Introduction Link
Appendix A
Local Contacts and Services
Infants (0 - 14 Months)

Newborn Reflexes      • Infant Development by Age and Domain
By Two Months of Age      • By Four Months of Age      • By Six Months of Age      • By Nine Months of Age
By 12 Months of Age      • Atypical Development

Human infants need intensive care and nurturing from birth until they are able to live competently within our complex world. Although an infant is almost helpless at birth, he has some skills and a strong set of reflexes to help him survive. While some of these reflexes gradually disappear, his skills grow rapidly during his first 12 months.

Newborn Reflexes

Newborns have a wide variety of reflexes that are important for survival and later development (Berk, 2008). A reflex can be described as “an inborn, automatic response to a particular form of stimulation” (Berk, 2008, p. 147). Although the age at which these reflexes disappear may vary, the continuation of these reflexes well beyond the normal age range may indicate neurological problems in children (Comley & Mousmanis, 2007). Please refer to the Signs of Atypical Development in Infants section for additional information about patterns in child development which may indicate a more serious concern. In the following table, a summary of some newborn reflexes is provided.

Reflex Stimulation Response Age of Disappearance Function
Eye blink Shine bright light at eyes or clap hand near head Infant quickly closes eyelids Permanent Protects infant from strong stimulation
Rooting Stroke cheek near corner of mouth Head turns toward source of stimulation 3 weeks (becomes voluntary head turning at this time) Helps infant find the nipple
Sucking Place finger in infant’s mouth Infant sucks finger rhythmically Replaced by voluntary sucking after 4 months Permits feeding
Swimming Place infant face down in pool of water Infant paddles and kicks in swimming motion 4-6 months Helps infant survive if dropped into water
Moro Hold infant horizontally on back and let head drop slightly, or produce a sudden loud sound against surface supporting infant Infant makes an “embracing” motion by arching back, extending legs, throwing arms outward, and then bringing arms in toward the body 6 months In human evolutionary past, may have helped infant cling to mother
Palmar grasp Place finger in infant’s hand and press against palm Spontaneous grasp of finger 3-4 months Prepares infant for voluntary grasping
Tonic neck Turn infant’s head to one side while he is lying awake on back Infant lies in a “fencing position”. One arm is extended in front of eyes on side to which head is turned, other arm is flexed 4 months May prepare infant for voluntary reaching
Stepping Hold infant under arms and permit bare feet to touch a flat surface Infant lifts one foot after another in stepping response 2 months in infants who gain weight quickly; sustained in lighter infants Prepares infant for voluntary walking
Babinski Stroke sole of foot from toe toward heel Toes fan out and curl as foot twists in 8-12 months Unknown
(Knobloch & Pasamanick, 1974; Prechtl & Beintema, 1965; Thelen, Fisher, & Ridley-Johnson, 1984 as cited in Berk, 2008)

Infant Development by Age and Domain

Note: all domains are interrelated, for example “recognize and calm down to familiar gentle voice” in the cognitive domain is also part of social, language and hearing development.

Note: All skills are listed by the age when most children should have accomplished them unless otherwise indicated. When observing a child between two ages refer to the younger age group (e.g., expect a three month-old child to accomplish the skills listed for two months of age).

By Two Months of Age
Expect the child to:

Social Emotional
  • Look at caregiver
  • Study caregiver’s face
  • Smile in response to caregiver
  • Imitate some facial expressions
  • Calm down when comforted by caregiver
  • Enjoy being touched and cuddled
Language Cognitive
  • Have different cries
    (e.g., tired, hungry)
  • Have a variety of sounds
    (e.g., coos, gurgles)
  • Laugh out loud
  • Recognize and calm down to familiar gentle voice
  • Watch faces intently
Gross Motor Fine Motor
  • Lift head when on tummy
  • Hold head up when held at caregiver’s shoulder
  • Raise head when lying on back
  • Bring hands together (at midline of body)
Open and shut hands
Perceptual (sensory)
Hearing Vision
  • Startle to loud or sudden noises
  • Can be quieted by a familiar friendly voice
  • Prefer complex sounds (e.g., noises, voices) to pure tones
  • Distinguish some sound patterns
  • Listen longer to human speech than to non-speech sounds
  • Turn eyes and head in the general direction of a sound
  • Follow things that are moving slowly with his eyes
  • Eyes wander and occasionally cross
  • Prefer black-and-white or high-contrast patterns (e.g., large squares, stripes, circles)
  • Prefer the human face to all other patterns
  • Prefer caregiver’s face over unfamiliar faces
  • Slow and inaccurate eye movements in tracking moving objects
  • Turn eyes and head to look at light source
Touch Taste and Smell
  • Respond to touch and pain
  • Distinguishes shape of object
    placed in palm
  • Prefer soft to coarse sensations
  • Dislike rough or abrupt handling
  • Touch, especially skin-to-skin, decreases infant’s stress hormones
  • Recognize the scent of his own mother’s breastmilk
  • Prefer the scent of human milk, even that of a different mother
  • Distinguish odours; prefer those of
    sweet-tasting foods
  • Avoid bitter or acidic smells
  • Distinguish sweet, sour, and bitter tastes;
    prefer sweetness
Nutrition Feeding skills
  • Breastfeed exclusively
  • Take 400 IU of Vitamin D per day
  • If not breastfeeding, take
    iron-fortified formula
  • Take no other fluids or solids
  • Suck well on the nipple
  • Use negative pressure to create effective seal
  • Cough or gasp if flow is too fast
  • Use a rhythmic sucking pattern with sucking bursts of 10 - 20 sucks
  • Coordinate suck - swallow - breathe pattern
  • Feed at least 8 times per day

