Developmental Milestones

Speech Milestones

For children under five, early intervention is critical in ensuring your child meets their developmental milestones. It is never too early to come in for an assessment. Children as young as 12 months come in to our clinic to check on the development of their skills.

  • Understands simple commands e.g. “no”
  • Recognises own name
  • Understands the names of familiar objects or people
  • Smiles, babbles and makes eye contact
  • Says “dad”, “mum” and a few other words
  • Enjoys songs, music and books
  • Tries to make familiar sounds (car and animal noises)
  • Understands to look when someone points to an object
  • Says the names of simple body parts (e.g. ‘nose’ or ‘tummy’)
  • Understands simple sentences (‘where is your shoe?’)
  • Uses more than 50 words (‘no’, ‘gone’, ‘mine’ and ‘teddy’)
  • Sings simple songs (Twinkle Twinkle Little Star)
  • Uses pronouns instead of names (‘he/she’, ‘it’)
  • Tries simple sentences (‘milk all gone’)
  • Understands ‘in’ and ‘on’ without cues (put the ball in the box)
  • Answers ‘what’ and ‘where’ questions
  • Understands how objects are used (a pencil is something to draw with)
  • Follows directions
  • Uses three to four word sentences
  • Begins to use basic grammar
  • Enjoys telling stories and asking questions
  • Is understood by familiar adults
  • Has favourite books and television programs
  • Asks ‘who’, ‘what’ and ‘why’ questions
  • Uses lots of words (approx. 900)
  • Often speaks in four to five word sentences
  • Uses correct grammar with occasional mistakes (‘I falled down’)
  • Uses language when playing with other children
  • Speaks clearly enough to be understood by most people
  • Grunts and knows most colours
  • Uses sentences of about six words with correct grammar
  • Talks about events which happened or might happen
  • Explains why something happens
  • Follows three step directions (‘stand up, get your shoes, wait by the door’)
  • Says how they feel and tells you their ideas
  • Speaks clearly enough to be understood by everyone
  • Knows opposites
  • Uses sentences of about six words with correct grammar
  • Talks about events which happened or might happen
  • Explains why something happens
  • Follows three directions (‘stand up, get your shoes, wait by the door’)
  • Says how they feel and tells you their ideas
  • Speaks clearly enough to be understood by everyone
  • Knows opposites
  • Is beginning to read and sound out words
  • Can count to thirty and knows the alphabet
  • Listens for extensive periods of time including to guest speakers
  • Follows instructions to complete a task e.g. cooking
  • Reasons and verbally problem solves difficult situations
  • Recalls and recites detailed series of events e.g. what they did in the holidays
  • Cooperates with others
  • Uses adjectives, time and number concepts
  • Knows the way we talk in the classroom can be different to on the playground
  • Is able to greet different people in different ways
  • Can read short novels and reads independently
  • Has developed strategies for ‘during’ and ‘after’ listening to help them process information
  • Follows complex instructions without visual support
  • Expresses their own opinions and justifies these ideas
  • Enjoys sharing opinions about games, music, movies or books
  • Describes events and things with great detail
  • Uses language to agree/disagree with others
  • Learns to understand how to use ‘slang’ with peers
  • Has begun learning from what they read and read to seek information
  • Analyses information as it is being read
  • Understands that your tone of voice and body language can affect how others interpret what you say
  • Listens to longer recounts i.e. news reports
  • Explains results through discussions with others
  • Can give class presentations and include props
  • Is using more complex vocabulary (synonyms)
  • Can identify opinions versus facts
  • Is able to use language skills to negotiate out of tricky situations
  • Reads a variety of texts and have started to writing short essays

Developmental Milestones - OT

For children under five, early intervention is critical in ensuring your child meets their developmental milestones. It is never too early to come in for an assessment. Children as young as 12 months come in to our clinic to check on the development of their skills.

