Ages and Stages - 18 Months

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In a previous post, I went over 16 months quiz, and for today's post I want to go over the 18 months quiz. There are several similarities, but stick around as I share a few more tips for your child's development. If you haven't already, check out 16 months post here. The questions are different for the different ages, and if you decide to test your child in these areas, I would recommend doing it more than once, in more than one type of setting, and reaching out to your healthcare provider if you have any concerns. The first page is pretty basic and seems to be the same for each test regardless of age, your child’s information, and your information. Pretty straightforward/standard.

The test has 5 categories they test in. ✨Communication ✨Gross Motor ✨Fine Motor ✨Problem Solving ✨Personal-Social

Followed by an overall question section and then the scoring guide. The answers are 3 categories (yes, sometimes, and not yet)

Communication 1. When your child wants something, do they tell you by pointing at it? 2. When you ask your child to, does he go into his room to find a familiar toy or object? (You might ask, "Where is your ball?" or say, "Bring me your coat," or "Go get your blanket.") 3. Does your child say eight or more words in addition to "Mama" and "Dada"? 4. Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat.” “Daddy play,” “Go home,” or “What’s this?” Does your child say both words back to you? 5. Without you showing them, does your child point to the correct picture when you say, "Show me the kitty," or ask, "Where is the dog?" (They need to identify only one picture correctly.) 6. Does your child say two or three words that represent three different ideas together, such as "See dog," "Mommy come home," or "Kitty gone"? (Don't count word combinations that express one idea, such as "bye-bye", "all gone," "all right," and "What's that?") Please give an example of your child's word combinations:

Communication Development Tips I want to note that I am not a professional, and if you have any concerns about your child's development, you should reach out to your child's medical professional. That being said, on the test I have and used for my child, we did it in conjunction with our healthcare professionals. The scoring guide has roughly anything below 15 as the black area, or area of higher area of concern. If your child falls in this area, intervention may be necessary. Definitely reach out to a professional to be certain. 15 - 30 is in the gray area, meaning your child falls in the warning area. I would still recommend reaching out to your doctor or medical professional for these results. When Addie fell into this category, our first steps recommend were Ages and Stages at home activities. 30-60 is considered more in range, meaning there may be less area of concern. Regardless of where your child scores, trust your gut and do what is right for your family. To determine the score, each yes is 10 points, each sometimes is 5 and not yet is zero. If all 6 questions on communication are yes that would make your score a 60. If they were all sometimes, then it would be 30. For communication at this stage, pointing to request, try encouraging your child to use words or gestures instead of just pointing. When they point at something, respond by saying the name of the object and encourage them to repeat the word. If they are not yet pointing, encourage pointing by modeling the behavior first. For example, if they want applesauce and are standing below maybe staring or grunting, try squatting to their level. Ask would you like some applesauce, and then point to apple sauce. You can also mimick hand signs and use pointing as you go through your normal days activies together. Another activity you can do together is to find familiar objects, and turn it into a game. Hide objects by simply covering them with a small blanket and asking them to find using verbal prompts. You can hold up two objects and ask them to point out an identifying characterization of that object. Such as holding a duck and a cow. "Can you point to the one that is yellow?" "Which animal is a cow?" "Does one of these say 'Moo'?" Of course you will want to cater these questions to your child's knowledge. If your child does not yet know a cow says "moo," then you may want to ask a different question.

Additionally, try engaging in regular conversations with your child, emphasizing new words and expanding their vocabulary. As you go through the house, say the words. "This is the chair, we sit here." "This is the table, we eat here." "We are walking down the hallway to the bathroom." Etcetera. When they do say new words, praise, encourage, repeat and expand. Another example is if they say "Dada", you can say "Yes! Dada! Dada is ready to play." "Do you want to play with Dada?" "Dada play?" When speaking the new word, make sure to face them, slow down, repeat the word while using it. Say it normal, sound it, repreat it. If they repeat it, wonderful! Make sure to praise them and show your excitement.

Be sure to read books together, label objects in the environment, and engage in imaginative play that encourages the use of different words. Encourage your child to combine words to express multiple ideas. Model two or three-word phrases during conversations and playtime. For example, "I see dog," "Mommy come home," or "Kitty go bye-bye." Ultimately remember, each child develops at their own pace, but consistent communication, positive reinforcement, and engaging activities can support their language development. Celebrate their progress and seek professional guidance if you have concerns about their communication skills.

Gross Motor

1. Does your child bend over or squat to pick up an object from the floor and then stand up again without any support?

2. Does your child move around by walking, rather than by crawling on her hands and knees?

3. Does your child walk well and seldom fall?

4. Does your child climb on an object, such as a chair, to reach something they want (for example, to get a toy on a counter to to "help" you in the kitchen)?

