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Take-home

Most babies follow a wide but predictable pattern of development, smiling by 6–8 weeks, head control by 4 months, sitting by 6–8 months, walking by 12–18 months. Wide variation within those ranges is normal. A small number of babies have an underlying neurological condition. Cerebral palsy is the most common, with a current birth prevalence of around 1.5 per 1,000 (roughly 1 in 670), down from ~2.1 per 1,000 in 1995–96 (Australian Cerebral Palsy Register). Earlier identification means earlier intervention and measurably better long-term function. Modern practice combines General Movements Assessment (GMA) at 3–5 months with the Hammersmith Infant Neurological Examination (HINE) and, where indicated, neonatal MRI, to detect concerns from as early as 3 months. If something feels off, raise it at the next review, over-checking is better than under-checking.

How development works

Babies develop along several streams at once:

Motor (movement): head control, rolling, sitting, walking, fine hand skills
Communication: sounds, babble, first words, sentences
Social-emotional: smiling, eye contact, attachment, play
Cognitive (thinking): attention, problem-solving, memory
Self-care: feeding, dressing, toileting (later)

Streams are linked but don’t move at the same pace. A baby can be early on smiling and slow on rolling, or vice versa, and still be entirely typical.

Why ranges, not exact ages, matter

Every milestone has a typical range. A “4-month milestone” means around half of babies achieve it by 4 months and most achieve it by 6 months. A baby at the late end of normal is still normal. What matters is:

The overall pattern: multiple streams progressing, even if at different paces
Consistent direction: gaining skills, not losing them
Two-sided symmetry: both arms, both legs, both sides of face working similarly

Corrected age (essential for preterm babies)

Always use corrected age until 2 years for preterm babies

If your baby was born before 37 weeks, their development is measured against their corrected age (or “adjusted age”), not their birth date.

Corrected age = chronological age − number of weeks born early

Example: a baby born at 32 weeks is 8 weeks early. At 6 months chronological age, they are 4 months corrected. They’ll be expected to do what a 4-month-old does, not a 6-month-old. This is just as true at 12 months and 18 months.

The Centre of Research Excellence in Newborn Medicine recommends using corrected age until at least 2 years of age for very preterm infants (born before 32 weeks), and to age 12 months for late preterm (34–36 weeks). After that, most catch up to their chronological age peers.

Typical milestones at a glance

These are population medians with wide normal ranges. Read the shape of the timeline, not the exact age. Look at trends over months and how the picture is moving, rather than fixating on a single milestone.

Population medians with the typical normal range. Use corrected age for preterm babies (chronological age minus the number of weeks born early) — see the note above.

A soft watercolour still-life of tiny cream knitted booties, a folded lavender muslin, a wooden rattle and a sage leaf sprig, symbolising the journey of early childhood growth.

What lives in each phase: the longer reference

The timeline above shows the median ages. The fuller checklist below is for the moments when you want to know what to look for at each stage.

Newborn to 6 weeks

Newborn reflexes, rooting, sucking, grasping, Moro (startle)
Focuses ~25 cm away and tracks faces briefly
Alerts and soothes to a familiar voice
Arms and legs flexed, with symmetric tone
Brief eye contact; calms with cuddling

2-4 months

Social smile at 6-8 weeks
Coos and vowel sounds; laughs out loud by ~4 months
Head control improves, steady briefly when held upright
Pushes up on forearms during tummy time
Hands open more, and come together at midline (~3 months)
Tracks across the midline

4-6 months

Rolls front-to-back from ~4 months, back-to-front by 6 months
Reaches and grasps toys; brings them to mouth
Sits with support
Babbles (“ba-ba”, without specific meaning)
Recognises familiar faces; turns to voice

6-9 months

Sits unsupported by ~8 months
Stranger awareness around 7-9 months, cuddly with parents, wary of unfamiliar people
Object permanence (looks for a hidden toy)
Transfers objects between hands
Babbles with consonants (“baba”, “dada”)
Bears weight when held standing

9-12 months

Crawls, or bottom-shuffles, scoots, or skips crawling (all normal)
Pulls to stand at furniture; cruises along it
Pincer grasp (thumb + index finger)
First meaningful words around 12 months
Waves, claps, plays peek-a-boo

