do you think he is learning through his pretend play?

Two-year-olds are very active. Their motor development allows them the freedom to explore in new ways as they run, jump and climb.

• Spend time outside, where there is plenty of room to safely run, jump and climb. Visit a neighborhood park where there are other children to play with. include our child in family sports, like swimming together or kickball.

• Create a safe lace in your home where your child can actively explore. Take walks with your child and use them as opportunities to each him important concepts such as big and small ads you compare houses on your block or leaves on the ground.

• How active is your child? Does he seem to be in constant motion or is he happy to sit and play quietly for long periods, or somewhere in between?

• What do you think your child is learning when he is playing actively? How do you know?



The report, From Neurons to Neighborhoods: The Science of Early Childhood Development, was a 2.5 year effort by a group of 17 leading professionals with backgrounds in neuroscience, psychology, child development, economics, education, pediatrics, psychiatry and public policy. They reviewed what was known about the nature of early child development and the influence of early experiences on children's health and well-being. The study was sponsored by a number of federal agencies and private foundations.