The Washington guide to promoting development in the young child

	Expected tasks	Suggested activities

Motor skills
1 to 3 months
1.	Holds head up briefly when prone	1.	Place infant in prone position
2.	Head erect and bobbing when supported in sitting	2.	Support in sitting position with his head erect 
	position	
3.	Head erect and steady in sitting position	3.	Pull infant to sitting position
4.	Follows object through all planes	4.	Provide with opportunity to observe people or activity
5.	Palmar grasp	5.	Hang bright-colored objects and mobiles within reach
6.	Moro reflex		across crib
		6.	Provide with opportunity to observe objects or people while
			in sitting position
		7.	Use infant seat
		8.	Alternate bright shiny objects with dark and light 
			visual patterns

4 to 8 months
1.	Sits with minimal support, with stable head and back	1.	Pull up to sitting position
2.	Sits alone steadily	2.	Provide opportunity to sit supported or alone when head and
3.	Plays with hands, which are open most of time		trunk control are stabilized
4.	Grasps rattle or bottle with both hands	3.	Put bright-colored objects within reach
5.	Picks up small objects, for example, cube	4.	Give toys or household objects: rattles, teething ring, cloth
6.	Transfers toys from one hand to other		animals or dolls, I-inch cubes, plastic objects such as cups,
7.	Neck-righting reflex		rings, and balls
		5.	Offer small objects such as cereal to improve grasp
		6.	Offer a variety of patterns or textures to play with
		7.	Use squeak toys

9 to 12 months
1.	Rises to sitting position	1.	Provide playpen, allow child to pull himself to standing position
2.	Creeps or crawls, maybe backward at first	2.	Give opportunity and space to practice creeping and crawling
3.	Pulls to standing position	3.	Have child practice moving on knees to improve balance
4.	Stands alone		prior to walking
5.	Cruises	4.	Have child use walker or straddle toys
6.	Uses index finger to poke	5.	Play airplane with child; have child practice catching himself
7.	Finger-thumb grasp		while rolling on large ball
8.	Parachute reflex	6.	Provide with objects such as spoons, plastic bottles, cups,
9.	Landau reflex		ball, cubes, finger foods, saucepans, and lids

13 to 18 months
1.	Walks a few steps without support	1.	Provide opportunity to practice walking, climbing stairs with help
2.	Balance when walking	2.	Give toys that can be pushed around
3.	Walks upstairs with help, creeps downstairs	3.	Supervise activity with paper and large crayons
4.	Turns pages of book	4.	Provide toys such as cubes, cups, saucepans, lids, rag dolls,
			and other soft, cuddly toys
		5.	Begin introducing child to swing

19 to 30 months
1.	Runs	1.	Provide opportunity to practice and develop activities
2.	Walks up and down stairs, one at a time (not	2.	Provide pattern for child while he watches and then encourage
	 alternating feet) 		him to try	
3.	Imitates vertical strokes	3.	Provide tricycle or similar pedal toys; secure foot on pedal if
4.	Imitates building tower of four or more blocks		necessary
5.	Throws ball overhand
6.	Jumps in place
7.	Rides tricycle

31 to 48 months
1.	Walks downstairs (alternating feet)	1.	Continue with blocks, combining materials, toy cars, and trains
2.	Hops on one foot	2.	Provide clay and other manipulating materials
3.	Swings and climbs	3.	Give opportunities to swing and climb
4.	Balances on one foot for 10 seconds	4.	Provide with activities such as finger painting, chalk, and
5.	Copies circle		black board
6.	Copies cross
7.	Draws person with three parts

49 to 52 months
1.	Balances well	1.	Provide with music and games to synchronize hand and
2.	Skips and jumps		foot; tapping with music, skipping, hopping, and dancing
3.	Can heel-toe walk		rhythmically to improve coordination
4.	Copies square
5.	Catches bounced ball

Feeding skills
1 to 3 months
1.	Sucking reflex present	1.	Consider a change in nipple or posturing if there is difficulty
2.	Rooting reflex present		in swallowing
3.	Ability to swallow pureed foods	2.	Introduce solids, one kind at a time (use small spoon, place
4.	Coordinates sucking, swallowing, and breathing		food well back on infant’s tongue)
		3.	Hold in comfortable relaxed position while feeding
		4.	Pace feeding tempo to infant's needs