12-18 months

Walks independently, most by 14 months (normal range 9-17 months)
Says 5-10 words by 18 months
Points to communicate
Follows simple commands
Drinks from an open cup with help
Scribbles

18 months - 2 years

Walks well, runs awkwardly, climbs onto furniture
2-word phrases (“more milk”) by 2 years; 50+ words by 24 months
Imitates household tasks
Pretend play begins
Points to body parts when named

Early signs that warrant a review

Most babies who do these things turn out to be fine, but earlier review means earlier reassurance, or earlier intervention if needed. The Australian (Novak et al. 2017) and international consensus is to act on concern, not wait.

Green — usually fine

Worth mentioning at your next paediatric or MCH visit

A single missed milestone within the typical range
Strong handedness: preferring one hand consistently before 18 months can mean the other side isn’t doing as well
Slight asymmetry: one arm or leg moves a bit less than the other
Mild stiffness or floppiness that comes and goes
Late head control at 4 months
Persistent fisting (closed fist with thumb tucked in) beyond 3–4 months
Excessive arching or stiffening when picked up

Amber — be alert

Book a same-week or same-fortnight review

No social smile by 3 months corrected age
No head control in supported sitting by 4 months corrected
Persistent strong handedness (using one hand for everything) before 18 months
Lost a skill they had previously (regression, at any age)
No babbling by 9 months corrected
Not weight-bearing when supported in standing by 9 months corrected
Not sitting unsupported by 9 months corrected
Asymmetric movement: one side consistently weaker, stiffer, or more limp than the other
Persistent toe-pointing when held upright (especially with stiff legs that cross, “scissoring”)

Red — act now

Same-day review

A baby who has lost a skill acutely (sudden change)
A seizure or unusual jerking
Sudden severe head tilt or eye deviation (squint that didn’t resolve)
Lethargic, floppy, or unresponsive
A bulging or tense fontanelle in an unwell baby

What is cerebral palsy?

Cerebral palsy (CP) is a group of conditions affecting movement, posture and coordination, caused by an injury or unusual development of the brain in the womb, around birth, or in the first years of life. It is the most common physical disability in childhood, with a current birth prevalence of around 1.5 per 1,000 (roughly 1 in 670), down from ~2.1 per 1,000 in 1995–96 (Australian Cerebral Palsy Register).

Important things to know about CP

CP is not progressive: the underlying brain injury doesn’t get worse over time
The outward picture can change as the child grows, especially during growth spurts
CP is a spectrum: most children with CP have mild motor impairment (GMFCS levels I-II), walking independently; a smaller proportion have more significant motor and learning challenges (GMFCS IV-V)
About half of children with CP have other neurodevelopmental conditions alongside (epilepsy, intellectual disability, vision or hearing impairment, autism)
Early intervention works: physiotherapy, occupational therapy, speech therapy and supports started in infancy lead to measurably better long-term function

Risk factors, but most CP arises with no clear risk factor

Preterm birth: the strongest single factor; risk increases with how early
Birth weight under 1,500 g
Multiple pregnancy (twins, triplets)
Birth asphyxia or significant resuscitation at birth
Neonatal stroke, infection (especially meningitis), or significant hypoglycaemia
Brain bleed or periventricular changes seen on neonatal ultrasound or MRI
Maternal infections in pregnancy (CMV, rubella, toxoplasmosis)

About half of all CP cases occur in babies with no obvious risk factors. Routine universal monitoring of milestones picks these up.

Modern early detection: GMA, HINE, MRI

Australia now leads the world in early CP diagnosis. The combination of three tools, used together, can reliably identify CP from as early as 3 months corrected age: far earlier than the historical “wait and see until age 2” approach.

