# Ages & Stages Questionnaires

## What to expect and how you can promote growth

### Moving beyond babyhood and into unique personality

As toddlers explore their abilities, begin to assert independence, and forge an identity, it is normal to push boundaries once in a while. Toddler development is where your baby becomes a more of an individual, wanting to exercise more control over things, and wanting to be understood. Gaining the ability to communicate is a huge step in and making all of that happen. But often toddler speech is still quite hard to understand, and that can create some frustration.

### Watching for Progress

Just as it’s natural for the toddler to rebel, it’s natural for parents to worry. Parents who wonder if their toddler is on track for developmental milestones can find solace in knowing they are not alone. Children develop at their own pace, and there’s not an exact time they’ll learn a specific skill, but common milestones do help establish a general idea of what to watch for and when. A recent study from the Centers for Disease Control (CDC) found that nearly 18% of children in the U.S. have a developmental disability.

Resources for parents to gauge their toddler’s developmental progress are easy to find, and pediatricians are always willing to lend an ear to concerned parents. If there are delays, early intervention services are accessible to all and can significantly improve long-term outcomes.

Jane Squires, Ph.D., is an expert in early childhood development and early identification of delays. She stresses the importance of involving parents in the monitoring of young children’s development. After all, who knows the child better than the parents? Squires is also lead author of the Ages & Stages Questionnaires, Third Edition (ASQ-3). Below, Squires shares some information about what skills to watch for as your toddler grows, and provides activity ideas to support your toddler’s development along the way.

### Developmental Milestones

What sorts of developmental milestones should parents notice, when it comes to typically developing children between 1 and 3 years of age? The Centers for Disease Control (CDC) gives us a breakdown on some noteworthy behaviors for most toddlers.

- **At 1 year:** waves “bye-bye”; calls a parent “mama” or “dada” or another special name; understands “no” (pauses)
- **At 18 months:** moves away from you, but looks to make sure you are close by; points to show you something interesting; looks at a few pages in a book with you; helps you dress them by pushing arms through sleeves or lifting up feet; tries to say three or more words besides “mama” or “dada”; follows one-step directions without any gestures, like giving you the toy when you say “Give it to me”; plays with toys in a simple way, like pushing a toy car; walks without holding onto anyone or anything; scribbles; climbs on and off a couch or chair without help.

### How parents can help

“The most important thing is scaffolding or seeing where the child is, taking them to the next step,” says Squires. “It’s the most important thing that parents can do for their children.” Reaching that next step can be fun—because you can get there in large part through play. Being present and engaged with your child is a priceless support, both for fostering healthy development and for having the kind of close, attentive relationship that allows for early identification if there is delay.

Squires suggests some simple activities parents can try with their children:

#### Babies 12–16 months of age:
- Cut up safe finger foods and let baby pick them up, feel the textures, and feed themselves.
- Give your toddler a small wagon or an old purse for “collecting” things. They can fill and empty it and pull it around.
- Expose your toddler to the joys of playing in water with bubbles.
- Help your toddler play cleanup games and sort objects into piles.

#### Toddlers 16–20 months of age:
- Sing action songs like “Itsy Bitsy Spider” and do the actions together.
- Collect empty cereal boxes, egg cartons, etc. and help your child set up their own grocery store.
- Use boxes/buckets for your toddler to throw beanbags or balls into.
- Turn objects upside down (books, cups, shoes, etc.) and see if the toddler notices and turns them back. Toddlers like “silly” games.
- Read a familiar story and pause frequently to leave out a word, asking your child to fill it in.
- Get a piece of paper large enough for you to trace an outline of your child. Talk about body parts and print the words on the paper, having the child draw and color on the poster.
- Play a jumping game when you take a walk, by hopping over cracks in a sidewalk (you may have to help at first).
- Build roads and bridges with blocks and use cars to teach location words (over, under, between, etc.).
- Wrap tape around one end of a piece of yarn and knot the other end, and allow your toddler to string large macaroni, large beads, or Cheerios.
- Pretending becomes more fun now! Pretend you are a dog.
- Take time to draw with your child when they show interest. Take turns drawing large shapes and coloring them in.

### Early Intervention is Key

In the event that delays are suspected, don’t panic! Identifying possible delays early puts you on the right path to getting the supports in place to help your child achieve better outcomes. Discuss your child’s development and any concerns with your pediatrician or child care provider. They’ll have lots of advice, as well as referral options for you to pursue early intervention services if needed. You can also do some homework online, including some of the additional resources shown on this page.