5. Does your child walk down stairs if you hold onto one of their hands? They may also hold onto the railing or wall. (You can look for this at a store, on a playground, or at home.)

6. When you show your child how to kick a large ball, do they try to kick the ball by moving their leg forward or by walking into it? (If your child already kicks a ball, mark "yes"for this item.)

Gross Motor Development Tips

The same scoring guide is used here. Roughly, to determine the score, each yes is 10 points, each sometimes is 5 and not yet is zero. However, for the scoring guides, 35 and under is in the black area and 40-45 is grey, leaving 50 - 60 in the desired range. Again, I am not a professional, and if you have concerns you should reach out to a professional. However, there are some tips you can try at home to promote your child's gross motor skills.

Encourage your child to bend over or squat by providing engaging toys or objects that require reaching down and standing up again. Offer praise and support as needed. Create a safe and open space for your child to encourage walking instead of crawling, using their favorite toys or objects as incentives. Guide them through the transition from crawling to walking. Engage your child in balance activities, such as walking on a balance beam or stepping on stepping stones, to improve their walking skills and reduce falls. Provide opportunities for climbing on age-appropriate structures or platforms while closely supervising for safety. Practice stair descending by holding your child's hand and guiding them down, encouraging them to hold onto the railing or wall. Start with small sets of stairs and gradually progress to larger ones. Finally, demonstrate and encourage kicking a large ball by moving their leg forward or walking into it, engaging in playful activities like kicking the ball back and forth or aiming at targets. Remember to create a safe environment, offer encouragement and support, and seek professional guidance if you have any concerns about your child's gross motor development.

While not necessary to encourage your child's development some gross motor toys you could purchase include: Climbing Triangle, Nugget Foam Couch, Similar to nugget/ from amazon, Foam corner slide.

Fine Motor

1. Does your child throw small ball with a forward arm motion? (If they simply drop it, mark "not yet")

2. Does your child stack a small block on top of another? (We use wooden blocks but you can use any toy roughly 1 inch in size, small cardboard boxes or even spools of thread.)

3. Does your child make a mark on paper with the tip of a crayon, pen or pencil when trying to draw?

4. Does your child stack three or more blocks or toys on top of each other by themselves?

5. Does your child turn the pages of a book by themselves? (They may turn more than one page at a time.)

6. Does your child get a spoon into their mouth right side up so that the food usually doesn't spill?

Fine Motor Development Tips

Personally, I struggled with this first question. "You want me to encourage my child to throw toys?" was literally my first question. In my mind, this was something to be discouraged, a negative activity. All the sports that involve throwing balls did not even occur to me, let alone the other skills that throwing develops. At the time of Addie's test, she was not at the point where she could throw a ball, and I was unsure how to encourage it. The first activity I read about was taking a small ball that would fit in her hand and show her how to throw it. My parents got her a talking egg that was intended to be thrown but she would just giggle and run it back and forth between us. While adorable, she wasn't throwing it. But we didn't give up. We gave her balled up socks, small dog toys, small balls, and just kept showing her what to do by throwing them down the hall. It didn't seem to catch on, though, until our interventionist suggested throwing them into a clothes hamper. Of course, she didn't immediately starting throwing after this, but it did seem to help. I'm not sure if she was finally catching on, or if the hamper made all the difference, but yesterday her D.I. showed her one of her balls, and suggested throwing it down her tunnel. She did it! I was beyond excited. When your child struggles and struggles with something, there is this joy you get when they finally get it that can't be compared to anything else. Oddly, Andrew told me that wasn't the first time she had thrown something. The first he noticed it was with the chalk. We were outside playing, and it was hot, the bugs were all over us. I can't speak for everyone, but for us, when we get bit those bites swell up. So I was trying to take her inside and she was not having it. Then she started throwing the chalk. Not nearly as exciting as the ball, actually more leaning into the whole fear I was having around encouraging throwing, but still, I am proud of my little girl and all of her accomplishments.

Outdoor Fine Motor Actities

Chalk, of course we mentioned above is great for developing those hand muscles for hand control and precision. While it's not necessary, consider using a chalk holder, like these. Addie and I both enjoy using them. They provide a little more stability and keep your hands a little cleaner. In addition to chalk, you can also set up a water painting station where your child can use a paintbrush and water to create designs on paper or other surfaces. There's no clean up which is a win-win. Another activity is to blow bubbles or use a bubble machine and encourage them to pop the bubbles.

Indoor Fine Motor Actities

Provide coloring materials such as crayons, markers, or colored pencils. Keep in mind not all coloring items are the same. They have made special markers that can only draw on a certain type of paper. (Linked here, baby shark, bluey, frozen, finding dory) They also have crayons that are shaped like an egg which may be easier for some children to hold. (Egg Crayons.)

