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Child Growth and Development

"The first six years of a child's life [have] the greatest impact on their future learning, health and development" (McCain & Mustard 1999)

Children depend on their parents and other caregivers to help them grow and develop. When parents know what to expect at each stage of development, it can be easier for them to meet their child's needs and understand their behaviour.


The Early Years Matter!

"Research shows that the quality of early childhood experiences will have long term effects on an individual's performance in the education system, their behaviour in adult life and their risks for chronic disease in adult life…. and that parenting is the most important influence on early child development" (Fraser Mustard).

Parents who spend time with their child every day:

  • Have a positive life-long effect on their baby's ability to reach their full potential
  • Promote language and brain development
  • Help build social skills like how to take turns and get along with others
  • Help children go from one activity to another because they know what to expect
  • Teach children to be independent and do things for themselves
  • Help build self-confidence

One in four Canadian children have a behaviour or learning difficulty when they start grade one. This has an impact on the child's ability to learn. Identifying growth and development concerns early is an important step in making sure that children get the help they need and are ready to learn when they start school.

The Enhanced 18-Month Well Baby Visit

A young child playing with blocks on the floorThe Enhanced 18-Month Well Baby Visit postcard is mailed out to all parents in York Region who have provided consent and have a 15-month old child. Eighteen months is an important milestone in a child’s development. Parents are encouraged to ask their doctor about the Enhanced 18-Month Well Baby Visit.

Information for Parents Who do not Have a Family Doctor or Nurse Practitioner

Health Care Connect helps Ontarians who do not have a family health care provider (family doctor or nurse practitioner) find one. This service refers families to a family doctor or a nurse practitioner in their community who is accepting new patients.

Parents may also choose to visit a walk-in clinic in their area.


Growth and Development From Birth to Five Years

Birth to Six Months

There are six primary areas of growth and development:

  • Physical
  • Cognitive
  • Emotional
  • Social
  • Language & communication
  • Self help

Children can develop in different areas at the same time.  For example, during play a child learns:

  • Trust (emotional development)
  • How to share (social development)
  • What to expect (cognitive/intellectual development)
  • How to use their bodies (physical development) (Mustard & McCain, 1999)

Visit Health Baby Healthy Brain to see short video clips on how parents can help their baby have a healthy brain.

Healthy Sleep for Infants

During the first six months, it is safest for a baby to sleep on his or her back, in a crib in the same room as his or her parents. This decreases the baby’s risk of Sudden Infant Death Syndrome and of developing flat spots on their heads. Neither is completely preventable, but there are steps parents can take to reduce the risk.

The Canadian Pediatric Society website has more information on flat heads and Sudden Infant Death Syndrome.

Language and Communication

During the first six months babies can communicate through a variety of sounds and gestures. They communicate different needs such as tiredness or hunger through different cries. They are able to coo, gurgle, babble and laugh and can smile in response to the laughs and smiles of their parents.

Parents can help their child develop communication skills by:

  • Reading, talking and singing to them
  • Smiling and laughing along with them
  • Playing face-to-face  with their baby, at the baby’s level
  • Offering their fingers for the baby to grasp
  • Holding and rocking their baby

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

Babies’ physical development includes gross and fine motor skills.

Gross motor development is what a baby can do with large muscle groups.  This includes the development of balance, coordination, strength and body awareness. For example the baby’s ability to roll his or her head from side to side.

Fine motor development is what a baby can do with small muscle groups, including the control of the arms and hands needed to pick up a toy.

By the time they reach six months, babies can reach, grasp and bang objects with their hands. They can also roll over.

At this age, babies like to play with:

  • A music box or soft musical toy
  • Soft cuddle toys
  • Rattles
  • Bright coloured toys to grasp
  • Teething rings

Their heads need to be supported and they need to breastfeed frequently during the day and night.

Vision

Newborns can see objects that are 20-40 centimetres away clearly. They can see the faces of people holding them. Babies like to look at mobiles and pictures on the walls.

By two months, babies can recognize their parents’ faces; by four months, babies can see clearly at any distance.

Visit Markham Stouffville Hospital's Vision page for more information.

Emotional Development

Babies are most interested in their parents’ voice and face. They want to be held closely so they can study faces. Parents should smile at them, talk to them and get to know how they like to be handled. Babies often relax when they are held close and cuddled, rocked, sang or talked to or played soft music.