By Four Months of Age
Expect the child to:

Social Emotional
  • Laugh and smile at caregiver
  • Respond to caregiver by making sounds and moving arms and legs
  • Enjoy playing with people and may cry when playing stops
  • Imitate some facial expressions
  • Cry differently for different needs
  • Show comfort and discomfort
Language Cognitive
  • Make sounds when looking at toys or people
  • Responds to caregiver by making sounds
  • Blow bubbles, sputter loudly
  • Make simple vocalizations containing mostly vowel, but sometimes a number of consonants (cooing stage)
  • Follow a moving object or
    person with his eyes
  • Glance from one object to another
  • Recognize familiar objects and people
  • Begin to have some awareness that objects exist even when he cannot see them
Gross Motor Fine Motor
  • Bring both hands to chest and keep head in midline when lying on back
  • Lift head and chest and support self on forearms when placed on tummy
  • Head does not lag when he is pulled into a sitting position
  • Push down on legs when feet are placed on a firm surface
  • Hold head steady when supported at the chest or waist in a sitting position.
  • Roll from side to back
  • Play with hands at midline of body
  • Bring hand to mouth (e.g. put toys or fingers in mouth)
  • Suck fingers and fists
  • Take swipes at dangling objects with hands
  • Grasp and shake hand toys
  • Reach for an object when supported in a sitting position
  • Hold an object briefly when placed in hand
  • Use ulnar grasp when reaching (e.g., infant’s fingers close against the palm)
Perceptual (sensory) View “by two months of age
Nutrition Feeding
  • View “by two months of age
  • May have developed a “routine” for feeding times
  • Feed frequently both day and night (7 - 12 times per day)

By Six Months of Age
Expect the child to:

Social Emotional
  • Smile and babble when given adult attention
  • Enjoy social play
  • Be interested in mirror images
  • Mimic facial expressions better and repeat them even after a time delay of up to one day
  • Inspect faces of his caregiver
  • Engage in self-soothing behaviours to control emotions (e.g., sucking fingers)
  • Express pleasure and displeasure
  • Distinguishes emotions by tone of voice
Language Cognitive
  • Turn head and look in direction
    of a new sound
  • Respond to own name
  • Seem to respond to some words
    (e.g., daddy, bye-bye)
  • Recognize and prefer caregivers voice
  • Listen and look at caregiver’s face
    when he or she speaks
  • Smiles and laughs in response to caregiver’s smiles and laughter
  • Make sounds while caregiver is
    talking to him
  • Vocalize pleasure and displeasure (e.g., squeal with excitement or grunt in anger)
  • Imitate cough or other sound
    (e.g. “ah, eh, buh”)
  • Babble, using a variety of sounds
  • Babble chains of consonants; make “ga, gu, da, ba” sounds (joins vowels and consonants); repeat syllables
  • Find partially hidden object
  • Swipe at and reach for object within view
  • Explore with hands and mouth
  • Respond to “peek-a-boo”
  • Spend longer studying toys and what to do with them
Gross Motor Fine Motor
  • Roll from back to side
  • Sit with support (e.g. pillows)
  • Support his whole weight on his legs when held in standing position
  • Push up on hands when on tummy
  • Use hands to reach, grasp, bang, and splash
  • Bring hands or toy to mouth
  • Shake objects
  • Reach with one hand
  • Use raking grasp (not pincer) using all fingers
  • Hold onto toys or objects
  • Pat and pull at your hair, glasses, and face
Perceptual (sensory)
Hearing Vision
  • Respond to speech sounds by stopping
    to play, becoming quiet
  • Turn head toward either side to
    locate a source of sound
  • Brighten to sound, especially to
    people’s voices
  • Can distinguish musical tunes
  • Identify location of a sound
    more precisely
  • Become sensitive to syllable stress patterns in own language
  • Turn head from side to side to follow a toy
  • Glance from one object to another
  • Prefer more complex pattern (e.g., checkerboard)
  • Colour vision is well developed by 4 months of age
  • 20/20 vision reached by 6 months of age
    (ability to see object clearly)
  • Eyes track moving objects with increasing skill; by 5 months of age, can track objects moving at differing speeds and on intricate paths
Touch Taste and Smell
  • Explore most objects with his mouth
  • Enjoy touch
    (e.g., being held, stroked, tickled)
  • Prefer a salty taste to plain water
  • Readily change taste preferences through experience
Nutrition Feeding
  • View “by two months of age
  • Begin to try iron-rich foods such as iron-fortified infant cereal or pureed meats
  • Show signs of readiness for solid foods:
  • Hold head steady when supported
    in a sitting position
  • Have lost the protrusion reflex that causes
    him to push solids out of his mouth
  • Show interest in foods others are eating

