Name:___________

Age: ___________

VISION AND HEARING ASSESSMENT

Position Age Milestone Mother statement Observation

Hearing Birth (0-3 months) Responds to sound by startle Crying,
changing body movement
3-4 months Turns his head toward the source of
sound
With bell, away from the 6 months Turns his head to one side and
visual field, at 1.5 feet, downward
below the level of ear
With bell, away from the 7 months Turns his head one side and looks
visual field, at 1.5 feet, upward
above the level of ear
10 months Looks directly toward the source of
sound
Point at picture and ask, “ 1 year Adult level Hearing
What is this?”

Vision Birth  Fixate on and follow a moving

person
 Can see a dangling ring held at 8–10
inches at 45°
4 Weeks  Fixate on his mother as she talks
 Can see a dangling ring held at 8–10
inches at 90°
12 weeks  Can see a dangling ring held at 8–10
inches at 120°
3–4 Months  Fixates intently on an object shown
to him (grasping with the eye)
  It appears that the child wants to
reach for the object
4 Months  Well established binocular vision
6 months  Adjust position according to location
of object.
1 Year  Follows rapidly moving objects
Hand regard – Should not After 1 Year  Later the child displays more
involve in Vision maturity in vision by not only
assessment. identifying smaller objects but also
Formal Objective being able to recognize them
measurement- At 2.5 -3
years.
Snellen chart use after- 3
years
RED FLAGS
 2 months: No fixation
 4 months: No visual tracking
 6 months: Does not turn to sound/voice

GROSS MOTOR DEVELOPMENT

Position Age Milestone Mother statement Observation

Supine and pull to sit: At birth Complete head Lag

Hold the neonate gently
from the arms to sitting
position

4 weeks Tries to hold neck momentarily and the curvature

of back is prominent

12 weeks Hold neck in the midline

Curvature of the back is not prominent

20 weeks ( 5 months) Maintain head in midline if head swayed from side

to side.

Head slightly flexed at chest

Ventral suspension Birth to 4 weeks Head Flops

Lift a neonate in prone

position and hold in the air
while the chest and
abdomen are supported

6 weeks Momentarily holds head in horizontal Plane

8 weeks Holds the head in horizontal plane for longer

duration
 12 weeks Holds the head above the horizontal plane

Prone position At birth Turns head to one side

Make a neonate to lie
down in the prone
position

2 weeks Keeps his knees flexed with high pelvis

4 weeks Momentarily lifts the chin

6 weeks Lies flat on pelvis with extended hips

8 weeks Lifts the face at 45° but the shoulder remains on the
bed

12 weeks Lifts the face at 45° with chin and shoulder off the
couch and support the upper body with forearms

4–6 months Roll over from back to side and then from back to
abdomen, then abdomen to back

6 months Lifts the face at 90° with chin and shoulder off the
couch and support the upper body with extended
 arms

8 months Crawls

10 months Creeps

Sitting 5 months Sit with support

6-7 month Sit with support of extended arm

8-9 months Sit without support

10 months Pivoting to play around with Toys

Standing and walking 6 months Bear weight when made to stand

9 months Begins to stand holding on to furniture

10–11 months Cruise around the furniture

12–13 months Stand independently and can walk when held from
one hand

13–15 months Walk independently

18 months Runs, crawl up and down the stairs, pull toy and
wheelchair

2 years Walk backward, 2 steps at a time, jump

3 years  Walking, running, climbing and jumping well

established;
 Climb upstairs with one foot/step, but while
coming down, keep feet on same stairs, ride
tricycle

4 years Move downstairs using alternate footing, can hop,

catches ball reliably, throws ball overhand, Ride
bicycle

5 years Skips and hops on alternate feet.

Throws and catches ball well

 Jumps rope

Skates with good balance

Walks backward with heel to toe

Jumps from a height of 12 inches and lands on toes;

Balances on alternate feet with eyes closed.