Nipissing District Developmental Screens

There are three Nipissing District Developmental Screens that can be completed at this time:

  • One and two months
  • Four months
  • Six months
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Six to 12 Months

Between six and 12 months, babies start to be curious about the people, places and things around them. Parents have a critical role in promoting growth and development by providing a safe, loving, stimulating environment.

Language and Communication

Most babies will start to say a few words between nine and 12 months. They will be able to communicate their likes, dislikes and emotions through facial expressions, actions and sounds.

By 12 months, babies will start to:

  • Squeal and scream to get their parents’ attention
  • Understand their own name
  • Understand simple words
  • Say simple sounds
  • Laugh and try to make sounds like you

Parents can help their child develop communication skills by:

  • Reading, talking, singing, clapping and playing with their baby
  • Offering a variety of toys during supervised tub play
  • Providing a safe place for their baby to crawl, walk and explore
  • Playing hide-and-seek with objects
  • Going for a walk outside and talking about everything they see and hear

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Vision

At nine months, babies can recognize faces and can tell familiar people from strangers. They will start to be aware of their surroundings and show an interest in things around them.

Physical Development

At 12 months, babies can pull themselves up to a standing position. They can walk by holding on to something for support. Parents need to make sure all cupboards, stairs and doorways have been child-proofed and are safe.

At this age, babies like to play with: 

  • Toys to bang together like pots and lids
  • Soft toys to throw and drop
  • Nested plastic cups
  • Cloth books with simple pictures and short sentences
  • Push toys to help while they learn to walk (for example: chairs, a large box or even a laundry basket)
  • Stacking toys
  • Squirting bath toys
  • Squeaky toys
  • Balls to roll and chase

Emotional Development

A six month old baby cannot be spoiled. Comfort them whenever they are unhappy or fussy.  Respond to them when they cry.

By seven months, babies may start to get upset when their parents leave and when meeting new people.

When they are upset, it is important that parents soothe and comfort their child by holding and hugging them and helping them to feel safe and secure. Hug, cuddle and sing to babies often throughout the day and tell them how wonderful they are.

Twelve months is a great time for parents to start teaching their children about their feelings by naming them.

Visit Loving Guidance and Positive Discipline for more information.

Nipissing District Developmental Screens

There are three Nipissing District Developmental Screens that can be completed at this time:

  • One at six months
  • One at nine months
  • One at 12 months
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12 to 18 Months

Toddlers love hearing the same story or playing the same game over and over again. They learn through repetition. It's normal for toddlers to want their own way. They will play happily beside another child but are still too young to share toys.

This is also the time for parents to book an Enhanced 18 Month Well Baby Visit with their primary care provider.

Language and Communication

Children can understand more words than they can say at this age. They will be able to say single words and follow simple instructions. By 18 months children know 20 or more words in any language. For example a child may know 10 words in English and 10 words in another language for a total of 20 words.

By 18 months, children can:

  • Understand words
  • Recognize and point to parts of their body
  • Follow instructions to find things
  • Copy the gestures of people around them
  • Make gestures
  • Ask for “more” or “again”

Parents can help their child develop communication skills by:

  • Reading, talking, singing and sharing time with their child
  • Giving children their own dish, cup and spoon
  • Allowing their child to feed themselves and to drink from a cup
  • Playing simple games
  • Naming objects, toys and body parts
  • Giving their child chances to play with other children

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

Physical growth slows down in a child's second year and body shape changes. Bones harden and muscles develop allowing children to walk, climb and dance.

By 18 months children are able to crawl, walk alone and walk up steps holding someone’s hand.

At this age, toddlers like to play with:

  • Nested plastic cups or boxes
  • Stacking rings
  • Building blocks
  • Dolls and stuffed animals to care for
  • Things to bang, shake and make music
  • Picture books

Emotional Development

By 18 months, children start to:

  • Respond in different ways to different people
  • Miss their parents when they are away
  • Watch how their parents react to a situation before they react

Nipissing District Developmental Screens

There are three Nipissing District Developmental Screens that can be completed at this time:

  • One at 12 months
  • One at 15 months
  • One at 18 months

Dental Health

There is a dental screening checklist for children 18-36 months, designed to help parents keep track of their child’s dental health and development.

York Region Public Health has Dental Programs that may help families in financial hardship with the cost of dental care.

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18 to 24 Months

Children are learning to be independent at this age but they still need to feel safe, secure and loved. They will explore their world and return to their parents for security. Children still need to be supervised at this age.

Language and Communication

Children love to imitate their parents. Copying their parents’ day to day tasks will be their favourite activity.

Children can recognize their own image and indicate what they want in words at this age.