Gross/Fine Motor

  • Walks with aid
  • Rolls a ball in imitation of adult
  • Reaches, grasps, puts object in mouth
  • Picks things up with pincer grasp (thumb and one finger)
  • Walks alone or with assistance on stairs
  • Picks up toys from floor without falling
  • Pulls and pushes toys
  • Builds tower of three small blocks
  • Scribbles with palmer grasp
  • Kicks a stationary ball up to 1 metre
  • Imitates circular, vertical, horizontal strokes
  • Builds tower of nine small blocks
  • Runs forwards well
  • Jumps in place with two feet together
  • Stands on one foot for 1-3 seconds
  • Kicks and throws a ball forwards
  • Cuts a continuous line across paper
  • Holds crayon with thumb and fingers
  • Uses one hand consistently in most activities
  • Cuts on line continuously
  • Runs around obstacles
  • Hops on one foot
  • Uses slide independently
  • Jumps over 15cm high and lands on both feet
  • Throws ball overhead
  • Catches a ball with arms straight in front of body
  • Copies circle and cross
  • Can draw a person with a head and 4 features
  • Copies/prints first name (letters large, awkward, reversed, not clear)
  • Jumps forward 10 times without falling
  • Walks up and down stairs independently, alternating feet
  • Balances on one foot for 5-10 seconds
  • Catches ball with elbows bent and arms held at sides
  • Copies squares
  • Writes first name from memory
  • Has a distinguished left or right hand dominance
  • Runs lightly on toes
  • Walks on balance beam
  • Can cover 2 metres hopping
  • Skips on alternate feet
  • Cuts out simple shapes staying within 6mm of the line
  • Copies triangle, traces diamond
  • Prints numerals 1 to 5
  • Has static tripod grip of pencil, developing dynamic tripod grip
  • Pastes and glues appropriately
  • Not achieving any developmental milestones
  • Significant loss of skills or child’s skills are regressing
  • Difference between right and left sides of body in strength, movement or tone
  • Loose and floppy movements (low tone) or stiff and tense (high tone)
  • Child walks on their toes all the time
  • Child is excessively clumsy
  • Child complains of persistent pain or fatigue
  • Strong parental concerns

Social / Emotional

  • Responds to their name
  • Plays favourites with familiar people
  • Enjoys simple interactive games (peek-a-boo)
  • Gives a toy when asked
  • Points to his or her toes, eyes, and nose
  • Points to objects or holds up objects to indicate a request
  • Uses eye contact to get someone’s attention
  • Initiates smiles, hellos or goodbyes with caregivers
  • Shows interest in other children
  • Initiates games like peekaboo
  • Engages in pretend play (feeding teddy bear)
  • Has more temper tantrums and becomes more defiant as attempts at independence and communication increase
  • Pretends that objects are something other than what they
    are (e.g. blocks are food)
  • Represents more complex events in play (e.g. plays doctor with doll)
  • Pretend play includes a 3-4 part logical sequence that evolves as play proceeds
  • Start to show and verbalise a wider range of emotion
  • Describes own activities during play
  • Builds large structures from block or chairs and centres play
    around them
  • Tantrums decreasing/only occurring because of change in routine or not getting what they want
  • Separates from parents more easily
  • Involves others in pretend play and discusses roles
  • Engages in complex adult role-playing
  • Are aware of their gender and may prefer to play with same-sex peers
  • Tests boundaries however are still eager to please and help out
  • Understands the emotion of being embarrassed
  • Inability to self-regulate emotions e.g. taking longer than expected to calm down
  • Difficulties transitioning between tasks or venues
  • Unusually disturbed by bright lights, loud noises, distinct
    smells or certain textured foods
  • Seeks sensory stimulation e.g. rubs objects on mouth or face, waves fingers side to side to cause flickering lights
  • Has intense interest in certain objects e.g. light switches, only plays with cars
  • Easily upset by change and needs to follow routines
  • Repeats body movements or has unusual body movements
    e.g. hand flapping, walking on toes
  • Unusual disinterest in interacting with others
  • Strong parental concerns


Our Team of trained therapists can help infants and children who are problem eaters or fussy feeders, in a range of areas.

We provide the following feeding services:

  • Assessment
  • Individual therapy
  • Multidisciplinary management
  • Parent training, education and support

We have team members who are fully qualified to assess and treat infants, toddlers and children who have feeding difficulties.

If you have any worries or concerns, please give us a call (02) 4721 4766. We are happy to have a chat to see if an assessment may be beneficial.

Myths about Feeding

Eating is not as natural or as easy as we think. Below are 10 Myths about Feeding:

No, breathing is our number one priority! If you can’t breathe, the body cannot function properly, and therefore won’t be able to eat. Eating is actually our third priority – postural stability (the ability to keep yourself from falling over) is our number two priority.

No, eating is only instinctive for the first month of life, where feeding starts as the reflex for suckling. Following this we have primitive reflexes that lay the foundations for developing skills needed to eat. Beyond 6 months of age, skills needed for eating need to be learnt and are intentional choices.

No, eating is one of the MOST complicated tasks a human being participates in. Eating involves every single organ system, every muscle in the body, and requires coordination of all of these elements at once!

No, there are up to 32 steps required during mealtimes, in the course of learning to eat.

No, children need to build skills for feeding and learn about foods first before manners, which includes playing with food and making a MESS!

No, for children that have feeding problems, eating doesn’t work and/or it hurts, and NO amount of hunger will overcome this.

No, children need to eat 6-9 times a day, to get enough nutrients and calories in!

It’s more than likely that a child with feeding difficulties has a combination of both behavioural and physical problems. If a child starts with a physical limitation to eating, it is highly likely that they will learn that eating doesn’t work and/or hurts for them and will develop behaviours to avoid it. Similarly, if a child starts with behavioural/environmental reasons for not eating, a lack of nutrition will quickly lead to physical/organic problems.

Food is food, they are either a protein, a starch or a fruit/vegetable. While some foods may have more nutritional benefits than others, labelling them as “good”, “bad” or “only to be eaten at X time” does not help a child develop positive associations with food.

The skills for eating need to be developed before children can have good manners. Children learn through making noises, being messy and playing with their food!

  • Ongoing poor weight gain (i.e. percentile rank fall) or weight loss
  • Coughing, spluttering, gagging while feeding
  • Ongoing problems with vomiting
  • Difficulty coordinating eating and breathing, with possible ongoing respiratory issues.
  • Coughing/choking on water/milk feeds frequently.
  • Inability to transition to baby food purees by 10 months of age.
  • Inability to accept table food solids by 12 months of age.
  • Inability to transition from breast/bottle to a cup by 16 months of age.
  • Toddler has not weaned off baby foods by 16 months of age.
  • Aversion or avoidance of foods with a specific texture, colour, nutritional group
  • Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing them in the child’s food range.
  • An infant who cries and/or arches at most mealtimes.
  • Feeding battles and/or fights about food.
  • Distress on seeing/entering highchair.
  • Restricted types of utensils used during feeding.
  • Child is difficult for everyone to feed.
  • Child/infant takes a long time to eat/feed.
  • Parental/Family history of an eating disorder, with a child not meeting weight goals.

Feeding Milestones

  • Efficient and effective suckling from breast or bottle.
  • Consistent weight gain.
  • Learning to control tongue movement to move purees around in the mouth.
  • Efficient feeding from breast or bottle – able to hold their own bottle.
  • Able to actively strip food from a spoon using their top lip.
  • ‘Munching’ (up-down- chewing with lumpy, soft food).
  • Some gagging on lumps and solid food is normal.
  • Able to messily drink from an open cup with support from adult.
  • Use of fingers in the mouth to move food and keep it in their mouth.
  • Continuing with breast/bottle feeding, moving towards increased cup drinking by 12 months.
  • Eating simple chopped table foods by 12 months, including easily chewed meats.
  • Clearing food off lips.
  • Using more circular jaw movements for chewing.
  • Uses fingers to self-feed soft, chopped foods.
  • More controlled biting (isolated from other body movements).
  • Getting into pattern of main meals and snacks in between, with milk feeds decreasing in amount/frequency as solids increase.
  • Grasping spoon with whole hand.
  • “Co-feeding” with an adult.
  • Holds and tips bottle and cup with two hands.
  • Chews and swallows firmer foods without choking.
  • Able to keep food in mouth during chewing.
  • Efficient finger feeding.
  • Moving chewed food around mouth with control.
  • Uses tongue to gather chewed pieces.
  • Emerging use of utensils.
  • Speed and efficiency of feeding develops.
  • Chewing strength improves.
  • Chews with lips closed and circular jaw movements.
  • Better able to manage hard to chew foods.
  • Increased utensil use including spoons and forks.
  • One handed open cup drinking without spilling.

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