By Nine Months of Age
Expect the child to:

Social Emotional
  • Have a special smile for familiar adults
  • Fuss or cry if familiar caregiver looks or behaves differently
  • Become upset when caregiver leaves
  • Possibly turn away from strangers in anxiety, caution, shyness or fear (stranger anxiety)
  • Smile at his image in a mirror
  • Respond to expressions of emotion
    from other people
  • Reach to be picked up and held
Language Cognitive
  • Turn to look for a source of sound.
  • Respond to telephone ringing or a
    knock on the door
  • Understand short instructions
    (e.g., “Wave bye-bye, “No”, “Don’t touch”)
  • Babble a series of different sounds
    (e.g., “babababa”, duhduhduh”)
  • Make sounds and/or gestures to
    get attention or help.
  • Imitate speech sounds
  • Look for a hidden toy
  • Struggle to get objects that are
    just out of reach
  • Drop toys and watch them fall
  • Begin to manipulate toys to make them do something (e.g., banging blocks together)
Gross Motor Fine Motor
  • Sit without support for a few minutes
  • Attempt to move by crawling, “bum” shuffling or pivoting on tummy
  • Stand with support, when helped
    into standing position
  • Control his upper body and arms
  • Lunge forward to grab toy
  • Pass an object from one hand to the other
  • Pick up small items using thumb and first finger (e.g., crumbs, cheerios, rice)
  • Bang two objects together
  • Use his hands and mouth to explore an object
  • Throw and drop objects
  • Pounce on moving toys
Perceptual (sensory)
Hearing Vision
  • Respond to soft levels of speech and other sounds
  • Temporarily stop action in response to “no”
  • Babble using a variety of repeated consonant-vowel combinations - e.g. “ba-ba”, “ga-ga”
  • Make sounds with rising and falling pitches
  • Notice small items the size of breadcrumbs
  • Show interest in pictures
  • Recognize partially hidden objects
  • Have developed depth perception
Touch Taste and Smell
Nutrition Feeding
  • Continue frequent and on demand breastfeeding
  • Take complementary iron-rich foods
    2 - 3 times per day
  • Take pureed, mashed or very soft foods
  • Begin to drink from cup
  • Show an interest in foods, open mouth, may lean forward when solids are offered
  • Show disinterest in food by keeping mouth closed, leaning or turning away
  • Swallow pureed or mashed food with very small, soft lumps
  • Use tongue in an up and down, not sideways movement

By 12 Months of Age
Expect the child to:

Social Emotional
  • Be shy or anxious with strangers
  • Cry when caregiver leaves; separation anxiety
  • Possibly be fearful in some situations
  • Imitate people in play
  • Show specific preferences for
    certain people and toys
  • Prefer mother and/or regular caregiver
    over all others
  • Extend arm or leg to help when being dressed
  • Test parental responses to his actions during feedings and play
  • Repeat sounds or gestures for attention
  • Play games with caregiver
    (e.g., peek-a-boo, pat-a-cake)
  • Show caregiver toys
  • Use facial expressions, actions, and lots of sounds or words to make needs known or to protest
  • Show many emotions such as affection, anger, joy or fear
  • Regulate emotions by moving (e.g., crawling) away from various situations
  • Seek comfort
    (e.g., reach up to be held when upset)
Language Cognitive
  • Pay increasing attention to speech
  • Look at person saying his name
  • Understand simple requests and questions
    (e.g., “Where is the ball?” “Find your shoes”).
  • Use simple gestures, such as shaking head
    for “no”; wave “bye-bye”
  • Combine sounds together as though talking
    (e.g. bada banuh abee)
  • Take turns making sounds with you
  • Use exclamations such as “oh-oh!”
  • Consistently use 3 or more words including “dada” or “mama” even if not pronounced accurately
  • Show interest in simple picture books
  • Explore objects in many different ways (shaking, banging, throwing, dropping)
  • Respond to music
  • Look at correct picture when the
    image is named
  • Imitate gestures
  • Begin to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)
  • Begin to explore cause and effect
Gross Motor Fine Motor
  • Get up into a sitting position from
    lying down, without help
  • Crawl or “bum” shuffle easily.
  • Creep on hands and knees supporting
    trunk on hands and knees
  • Get from sitting to crawling or prone
    (lying on stomach) position
  • Pull up to stand at furniture
  • Walk holding onto your hands or furniture
  • Stand momentarily without support
  • May take two or three steps without support
  • Start to climb stairs/steps or furniture
  • Put objects into container
  • Take things out of containers (e.g., blocks)
  • Let objects go voluntarily
  • Pick up small items using tips
    of thumb and first finger
  • Push a toy
  • Take off socks
Perceptual (sensory)
Hearing Vision
  • Recognize the same melody played
    in different keys
  • Will turn and find sound in any direction
  • “Screens out” sounds not used in native language
  • Detect speech units crucial to understanding meaning, including familiar words and regularities in sound and word sequences
  • Prefer patterns and moving patterns
  • Detect familiar objects even when represented by an incomplete drawing
  • Look through windows and
    recognize people
  • Recognize pictures or people in pictures
  • Play hide and seek
Touch Taste and Smell
  • Explore a variety of textures with hands and sometimes with mouth
  • Willing to try a variety of new tastes
  • Show likes and dislikes of tastes and smells
Nutrition Feeding
  • Take complementary iron-rich foods
  • Take bite-sized pieces of table food
  • May drink whole milk
  • Feed at regular times
  • May have 3 meals and 2 snacks
  • Finger-feed himself some foods
  • Hold, bite and chew crackers
  • Use side to side tongue movements as well as up and down

Milestones taken from: Berk, 2008; Berk & Roberts, 2009; Curtis & Schuler, 2005; Ertem et al., 2008; Grenier & Leduc, 2008; Kent, 2005; Nipissing District Developmental Screen; Rourke, Leduc, & Rourke, 2006; Sears & Sears, 2003; Shelov & Hannemann, 2004

Also referenced:
(Health Canada 2004; CPS, Dietitians of Canada & Health Canada, 2005; Watson Genna, 2008)

Atypical Development

Although all children develop at their own rate, there are certain signs in a child’s development which may indicate more serious concerns. If any of the following signs of atypical development are noted in children, these concerns should be discussed with the child’s primary health care professional (First & Palfrey, 1994; Shelov & Hannemann, 2004). Subsequently, a referral to the appropriate specialist may be required.

  • Age: two to four weeks
    • Sucks poorly and feeds slowly
    • Doesn’t blink when shown a bright light
    • Doesn’t focus and follow a nearby object moving slowly from side to side
    • Rarely moves arms and legs; seems stiff
    • Seems excessively loose in the limbs, or floppy
    • Lower jaw trembles constantly, even when not crying or excited
    • Doesn’t respond to loud sounds
  • Age: one to four months
  • Age: five to eight months
    • Still has Moro reflex after six months
      (e.g., "startle reflex" involving the spreading and unspreading of arms - link)
    • Seems very stiff, with tight muscles
    • Seems very floppy, like a rag doll
    • Head still flops back when body is pulled up to a sitting position
    • Reaches with one hand only
    • Refuses to cuddle
    • Shows no affection for the person who cares for him
    • Doesn’t seem to enjoy being around people
    • One or both eyes consistently turn in or out
    • Persistent tearing, eye drainage, or sensitivity to light
    • Does not respond to sounds around him
    • Has difficulty getting objects to his mouth
    • Seems inconsolable at night after five months
    • Doesn’t smile spontaneously by five months
    • Cannot sit with help by six months
    • Does not laugh or make squealing sounds by six months
    • Doesn’t roll over in either direction (front to back or back to front) by six months
    • Does not actively reach for objects by seven months
    • Doesn’t follow objects with both eyes in the near (25cm) and far (1.5m) ranges by seven months
    • Does not bear some weight on legs by seven months
    • Does not try to attract attention through actions by seven months
    • Unable to hold rattle by seven months
    • Not searching for dropped objects by seven months
    • Unable to hold an object in each hand by seven months
    • Does not babble by eight months
    • Shows no interest in games of peek-a-boo by eight months
  • Age: nine to 12 months
    • Does not crawl
    • Consistently drags one side of body while crawling
    • Cannot stand when supported
    • Does not search for objects that are hidden while he watches
    • Says no single words (“mama” or “dada”)
    • Does not use gestures, such as waving or shaking head
    • Does not point to objects or pictures
    • Does not use the pincer grasp by 12 months
    • Is hard to console, stiffens when approached

If you are concerned about the development of a child, go to Local Information.