Play as a Sign of Development

Parents and health practitioners often track and measure development by observing milestones from infancy to young adulthood. Developmental milestones are signs of physical, social, and intellectual maturation. Smiling, stacking blocks, walking, and talking are examples of developmental milestones that provide valuable insight into a child’s development.

All children mature and develop at their own pace. Parents and caregivers should know that a child will not always develop play skills at the same rate as some of her peers. Developmental milestones are often measured using an age range, rather than one specific age, to reflect typical variations. Although no two children grow at the same rate, experts agree that there are “typical” signs of development

Developmental Milestones: Birth to Two Years
A child goes through many physical and mental changes during the first years of her life. Here are some developmental milestones for your child’s first two years. These mainly focus on motor skills, sensory skills and language-social skills.

At three months, a child should be able to:

  • Lift her head
  • Turn her head from side to side when lying on her stomach
  • Follow moving objects with her eyes
  • Grasp an object
  • Turn towards bright colors and lights
  • Recognize a bottle or breast
  • Respond to shaking a rattle or bell
  • Make cooing or gurgling sounds
  • Anticipate being lifted
  • React to peek-a-boo games
  • Communicate through crying or facial expressions.

At six months, a child should be able to:

  • Hold his head steady
  • Play with his toes
  • Help hold a bottle
  • Move toys from one hand to the other
  • Sit with only a little support
  • Roll over
  • Open his mouth for spoon
  • Imitate familiar actions you perform
  • Babble
  • Recognize familiar faces
  • Laugh
  • Smile at himself in the mirror

At twelve months, a child should be able to:

  • Drink from a cup with help
  • Grasp small objects using her thumb and index finger
  • Knock two blocks together
  • Sit well without support, crawl, and briefly stand alone
  • Copy sounds and actions
  • Respond to music with body motions
  • Look for objects that fall out of sight
  • Babble with sounds that are like talking, and say her first word
  • Show affection to familiar adults
  • Show mild to severe anxiety at separation from parents
  • Raise her arms to be picked up
  • Understand simple commands

At eighteen months, a child should be able to:

  • Push and pull things
  • Turn pages in a book
  • Stack two blocks
  • Scribble with crayons
  • Walk without help
  • Identity objects in a book
  • Laugh at silly actions
  • Follow simple one-step directions
  • Solve problems by trial and error
  • Say 8 to 10 words you can understand
  • Look at the person who is talking
  • Ask for something by pointing or using one word
  • Seek attention
  • Play alone with toys
  • Compete for other children’s toys
  • Pretend with toys

At two years, a child should be able to:

  • Drink through a straw
  • Feed himself with a spoon
  • Toss or roll a ball
  • Operate a mechanical toy
  • Bend over and not fall
  • Take steps backwards
  • Explore surroundings more thoroughly
  • Point to 5 to 6 parts on a doll when prompted with a question
  • Use a vocabulary of several hundred words
  • Use two- to three-word sentences
  • Say names of toys
  • Imitate parents
  • Act shy around strangers
  • Take turns in play with others
  • Treat dolls and toys as if they were alive
  • Use pretend actions with toys to represent real activities
  • Show use of “me” and “mine”
  • Laugh at silly labeling of objects
  • Enjoy the same books over and over

When to Consult a Healthcare Provider
To get a complete picture of your child’s strengths, areas of need, and developmental level, pay attention to the overall pattern of development, instead of focusing on a particular developmental milestone. Caregivers might be concerned that a child is not yet talking when many peers are already displaying this skill. But the age at which children begin talking varies greatly. However, if an infant or child is not reaching many major milestones, this might be a sign of a developmental delay or disorder. If you suspect this is true for your child, contact a healthcare provider as soon as possible. Your pediatrician may refer your child for further evaluation and testing with a specialist.

Play and Children with Disabilities
Studies have shown the importance of play in practicing and developing competency for children with various disabilities.

  • Children with social and emotional disabilities such as Autism Spectrum Disorder (ASD) , Sensory Integration Dysfunction, and anxiety or depression commonly struggle with communication, self-coping skills, attentiveness, and confidence. Children with ASD may lack the mental representation and language competencies needed for pretend play. Or they may lack skills in generating ideas for spontaneous play.
  • Children with physical disabilities such as visual impairment, cerebral palsy, or muscular dystrophy may have trouble handling materials or manipulating materials in a constructive way. They may also have trouble with balance and spatial awareness.
  • Children with intellectual disabilities, such as Down Syndrome or Fragile X Syndrome, may have trouble engaging in more sophisticated levels of dramatic play or activities that require thinking abstractly. Children with intellectual disabilities may also engage in more exploratory behaviors than in more direct, functional play.

Play » Links & Resources


Parham, Diane & Fazio, Linda, (1997). Play and Occupational Therapy for Children. Mosby-Year Book, Inc, USA.

Wolfberg, Pamela, (2003). Peer Play and the Autism Spectrum: The Art of Guiding Children’s Socialization and Imagination. Autism Asperger Publishing Co, USA.