Development is assessed in four domains — gross motor, fine motor, language and social — and each has anchor milestones the exam expects you to know by month.
How it's asked: "A child can do X and Y but not Z — what is the age?" Pick the age where all the listed skills fit.
Why this is true
Motor development follows myelination, which proceeds cephalocaudally (head control before sitting before walking) and proximodistally (whole-hand grasp before the pincer grasp). That is why head holding comes at 3 months but walking at 12, and why fine motor control of the fingertips is one of the last things to mature. Language and social skills depend on cortical maturation and interaction, so they are the domains most affected by hearing loss or deprivation.
Key points
Anchor milestones
| Age | Gross motor | Fine motor | Language | Social |
|---|---|---|---|---|
| 3 months | Neck holding | Hands open | Cooing | Recognises mother |
| 6 months | Sits with support | Transfers objects | Monosyllables | Stranger anxiety begins |
| 9 months | Stands holding on | Immature pincer | Bisyllables | Waves bye-bye |
| 12 months | Walks alone | Mature pincer | 1–2 words | Plays simple games |
| 2 years | Runs, climbs stairs | Tower of 6 cubes | 2-word phrases | Parallel play |
| 3 years | Rides tricycle | Copies a circle | Sentences | Knows own gender |
Common traps
- Correct for prematurity up to 2 years: a baby born 2 months early is assessed against their corrected age.
- When several milestones are listed, the answer is the age at which the most advanced one is achieved.
Mnemonic
Circle at 3, cross at 4, square at 4½, triangle at 5.
Clinical case
A child sits without support, transfers objects hand to hand and says 'ba', but does not yet stand holding on or say 'mama'.
High-yield
Social smile 2 m, neck holding 3 m, sitting 6–8 m, standing 9 m, walking 12 m. Pincer: immature 9 m, mature 12 m. Circle 3 y, square 4½ y.
Quick check
Q1.A child who can copy a cross but not a square is approximately:
Q2.Mature pincer grasp is achieved at: