Screening Tools

Screening Tools

Speech and Language Milestones by Age

 Birth to 5 months
  • Coos
  • Vocalizes pleasure and displeasure sounds differently (laughs, giggles, cries, or fusses)
  • Makes noise when talked to
 6 to 11 months
  • Understands “no-no”
  • Babbles (says “ba-ba-ba”)
  • Says “ma-ma” or “da-da” without meaning
  • Tries to communicate by actions or gestures
  • Tries to repeat your sounds
  • Says the first word
 12 to 17 months
  • Answers simple questions nonverbally
  • Says 2 to 3 words to label a person or object (pronunciation may not be clear)
  • Tries to imitate simple words
  • Vocabulary of four to 6 words
 18 to 23 months
  • Vocabulary of 50 words, pronunciation is often unclear
  • Asks for common foods by name
  • Makes animal sounds, such as “moo”
  • Starting to combine words, such as “more milk”
  • Begins to use pronouns, such as “mine”
  • Uses 2-word phrases
 2 to 3 years
  • Knows some spatial concepts, such as “in” or “on”
  • Knows pronouns, such as “you,” “me” or “her”
  • Knows descriptive words, such as “big” or “happy”
  • Uses 3-word sentences
  • Speech is becoming more accurate, but may still leave off ending sounds. Strangers may not be able to understand much of what is said.
  • Answers simple questions
  • Begins to use more pronouns, such as “you” or “I”
  • Uses question inflection to ask for something, such as “my ball?”
  • Begins to use plurals, such as “shoes” or “socks” and regular past tense verbs, such as “jumped”
 3 to 4 years
  • Groups objects, such as foods or clothes
  • Identifies colors
  • Uses most speech sounds, but may distort some of the more difficult sounds, such as l, r, s, sh, ch, y, v, z, th. These sounds may not be fully mastered until age 7 or 8.
  • Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them
  • Strangers are able to understand much of what is said
  • Able to describe the use of objects, such as “fork” or “car”
  • Has fun with language; enjoys poems and recognizes language absurdities, such as, “Is that an elephant on your head?”
  • Expresses ideas and feelings rather than just talking about the world around him or her
  • Uses verbs that end in “ing,” such as “walking” or “talking”
  • Answers simple questions, such as “What do you do when you are hungry?”
  • Repeats sentences
 4 to 5 years
  • Understands spatial concepts, such as “behind” or “next to”
  • Understands complex questions
  • Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words, such as “hippopotamus”
  • Uses some irregular past tense verbs, such as “ran” or “fell”
  • Describes how to do things, such as painting a picture
  • Lists items that belong in a category, such as animals or vehicles
  • Answers “why” questions
 5 years
  • Understands time sequences (for example, what happened first, second, or third)
  • Carries out a series of 3 directions
  • Understands rhyming
  • Engages in conversation
  • Sentences can be 8 or more words in length
  • Uses compound and complex sentences
  • Describes objects
  • Uses imagination to create stories

If your child missed 2 or more of the speech and language milestones based on age, please contact us for a free speech and language screening provided by a licensed Speech-Language Pathologist. This screening will help us to determine if an assessment is recommended for your child.

Occupational Therapy Milestones by Age

Birth – 3 months

Fine Motor / Visual Motor / Self Help

  • Tracks contrasting visual stimuli from side to midline
  • Looks at hands
  • Clutches and pulls at clothing
  • Blinks at sudden visual stimuli
  • Follows with eyes upward
  • Follows with eyes downward
  • Grasps rattle briefly
  • Scratches at blanket with fingers
  • Breastfeeds or drinks from a bottle without choking, coughing, or gagging
  • Arms become active at sight of colorful rattle
  • While on back, briefly brings hands together at midline
  • Bears some weight on forearms while on belly
  • While on belly, works to momentarily lift and turn head

Gross Motor

  • Turns head to each side when on back
  • Holds head up 45 degrees when on tummy
  • Head bobs upright in supported sitting
  • Has random body movements
 3 months – 6 months

