Southwest Children’s Center: Developmental Milestones 101

Alamo City Moms Blog is happy to partner with Southwest Children’s Center to bring you information of their services and expertise. Today, Dr. Megan Hogue of Southwest Children’s Center is sharing more on childhood development as well as her own insights as a mother.

Southwest Children Center Logo 1I thought having kids was going to be breezy. I mean, I AM a pediatrician. I would have at least two, back to back, and strap them to my body in perfect baby wearing fashion, executed with the precision of a ninja, cruise through Whole Foods smiling with my adorable posse and pick up organic-free-range-air chilled-no antibiotic groceries for the all-organic-never processed menu I’d sat and planned that morning, as I leisurely sipped my Diet Coke.

After years of trying, I had my baby. I never mastered the Moby wrap after numerous YouTube videos and a near-miss dropped baby incident. My kid never smiles at the grocery store, the mere mention of it being acid to his ears, and yesterday, my kid ate ONE graham cracker as his sustenance for the ENTIRE day. ONE. On the upside, I do drink a LOT of Diet Coke.

I love being a mama, every single second of it. But I also love when parents of my patients tell me that it’s hard. Because it is and none of us have it all together—it’s the communion of our hot-mess-edness that is often the relief we are searching for. After all, there are legitimately so many things to be worried about as a parent. Is my child eating enough? Growing appropriately? Hitting developmental milestones? Making friends? In too few activities? Too many activities? Will he be ready for school? Is my 3 ½ year old EVER GOING TO BE POTTY-TRAINED SO THAT HE CAN EVENTUALLY ATTEND SCHOOL?!?!  (Sore subject.)


At every pediatrician visit for well care, your child’s doctor probably asks if your child is hitting certain developmental milestones—Is he smiling? Is she rolling? Is he saying 50 words? Can she draw a person with four body parts? I know that I sometimes breeze through this checklist but I don’t give you many ideas of HOW to help your child reach these milestones. This can be stressful to the Mom whose neighbor’s two-year-old is riding his bike down the slide, while her own, older son can barely walk without face planting every 3 steps—trust me, I speak from experience.

So, I am here to offer some ideas about what you can be working on with your child by age and why it’s helpful to these things. I have included specific ideas because I hate when people say, “work on his fine motor skills”—ummmm …HOW? LIKE WHAT? This list is by no means exhaustive. I scour the internet constantly for ideas to use with my own son and the possibilities are endless, but these are some of my tested favorites.

Also, please don’t stress about planning every second of your child’s day with activities to promote development—unstructured play is JUST AS IMPORTANT to your child learning how their world works.

Finally, if I ever see you at Whole Foods, I can promise my kid will be the one screaming and I’ll be the one tossing fruit snacks in my basket. I’ll throw you a smile because being in charge of growing a little one is pretty amazing, regardless of how messy it is.

0 – 6 Months

Your baby is brand new, and if you’re anything like me, you’re just trying to keep everyone alive every day and maybe carve out some time for a shower. Maybe. If you end up with some extra time, try some of these activities because from the second your child comes out of you, your little one is learning.

Tummy Time


We all know that babies need to sleep on their backs as a precaution against SIDS (Sudden Infant Death Syndrome), but your baby needs time on their tummy while awake. Doing this prevents a flat head and strengthens your baby’s neck and upper body muscles. Aim for 5 minutes, 2 to 3 times a day to start, increasing the amount of time as tolerated. Try laying out some brightly colored toys so that your baby can see them from this position. Remember that a newborn retina can only detect large contrasts between light and dark, or black and white, so flashcards or toys that are black and white are most stimulating early on—google black and white flashcards for babies—there are a million you can print out.

You can also get your baby’s attention with an object and move it back and forth slowly so that it is tracked with the eyes. Another activity is to try rolling your baby from tummy to back. Weeeeeee! Something else fun to do is to stand over your baby, then lower slowly to a squatting position so you are very close to the baby’s face. Don’t forget that your newborn can only see about 8 to 10 inches in front of them!

Take a Touch Tour

Try carrying your baby around the house and give him a chance to touch things.  Name each object as you touch it and include soft and hard things, rough and smooth. You can try touching slightly warm and cool water at the sink or cold things briefly in the freezer. If it’s not too hot outside, take the game outdoors—touch trees, leaves, flowers, or put your baby’s feet in the grass.

Infant Massage

Parents are not the only ones who could use a good massage from time to time—infants enjoy gentle, regular massage as well. The benefits of bonding through massage are not only well established, but it can also help ease your baby’s tummy troubles and teething pains, calm when fussy, and soothe to sleep.

Choose a regular time each day—I used to do it after bath time, right before bed, and don’t do it after a meal unless you are okay with possibility of seeing it again. Try using unscented lotion or a small dab of oil—only use an oil that is edible, unscented, and either a cold-pressed fruit or vegetable oil—think coconut, grape seed, apricot, or avocado oil. You can find lots of infant massage techniques online.

Read, Read, Read

Reading to your infant promotes early language development, so make time to do it, and do it often.  Talk to your child constantly—she doesn’t care what it’s about, she just likes hearing your voice.

6 – 12 Months


This age was one of my favorite phases with my guy: the creeping, crawling, cruising, walking phase. Toys become fun and children suddenly learn that they can use their bodies to do things like wave, play peek-a-boo, and use their voices to make all kinds of sounds culminating in that oh-so-desired “dada”—that clearly should have been a “mama.”

Obviously any toy that lights up or plays a song (I still have songs from our infant time seared into my memory) are fun. Time on the tummy continues to be important for motor skill development so don’t ditch this exercise time. Exersaucers are great as soon as your child can sit with minimal support and has good head control. We generally discourage infant walkers for safety reasons—there are some places your infant should not be walking—i.e. accidentally down the stairs.