4 to 8 months
1.	Tongue used in moving food in mouth	1.	Give finger foods to develop chewing, stimulate gums, and
2.	Hand-to-mouth motions		encourage hand-to-mouth motion (cubes of cheese, bananas,
3.	Recognizes bottle on sight		dry toast, bread crust, cookies)
4.	Gums or mouths solid foods	2.	Encourage upright supported position for feeding
5.	Feeds self cracker	3.	Promote bottle holding
		4.	Introduce junior foods

9 to 12 months
1.	Holds own bottle	1.	Bring child in highchair to table and include in part of or
2.	Drinks from cup or glass with assistance		entire meal with family
3.	Finger feeds	2.	Have child in dry comfortable position with trunk and feet
4.	Beginning to hold spoon		supported
		3.	Encourage self-help in feeding; use of table foods
		4.	Offer spoon when interest is indicated
		5.	Introduce cup or glass with small amount of fluid

13 to 18 months
1.	Holds cup and handle with digital grasp	1.	Continue offering finger foods (wieners, sandwiches)
2.	Lifts cup and drinks well	2.	Use nontip dishes and cups: dishes should have sides to
3.	Beginning to use spoon, may turn spoon upside		make filling of spoon easy
	down before reaching mouth	3.	Give opportunity for self-feeding
4.	Difficulty in inserting spoon into mouth	4.	Provide fluids between meals rather than having child fill up
5.	May refuse food		on fluids at mealtime

19 to 30 months
1.	Drinks without spilling	1.	Encourage self-feeding with spoon
2.	Holds small glass in one hand	2.	Do not rush child
3.	Inserts spoon in mouth correctly	3.	Serve foods plainly but in attractive servings
4.	Distinguishes between food and inedible material	4.	Small servings of food will encourage eating more than
5.	Plays with food		large servings

31 to 48 months
1.	Pours well from pitcher	1.	Encourage self-help
2.	Serves self at table with little spilling	2.	Give opportunity for pouring (give rice and pitcher to
3.	Rarely needs assistance		promote pouring skills)
4.	Interest in setting table	3.	Encourage child to help set table
		4.	Have well-defined rules about table manners

49 to 52 months
1.	Feeds self well	1.	Socialize with child at mealtime
2.	Social and talkative during meal	2.	Have child help with preparation, table setting, and serving
		3.	Include child in conversations at mealtimes by planning 
			special times for him to tell about events, situations, or
			what he did during the day

Sleep
1 to 3 months
1.	Night: 4- to 10-hour intervals	1.	Provide separate sleeping arrangements away from parents’
2.	Naps: frequent 		room	
3.	Longer periods of wakefulness without crying	2.	Reduce noise and light stimulation when placing in bed	
		3.	Have room at comfortable temperature with no drafts or 
			extremes in heat
		4.	Reverse position of crib occasionally 
		5.	Place child in different positions from time to time for sleep
		6.	Alternate from back to side to stomach
		7.	Keep crib sides up

4 to 8 months
1.	Night: 10 to 12 hours	1.	Keep crib sides up
2.	Naps: 2 to 3 (1 to 4 hours in duration)	2.	Refrain from taking child into parents' room if he awakens
3.	Night awakenings	3.	Check to determine if there is cause for awakenings: hunger,
			teething, pain, cold, wet, noise, or illness
		4.	If a baby-sitter is used, attempt to find some person with 
			whom infant is familiar. Explain bedtime and naptime 
			arrangements 

9 to 12 months
1.	Night: 12 to 14 hours	1.	Short crying periods may be source of tension release
2.	Naps: 1 to 2 (I to 4 hours in duration)		 for child
3.	May begin refusing morning nap 	2.	Observe for signs of fatigue, irritability, or restlessness if 
			naps are shorter
		3.	Provide familiar person to baby-sit who knows sleep routines

13 to 18 months
1.	Night: 10 to 12 hours	1.	Night terrors may be terminated by awakening infant and
2.	Naps: 1 in afternoon (I to 3 hours in duration)		offering reassurance
3.	May awaken during night crying (associated with	2.	Check to see that child is covered 
	wetting bed) 	3.	Avoid hazardous devices to keep child covered, including
4.	As he becomes more able to move about, he may		 blanket, clips, pins, and garments that enclose child to neck	
	uncover himself, become cold, and awaken	

