From the Guidelines
A healthy three-year-old child is expected to demonstrate specific developmental milestones, including pedaling, climbing on and off furniture, copying a circle drawing, and drawing a person with head and one other body part, as outlined in the most recent and highest quality study 1.
Developmental Milestones
The following are key developmental milestones for a healthy three-year-old:
- Gross Motor Milestones:
- Pedals
- Climbs on and off furniture
- Fine Motor Milestones:
- Copies a circle drawing
- Draws a person with head and one other body part
- Builds a bridge with 3 blocks These milestones are based on the study published in Pediatrics in 2013 1, which provides a comprehensive outline of developmental surveillance and screening for children.
Importance of Surveillance
Developmental surveillance is crucial for identifying potential delays or disorders in children. This 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
The administration of a brief standardized screening tool can aid in the identification of children at risk for a developmental disorder. Many screening tools can be completed by parents and scored by non-physician personnel, with pediatric providers interpreting the screening results 1.
Clinical Evaluation
A physical examination and neurologic examination are essential for assessing motor development and identifying potential concerns. The examination should consider congenital myopathies or lower motor neuron disorders, and involve a discussion of the child's medical history, including prenatal, perinatal, and interval history 1.
Parental Concerns
Parents' concerns about their child's development should be taken seriously, and clinicians should ask about perceived differences between the child's abilities and those of their age-matched peers. This information can help identify potential delays or disorders and inform the development of an appropriate treatment plan 1.
From the Research
Developmental Milestones for a Healthy Three-Year-Old
- At three years old, children typically experience significant developmental milestones, although the provided studies do not directly outline these milestones 2, 3, 4, 5, 6.
- However, it is known that around this age, children's language development becomes more complex, and they start to use simple sentences and identify basic shapes and colors.
- The studies focus more on the identification and intervention of developmental delays and disorders rather than typical developmental milestones.
Identification of Developmental Delays
- Between 5% and 12% of children ages 2 to 5 years are diagnosed with a speech or language delay, with 50% of these children experiencing persistent delays into adolescence 2.
- Approximately 9.9% of children present with difficulties in language development, with 7.6% having no serious additional impairments and 2.3% associated with language-relevant comorbidities 3.
- Children in their third year of life with developmental language delay are at risk of later developmental language disorders (DLD) 3.
Intervention for Developmental Delays
- Parent training, language therapy, and phonological or integrated phonological treatment methods are recommended interventions for developmental language delay and disorders 3.
- Early parent- and child-centered speech and language intervention, combined with educational language support, can improve the effectiveness of managing developmental language delay and disorders 3.
- Therapeutic playgroups, such as the Learn, Engage and Play (LEaP) playgroup, may assist in improving family-support and goal achievement outcomes for children with developmental delays 6.