By 24 months old, children can:

  • Say two words together
  • Say the words "what's that?"
  • Pick one thing out from a group of objects
  • Sort things by shape, touch, colour and size
  • Watch other children play and play beside them
  • Take off their own shoes, socks or hat

Parents can help their child develop communication skills by:

  • Reading, talking, singing and sharing time with their child
  • Naming objects, toys and body parts
  • Giving their child chances to imitate others
  • Giving their child clothing for dress up
  • Giving their child toys that imitate household activities
  • Looking through family albums together

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

By 24 months, children can run, jump and climb and can go down steps by themselves with supervision.

At this age, toddlers like to play with:

  • Dolls
  • Stuffed animals
  • Toy spoons, cups and plates
  • Toy vacuum cleaners and tools
  • Clay, finger paints or play dough
  • Containers to fill and empty
  • Pails and shovels
  • Books with pictures
  • Building blocks

Nipissing District Developmental Screens

There are two Nipissing District Developmental Screens that can be completed at this time:

  • One at 18 months
  • One at 24 months

Dental Health

There is a dental screening checklist for children 18 to 36 months, designed to help parents keep track of their child’s dental health and development.

York Region Public Health has Dental Programs that may help families in financial hardship with the cost of dental care.

Parents,babies,children,toddlers,preschoolers,school-aged children,development,communication,physical development,emotional development,growth and development The Regional Municipality of York en-US

Two to Three Years

Toddlers can walk up and down steps, kick a ball and jump off a step at this age. Since children do not understand danger, they still need to be supervised. Between two and three years, children can dress and undress themselves with help.

Language and Communication

Toddlers enjoy repetition and start to ask the question "why?” As toddlers become more independent, they will get a lot of joy from doing things themselves and helping their parents.

"No" may be a child's favourite word at this age.

By three years old, children can:

  • Speak in sentences of five or more words
  • Understand two and three step directions
  • Throw a ball forward at least one metre
  • Walk up the stairs using a handrail and stand on one foot briefly
  • Share some of the time
  • Play with others comfortably
  • Listen to music or stories for five to 10 minutes with their parents

Parents can help their child develop communication skills by:

  • Reading, talking, singing and playing guessing games with their child
  • Playing catch, tag and chase games
  • Giving their child the chance to play in water, sand and snow
  • Encouraging their child’s attempts to dress, feed and wash themselves and clean up
  • Allowing their child to help with household tasks
  • Giving their child the chance to play with other children

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

This is a very active age. Children are learning how to use their body and hands in different ways. This means that they will enjoy activities that involve movement, such as jumping and climbing. 

At this age, children like to:

  • Read colourful, interesting books with familiar objects and simple stories
  • Play with crayons, finger paints, play dough, glue, chalk, beads and building blocks
  • Play matching, sorting and pretend play games
  • Do easy puzzles
  • Play with balls
  • Stand, walk, run or hop over a line made on the floor with masking tape
  • Play with pails and shovels

Emotional Development

Toddlers know what they do and do not want. They may not be able to express their emotions in an appropriate way, which may result in temper tantrums. They may be afraid of things that did not bother them before. Their fears are real to them and parents can help them feel safe.

Toddlers are learning about relationships with others. They enjoy playing with other children for short periods of time and can share some of the time.

Nipissing District Developmental Screens

There are three Nipissing District Developmental Screens that can be completed at this time:

  • One is at two years
  • One at 30 months
  • One is at three years

Dental Health

There is a dental screening checklist for children 18-36 months, designed to help parents keep track of their child’s dental health and development.   

York Region Public Health has Dental Programs that may help families in financial hardship with the cost of dental care.

Parents,babies,children,toddlers,preschoolers,school-aged children,development,communication,physical development,emotional development,growth and development The Regional Municipality of York en-US

Three to F​our Years

Preschoolers start to play with others and learn to share.

Language and Communication

Preschoolers are able to speak simple sentences of five or more words. Many preschoolers love to sing songs. They can understand and follow simple, reasonable rules. By four years old they can know their full name, address and telephone number.