19 to 30 months
1.	Night: 10 to 12 hours	1.	Quiet period of socialization prior to bedtime-reading child
2.	Naps: 1 (1 to 3 hours duration)		book or telling story
3.	Doesn't go to sleep at once¾keeps demanding	2.	Holding child¾talking quietly with him
	 things	3.	Ritualistic behavior may be present; allow child to carry out	
4.	May awaken crying if wet or soiled 		routine; helps him overcome fear of unexpected or fear of	
5.	May awaken because of environmental change of 		dark; for example, child may wish to arrange toys in	
	temperature, change of bed, change of sleeping 		certain way		
	room, addition of sibling to room, absence of parent,	4.	Explain bedtime ritual to baby-sitter
	from home hospitalization, trip with family, or	5.	Give more reassurance, spend more time before bedtime
	relatives visiting		preparation
		6.	Provide familiar bedtime toys or items
		7.	Allow crying-out period if he is safe, comfortable,  and
			 tucked in
		8.	Place in bed before he reaches excessive state of fatigue,
			excitement, or tiredness
		9.	Eliminate sources of stimulation or fear
		 10.	Maintain consistent hour of bedtime

31 to 48 months
1.	Daily range: 10 to 15 hours	1.	Television programs may affect ability to go to sleep: avoid
2.	Naps: beginning to disappear		violent television programs
3.	Prolongs process of going to bed	2.	Anxiety about going to bed and desire to stay up with parents
4.	Less dependent on taking toys to bed		requires limits
5.	May awaken crying from dreams	3.	Regularity and consistency important to promote good sleep
6.	May awaken if wet		habits	
		4.	Reassurance¾night light or leaving door ajar
		5.	Do not use bedtime or naptime as punishment
		6.	Encourage naps if signs of fatigue or irritability are evidenced

49 to 52 months
1.	Daily range: 9 to 13 hours	1.	Encourage napping if excessive or strenuous activity occurs
2.	Naps: rare		and child is overly tired
3.	Quieter during sleep	2.	Explain to child if baby-sitter will be there after child is asleep

Play
1 to 3 months
1.	Quieted when picked up	1.	Encourage holding and touching of child by mother
2.	Regards face of others	2.	Provide with cradle gyms and mobiles, brightly colored, visually
			interesting objects within arm's distance

4 to 8 months
1.	Plays with own body	1.	Begin patty-cake and peekaboo
2.	Differentiates strangers from family	2.	Provide for periods of solitary play (playpen)
3.	Seeks out objects	3.	Encourage holding and touching of child by mother
4.	Grasps, holds, and manipulates objects	4.	Provide variety of multicolored and multitextured objects that
5.	Repeats activities he enjoys		child can hold
6.	Bangs toys or objects together	5.	Encourage exploration of body parts
		6.	Provide floating toys for bath

9 to 12 months
1.	Puts objects in and out of containers	1.	Continue mother-infant games
2.	Examines objects held in hand	2.	Give opportunity to place objects in containers and pour out
3.	Plays interactive games (peekaboo)	3.	Provide large and small objects with which to play
4.	Extends toy to other person without releasing	4.	Encourage interactive play
5.	Works to get toy out of reach

13 to 18 months
1.	Plays by himself¾may play near others	1.	Introduce to other children even though child may not play with
2.	Has preferred toys		them
3.	Enjoys walking activities, pulling toys	2.	Provide music, books, and magazines
4.	Throws and picks up objects, throws again	3.	Encourage imitative activities¾helping with dusting, sweeping,
5.	Imitates, for example, reading newspaper,		stirring
	sweeping

19 to 30 months
1.	Parallel play¾not interactive but plays alongside	6.	Provide with new materials for manipulating and feeling¾finger
	another child 		paints, clay, sand, stones, water, and soap		
2.	Uses both large and small toys		Wooden toys¾cars and animals
3.	Rough-and-tumble play		Building blocks of various sizes, crayons, and paper		
4.	Play periods longer than before¾interested in		Rhythmical tunes and equipment-swing, rocking chair, rocking		
	manipulative and constructive toys		horse		
5.	Enjoys rhymes and singing (television programs)		Children's books¾short, simple stories with repetition and		
			familiar objects; enjoys simple pictures, brightly colored	
		7.	Guide child's hand to actively participate with specific activities,
			for example, using crayons, hammering	

31 to 48 months
1.	In playing with others, beginning to interact, sharing	1.	Encourage play with small groups of children
	toys, taking turns	2.	Encourage imaginative and dramatic play activities
2.	Dramatizes, expresses imagination in play	3.	Music: singing and experimenting with musical instruments
3.	Combining playthings; more use of constructive	4.	Group participation in rhymes, dancing by hopping or jumping
	materials 	5.	Drawing and painting (seldom recognizable)
4.	Prefers two or three children to play with; may have
	special  friend

