31 Developmental Anchor Points Age 0-2
| Question | NB | 4 weeks | 6 weeks | 8 weeks | 28 weeks | 1 year | 2 years |
| 1. Does the child make eye contact with the caregiver? | Fixates on face | Holds gaze briefly
Fixates on face |
Holds gaze | Follows moving objects/caregiver past midline, regards examiner’s hand holding object, focused attention | Holds gaze. Prefers primary parent. Looks at speaker. | Holds gaze. Prefers primary parent. Looks at speaker. | Holds gaze. Prefers primary parent. Looks at speaker. |
| 2. Are the child’s actions purposeful? | Moves head to side, dominated by primitive reflexes | Reaches (with some discoordination) | Reaches | Symmetric movements, will passively grasp handed object | Reaches with coordinated smooth movement | Reaches and manipulates objects, tries to change position, if mobile may try to get up | Reaches and manipulates objects, tries to change position, if mobile may try to get up and walk |
| 3. Is the child aware of his/her surroundings? | Calm awake time | Awake alert time
Turns to primary caretaker’s voice May turn to smell of primary caretaker |
Increasing awake alert time
Turns to primary caretaker’s voice May turn to smell of primary caretaker |
Facial brightening or smile in response to nodding head, frown to bell, coos | Strongly prefers mother, then other familiars
Differentiates between novel and familiar objects |
Prefers primary parent, then other familiars, upset when separated from preferred caretakers. Comforted by familiar objects, especially favorite blanket or stuffed animal | Prefers primary parent, then other familiars, upset when separated from preferred caretakers. Comforted by familiar objects, especially favorite blanket or stuffed animal |
| 4. Does the child communicate needs and wants? | Cries when hungry or uncomfortable | Cries when hungry or uncomfortable | Cries when hungry or uncomfortable | Cries when hungry or uncomfortable | Vocalizes /indicates about needs, eg. hunger discomfort, curiosity in objects, or surroundings | Uses single works, or signs | 3-4 word sentences, or signs. May indicate toilet needs, calls self or me |
| 5. Is the child restless? | No sustained awake alert state | No sustained calm state | No sustained calm state | No sustained calm state | No sustained calm state | No sustained calm state | No sustained calm state |
| 6. Is the child inconsolable? | Not soothed by parental rocking, singing, feeding, comforting actions | Not soothed by parental rocking, singing, feeding, comforting actions | Not soothed by parental rocking, singing, feeding, comforting actions | Not soothed by parental rocking, singing, feeding, comforting actions | Not soothed by usual methods, eg. singing, holding, talking | Not soothed by usual methods, eg. singing, holding, talking, reading | Not soothed by usual methods, eg. singing, holding, talking, reading (May tantrum, but can organize) |
| 7. Is the child underactive — very little movement while awake? | Little if any flexed and then relaxed state with primitive reflexes
(Child should be sleeping comfortably most of the time) |
Little if any reaching, kicking, grasping (still may be somewhat discoordinated) | Little if any reaching, kicking, grasping (still may be somewhat discoordinated) | Little if any purposing grasping, control of head and arm movements, such as pushing things that are noxious away | Little if any reaching, grasping, moving around in bed, pushing things away | Little if any play, efforts to sit up, pull up, and if mobile crawl or walk around | Little if any more elaborate play, efforts to sit up and move around, and if able to stand, walk, or jump |
| 8. Does it take the child a long time to respond to interactions? | Not making sounds or reflexes active as expected (grasp, suck, moro) | Not making sounds or reflexes active as expected (grasp, suck, moro) | Not kicking or crying with noxious stimuli | Not cooing, smiling, or focusing gaze in response to interactions | Not babbling or smiling/laughing in social interactions (or even actively rejecting an interaction) | Not following simple directions. If verbal, not engaging in simple dialogue with words or jargon | Not following 1-2 step simple commands. If verbal, not engaging in more complex dialogue |