Fine Motor / Visual Motor / Self Help

  • Looks at objects a few feet away
  • Mouths objects
  • Can follow with eyes without head movement
  • Uses arms to pivot while on belly
  • Briefly keeps both hands on bottle
  • Grasps cube against palm
  • Mouths hands
  • Tracks objects/people from side across midline
  • Extends arms straight toward rattle
  • While on back, clasps hands together at midline
  • Props on forearms while on belly
  • Notices tiny object(s)
  • Eats small amounts of pureed baby food

Gross Motor

  • Lifts chest from surface when on tummy
  • Pushes up on straight elbows on tummy
  • Rolls belly to back (both sides)
  • Sits w/slight support for brief moments
  • Pivots around on belly
  • Actively moves head when in supported sitting
  • Head control in all positions
 6 months – 9 months

Fine Motor / Visual Motor / Self Help

  • Drops objects in space
  • Attends to pictures
  • Uses arms for “so big”, “peek a boo,” “pat a cake”
  • Shakes rattle
  • Bangs object on table
  • Transfers objects from hand to hand
  • Rotates wrist while holding toy
  • Pokes at objects using index finger
  • Reaches in all directions
  • Feeds self: increasing variety of food sizes/shapes
  • Holds & drinks from bottle or spouted cup
  • Rakes cheerios, scooping with several fingers

Gross Motor

  • Sits independently
  • Rolls back to belly
  • Stands, holding on (may bounce on legs)
  • Pulls to stand at furniture (using mostly upper body)
  • Belly crawls
  • Gets into quadruped (hands & knees position)
9 months – 12 months (1 year)

Fine Motor / Visual Motor / Self Help

  • Holds leg & foot out for putting on pants & shoes
  • Holds arms out for dressing/undressing
  • Uses fingers (not palm) to hold small cube
  • Releases object independently on surface
  • Puts objects in a large container
  • Places 1 large block on top of 2nd block
  • Clasps hands together
  • Uses pincer (thumb & index finger) grasp to pick up cheerios
  • Bangs objects together at midline
  • Removes rings from a stacking pole

Gross Motor

  • Sits well to play
  • Transitions from sitting to belly
  • Creeps/crawls on hands and knees
  • Stands momentarily
  • Cruises along furniture
  • Walks with hands held
12 months – 18 months

Fine Motor / Visual Motor / Self Help

  • Turns 2-3 pages at a time of a board book
  • Points with index finger
  • Holds toy in 1 hand & manipulates it with the other hand
  • Removes hat
  • Removes socks & shoes
  • Stacks 2-3 cubes
  • Dumps contents from a jar
  • Pushes arms through sleeves, legs through pants
  • Places circle in a shape sorter
  • Eats a variety of soft/chopped table foods
  • Holds cup by the handle
  • Stirs spoon in a cup (following demonstration)
  • Drinks from cup (with some spilling)

Gross Motor

  • Stands alone well
  • Kneels
  • Walks without support
  • Creeps/crawls up stairs
  • Walks hurriedly
  • Walks backwards
  • Walks up stairs with hand held
 18 months – 24 months (2 years)

Fine Motor / Visual Motor / Self Help

  • Removes loose fitting shoes
  • Unzips large zipper
  • Uses both hands together at midline
  • Places tiny objects in small mouth container
  • Imitates vertical & circular strokes
  • Sits on potty chair with assistance
  • Washes hands partially
  • Scribbles on paper
  • Builds a block tower with more than 3 blocks
  • Begins to hold crayon with finger tip & thumb (may have hand pronated down)
  • Scoops food with spoon with some spillage

Gross Motor

  • Kicks a ball forward
  • Runs fairly well
  • Climbs into adult chair
  • Picks up toys from floor without falling
  • Squats in play w/out losing balance
  • Walks up & down stairs holding rail with both feet on each step
 24 months – 30 months

Fine Motor / Visual Motor / Self Help

  • Imitates horizontal strokes
  • Snips with scissors
  • Strings large beads
  • Puts shoes on with assistance
  • Stacks more than 5 cubes
  • Unbuttons one large button
  • Washes hands independently
  • Folds paper in half
  • Helps w/pushing pants down & pulling them up
  • Holds cup with 1 hand
  • Spears food with fork with some spillage
  • Uses spoon with little spillage
  • Unwraps some food packages
  • Can turn pages in book 1 at a time