49 to 52 months
1.	Dramatic play and interest in going on excursions	1.	Painting and drawing (objects will be out of proportion; details
2.	Fond of cutting and pasting, creative materials		that are most important to child are drawn largest)
3.	Completes most activities	2.	Encourage printing of numbers and letters
		3.	Clay: making recognizable objects
		4.	Cutting and pasting
		5.	Provide with materials, for example, boxes, chairs, barrels,
			for building sturdy structures

Language
1 to 3 months
Receptive abilities
1.	Movement of eyes, respiration rate, or body activity	1.	Observe facial expressions, gestures, bodily postures, and
	changes when bell is rung close to child's head		movements when vocalizations are being produced
2.	Smiles when socially stimulated	2.	Smile and talk softly in pleasant tone while holding, touching,
3.	Has facial, vocal, and generalized bodily responses 		and handling infant
	to faces	3.	Hold, touch, and interact frequently with infant for pleasure		
4.	Reacts differently to adult voices	4.	Refrain from letting infant engage in prolonged and incessant
			 crying

Expressive abilities	
1.	Makes prelanguage vocalizations that consist of
	cooing, throaty sounds, for example, gu
2.	Makes "pleasure" sounds that consist of soft vowels
3.	Makes "sucking" sounds
4.	Crying can be differentiated for discomfort, pain, and
	hunger as reported by mother
5.	An "A" sound as in cat is commonly heard in distress
	crying

4 to 8 months
Receptive abilities
1.	Eyes locate source of sound	1.	Engage in smiling eye-to-eye contact while talking to infant
2.	Responds to "hi, there" by looking up at face that	2.	Vocalize in response to inflectional patterns and when infant
	is across and in front of him		is producing babbling sounds; echo the sounds he makes
3.	Head turns to sound of cellophane held and	3.	Observe for subtle communication clues such as eye
	crunched 2 feet away and at a 135-degree angle on		aversion, struggling to move away, flushing of skin, tension
	either side of head 		of body, or movement of arms
4.	Will turn head to locate sound of "look here" when 	4.	Vocalize with infant during handling, while feeding, bathing,
	spoken at a 90-degree angle from head 2 feet away* 		dressing, diapering, bedtime preparation, and holding		
5.	Turns head to sound of rattle		
6.	Responds differently to vacuum cleaner, phone,	5.	Stimulate laughing by light tickling
	doorbell, or  sound of dog barking: may cry, whimper,	6.	Observe child's reactions to bells, whistles, horns, phones,
	look toward  sound, or mother may report change in		laughing, singing, talking, music box, noisemaking toys, and
	body tension 		common household noises
 7.	Responds by raising arms when mother reaches	7.	While talking to infant, hold in position so that he can see your		
	toward child and says "come up" 		face
		8.	Have infant placed at position of eye level while talking to him	
Expressive abilities		throughout the day
1.	Uses different inflectional patterns: 	9.	If crying or laughing sounds are not discerned at this stage,		
	ah       uh       ah		report to family physician, pediatrician, public health nurse, or
2.	Laughs aloud when stimulated		well-child clinic
3.	Has differential patterns of crying when hungry, in		
	pain, or angry
4.	Produces vowel sounds and chained syllables
	(baba, gugu, didi)
5.	Makes "talking sounds" in response to others 
	talking to him
6.	Babbles to produce consonant sounds: ha, da,
	 m-m
7.	Vocalizes to toys
8.	Says "da-da" or "ma-ma" but not specific to
	 presence of parents

9 to 12 months
Receptive abilities
1.	Ceases activity when name is pronounced or	1.	Gain child's attention when giving simple commands
	"no-no" is said 	2.	Accompany oral directions with gestures
2.	Gives toys on request when accompanied by	3.	Vocalize with child during feeding, bathing, and playtimes
	facial and  bodily gestures	4.	Provide sounds that child can reproduce such as lip smacking
3.	Attends to simple commands		and tongue clicking
		5.	Repeat direction frequently and have child participate in action:		
Expressive abilities		open and close the drawer; move arms and legs up and down
1.	Imitates definite speech sounds such as tongue	6.	Have child respond to verbal directions: stand up, sit down,
	clicking, lip smacking, or coughing 		close door, open door, tum around, come here
2.	Should have two words that are specific for parents:		
	"mama," "dada," or equivalents

