Most of us are aware of the developmental milestones pediatricians and GP’s will be monitoring such as weight, length, age at which children crawl and walk etc but I would like to now look at development from a slightly different perspective based on the work of the late Dr Stanley Greenspan. Dr Greenspan was a developmental psychiatrist who developed an approach to help children recover from Autism and which was eventually extended to include all children with learning and developmental issues.

Dr Greenspan theorized that six basic developmental skills or milestones lay the foundation for all learning and development. This is the key because it is during these six milestones that a child integrates all the information they have received and processed from the systems I have just discussed and this is what results in being able to potty train, or learn to dress yourself, or learn to speak, read and write as well as how to socialize. And what integrates all these systems, the “glue” is appropriate emotional experiences through interaction with others.


Children without special needs often master these skills relatively easily, but children with challenges often don’t. If this is recognised and early intervention applied the prognosis is so much better.

This does not mean that children with challenges can’t master these milestones; it just means that because of their biological challenges mastery becomes more difficult. By understanding these skills and the factors that influence them and by working direction on them, caregivers, teachers and therapists can often help even those children with what are thought to be chronic disorders master many of them.

Appropriate emotional experiences during each of the six developmental phases help children develop critical cognitive, social, emotional, language, and motor skills, as well as a sense of self.

In the earliest days of life a child knows themselves primarily through their response to their physical world: gas, bubbles, movements, sights, sounds, textures and other sensations. Soon the child responds particularly to their parents, their voice, smiles and special smells.


Patterns of movement create states of share joy. By 4-8 months the child begins to take a rattle and may even give it back or throw it back in frustration. The child smiles and makes sounds expecting to get a smile, a frown or a sound in return. For the first time the child knows themselves in part as distinct from others, as a person of volition, as someone who can initiate an action and have an impact on the world.

As the year progresses, emotional gestures grow in complexity. By 12-16 months the child doesn’t merely reach when Daddy offers a toy, but they can take Daddy to the shelf to get the toy they really want. They know themselves as someone who can string together a series of actions to communicate their intentions to another person.

Months pass and the child’s actions grow more complex once again. By 18-20 months she feeds her dolls instead of merely cuddling them and explains her actions, saying “dolly eat”. Now the child knows themselves in terms of ideas. The child can picture themselves and others in their mind.

The child can generate ideas and tell the world about them with her words. More months pass and the child grows more complex still. By 36 months the child can tell you “ lets ride bikes” pausing at the door to see whether it’s cold out, the child might then say, “better put our jacket on first” Now the child is a logical, cohesive, thinking person.

Through all these stages the child’s emotional, social and cognitive skills grow and the child’s sense of self grows increasingly complex. This sense of self will continue to expand as the child grows older and as new experiences stir their interests and capabilities in a new direction, but the child’s functional sense of self, that core emotional sense that forms the foundation for further learning, is in place. It was nurtured through millions of daily interactions, primarily with the parent, as every glance, every smile, every tickle, every question built the child’s sense of who they are.

Thanks to these interactions, the child can layer on additional cognitive, intellectual and social skills to serve him through out his life. The child is prepared for the further challenges of their development and for the world.



These six basic steps form a developmental ladder, each layers new abilities onto those of prior stages. We call these steps the six milestones because each one marks a major turning point in the life of the child.

Children who receive warm nurturing and do not have developmental challenges often master these milestones automatically by the age of 4/5. But children with challenges need help from parents and therapists and often take longer to achieve mastery. Instead of reaching out to be picked up at 8/9 months, a child with motor challenges may do so at 14/15 months. Instead of imitating his mothers vocal tone and babbling reciprocally at 10 months, a baby with auditory processing challenges may do so at 17-18 months. Instead of linking abstract ideas by the age of 3 a child with multiple challenges may do so at 5,6 or 7 and that is fine. When the child is 45 years old it may not matter whether your child learned to babble reciprocally at 8 or 17 months or learned to write at the age of 6 or 10.

It matters less at what age a particular skill is learned than how well it is learned and whether progress continues. As these basic skills are learned early in life, extra time is usually available to master them. These basic capacities are vital because they are the foundation for all future learning and development in your child’s life. They are the foundation of an 80 storey building: to hold the building up, they must be very solid.


The six developmental milestones are:


Self-regulation and interest in the world:

From birth the child is suddenly exposed to a multitude of sensations, the first challenge a child has is to take in this sensory panorama while regulating their response and remaining calm
Falling in love: Along with interest in the world comes a special love for the world of humans relationships, but not just any relationships, the infant wants their primary caregivers or parents, they become the single most important aspect in their world, when they enter the child will let you know how special you are by the gleem in their eye.

Two way communication:

When the baby falls in love with their parents an interesting thing happens, they realize they can have an impact on them, when mom smiles at the baby, baby smiles back. The baby expresses a feeling or an intention and the caregiver responds. This is the beginning of communication: the baby and the grownups are having a dialogue.

Complex communication:

Once the child has mastered the basics of two way communication, the number of circles they can open and close increase as well as grow in complexity. Now the child responds with a series of gestures linked to form a response. The child now has a vocabulary of gestures to express their wishes and communicate fairly complicated thoughts. Running to mom, giggling and giving her a hug, taking dad to the fridge and pointing to the juice.

Creating emotional ideas:

The child’s ability to form ideas first develops through play, the child uses toys and play to explore a range of intentions and wishes that they feel, and along with this idea laden play comes the expanded use of words. Through this the child is learning that symbols stand for things. The child can now manipulate ideas and use them in ways that meet his needs. The word bath is a symbol for the activity in the tub, or cross is a symbol for that bursting feeling inside.

Emotional and logical thinking:

Previously the child’s expressions of emotions were like little unconnected islands, at this stage emotional thinking connects the pieces together and we see the emergence of the concepts of space, time and problem solving. WHY