How to Learn (Understand and Memorize)

Pediatric Developmental Milestones

How to Commit This Stuff to Memory
1. First memorize the months of the well child checks. This is important for creating
a framework for memorizing the milestones and will also help when you start
memorizing vaccine schedules. The timing of both milestones and vaccines is
based on this well child check schedule. The visits are 2 days, 2 weeks, 2 months,
then add 2 months twice (4 months, 6 months) then space it out as we get less
anxious and the rate of expected milestone acquisition declines. So 2d, 2w, 2m,
4m, 6m, 9, 12, 15, 18, 24m, 3y, 4y, 5y.
-So initially think 2, 2 days, 2 weeks, 2 months, 4 months, 6 months
-after month 6, it is by 3 for four visits, so 9, 12, 15, 18
-after this it is by full years, 2, 3, 4, 5
2. Once this is down, we memorize the gross motor milestones for each visit. This
will be the only milestone category that we have to rotely associate with months.
We will use it as a memory base and hook the other milestones in to it.
A good way to memorize motor is to divide these milestones into two categories:
birth to 1 year, and 15 months to 5 years.

Birth to 1 Year: Remember that the goal of the first year is to be able to
walk (walk at 12 months). At six months you are halfway there (remember sit at
six). Just with these two milestones you can pretty much fill in everything else.
Remember that everything is from head to toe. So 2 months (the first time we
really check milestones) you check for head lifting (neck control). You roll at 4
months (at level of shoulders and chest). Then, again, at six you sit. You crawl at 9
months and pull to stand (crawl, pull to stand at 9 months) which makes sense as
being between sitting and walking.
In Review:
2 months: lift head 45 degrees (chin left )
4 months: roll over (front to back first, then back to front, easier if you can push
off with hands)
6 months: sit (halfway to goal, halfway through year, sit at six)
9 months: crawl, stand (halfway between sitting and goal)
12 months: walk (the goal)
15 months 5 years: Memorize these milestones in a story as they are harder to
associate with particular months like the first year. Using this progression story may
help you.
15 months: walks well
18 months: throws objects
24 months/2 years: up and down stairs (one foot at a time); run
3 years: Tricycle (3 wheels, 3 years), jump in place

4 years: up and down stairs alternating feet (2 feet x up/down = 4), balance on 1
foot for 4 seconds (legs look like a 4 when on 1 foot), hop
5 years: skip (5 looks like an Skips)

Story:
a child on the 1st floor of her house sits up, crawls, cruises, then
1) WALKS to stairs,
1.5) THROWS object up stairs,
2) CLIMBS up the stairs and RUNS to his trike,
3) RIDES a trike upstairs, JUMPS off,
4) RUNS down the stairs, HOPS off the stairs and
5) SKIPS away
3. Once youve memorized the months of well child checks and corresponding gross
motor milestones, begin to memorize the archetype babies for each age group.
These little stories incorporate all the other milestones into a single image which is
much easier than trying to memorize many unrelated facts. There are some ways
to conceptually link milestones across categories, but they are not frequent enough
to be useful for fast recall and the salient milestones and timing which is what
happens on tests and during morning report.
Here are all the babies with milestones listed:

2 months: lift head 45 degrees (when laying on face), turns to sound, follows
objects past midline, social smile

Parents Little Baby: looks up to sound, smiles because he sees both

his parents, one on either side of midline

4 months: lift head 90 degrees/raise up to chest, roll over, find midline, reach
for objects, puts objects in mouth, coos (these are vowel sounds), and laughs
Fat Happy Baby: baby is rolling and laughing and cooing because he just
discovered midline and is reaching for cake that he will cram into his mouth

6 months:

sit up with no head lag, raking grasp, transfer objects between

hands, babbles (consonants), recognizes familiar faces
Street-Corner Baby: sitting up on sidewalk, transferring a rake from hand
to hand while babbling at people he thinks he recognizes

9 months: Crawl, pull to stand, point, specific babbling (mama, dada), stranger
anxiety

Watch Dog Baby: crawls to window, pulls to stand to see out, points at
stranger in yard and says mama to get attention of parents.

12 months: Walk, pincer grasp, 1 word, patacake, bye bye, peekaboo

Playful Zombie Baby:

walking at you, snapping pincers, repeating one

word over and over (brrraaaaains), and just wants to play patacake and peekaboo
before waving bye bye.

15 months: walks well, imitates, controlled release of blocks (can stack 2)

Little Sister Baby: wants to be just like big sister, walks confidently to the
blocks and imitates making a 2 block tower

18 months: Throw, scribble, 4 block tower, 1 step command, uses spoon/cup,

points to parts of body

Sir Charming Baby: needs to get note to Rapunzel so scribbles note on

paper to throw into high 4 block tower, catapult has cup on end, shoves note in
with spoon, and throws note at tower, hitting Rapunzel in the face

2 years:

Run, stairs (1 foot at a time), 20-50 words, 2 step command, parallel

play

Bad Twins: mom gives two commands to twin boys to run to the stairs, then
walk up the 25 stairs. Each walks up the 25 stairs not helping the other.

3 years: Jump, Tricycle, dresses self (shirt, pants, shoes), full name, you, me, I
James Bond Baby: springs into action . . . jumps into 3-piece suit, stands in
front of mirror and says full name, jumps on tricycle. You.Me. I, is his pickup line.

4 years: Stairs (alternating feet), hop, undresses, 1 foot (4 seconds), 4 word

phrases (complete sentences), cooperative play

Bedtime (b4 sleep ) Story Baby: really wants story time, so runs up
stairs, hops on one foot to undress, so she and mom can read a story together. A
Wrinkle in Time.

5 years:

Skip, Tie shoes, Difference between reality/fantasy

Oz Baby: ties ruby shoes, skips down Yellow Brick Road back to Kansas
Review of Approach to Memorization
1. Learn ages of well child checks from birth to 5 years. Its not important to
memorize in and of itself, but will really help you keep milestones and vaccine
schedules straight:
-be able to rattle off all the checks (2, 4, 6 . . . remember 2-5 years are only annual
checks so you really only have to memorize up to 2 years old)
-a flash card is helpful for this, just know it cold.
2. Learn associated gross motor milestones for each visit (make sure you

understand the physiologic basis for the gross motor milestone progression as it will
help you figure things out if you ever forget a particular milestone for a given
month and can only remember the milestones around that month)
-flashcards helpful
3. Learn the archetype baby for each age (make sure you can visualize everything
that baby is doing, the more vivid the picture, the faster you learn it, the easier it is
to retain, and the faster you will be able to recall the milestones)
-again, flashcards helpful
That should do it! Knock this stuff out early in residency so you can move on to
learning more conceptually difficult stuff. Here is a few examples of how youll see
it during your education.