13 to 18 months
Receptive abilities
1.	Attends to person speaking to child	1.	Incorporate repetition into daily routine of home
2.	Finds "the baby" in picture when requested, for		a. Feeding: name baby's food and eating utensils; ask if he
	example, on baby food jar, in magazine, or in 		    is enjoying his dessert; concentrate on reviewing a day's
	storybooks		    events in simple manner
3.	Indicates wants by gestures		b. Household duties: mother names each item as she dusts;
4.	Looks toward family members or pets when named		    pronounces word while cooking and preparing foods
			c. Playing: identify toys when using them; explain their function
Expressive abilities	2.	Let child see mouthing of words
1.	Uses three words other than mama and dada to	3.	Encourage verbalization and expression of wants
	denote specific objects, persons, or actions	
2.	Indicates wants by naming object such as cookie	

19 to 30 months
Receptive abilities
1.	Points to one named body part	1.	Continue to present concrete objects with words; talk about
2.	Follows two or three verbal directions that are not		activities child is involved with
	accompanied by facial or body gestures, for example,	2.	Include child in conversations during mealtimes
	“put ball on table”, “give it to mommy”, or “put toy	3.	Encourage speech by having child express wants
	in box”	4.	Incorporate games into bathing routine by having child name
			and point to body parts
Expressive abilities	5.	As child gains confidence in remembering and using words
1.	Combines two different words, for example, "play		appropriately, encourage less use of gestures
	ball," "want cookie"	6.	Count and name articles of clothing as they are placed on child
2.	Names object in picture, for example, cat, bird, dog,	7.	Count and name silverware as it is placed on table
	horse, man	8.	Sort, match, and name glassware, laundry, cans, vegetables,
3.	Refers to self by pronoun rather than by name			and fruit with child
		9.	Have child keep scrapbook and add new picture every day to
			increase recognition of vocabulary words
		 10.	Spend 15 to 20 minutes per day going through booklets and
			naming pictures; have child point to pictures as objects are
			named
		 11.	Help child develop functional core vocabulary to express safety
			needs and information about neighborhood
		 12.	Whenever possible, use word (for example, paper), show
			object, have child handle and use it, encourage him to
			watch your face while you say the word, and suggest that
			he repeat it; refrain from undue pressure

31 to 31 months
Receptive abilities
1.	Takes turns when asked while playing, eating	1.	Read stories with familiar content but with more detail,
2.	Attends longer to stories and television programs		nonsense rhymes, humorous stories
3.	Demonstrates understanding of two prepositions	2.	Expect child to follow simple commands
	by carrying out two commands one at a time, for	3.	Give child opportunity to hear and repeat his full name
	example, "put the  block under the chair"	4.	Listen to child's explanation about pictures he draws
4.	Can follow commands asking for two objects or 	5.	Encourage child to repeat nursery rhymes by himself and
	two actions		with others
5.	Demonstrates understanding of concepts of big	6.	Address child by his first name	
	and little; for example, selects larger of two balls 
	when asked for big one
6.	Points to additional body parts

Expressive abilities
1.	Uses regular plurals, for example, adds "s" to 
	apple, box, orange (does not use irregular plurals, 
	for example, mouse to mice)
2.	Gives first and last name
3.	Names what he has drawn after scribbling
4.	On request, tells you his sex; for example, "Are
	you a little  boy or a little girl?"
5.	Can repeat a few rhymes or songs
6.	On request, tells what action is going on in picture,
	for example, the kitten is eating

37 to 48 months
1.	Expresses appropriate responses when asked	1.	Provide visual stimuli while reading stories
	what child  does when tired, cold, or hungry	2.	Have child repeat story
2.	Tells stories	3.	Arrange trips to zoo, farms, seashore, stores, and movies
3.	Common expression: I don't know		and discuss with child
4.	Repeats sentence composed of twelve to	4.	Give simple explanations in answering questions
	thirteen syllables, for example, "I am going when
	daddy and I are finished  playing"
5.	Has mastered phonetic sounds of p, k, g, v, tf,
	d z, lr, hw, j, kw, l, e, w, qe, and o

49 to 52 months
Receptive abilities
1.	Points to penny, nickel, or dime on request	1.	Play games in which child names colors
2.	Carries out in order command containing three	2.	Encourage use of please and thank you
	parts, for example, "pick up the block, put it on	3.	Encourage social-verbal interactions with other children
	the table, and bring the book to me"	4.	Encourage correct usage of words
		5.	Provide puppets or toys with movable parts that child can
Expressive abilities		converse about
1.	Names penny, nickel, or dime on request	6.	Provide group activity for child; children may stimulate each
2.	Replies appropriately to questions such as, "What		other by taking turns naming pictures
	do you do when you are asleep?"	7.	Allow child to make choices about games, stories, and activities
3.	Counts three objects, pointing to each in turn	8.	Have child dramatize simple stories
4.	Defines simple words, for example, hat, ball	9.	Provide child with piggy bank and encourage naming coins as
5.	Asks questions		they are handled or dropped into bank
6.	Can identify or name four colors

