What is the developmental level of a child who can crawl, pull to stand, walk holding on, wave, play ball, drink from a cup, has a pincer grip, bangs two blocks together, and says four words?

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Developmental Assessment: 12-Month Level

This child is functioning at a 12-month developmental level across all domains—gross motor, fine motor, language, and social skills—making option (a) the correct answer. 1

Gross Motor Skills Analysis

The child's gross motor abilities align precisely with 12-month expectations:

  • Crawling is typically achieved by 9 months, representing an earlier milestone that this child has mastered 2
  • Pulling to stand is expected at 9 months according to standardized developmental tables 2
  • Walking while holding on (cruising) represents the transitional skill between 9-12 months, with independent walking typically achieved by 12 months 2, 1
  • The progression from pulling to stand through cruising to independent walking at 12 months follows the expected developmental trajectory 1, 3

Fine Motor Skills Analysis

The fine motor abilities demonstrated form the classic triad of 12-month fine motor development:

  • Pincer grip (thumb-finger grasp) is expected at 8 months but continues to be refined through 12 months 2
  • Banging two blocks together is specifically listed as an 8-month milestone that remains characteristic of 12-month assessment 2, 1
  • Placing a block in a cup completes the triad of fine motor skills characteristic of 12-month development 1

These three skills together—pincer grasp, banging blocks, and placing block in cup—are the hallmark fine motor achievements assessed at 12 months 1.

Language and Social Development

The expressive language and social skills are appropriate for 12 months:

  • Four words including "Mum" and "Dad" falls within normal range for 12-month expressive language, as the first real word typically appears at 12 months with 4-6 words expected by 15 months 2, 1
  • Waving, playing ball, and drinking from a cup are social and adaptive skills consistent with 12-month development 1

Why Not Other Age Levels?

18-month level (option e) is incorrect because an 18-month-old should demonstrate more advanced skills including:

  • Walking backward and running 1
  • Walking up steps with hand held 1
  • Scribbling 2
  • Building a tower of 2 cubes 2, 1
  • Speaking 10-15 words 2

2-year level (option d) is incorrect because a 2-year-old should demonstrate:

  • Jumping and riding toys without pedals 1
  • Building towers and trains with 3 blocks 1
  • Speaking 2-word sentences 2
  • Building a tower of 6 cubes (by 22 months) 2

9-month level (option c) is incorrect because while some gross motor skills (crawling, pulling to stand) appear at 9 months, the fine motor triad and language development exceed 9-month expectations 2, 1

6-month level (option b) is clearly incorrect as the child has far surpassed 6-month milestones such as sitting without support and transferring objects hand to hand 2

Clinical Context

The American Academy of Pediatrics emphasizes that developmental assessment should consider the full pattern of skills across all domains rather than isolated achievements 1. This child demonstrates consistent performance at the 12-month level across gross motor, fine motor, language, and social domains, confirming this as the appropriate developmental age 1.

References

Guideline

Developmental Assessment at 12 Months

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Walking Development in Infants

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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