Support for Appendix C

Milestones for Teaching and Learning

In Chapter 14 we describe techniques for training medical, nursing and non-medical students, residents and fellows. Trainees, especially pediatric residents, are required to memorize milestones in order to pass their boards. Milestones checklists are useful when trainees visit day care centers and schools because they offer insight into child development (e.g., how exactly do 2-year-olds differ from 3-year-olds?) and hone clinical observation skills.

The list of milestones downloadable on this page was compiled by numerous developmental-behavioral educators and pediatricians. The list covers all developmental domains (including social-emotional and cognitive/academic skills) from birth to eight years of age.

The milestones represent performance at the 50th percentile. Thus half of all children will not demonstrate the skills shown and many of those performing below the 50th percentile are children who remain in the broad range of average.

But which children truly need help? Unlike accurate screening tests, milestones checklists lack clear directions and definitive criteria for administering/scoring items. Milestones checklists are helpful for teaching and learning but checklists should never be used to make decisions about children’s needs. Trainees need clear advice not to use milestones checklists as screening tools.