Discipline	
1 to 3 months
1.	Draws attention by crying	1.	a. Needs should be identified and met as promptly as possible
			b. Every bit of fussing should not be interpreted as emergency
			    requiring immediate attention
			c. Infant should not be ignored and permitted to cry for
			    exhaustive periods
2.	Infant desires whatever is pleasant and wishes	2.	Begin to present limit of having to wait so that infant can learn
	to avoid unpleasant situations		that tension and discomfort are bearable for short periods
3.	Beginning to "wiggle" around	3.	Place infant on surfaces that have sides to protect him from
			falling off

4 to 8 months
1.	Begins to respond to "no-no"	1.	a. Reserve "no-no" for times when it is really needed
			b. Be consistent with word "no-no" for same activity and event
			    that requires it; be friendly and firm with verbal control of
			    limit setting
2.	Infant who is left alone for long periods of time	2.	Make special efforts to attend to infant when he is quiet and
	may become bored or fretful; learns that		amusing himself
	crying and whining result in attention
3.	Beginning to show signs of timidity and fretfulness	3.	a. Gradually introduce strangers into infant's environment
	and may whimper and cry when mother separates		b. Refrain from promoting frightening situations with strangers
	from him or when strangers pick him up		    during this stage
			c. Play hiding games like peekaboo in which mother disappears
			    and reappears
			d. Allow infant to cling to mother and get used to persons a little
			    at a time
			e. If baby-sitter is used, find person familiar to infant or
			     introduce for brief periods before mother leaves infant in
			     her care
			f. Encourage gentle handling by mother, father, and siblings.
			    Discourage rough handling, particularly by strangers
4.	Beginning to grasp objects and bring to mouth	4.	a. Provide toys that do not have small detachable parts
	but unable to differentiate safe from hazardous		b. Check frequently for small objects in his line of reach
	items.	5.	When traveling in car, place in crib or seat with safety belts
			securely fastened

9 to 12 months
1.	Beginning to respond to simple commands, for	1.	a. Avoid setting unreasonable number of limits
	example, "pick up the ball, put the toy in the box"		b. Give simple commands one at a time
			c. Once limit is set, adhere to it firmly each time and connect it
			    immediately with misbehavior
			d. Respond with consistency in enforcing rule
			e. Allow time to conform to request
			f. Gain child's attention
2.	Ready to go places on his own and is trying out	2.	a. Begin setting and enforcing limits on where child is allowed
	newly developing motor capacities (not to be	   	    to travel and explore
	confused with naughtiness, "spoiled," or		b. Remove tempting objects
	stubbornness)		c. Remove sources of danger such as light sockets, protruding
			    pot handles, hanging table covers, sharp objects, and hanging
			    cords
			d. Keep child away from fans, heaters, and certain drawers and
			   do not place vaporizer close to infant's crib
			e. Keep high chair at least 2 feet away from working and
			    cooking surfaces in kitchen
			f. Use gate to keep child out of kitchen when it is being used
			g. Be certain that pans, basins, and tubs of hot water are never
			    left unattended
			h. Remove all possible poisons or substances that are not food
			    that can be eaten or drunk off floor, low-level cabinets, and
			    under sink
			 i. Keep child from objects or surfaces that he may chew, for
			   example, porch rails, windowsills, repainted toys or cribs that
			   may contain lead
			 j. Instruct baby-sitter on all safely items
3.	Has emerging desires to look at, handle, and	3.	a. Experiment with diversionary measures
	touch objects		b. Provide child with own play objects
4.	Explores objects by sucking, chewing, and biting	4.	a. Remove household poisons, cosmetics, pins, and buttons
			    that he could put in his mouth
			b. Be certain that objects that go into mouth are hygienic
			c. Check toys for detachable small parts
5.	Beginning to test reactions to certain parental	5.	a. Once problem behaviors are defined, plan to work on
	responses during feeding and may become		    changing only one behavior at a time until child behaves
	choosy about food		    or conforms to expectations
			b. Be certain that child understands old rules before adding
			    new ones
			c. Respond with consistency in enforcing old rules: enforce
			    each time, do not ignore next lime
			d. Provide regular pattern of mealtimes
			e. Refrain from feeding throughout day
			f. Allow child to decide what he will eat and how much
			g. Introduce new foods gradually over period of time
			h. Continue to offer foods that may have been rejected first time
			i. Do not force food
			j. Refrain from physically punishing child for changes in eating
			   habits
6.	Beginning to test reactions to parental responses	6.	a. Provide regular time for naps and bedtime
	at bedtime preparation		b. Avoid excessive stimulation at bedtime or naptime
			c. Ignore fussing and crying once safety and physical needs
			   are satisfied and usual ritual is carried out
			d. Keep child in own room
			e. Refrain from picking up and rocking and holding if needs
			   seem satisfied

