A medical student is reviewing the electronic medical record of a healthy 5-year-old boy. The record contains several physician observations made during routine well-child visits over the years. Assuming the child achieved all developmental milestones at the typical expected age without delay, arrange the following documented observations in chronological order from earliest to latest appearance.
- 1The infant transfers a block from the right hand to the left hand.
- 2The infant pulls himself up to a standing position holding onto the examination table.
- 3The toddler independently builds a tower of four blocks.
- 4The child walks up the clinic stairs using alternating feet.
- 5The child successfully copies a cross drawn by the physician.
Answer
The correct chronological order is: transferring a block (6 months), pulling to stand (9 months), building a tower of four blocks (18 months), walking up stairs with alternating feet (3 years), and copying a cross (4 years).
Normal pediatric development follows a predictable progression. Transferring objects from hand to hand is a 6-month fine motor milestone. Pulling to a stand is a 9-month gross motor milestone. Stacking a tower of four blocks is an 18-month fine motor milestone. Walking up stairs with alternating feet is a 3-year (36 months) gross motor milestone. Finally, copying a cross is a 4-year (48 months) fine motor milestone. Arranging these from earliest to latest yields the correct developmental sequence.
Step-by-Step Solution
Key Concept
Normal pediatric developmental milestones follow a predictable chronological sequence across fine motor, gross motor, language, and social-adaptive domains.