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Developmental milestones
Development questions do not require remembering every milestone: they require a few "anchors" in each domain (gross motor, fine motor, language and social) and the "red flags" — and any loss of skills is a red flag at any age.
Why it matters in the exam
The exam describes a child and what he can do, and asks his age or whether development is normal. Anchors are therefore needed: a social smile at 6 weeks, head control at 4 months, sitting without support at 6–8 months, walking independently at 12–15 months, first words around 12 months, two-word phrases at 24 months. In a preterm baby, corrected age is used up to two years.
Other questions deal with autism and language delay. The AAP recommends autism screening (M-CHAT-R/F) at 18 and 24 months; red flags are no pointing or babbling by 12 months, no single words by 16 months and no spontaneous two-word phrases by 24 months. Every language delay needs a hearing test. Hand preference before 18 months suggests weakness on the other side.
Key points
- Anchors: smile at 6 weeks, sitting at 6–8 months, walking at 12–15 months.
- Language: first words around 12 months, two-word phrases at 24 months.
- Autism screening at 18 and 24 months.
- Loss of skills is a red flag at any age.
- Not walking by 18 months or no words by 16 months — work-up.
Summary table
| Age | Gross motor | Fine motor | Language and social |
|---|---|---|---|
| 2 months | Lifts head when prone | Hands open | Social smile (already from 6 weeks) |
| 4–6 months | Head control, rolls over | Reaches and grasps | Laughs, babbles |
| 9 months | Sits steadily, crawls, pulls to stand | Early pincer grasp | Stranger anxiety, "bye-bye", non-specific "mama" |
| 12 months | Walks with support or first steps | Fine pincer grasp | 1–3 words, points, follows a simple command |
| 18 months | Walks well, starts to run | Builds a tower of 3–4 cubes | About 10–20 words |
| 24 months | Runs, climbs stairs | Tower of 6 cubes | Two-word phrases, half of speech understood by strangers |
| 3–4 years | Tricycle, hops on one foot at 4 | Copies a circle at 3, a cross at 4 | Sentences of 3 words or more; plays with other children |
Free exam questions
בת 9 שנים, סובלת מזה שלושה ימים מהתפתחות הדרגתית של אי- יציבות רגשית, תנועות בלתי נשלטות בידיים וברגליים עם תנועות "ריקוד" של הידיים. בבדיקות המעבדה לציין Antistreptolysin O (ASLO) של 440 יחידות/מל' (ערך תקין 0-200 יחידות). בירור אוטואימוני ומדדי הדלקת תקינים. מהי הפרוגנוזה ? של מחלתה הסבירה (the question as examined, in Hebrew)
- א. המחלה צפויה להחמיר עד צורך לשימוש בכסא גלגלים
- ב. המצב יישאר סטטי ללא שינוי משמעותי לשארית חייה
- ג. צפוי שיפור הדרגתי אך עם נזק שאריתי קל לכל ה.חיים
- ד. צפויה הבראה מלאה תוך שנה מתחילת הסימנים
?מה מצופה מילד בגיל שנתיים לבצע (the question as examined, in Hebrew)
- א. לצייר משולש
- ב. לקפוץ על רגל אחת
- ג. לעלות במדרגות
- ד. לרכב על אופניים
In the full version for subscribers
- A simple algorithm
- Memory aid
- Exam traps
- 5 review cards
- Enough for IMLE
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Sources
- AAP Clinical Report: Promoting Optimal Development — Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening, 2020 — Surveillance and screening schedule
- AAP Clinical Report: Identification, Evaluation, and Management of Children With Autism Spectrum Disorder, 2020 — Screening at 18 and 24 months
- Nelson Textbook of Pediatrics, 22nd edition (2024) — Developmental Milestones
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-02. The text may contain errors; when in doubt, check the source.