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Developmental milestones record - 18 months

Definition

The typical 18-month-old child will demonstrate certain physical and mental skills. These skills are called developmental milestones.

Information

All children develop a little differently. If you are concerned about your child's development, talk to your child's health care provider.

PHYSICAL AND MOTOR SKILL MARKERS

The typical 18-month-old:

• Has a closed soft spot on the front of the head (fontanelle closure)

• Is growing at a slower rate and has less of an appetite compared to the months before

• Is able to control the muscles used to urinate and have bowel movements, but may not be ready to use the toilet

• Runs stiffly and falls often

• Is able to get onto small chairs without help

• Walks up stairs while holding on with one hand

• Can build a tower of 2 to 4 blocks

• Can use a spoon and cup with help to feed self

• Imitates scribbling

• Can turn 2 or 3 pages of a book at a time

SENSORY AND COGNITIVE MARKERS

The typical 18-month-old:

• Shows affection

• Has separation anxiety

• Listens to a story or looks at pictures

• Can say 10 or more words when asked

• Kisses parents with lips puckered

• Identifies one or more parts of the body

• Understands and is able to point to and identify common objects

• Often imitates

• Is able to take off some clothing items, such as gloves, hats, and socks

• Begins to feel a sense of ownership, identifying people and objects by saying "my"

PLAY RECOMMENDATIONS

• Encourage and provide the necessary space for physical activity.

• Provide safe copies of adult tools and equipment for the child to play with.

• Allow the child to help around the house and participate in the family's daily responsibilities.

• Encourage play that involves building and creativity.

• Read to the child.

• Encourage play dates with children of the same age.

• Avoid television and other screen time before age 2 years.

• Play simple games together, such as puzzles and shape sorting.

• Use a transitional object to help with separation anxiety.

References

American Academy of Pediatrics Committee on Practice & Ambulatory Medicine. 2024 Recommendations for preventive pediatric health care: Policy statement. Pediatrics.2024;154(1):e2024067201. PMID: 38910527 pubmed.ncbi.nlm.nih.gov/38910527/.

Carter RG, Feigelman S. The second year. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 24.

Marcdante KJ, Kliegman RM, Schuh AM. Normal development. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 7.

Review Date: 10/20/2024

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.