13 to 18 months
1.	Understands simple commands and requests	1.	a. Begin with one rule; add new ones as appropriate
			b. In selecting new rules, choose on the basis of being able to
			    clearly define it to self and child, having it reasonable and
			    enforceable at all times; demand no more than fulfillment of
			    defined expectations
			c. Plan decisive limits and plan to give consistent attention to
			    them
2.	In learning mastery over impulses and self-control, 	2.	a. Immediately correct errors in behavior as they occur
	child begins testing out limit setting		b. Use consistent enforcement of short-term rules (which are
			    given as verbal commands) and long-term rules (which 
			    pertain to chores and family routines)
			c. Ignore temper tantrums
			d. Show child when you approve of his behavior and praise for
			    obedience throughout day
3.	With increasing fine motor control, child can	3.	a. Set limits regarding play with doorknobs and car door handles
	manipulate objects that may be hazardous		b. Keep away from open windows; latch screens
			c. Supervise around pools and ponds or drain or fence them
			d. Lock cabinets
			e. Keep open jars and bottles out of reach
			f. Use gate to protect child from falling down stairs

19 to 30 months
1.	Attention span increasing	1.	a. Gain attention before giving simple commands, one at a
			    time; praise for success
			b. Add new rules as child conforms to old ones
			c. Refrain from expecting immediate obedience
2.	Begins simple reasoning¾asks question why;	2.	Make special efforts to answer questions; give simple
	may be repetitive		explanations; gauge need for simplicity by number of times
			act is repeated or question asked
3.	Interested in further exploration of environment;	3.	a. Supervise on stair rails and waxed floors
	may lack physical control		b. Set rules about crossing streets and carrying knives, sharp
			    objects or glass objects
			c. Have outdoor play area securely fenced or supervised
			d. When riding in car, secure child safely by seat belt or 
			    car seat
			e. Keep matches out of reach
			f.  Shield adult tools such as knives, lawnmowers, sharp tools
4.	Negative behavior is expected; responds more	4.	a. Practice consistency in responding to behavior
	frequently with word "no"; may show more resistance		b. Allow more time to conform to expectation
	at bedtime preparation and during mealtime
5.	Behavior may change if new sibling is introduced	5.	a. Explain verbally or through play that new child is expected
	into family unit		b. Exercise more patience with child
			c. Set special times aside for parental attention to child
			d. Allow child to help with special care tasks of new sibling

31 to 48 months
1.	Displays more interest in conforming	1.	a. Exercise consistency in parental demands, enforce each
			    time and avoid ignoring behavior next time
			b. Show concrete approval and give immediate recognition
			    for acceptable behavior
			c. Refrain from use of threats that produce fearfulness
2.	Shows greater understanding when simple	2.	a. Give simple explanations; allow child chance to demonstrate
	reasoning is communicated		    understanding by talking about event, situation, or rule
			b. Eliminate unnecessary and impractical rules
			c. Refrain from constant verbal reprimands
			d. Denial of privileges should not be excessive or prolonged
3.	Will respond to simple commands such as	3.	a. Assign simple household tasks that child can carry out
	put toys away		    each day; show approval for performance and success
			b. Decide if child is capable of doing what is asked by
			    observing him
			c. Determine how much time is necessary to complete a chore
			    or activity before expecting maximum performance
4.	Displays a greater independence in general	4.	a. Be extra cautious about supervising riding tricycles in streets
	activities		   and watching for cars in driveways
			b. Do not permit dashing into street while playing
			c. Do not allow child to follow ball into street
			d. Areas under swings and slides should not be paved
			e. Provide an imitative model that child can copy; for example,
			    do not jaywalk
			f. Provide scissors that are blunt tipped

