Developmental Milestones (OSCE)


Developmental milestones: 

 Median age of acquisition’: when achieved by 50% of children   

 Limit age’: when children should have achieved milestone  

 If not achieved by ‘limit age’, it is a red flag meaning more investigations are required  

 You should target your questions based on the child’s age  

 Offer the child toys to play with to aid assessment  

Developmental areas


Gross motor development: 

 Newborn: flexed limbs, head lag 

 6 to 8 weeks: lifts head to 45° 📐

 6 to 8 months: sits independently, ‘limit age’ = 9 months  

 8 to 9 months: crawls 

 10 months: stands independently, moves around furniture 

 12 months: unstable walking, ‘limit age’ = 18 months 

 15 months: stable walking 

 2.5 years: running and jumping 🏃


Vision and fine motor development: 

 6 weeks: turns head to follow movement, ‘limit age’ = 3 months 

 4 months: reaches for toys, ‘limit age’ = 6 months 

 4 to 6 months: palmar grasp (curl fingers towards palm around object)  

 7 months: passes toys between hands, ‘limit age’ = 9 months  

 10 months: mature pincer grip (using thumb and index fingertips to pick up small objects), ‘limit age’ = 12 months 

 16 to 18 months: uses crayons to make marks 

 Brick building: tower of 3 (18 months), tower of 6 (2 years), tower of 8/train of 4 (2.5 years), bridge (3 years), steps (4 years) 

 Pencil skills without copying: draws line (2 years), draws circle (3 years), draws cross (3.5 years), draws square (4 years), draws triangle (5 years) (Pencil skills with copying: 6 months prior) 


Hearing, speech and language development: 

 Newborn: startles at loud noises 👂

 3 to 4 months: vocalises, coos, laughs

 7 months: soft sounds, polysyllabic babble 

 7 months: uses sounds randomly 

 10 months: uses sounds properly to mama/dada 

 12 months: 2 to 3 words (excluding mama/dada) and understands name 👂

 18 months: 6 to 10 words 

 20 to 24 months: 2+ word phrases  

 2.5 to 3 years: 3 to 4 word sentences 


Social, emotional and behavioural development: 

 6 weeks: responds with a smile, ‘limit age’ 8 weeks 

 6 to 8 months: puts food in mouth on own 🍩

 10 to 12 months: waves goodbye and plays peek-a-boo 

 12 months: uses 2 hands to drink from cup 

 18 months: gets food to mouth using spoon  

 18 to 24 months: symbolic play (using objects/actions/ideas in play), ‘limit age’ = 2 to 2.5 years 

 2 years: toilet trained during daytime, removes some of own clothing 

 2.5 to 3 years: parallel play (playing alongside others but do not influence each other), development of interactive play, takes their turn 


  1. Assess gross motor development
  2. Assess vision and fine motor development
  3. Assess hearing, speech and language development
  4. Assess social, emotional and behavioural development


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