From the Guidelines
A healthy female infant should reach specific developmental activity benchmarks, including lifting her head and chest in prone position by 2 months, rolling over prone to supine and supporting on elbows and wrists in prone by 4 months, and walking independently by 12 months, as outlined in the most recent and highest quality study 1.
Developmental Milestones
The following are the expected developmental activity benchmarks for a healthy female infant:
- By 2 months: Lifts head and chest in prone position
- By 4 months: Rolls over prone to supine, supports on elbows and wrists in prone, and plays with fingers in midline
- By 9 months: Rolls over supine to prone, sits without support, pulls to stand, and crawls
- By 12 months: Walks independently and stands
- By 18 months: Walks backward, runs, and walks up steps with hand held These milestones are based on the study published in Pediatrics in 2013 1, which provides a comprehensive overview of motor milestones for developmental surveillance at preventive care visits.
Importance of Surveillance
It is essential to monitor a child's development through surveillance, which involves eliciting and attending to parents' concerns, documenting and maintaining a developmental history, making accurate observations of the child, identifying risk and protective factors, and maintaining an accurate record of the process and findings 1.
Screening Tools
Developmental screening tools, such as the Capute Scales and the Beery-Buktenica Developmental Test of Visual-Motor Integration, can be used to identify children at risk for developmental disorders 1.
Neurologic Examination
A neurologic examination should be performed to assess a child's posture, play, and spontaneous motor function, and to identify any concerns about motor development, such as delayed acquisition of skills, involuntary movements, or regression of skills 1.
From the Research
Developmental Activity Benchmarks for a Healthy Female Infant
The following are some developmental activity benchmarks for a healthy female infant:
- Rolling over: typically achieved by 4 months 2
- Sitting: typically achieved by 9 months 2
- Crawling: typically achieved by 9 months, with creeping being associated with a 1-month delay in walking and inability to move forward being associated with a 2-month delay in walking 2
- Walking: typically achieved between 12-14 months, with earlier achievement associated with earlier rolling over, sitting, and crawling 2
- Language and social milestones: typically achieved at various ages, with parental knowledge of these milestones being crucial for early identification of developmental delays 3
Factors Influencing Developmental Milestones
Several factors can influence the achievement of developmental milestones, including:
- Child age: associated with lower developmental status in the presence of positive behavioral screening scores 4
- Social determinants of health: associated with lower developmental status 4
- Medicaid: associated with lower developmental status 4
- Male sex: associated with lower developmental status 4
- Child race: associated with lower developmental status 4
Importance of Early Identification and Intervention
Early identification and intervention are crucial for addressing developmental delays and promoting healthy development in infants 5, 6, 3. Regular surveillance and periodic screening can help identify specific areas of developmental and behavioral concerns, and suggest a need for further evaluation and intervention 5, 6.