49 to 52 months
1.	Can be given two or three assignments at one	1.	Give more opportunities to be independent
	time; will carry out in order	2.	Use simple explanations and reasoning
2.	Complies readily with reasonable, well-defined,	3.	Ask child to define role if he disobeys
	and consistent requirements	4.	Have child correct mistakes as they occur
3.	Understands reasoning	5.	Do not use punishment without warnings
		6.	Praise for successful performance
		7.	Use gold stars on chart for rewards
		8.	If leaving for social obligation, vacation, or visiting away from
			home, let child know
		9.	Avoid making promises that cannot be kept
		 10.	Avoid bribing, ridicule, shaming, teasing, inflicting pain, using
			unfavorable comparison with other children, and exhibition of
			behavior by parents they are trying to stop in child
		 11.	Remember that child may be imitating models of behavior set
		     by parents, brothers, sisters, a neighborhood child, or
			maybe a television hero
		 12.	Recognize that there are stress periods in family or child's life
			that may result in changes in child's behavior, including
			accidents, illness, moving into new neighborhood, separation
			from friends, death, divorce, and hospitalization of child or
			parents (be more patient with child's behavior, give more time
			to conform, show more approval for mastery of tasks, and
			exercise consistency in handling problems as they occur)

Dressing
13 to 18 months
1.	Cooperates in dressing by extending arm or leg	1.	Encourage child to remove socks, etc. after task is initiated
2.	Removes socks, hat, mittens, shoes		for him
3.	Can unzip zippers	2.	Do not rush child
4.	Tries to put shoes on	3.	Have him practice with large buttons and with zippers

19 to 30 months
1.	Can undress	1.	Provide opportunities to button with extra-large-sized buttons
2.	Can remove shoes if laces are untied	2.	Encourage and allow opportunity for self-help in getting drink,
3.	Helps dress		removing clothes with help, hand washing, unbuttoning, etc.
4.	Tries to unbutton	3.	Simple clothing
5.	Pulls on simple clothes	4.	Provide mirror at height child can observe himself for
			brushing teeth, etc.

31 to 48 months
5.	Greater interest and ability in dressing	1.	Provide with own dresser drawer
6.	Intent on lacing shoes (usually does incorrectly)	2.	Simple garments encourage self-help; do not rush child
7.	Does not know back from front	3.	Provide large buttons, zippers, slipover clothing
8.	Washes and dries hands, brushes teeth	4.	Self hand washing but help with brushing teeth
9.	Can button	5.	Provide regular routine for dressing, either in bathroom or
			bedroom

49 to 52 months
1.	Dresses and undresses with care except for tying	1.	Assign regular task of placing clothes in hamper or basket
	shoes and buckling belts	2.	Continue to use simple clothing
2.	May learn to tie shoes	3.	Encourage self-help in dressing and undressing
3.	Combs hair with assistance	4.	Allow child to select clothes he will wear

Toilet training
9 to 12 months
1.	Beginning to show regular patterns in bladder	1.	Watch for clues that indicate child is wet or soiled
	and bowel elimination	2.	Be sure to change diapers when wet or soiled so that child
2.	Has one to two stools daily		begins to experience contrast between wetness and dryness
3.	Interval of dryness does not exceed 1 to 2 hours

13 to 18 months
3.	Will have bowel movement if put on toilet at	1.	Sit child on toilet or potty chair at regular intervals for short
	approximate time		periods of time throughout day
4.	Indicates wet pants	2.	Praise child for success
		3.	If potty chair is used, it should be located in bathroom
		4.	Training should he started when social disruptions are at
			minimum
		5.	Respond promptly to signals and clues of child by taking him
			to bathroom or changing pants
		6.	Use training pants, once toilet training is commenced
		7.	Plan to begin training when disruptions in regular routine are
			minimized, that is, do not begin on vacation

19 to 30 months
1.	Anticipates need to eliminate	1.	Continue regular intervals of toileting
2.	Same word for both functions	2.	Reward success
3.	Daytime control (occasional accident)	3.	Dress in simple clothing that child can manage
4.	Requires assistance (reminding, dressing, wiping)	4.	Remind occasionally, particularly after mealtime, juicetime,
			naptime, and playtime
		5.	Take to bathroom before bedtime
		6.	Bathroom should be convenient to use, easy to open door

31 to 48 months
1.	Takes responsibility for toilet if clothes are simple	1.	May still need reminding
2.	Continues to verbalize need to go; apt to hold out	2.	Dress in simple clothing that child can manage
	too long	3.	Ignore accidents; refrain from shame or ridicule
3.	May have occasional accident	
4.	Needs help with wiping

49 to 52 months
1.	General independence (anticipates needs,	1.	Praise child for his accomplishment
	undresses, goes, wipes, washes hands)

*Do not test for localization of sound by producing sound directly behind infant's head.