PaediatricsPending review

Developmental milestones

Development unfolds as a predictable, ordered sequence across four domains, so comparing a child against expected order (not just a single skill) is what turns a routine check into a screening tool for underlying problems.

In a nutshell

Development is screened across four domains (gross motor, fine motor & vision, hearing/speech/language, social/emotional/behavioural), which progress in a fixed, predictable order because of cephalocaudal and proximal-to-distal maturation. This ordered sequence is what makes milestone checklists useful for screening, with referral triggered by the limit age (not the median age) for a skill. Any regression of a previously acquired skill is always pathological and needs urgent assessment.

Classic presentation

A child is reviewed at a routine health visitor check, and milestones across all four domains are compared against expected median and limit ages, using the red book to track progress over time.

Key points

  • Four domains: gross motor; fine motor & vision; hearing, speech & language; social, emotional & behavioural. Delay can be isolated to one or global across all.

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Educational content pending clinical review. Not medical advice.