6–8 years Runs, jumps, climbs and hops;

Coordination improving

8–10 years Performs tricks on bicycles; Begins to participate in

organized sports; Throws a ball skilfully

10–14 years Enjoys all physical activities

14–16 years Clumsiness occurs due to rapid physical growth;

Motor functions comparable to adult

17 years onward Motor functions comparable to that of adult

RED FLAGS  1–2 months: Early rolling “Early rolling is a

red flag because it reflects abnormal muscle
tone and lack of normal motor control rather
than true developmental advancement.”
 3 months: Persistent fisting
 4 months: Lack of steady head control while
sitting
 9 months: Inability to sit
 18 months: Inability to walk independently
 Fine Motor skills

Position Age Milestone Mother Observati

statemen on
t

Hand eye co-ordination 12–20 weeks Hand regard: observe hand intensity

3–4 months Offer dangling ring and observe how infant

reaches up to it, if uses both hands to reach this is
called bimanual reach

6 months Offer dangling ring and observe how infant

reaches up to it, if uses one hands to reach, this is
called unidextrous reach,

offer a cube and see how infant holds it. He will

use ulnar border to hold it

6–7 months Offer a cube and look transfer of objects from

one hand to other

8–9 months Offer a cube and see how infant holds it. He will
use radial border to hold it.

At 9 months, offer paper pellets, the infant will

try to hold them with thumb and index finger
and will demonstrate immature grasp

1 year Offer paper pellets, the infant will try to hold

them with thumb and index finger and will
demonstrate mature grasp known as pincer
grasp

Hand to mouth coordination 0–1 year Puts everything into mouth

 6 months Starts chewing

12 months Drinks from cup but spills

15 months Drinks from cup without spillage.

18 months, 2 years Feeds self well with spoon

Dressing skills 1 year Pull off mittens, caps and socks

18 months Untie, but fumbles with buttons

2 years Put on shoes or socks, undress

completely

3 years Dress and undress fully, if helped with buttons

4 years Buttoning

5 years Able to tie shoe laces

Advance hand skills 15 months Scribbles on a paper; Turns 2–3 pages of a book at a
time

18 months Draw a stroke with pencil; Build a tower of 2–3 cubes

2 years Turns one page at a time; Unscrew lids; Turns door knobs
3 years  Builds a tower of 9 or 10 cubes;
 Proficiently places small pellets in a narrow-necked
bottle;
 copies a circle, names what has been drawn,
 Make circle with facial features, eye dots, nose

4 years  Builds bridge with 3 cubes;


 Uses scissors successfully to cut out picture
following outline;
 Can lace shoes, but may not be able to tie bow; In
drawing, Copies cross- 4 years, Copies Square- 4.5
years
 Adds three parts to stick figure with facial features
(eye, nose, lips)

5 years  Ties shoelaces, uses scissors, simple tools, or pencil

very well;
 Copies triangle, adds seven to nine parts to stick
 figure, prints a few letters, numbers, or words, such
as first name

6–8  Draws a person with 12–16 parts; Flag; Daimond

years  Has improved eye-hand coordination;
 Improved table manners;
 Self-care managed

8–10 years  Uses both hands independently; Draws a person

with 18–20 parts; Dresses self completely
 Able to draw doctor sign

10–12  Draw a man with all parts and start adding finer
years details;
 Coordination continues to improve

12–14 years Eye-hand coordination at adult level; Possesses

 manual dexterity

14–16 years Adult level Adult level

17 years onward Adult level Adult level

PERSONAL Social AND general understanding

Domain Age Milestone Mother’s Observation

Statement

Personal- 1 month Identify with his mother while talking

social

6–8 Social smile

weeks

3 months Recognises mother

6 months Smiles at mirror, imitates acts such as cough or tongue protrusion

7 months Stranger anxiety, inhibits to “No”

9 months Waves “bye-bye”, repeats any performance that evokes an appreciative response

10 Pat a cake game( Clapping game)

months

12 Play simple ball games, comes on calling

months
 15 Points at object of need, recognizes Body parts
months

18 Domestic mimicry
months

2 yease- Pulls people to show toys no sharing-> then parallel play.

2.5 years

3 years  Dry by Day

 Told which shoe is right and left, stranger anxiety is still there;
 Has increased attention span; Feeds self completely;
 Can prepare simple meals, such as cold cereal and milk;
 Can help to set table, care of dishes without breaking;
 May have fears, especially of dark and going to bed; Knows own sex and sex of others;
 Play is parallel and associative;
 begins to play simple games but often follows own rules, begins to share toys

4 years Very independent- Goes to Toilet Alone; Tends to be selfish and impatient; Aggressive
physically as well as verbally; Take pride in accomplishments; Has mood swings; Shows off
dramatically, enjoys entertaining others; Still many fears; Play is associative, imaginary
playmates are common, uses dramatic, imaginative, and imitative devices; Sexual
exploration and curiosity demonstrated through play, such as being “doctor” or
“nurse”

5 years  Less rebellious and quarrelsome than at age 4 years;

 More settled and eager to get down to business;
 Not as open and accessible in thoughts and behavior as in earlier years;
 Independent but trustworthy and are responsible;
 Do things right and to please others, tries to live by rules; Has better manners;
 Care for self totally except for teeth; occasionally needing supervision in dress or
hygiene; Not ready for concentrated close work or small print because of slight
farsightedness.
 Still unrefined eye-hand coordination; Cooperative play; tries to follow rules but may
 cheat to avoid losing;
 Separation anxiety decreases significantly

6–8 years Continues to be egocentric, bossy; Craves attention; Jealous of sibling;

Fears injury to body

8–10 Curious about everything; Concerned about relationships with others;

years
Becoming peer-oriented; Relationships with peer oriented

10–12 Has greater self-control; Respects parents and their role; Joins groups formal and
years informal

12–14 Egocentric; Has intense loyalty to peer groups; Shows mood swings; Experiences sense
years of loss as begins to separate from parents; Continues same sex friendships

14–16 Egocentrism diminishes; Separation from parents continues; Heterosexual relationship

years

17 years Establishes interdependent relationship with parents; Has fewer but closer friends;
onward Heterosexual relationships are the rule

Red flags  6 months: Lack of smiles or other joyful expressions

 9 months: Lack of reciprocal (back-and-forth sharing of vocalizations, smiles, or facial
expressions)
 12 months: Failure to respond to name when called, absence of babbling, lack of
reciprocal gestures (showing, reaching, waving)
 15 months: Lack of proto-declarative pointing or other showing gestures, lack of single
words
 18 months: Lack of simple pretend play, lack of spoken language/gesture combinations
 24 months: Lack of two-word meaningful phrases (without imitating or repeating)

Language development

Domain Age Milestone Mother’s Observation

 Statement

Languag 8–10 weeks • Vocalize with vowel sounds “ah”, “uh” (e.g., “aaah”, “uhh”)
e

3–4 months • Squeals with delight and laughs loud (high-pitched squeal)

5 months • “ah goo, gaa” (cooing)

6 months • Mono syllables (ba, da, pa) (“ba”, “da”)

 Babble and Razing

8–9 months • Bisyllables (mama, baba, dada)

9–10 months • Imitate sounds from native language (copies parents’ sounds)

12 months • Joins 2–3 words (“give ball”, “mama come”) • Vocabulary: 2–3 words (mama, papa, ball)

18 months • Vocabulary: 10–15 words (milk, dog, bye)

2 years • Vocabulary ~100 words • Joins 2–3 words (“want milk”)

3 years • Asks many questions (“why?”, “what?”)

• Telegraphic speech (“want milk”, “go park”)

• Uses 3–4 word sentences (“I want water”)

• Talks continuously

• Repeats sentence of six syllables

• Vocabulary: ~900 words

4 years • Coherent account of events (“I went to park”)

• Uses 4–5 word sentences

• Questioning at peak
 • Tells exaggerated stories

• Uses prepositions (under, on, behind)

• Names colors (red, blue)

• Vocabulary: ~1,500 words

5 years • Uses 6–8 word sentences (“I went to school with my friend”)

• Names coins

• Names colors

• Describes pictures

• Knows days (Monday, Sunday)

• Follows 3-step commands (“pick ball → give → sit”)

• Vocabulary: ~2,100 words

6–8 years • Follows series of 3 commands

• Responds to praise

• Repeats 10–12 word sentences

• Vocabulary: ~2,500 words

8–10 years • Follows suggestions better than commands (“you should study”)

• Uses shorter, compact sentences

• Vocabulary: 4,000–5,000 words

10–12 years • Uses numbers beyond 100

• Enjoys riddles

• Vocabulary: Oral ~7,200, Reading ~50,000

12–14 years • Uses slang

• Uses distinct meanings

Red flags 9 months: Lack of babbling consonant sounds