Don’t forget to continue reading every single day. This may be the most important activity you do with your child.

Peek-A-Boo Basics

Try getting on the floor with your child to play peek-a-boo with your own face under a blanket.  Use your voice to call his name from different directions in order to encourage him to lift his head high and keep his eyes moving trying to find you.

Nursery Rhymes and Singing

Saying silly nursery rhymes and singing songs are fun at this age because these encourage dancing and clapping. Introducing infants to music has been shown to promote early language skills.

Texture Crawl

Babies love exploring their world through touch. When your child starts crawling, try covering the floor with different textured fabrics and surfaces to crawl over. Try felt, a plastic placemat, fur, feathers, bubble wrap, a cookie sheet, parchment paper, playdough, and anything else SAFE with no sharp edges that you can think of. Talk to your baby about the textures as he explores—is it rough? Soft? Cool? Sticky? If your child wants nothing to do with certain textures, no biggie—the goal is exposure.  If you don’t want to torture yourself putting together a texture maze for your child, take your baby outside and have him step on cool concrete or soft grass because activities like this encourage sensory exposure too!

What Do You See?


Babies love looking at themselves! Get a box and glue a small plastic mirror inside of it. If you want, you can decorate the outside of the box with colorful paper or pictures. Place a lid on top of the box and help your child open it to see her face! Show her different expressions in the mirror by modeling different emotions as you look into the mirror. You can also glue or Velcro photographs inside the box—try using pictures of family, friends, or pets.

Unwrap It!

Anyone who has experienced a first Christmas or birthday with their child knows that often unwrapping the present and playing with the box is WAY more exciting than the actual present. Try wrapping empty boxes in paper and letting them unwrap them—great fine motor practice! To make things even more exciting, you can enclose favorite small belongings like books, blankets, or toys—or my son’s favorite—several small pieces of cereal or crackers, or a green bean! Maybe I should have wrapped up a green bean…hindsight man.

1 Year to 2 Years

Your child’s motor skills—both fine motor and gross motor—are improving rapidly. His walking and running skills are becoming firmly established. He will start to climb and you may learn he can do this for the first time when he’s standing on top of your bar stool. (Or so I hear.) He is learning to stack things, bang things, and place objects inside others. His grip is improving too—scribbling and using a sippy cup independently are common milestones attained during this time. He may start to engage in pretend play by doing things like feeding dolls or stuffed animals, pretending to use the telephone, or any activity that copies what you do.

Did I mention how important it is to READ TO THEM?

Music and Instruments


This is a good age to introduce instruments. Sets are certainly sold that include things like xylophone, cymbals, drums, triangles, but you can make your own instruments too! My son’s favorite drum was an empty oatmeal container. Pots and pans make great instruments and don’t be afraid to sing along to the music you are making. Try songs that have interactive parts and help your child learn to move their bodies in new ways and make new sounds, for example, Old McDonald Had a Farm, Wheels on the Bus, and Row, Row, Row Your Boat.

Lay the Framework for Pretend Play

Soon you’ll be setting up grocery stores, play kitchens, and vet offices for your child to play with on a regular basis, but you have to TEACH them how to pretend first. Try giving your child instructions like, “Let’s pretend you are a rabbit.  Can you hop like a rabbit?” or “Can you slither like a big long snake?” Try to get him to pretend he is other objects: a flower opening on a summer day or a balloon being filled with air. Encourage him to feed his stuffed animals, put them to bed, and give them baths. You can even throw one of his favorite animals a birthday party. A great activity is to give your child an old cell phone of yours and pretend you are calling him.

Texture and Sensory Practice

From birth, children learn about the world by touching, tasting, smelling, seeing and hearing things around them. Sensory play is so crucial to brain development because it strengthens the neural pathways that are important for all types of learning. There are endless activities appropriate for this age group, but try a few of these:

  • Walking different textures. Think bubble wrap, or sticky contact paper, or shaving cream, or sand.
  • Playing with water. Win extra “cool Mom” points for making it colored. Practice mixing the different colors.
  • Playing with playdough. Try making your own! Pull pieces of playdough out of your child’s mouth when they try to eat it…THIS is something he will want to eat.
  • Creating a smelling activity. Have them smell things around the house, think vanilla, cinnamon, an orange, fresh ginger, garlic, lavender oil, etc.
  • Rolling a train or car on their backs, then moving it to different body parts saying the body part you are touching as you go: “There’s a train on your head, there’s a train on your arm,” etc.
  • Practicing scribbling with crayons on paper. This will help them develop that fine motor pincer grasp more and also gives them some sensory feedback. Pin up paper on an easel or on the wall and have them practice scribbling in the vertical plane. This gives kids more sensory input and works on shoulder strength.
  • Finger painting with actual paints, or my favorite, chocolate pudding.

Balls, Balls, Balls

It will be a while before your child has sufficient hand eye coordination to wallop a ball with a bat, but start giving them the skills they will need and help your child recognize that their movements can serve a purpose. At the beginning, try blowing up several balloons but don’t forget deflated balloons can be a choking hazard! Kick them, bat at them with your hands, pick them up and put them into a big box. Lay your child down and cover them with balloons. As your child approaches  two-years-old, introducing a little basketball goal or soccer goal is a fun activity.


I’ve written another article about great two- to four-year-old developmental activities to try with your kids, all tested and approved by my son! You can find it in an upcoming issue of our Southwest Children’s Center newsletter.

I’m also going to tackle the topic of Kindergarten Readiness as soon as I can get out of the fetal position and give myself a pep talk–KINDERGARTEN?! How is my baby almost in KINDERGARTEN? It goes way too fast, doesn’t it?
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