By four years old, children can:

  • Understand three-part related directions and longer sentences such as “put your toys away and wash your hands before lunch”
  • Make requests
  • Ask and answer many questions such as: What? Where? Why?
  • Talk about things they have done or describe what is happening in a picture
  • Talk about how they feel and try to comfort someone who is upset
  • Go up and down stairs using alternating feet
  • Undo buttons and zippers
  • Use the toilet during the day
  • Take turns and share with other children in small group activities

Parents can help their child develop communication skills by:

  • Reading, talking, singing and sharing time with their child
  • Asking their child questions about the stories they read together
  • Playing simple games that involve taking turns
  • Giving their child many choices and chances to do things themselves
  • Letting their child help with small chores
  • Giving their child many chances to draw, paint, practice cutting and colour
  • Giving their child chances to play with other children

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

Preschoolers love physical activity! They can now walk up and down steps using alternating feet and ride a three-wheeled bike.

At this age, preschoolers like to play with:

  • Picture and story books
  • Bats, rackets, hockey sticks, balls and skipping ropes for active play
  • Bicycles
  • Crayons, finger paints and play dough
  • Puzzles
  • Obstacle courses to practice running, crawling, balancing, climbing, jumping and hopping on one or both feet
  • Other children

Emotional Development

Preschoolers are starting to learn how to show their affection. They enjoy being with their parents and playing with other children.

They are learning to share and take turns, but they still need some help. They still need to feel safe, secure and loved.

Preschoolers enjoy doing things with their parents and are eager to please them. Temper tantrums happen less often.

Nipissing District Developmental Screens

There are two Nipissing District Developmental Screens that can be completed at this time:

  • One at three years
  • One at four years

Dental Health

There is a dental screening checklist for children 18-36 months, designed to help parents keep track of their child’s dental health and development.   

York Region Public Health has Dental Programs that may help families in financial hardship with the cost of dental care.

Parents,babies,children,toddlers,preschoolers,school-aged children,development,communication,physical development,emotional development,growth and development The Regional Municipality of York en-US

Four to Five Years

Children are getting ready to go to school at this age. Parents with four year olds who are not in school should give their child chances to join in group activities or programs.

Language and Communication

At this stage, children can play games with simple rules. Four year-olds ask a lot of questions, such as "How?" and "Why?”

By five years old, children enjoy talking to people about things that they find interesting. Children can speak clearly in adult-like sentences most of the time.

During this stage, children start to play well in a group and follows rules. Their self-esteem and confidence are growing at this age.

By five years old, children will:

  • Use sentences that sound almost like an adult
  • Be able to say most speech sounds
  • Know most of the letters of the alphabet and the sounds that they make
  • Use sentences to describe objects and events
  • Follow more than one request at a time
  • Count from one to 10 and be able to answer how many there are of something
  • Stop, start and change direction smoothly when running
  • Hold a crayon or pencil correctly
  • Throw and catch a ball successfully most of the time
  • Use scissors to cut along a thick line drawn on a piece of paper
  • Work alone at an activity for 20 to 30 minutes
  • Share willingly with others

Parents can help their child develop communication skills by:

  • Reading, talking, sing and sharing time with their child
  • Giving their child the chance to tell stories
  • Talking to their child about their experiences
  • Giving their child many chances to cut, draw and colour
  • Giving their child chances to do simple household tasks and help with baking and cooking
  • Giving their child chances to play with other children
  • Playing hide and seek, tag, dodge the ball and red rover with their child

Parents who have concerns about their child's speech and language development can visit Markham Stouffville Hospital's Speech and Language page. 

Physical Development

School-aged children are full of energy. They can walk in a straight line and hop on one foot. They can also feed themselves, undo buttons and zippers and sort items by shape, size and colour.

At this age, children like to play with:

  • Crayons, markers, paper, paint, children's scissors and glue
  • Toys to build with and put together in different ways
  • Clothes to dress up in, props and puppets for make-believe play
  • Story books, board games and puzzles
  • Their bicycle (with or without training wheels) while wearing a helmet
  • Their friends

Emotional Development

School-aged children are learning self-control and how to cooperate. They are becoming more independent.

By noticing when their child is doing something well and telling them how proud of them they are, parents will help their children feel good about themselves and motivate them to do it again.

Parents can help them learn about the feelings of others through stories.

Nipissing District Developmental Screens

There are three Nipissing District Developmental Screens that can be completed at this time:

  • One at four years
  • One at five years
  • One at six years
Parents,babies,children,toddlers,preschoolers,school-aged children,development,communication,physical development,emotional development,growth and development The Regional Municipality of York en-US

Tools and Resources for Parents

The Nipissing District Developmental Screen

Little boy in green shirt pointingThe Nipissing District Developmental Screen (NDDS) is a checklist that provides a snapshot of a child's development until age six. It can help identify any areas where a child may need some extra help and activities to encourage development. Register your child at eNDDS for:

  • A checklist that captures a snapshot of your child’s development
  • Email reminders when it’s time to do the next checklist
  • Tips and activities to encourage your child’s development

The Enhanced 18-Month Well Baby Visit

One and a half years is an important milestone in a child's growth and development. It is important for parents to take their child to visit a health care provider at this time.