Gross Motor

  • Pushes, pulls, or carries toys while walking

 30 months – 36 months (3 years)

Fine Motor / Visual Motor / Self Help

  • Imitates a 3-cube bridge & 4-cube train
  • Copies a circle (with visual aid)
  • Builds cube tower with more than 8 cubes
  • Unties & removes shoes
  • Removes pull over shirt
  • Puts on front button shirt (without buttoning)
  • Tries to put socks on
  • Goes to bathroom independently (needs help with wiping)
  • Brushes hair with supervision
  • Pushes, winds, slides to activate toy
  • Pours liquid from 1 container to another
  • Uses a napkin

Gross Motor

  • Jumps forward, sideways, & backwards
  • Catches a ball, may trap at chest
  • Walks up stairs and down stairs with alternating feet while holding rail
  • Runs wells, avoids obstacles
  • Walks backwards 10 feet
  • Balances on 1 foot for 1-5 seconds, & hops on 1 foot
  • Pedals a tricycle
 36 months – 42 months

Fine Motor / Visual Motor / Self Help

  • Unscrews a jar lid
  • Cuts 6 inches across a paper
  • Displays hand dominance
  • Winds a knob on a toy
  • Builds a 4-cube wall
  • Puts shoes on (may be on incorrect feet)
  • Completes a 5 – 8 piece interlocking puzzle
  • Laces 3 holes (after demonstration)
  • Sorts objects (ex. by color)
  • Fastens/unfastens large buttons
  • Holds pencil thumb & 3 or more fingers (pinky-side facing down along paper)

Gross Motor

  • Imitates simple postures
  • Throws tennis ball overhand 10 feet
  • Catches a medium-sized ball from 5 feet away
 42 months – 48 months (4 years)

Fine Motor / Visual Motor / Self Help

  • Puts on pants
  • Puts on socks & shoes (intermittent assistance)
  • Zips down pants
  • Unbuckles
  • Unbuttons & buttons medium-sized buttons
  • Holds pencil in tripod (3-finger) or quadrupod (4-finger) grasp
  • Copies a cross
  • Washes & dries hands and face
  • Tries to wipe self after toileting
  • Completes snaps
  • Cuts across paper remaining within 1⁄4 inch of line
  • Traces within a 1⁄2 inch path
  • Holds glass/cup with one hand

Gross Motor

  • Walks up & downstairs alternating feet, without rail
  • Jumps down from 1 ft height with feet together, maintaining balance
  • Gallops
  • Walks on a line
  • Throws tennis ball underhand 8 – 10 feet
 48 months – 54 months

Fine Motor / Visual Motor / Self Help

  • Copies a diagonal stroke, X, and square
  • Cuts out a circle within 1⁄4 inch accuracy
  • Draws a 3-part person
  • Uses dominant hand consistently
  • Holds spoon/fork with fingers
  • Traces medium-sized geometric shapes within 1/8 inch accuracy
  • Completes 5-piece puzzle

Gross Motor

  • Catches a tennis ball
  • Throws ball overhand 10 feet
 54 months – 60 months (5 years)

Fine Motor / Visual Motor / Self Help

  • Buckles
  • Connects a zipper & zips up
  • Independently fastens Velcro fasteners
  • Places shoes on correct feet
  • Colors 2×2 inch area with 75% coverage within lines
  • Places paperclip on paper (after demonstration)
  • Draws a person with 6+ parts
  • Builds 6 cube pyramid
  • Knows front vs. back of clothing & inside vs. outside
  • Sucks through straw while holding container with 1 hand
  • Completes toileting hygiene independently
  • Thoroughly brushes teeth
  • Performs opposition (each finger to thumb within 8 seconds)
  • Cuts out a square within 1⁄4 inch accuracy
  • Copies an triangle
  • Has dynamic pencil grasp

Gross Motor

  • Stands on one foot 10 seconds
  • Skips
  • Pumps a swing
  • Begins jumping rope
  • Somersaults
  • Walks on balance beam forward and backward

If you have any concerns about your child in relation to the categories described above, please contact us for a free occupational therapy screening provided by a licensed Occupational Therapist. This screening will help us to determine if an assessment is recommended for your child.