Anticipatory guidance for cognitive and social-emotional development: Birth to five years (part 2)

The present article can serve as a model to help clinicians better understand and recognize markers of cognitive and social-emotional development in young children. The anticipatory guidance in this document is based on the typical development at each chronological age. Corresponding milestones in the domains of cognitive and social-emotional development are outlined in Tables 1. The separation of cognitive and social-emotional milestones into discrete categories is sometimes artificial because the two domains are inextricably linked. The milestones tables generally use the upper limits of the normal range to place each attainment, with the age range of attainment in brackets. Safe online shopping for drugs: buy viagra super active online to make your drugs cheaper.

TABLE 1 Cognitive and social-emotional milestones, newborn to 12 months of age 

Age Cognitive milestones Social-emotional milestones
Newborn Best visual focal distance 8-12 inches Turns to visual and auditory stimuli that interest him

Prefers human face, contrast, colours, high-pitched voice

Displays at least three emotions (anger, sadness, joy) Begins to self-regulate through states with less crying and more alert times Empathy: Cries when other infants cry, mood reflects emotions of others’ faces
2 months Follows slow horizontal arc through midline on both sides (2 months) Increased length of visual concentration, uses actions to achieve a goal (0-6 months) Calms when spoken to (0-3 months)Begins to be awake more during the day and sleep more at night (8 weeks)
4 months Watches own hands and their actions (2-3 months)Visually searches the room to find familiar caregiver (3 months) Observes patterns of association (0-6 months)

Anticipates routines (momentarily delays gratification) (3 months)

Social smile, laughs in response to playful interactions (1.5-4 months) Initiates interactions with compelling force (3-6 months) Has predictable sleep and eating schedule (3-6 months)

Able to self-soothe briefly, usually settles self back to sleep (3-4 months)

6 months Sensorimotor exploration (mouthing, visual), prefers novelty (6-12 months) Trial and error problem solving (0-6 months) Concentrates for increasing periods of time on toys (0-6 months) Persists, self-corrects actions to achieve goals (0-6 months)

Looks for dropped or partially hidden objects (4-6 months)

Turn-taking ‘conversations’ (3-6 months) Upset if parent does not respond to initiations Responds preferentially to familiar people (3-6 months) Empathy: Shows interest in other infants (6 months) Bangs objects together (3-6 months)
9 months Object permanence (7 months) Explores caregiver’s face (7 months), likes to look at self in mirror (4-8 months)

“Means-end behaviour” to purposefully search for hidden objects (7 months)

Imitates sequences of adult actions (6-12 months)

Attachment (child ^ parent) development is established (7 months) Stranger and separation anxiety, when caregiver returns shows pleasure and can be comforted (9-12 months) Plays pat-a-cake (9 months)
12 months Keeps mental picture of object, looks for one not seen hidden (12 months) Trial and error exploration (6-12 months), functional use of toys (9-12 months) Understands ‘no’ (9-12 months), ‘cause and effect’ toys (6-12 months)Intentional communication using gestures and vocalization (9-12 months) Uses gestures (reaches to be picked up, waves), plays peek-a-boo (9-12 months) Joint attention: Shows by extending arm, pointing, or extending object (9-12 months) Shows a variety of facial expressions (9-12 months) Empathy: Starts to offer objects to other babies (12 months)

* Numbers in parentheses indicate references

Category: Anticipatory guidance

Tags: Child development, Child guidance, Evidence-based practice, Preventive psychiatry, Problem solving, Psychological adaptation

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