Ontario has funded a longer, more in-depth 18 month visit. Parents should ask their health care provider about this Enhanced 18-Month Well Baby Visit or visit the Ontario Ministry of Children and Youth Services website or machealth Ontario's Enhanced 18-Month Well-Baby Visit website to learn more.

Rourke Baby Record For Parents

The Rourke Baby Record (RBR) for Parents website is a place to find reliable parent-friendly resources and is designed to help parents answer questions about children up to age five years.

Healthy Brain Development

Visit Healthy Baby Healthy Brain to see short video clips on how parents can help their baby have a healthy brain.

The Brain Hero Video from the Center on the Developing Child at Harvard University is an amazing three-minute video that depicts how the actions of a range of people in the family and community can affect a child’s development.

Speech and Language

Markham Stouffville Hospital Child Development Programs (CDP) offers services to children from birth to kindergarten in three programs: Hearing, Speech & Language and Blind-Low Vision. Visit Markham Stouffville Hospital’s www.childdevelopmentprograms.ca for more information.

Mental Health and Wellness in Pregnancy and Parenthood

Pregnancy or having a baby is not always easy. The adjustment to parenthood can be challenging for many families. Visit Mental Health and Wellness in Pregnancy and Parenthood for information on programs and services.

Parenting Education and Support

York Region offers free programs on a variety of parenting topics. These include groups and webinars led by Public Health Nurses. Programs are offered at locations throughout York Region. Visit Parenting Education and Support for more information on programs and services.

Nutrition and Breastfeeding

Eating is much more than just nutrition. Feeding your baby is the start of their relationship with food and eating. To find out more about proper nutrition for babies, toddlers and preschoolers, visit the Feeding Babies and Young Children page.

See also Children Services for information on York Region’s programs, subsidies and resources for parents and child care providers.

York Region also provides programs, services and information designed for parents to help their children grow and develop.

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Tools and Resources for Professionals

Child and Family Health Programs Referral Form

The Healthy Babies Healthy Children (HBHC) Program is voluntary and offered at no direct cost to families. HBHC Public Health Nurses and Family Visitors provide information, support, and links to community resources for eligible women and their families from the prenatal period up to the transition to school. To make a referral, complete the Referral to Child and Family Health Programs form.

Red Flags Guide

The York Region 2018 Red Flags guide is a quick reference tool to assist early years and health care professionals in knowing when and where to refer children from birth to the age of six years for whom there are potential health, growth and development concerns.

Enhanced 18-Month Well Baby Visit

Ontario's Enhanced 18-Month Well Baby Visit Information and brochure

Rourke Baby Record

The Rourke Baby Record (RBR) is a system many Canadian doctors and healthcare professionals use for well-baby and well-child visits for infants and children one week to five years of age. It includes forms for charting well-baby visits as well as supporting resources.

Brain Architecture

The Center on the Developing Child provides information on brain architecture and how a child’s brain is shaped. The video Building Adult Capabilities to Improve Child Outcomes: A Theory of Change depicts a theory of change from the Frontiers of Innovation community for achieving breakthrough outcomes for vulnerable children and families.

On Track

On Track is an online reference guide available through Best Start by Health Nexus. On Track provides professionals who work with young children and families with indicators of healthy child development from birth to six years of age.

Mental Health and Wellness in Pregnancy and Parenthood

Pregnancy or having a baby is not always easy. The adjustment to parenthood can be challenging for many families. Visit Mental Health and Wellness in Pregnancy and Parenthood for information on and referral to the Transition to Parenting program and other supports.

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Related Resources

External Resources

Links to other sites are provided as a reference to assist in identifying internet resources that are available on a particular subject. Internet resources are not substitutes for the advice of a qualified medical practitioner. We do not assume responsibility for the accuracy or appropriateness of the information contained on these sites, nor do we necessarily endorse the viewpoints on these sites.

 

 


Parents,babies,children,toddlers,preschoolers,school-aged children,development,communication,physical development,emotional development,growth and development The Regional Municipality of York en-US Child Growth and Development Child Growth and Development Find tools and resources for parents to help children grow and develop. When parents know what to expect at each stage of development, it can be easier to meet their child’s needs and understand their behaviour.

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