The early-detection toolkit

General Movements Assessment (GMA)

A video-based assessment lasting 3–5 minutes
Looks at spontaneous movements while baby is awake and alert
Best done at the “fidgety” period: 12 to 20 weeks corrected age
A trained clinician scores the movements; abnormal “fidgety” movements are highly predictive of CP (90%+ specificity)
Done routinely in NICU follow-up clinics across Victoria
The Cerebral Palsy Alliance offers GMA screening for high-risk infants (ask about eligibility)

Hammersmith Infant Neurological Examination (HINE)

A structured neurological examination taking ~10 minutes
Used from 2–24 months of age
Looks at tone, posture, reflexes, movements, and milestones
Scored out of 78; specific score patterns predict CP
Combined with GMA, accuracy is very high

Neonatal MRI

Brain MRI in the newborn period, usually for babies who’ve had a difficult birth, are very preterm, or had specific concerns
Identifies brain injury patterns associated with CP
A normal MRI is reassuring; an abnormal MRI prompts close follow-up

When all three tools are concerning, the diagnosis of “high risk for CP” can be made by 3–6 months, and early intervention starts immediately, not after a confirmed diagnosis at age 2.

Follow-up programs for preterm babies

The Centre of Research Excellence in Newborn Medicine (CRE) guideline (NHMRC-approved 2024) recommends structured follow-up for very preterm infants. The exact program varies by hospital, but typical Victorian practice:

Typical preterm follow-up schedule

Very preterm (born < 32 weeks)

NICU discharge review by neonatologist
GMA at 3–4 months corrected
HINE at 6–9 months corrected
Developmental assessment (Bayley scales) at 2 years corrected age
School-readiness assessment at 5 years if any concerns earlier
Long-term outcomes monitoring to school age

Late preterm (34 to 36+6 weeks)

More likely to slip through cracks because they look so well. Safer Care Victoria specifically flags this
6-week paediatric review with explicit attention to feeding, growth and tone
6-month check including milestones and head shape
MCH and GP visits as per universal Victorian schedule
Lower threshold for referral if any concerns emerge

Term babies with risk factors (asphyxia, infection, hypoglycaemia, congenital anomalies, growth restriction)

Follow-up similar to very preterm, tailored to the specific risk
GMA usually included

If your baby is in one of these groups and you haven’t been offered structured follow-up, ask. The hospitals run these programs.

What you can do at home

The strongest evidence base for supporting any baby’s development is the same as for general health and wellbeing:

What helps every baby develop

Talk to your baby: narrate the day, sing, read books from birth (the volume and variety of words is the single biggest language predictor)
Tummy time, see tummy time, builds the motor foundation
Floor time: let baby move freely on a safe surface, no “containers” (long stretches in capsules, bouncers) when awake
Responsive feeding and settling: answer cues; reliable, warm responses build the brain
Plenty of skin-to-skin and cuddles
Limit screens for under-2s. Guidelines say none for under 2; 1 hour or less for 2–5 years, with you watching together
Get to your MCH visits: every check-in is one more opportunity to catch concerns early
Raise concerns early: parents often notice subtle changes before clinicians do

There is no evidence that expensive “baby genius” videos, apps, or accelerated programs make a difference. The best development tool is a parent who is present, talkative, responsive and rested.

Common questions

“My friend’s baby walked at 9 months, mine isn’t even crawling at 11. Is something wrong?”

Probably not. The normal range for walking is 9–17 months. Some babies skip crawling entirely. Look at the overall picture: is your baby progressing in some way each month? If yes, that’s reassuring. If you’re worried, mention it at your next review, that’s what we’re here for.

“My baby uses one hand much more than the other, is that bad?”

Strong handedness before 18 months is worth checking. Babies typically use both hands fairly equally until then, with adult-level preference emerging around age 2. Often nothing, but always worth mentioning.

“When should I worry about late talking?”

By 18 months most babies have 5–10 words; by 24 months, 50+ words and 2-word phrases. Late talking can be fine in toddlers who are otherwise on track socially, but early intervention works, so it’s worth checking. A hearing test plus a speech-and-language assessment is straightforward; your GP or paediatrician can arrange referral and explain the support pathways available (including Medicare and the NDIS Early Childhood approach).

“What is the NDIS Early Childhood approach?”

The National Disability Insurance Scheme (NDIS) Early Childhood approach is the funded support pathway for children under 9 with developmental delay or disability. Your GP, paediatrician, MCH nurse or therapist can refer. You don’t need a confirmed diagnosis to start. See ndis.gov.au.

When to seek help