0–6 Months

No head control at 2 months ^{Footnote 1 Footnote 2}

• At 2 months, infant should lift head and chest in prone position ^{Footnote 1}

• Evaluate pull-to-sit with attention to head lag; if a child has head lag at 4 months, evaluate other age-appropriate motor milestones (e.g. rolling over) and re-evaluate in 1 month. If child is still not age-appropriate, CK test and referral are recommended ^{Footnote 3 Footnote 4}

Not making sounds at 4 months ^{Footnote 2}

• At 4 months, most babies have begun to babble and copy sounds they hear

Not reaching or grasping by 6 months ^{Footnotes Footnotes Footnotes Footnotes 1,2,4}

• At 6 months, most babies show curiosity about things around them and try to grab things that are out of reach; they have usually begun to pass things from one hand to the other at this stage

Not rolling over by 6 months ^{Footnotes Footnotes Footnotes Footnotes 1,2,4}

• At 4 months, most infants are able to roll over prone to supine, and at 6 months roll over supine to prone ^{Footnote 1}

6–18 Months

Not sitting independently at 9 months ^{Footnote 1 Footnote 2}

• At 9 months, infants should sit well without support. Assess ability to achieve and maintain a sitting position: if the child is not sitting independently by 7 months or able to get into a sitting position by 9 months, CK should be measured ^{Footnote 1 Footnote 2}

Not crawling by 9–15 months ^{Footnotes Footnotes Footnotes 3–5}

Not speaking first words by 12 months ^{Footnote 4}

• By 12 months, most infants are able to say simple words such as “mama” and “dada” and try to repeat words said by their caregiver ^{Footnote 14}

Difficulty rising to stand by 18 months ^{Footnotes Footnotes Footnotes Footnotes 1,2,4}

• Watch for independent rise from floor from a supine position after child can walk well without assistance. Watch to see if child rises by putting hands on knees or thighs, or cannot rise without pulling up ^{Footnote 4}

Not walking well by 16–18 months ^{Footnotes Footnotes Footnotes Footnotes Footnotes Footnotes Footnotes 1,4,7}

• At 18 months, the toddler should sit, stand and walk independently. ^{Footnote 7} If the child is not walking well at 18 months or has any regression, CK should be measured and the child referred to a paediatric neurologist ^{Footnote 1}

2–3 Years

Gowers’ sign from approximately 2 years old ^{Footnote 1}

Not walking smoothly at 2 years old (tip-toe walking) ^{Footnote 1}

Not jumping at 2 years old ^{Footnote 2}

Difficulty running or climbing at 3 years old ^{Footnote 2 Footnote 3}

• Particularly note the quality of running, especially if there are other motor concerns

Not speaking in sentences at 3 years old ^{Footnote 3}

• By 3 years old, most children can name most familiar things, say their first name, age and sex, and words like “I,” “me,” “we,” and “you”, talk well enough for strangers to understand most of the time, and carry on a conversation using 2 to 3