Milestones: Infants–Elderly

Nursing Knowledge

Milestones: Infants–Elderly

Developmental milestones are specific skills or behaviors expected to be achieved by infants and older children and adolescents at certain ages. These can include motor skills, social behaviors, language, and cognitive abilities. In adults, factors of aging become relevant and influence the requirements of nursing care. For nurses, monitoring these milestones is helpful for early identification of developmental delays or potential health issues, as well as for providing age-appropriate care.
Last updated: December 4, 2023

Table of contents

What are developmental milestones? 

Developmental milestones are specific skills or behaviors that most children achieve by a certain age, such as walking or talking. They are used to assess a child’s developmental progress. Monitoring these helps identify potential developmental delays or concerns.

What are growth stages? 

Growth stages refer to specific periods in human development characterized by rapid physical and/or psychological change. Examples include infancy, childhood, adolescence, and adulthood. Monitoring growth stages helps in understanding and anticipating health needs relevant to each stage.

Infant milestones: 1 month–1 year

Physical milestones for infants

  • Can sit straight if propped up
  • Can roll from front to back
  • Can raise head 90 degrees while on stomach

Cognitive milestones for infants

  • Able to coo
  • Able to open mouth for bottle
  • Looks at hands with interest

Psychosocial milestones for infants

  • Smiles on his own
  • Looks at you, moves, or makes sounds to get or keep your attention

Nursing care tips for infants

  • Hold, swaddle and pat for comfort.
  • Use soft voice and calm approach.
  • Sing songs.

Toddler developmental milestones: 1–3 years

Physical milestones for toddlers

  • Can turn pages of a book
  • Ready for toilet training
  • Reaches 1⁄2 of final adult height

Cognitive milestones for toddlers

  • Able to communicate needs
  • Can organize phrases
  • Vocabulary has increased.

Psychosocial milestones for toddlers

  • Mimics activities
  • Enjoys being read to
  • Enjoys play that involves building and creating

Nursing care tips for toddlers

  • Let the child hold some of your equipment.
  • Let toddler sit on parent’s lap.
  • Give praises.

Preschool children milestones: 3–5 years

Physical milestones for preschool children

  • Has 20/20 vision
  • Sleeps 11–13 hours at night
  • Shows improved balance

Cognitive milestones for preschool children

  • Has vocabulary over 1000 words
  • Can use past tense
  • Can count to 4

Psychosocial milestones for preschool children

  • Can be taught to do small chores
  • Can participate and follow rules
  • Can share and play with other children

Nursing care tips for preschool children

  • Coach the child to ask more questions.
  • Give child choices from acceptable options (e.g., do you want your shot in the right arm or left arm?).
  • Use drawings to explain procedures.

Children in elementary school: 6–10 years

Physical milestones for elementary school children

  • Ability to make bed
  • Dresses appropriately
  • Writes neatly

Cognitive milestones for elementary school children

  • Rapid mental skill development
  • Less focused on oneself
  • Uses five- to seven-word sentences

Psychosocial milestones for elementary school children

  • Begins thinking about future
  • Wants to be accepted
  • More independent of family

Nursing care tips for elementary school children

  • Knock on door before entering.
  • Provide fresh air.
  • Encourage deep breathing to allay anxiety.

Adolescents: 13–19 years

Physical changes in adolescents

  • Rapid growth
  • Development of reproductive organs/secondary sex characteristics

Cognitive changes in adolescents

Increased rational thinking ability

Psychosocial changes in adolescents

  • Self-identity formation
  • Exploration of sexuality
  • Social pressures
  • Emotional lability

Nursing care tips for adolescents

  • Open-ended questions
  • Non-judgmental communication
  • Allow separation from parents.
Adolescent and adult milestones

Bonus download: growth stages: adolescent–mature adult

Understand growth and development in order to provide appropriate, individualized care across the lifespan

Early adults: 20–39 years

Physical changes in early adults

Childbearing years: possible gestational changes for those capable of pregnancy 

Cognitive changes in early adults

Critical thinking habits increase. 

Psychosocial changes in early adults

  • Maturation
  • Career focus
  • Adult relationships
  • Stress related to life goals

Nursing care tips for early adults

  • Consider relationship status, occupation and social stressors.
  • Assess barriers to wellness.

Middle adults: 40–64 years

Physical changes in middle adults

  • Aging
  • Increased risk of disease/illness
  • Perimenopause/menopausal changes

Cognitive changes in middle adults

Cognitive changes rare, related to illness or injury

Psychosocial changes in middle adults

  • Changes in self-image
  • Family and financial responsibility/stress
  • Career transitions
  • Changes in sexuality

Nursing care tips for middle adults

  • Normalize physical changes and menopausal transition.
  • Encourage disease-specific screening and prevention.

Mature adult: 65 years and older

Physical changes in mature adults

Physical and functional decline often occurs as age progresses.

Cognitive changes in mature adults

  • Cognitive function and short term memory often decline with progressive aging. 
  • Possible depression related to role transition and isolation

Psychosocial changes in mature adults

  • Retirement
  • Changes to daily routine, environment, housing
  • Social isolation
  • Changes in sexuality

Nursing care tips for mature adults

  • Assess functional and cognitive baseline, monitor changes.
  • Continue disease-specific screening and prevention.
  • Consider stressors related to isolation, loss and grief.


Milestones: Infants–Elderly

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Physical, cognitive, and psychosocial changes in infants, toddlers, preschoolers, and school-aged children

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