Another great activity is reading to your child and allowing them to turn the pages. Try this with a book that has thicker pages. Bonus points for the sensory books, and this activity also helps with communication and personal - social. (I love you to the moon book. Dino Sensory Book.10 Board Books Perfect for starting their library. )

Stacking blocks, are also another great tool for developing fine motor skills. Three of my favorite options for this are Melissa & Doug Wooden Building Set, B. – Baby Blocks, and Melissa & Doug Deluxe ABC/123 1-Inch Blocks.

There are ton of free or low cost ways to improve fine motor skills such as simply using items you already have. A pen and a piece of paper is great alternative if you don't have markers and crayons. A simply paintbrush and a bowl of water. While you don't need to spend money to help your child's development here a few other toys that I love for improving fine motor skills; tubes, Hegehog, pull toy, dino sorting.

Tips for Improving Hand-Eye Control While Eating

For the 6th question, here are some tips to help improve your childs ability to eat with a spoon. Encourage your child to self-feed using utensils. Provide age-appropriate utensils and gradually increase the difficulty by introducing different textures and types of food. Support your child's self-feeding skills by offering opportunities to practice using a spoon. Encourage them to bring the spoon to their mouth right side up, promoting hand-eye coordination and control. Gradually increase the difficulty by introducing different textures and types of food. Some of my favorite utentils to offer my child include: What Addie uses now, Toddler Utensils. a good starter set, slightly more realistic option. You may have to try more than one option before you find one that works best for your child.

Scoring

For this one, 0-30 (ish) is considered the black area, 35-40 is in the grey area, and 45 - 60 is the desired range. (scroll to the bottom for a picture of the scoring guide)

Problem Solving

1. Does your child drop several small toys, one after another, into a container like a bowl or box?

(you can show them how to do it)

2. After you have shown your child how, do they try to get a small toy that is slightlyout of reach? ( May use spoon, stick, or similar tool) *

3. After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? (You can show them how.) (You can use baby bottle or soda bottle to try this)

4. Without showing them, can your child scribble back and forth when you give them a crayon, pen or pencil?

5. After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your child scribbles back and forth.

6. After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? (Do not show them how for this one.) (You can use baby bottle or soda bottle to try this)

Problem Solving Development Tips

For this first question, there is more than one way to do this, you can take any container and give your child a few toys or items to drop into it. Here are some suggestions and this can actually work for question 3 and question 6. Basically, take a container (I would start with a larger open container than a bottle such as a cup. I included a link for cups, but seriously any cup will work) You can take any small item, likegoldfish or Cheerios. It doesn't have to be food, but my daughter is still at the age where she wants to put items in her mouth, so I went with the ones that would be ok if she ate them. Alright, so take a handful of those and put them on one side and encourage your child to move them from one side to the cup. Once it seems like they have that down, try again with a bottle. Once they have that down, try having them turn it upside down. We struggled many times before she got this. Some other ways you can try this activity is to take 1 inch size toys such as blocks(wooden, or plastic), or shape sorter (wooden or plastics), lay them out on the floor and encourage them to move them to another container. I found that Addie had an easier time with the 1 inch toys than the smaller food items simply because with the food items she wanted to eat the goldfish and Cheerios. The moral of this is find what works for your child, show them how to do it, stay patient and keep trying. If they struggle, try it later and with different options.

Ok let's address question 2. Did you notice I put an * asterisk there? Here's why. I read that question for the first time and thought "WHAT?" Are there moms out there giving their children sticks to get hard to reach items? Basically, I reworded it slightly than what the actual test asks. On the test it states "After you have shown your child how, does she try to get a small toy that is slightly out of reach by using a spoon, stick or similar tool?" For our house, those items aren't something Addie can get on her own, we would have to give them to her. It seemed like a strange concept, and the pedatrician didn't have much to say when I asked. So I decided to ask Addie's D.I., and she seemed confused. I showed her the test and she said she would look into it and get back to me. The next time we spoke, she said that she believed that it wasn't really about them using the item but more about their ability to get to the item that is hard to reach and that the question is just worded oddly. So, for the sake of this, I decided to re-word it into a better format.

Now let's talk about a way you can do this (without using a stick.) When Addie was being tested, I noticed the woman used a small box. It was clear and the way it was set up Addie had to reach low to get to the ball, if she tried to reach high the box would block her from getting the ball. I couldn't find an exact replica of what she used but similar to that is this box the ball goes into the top, and the child has to open the box to retrieve the ball. Of course, you could probably make one out of an old shoebox or attempt another creative way of doing this. If you do, let me know because I would love to hear about it!

Some other great options are Toy Shape Puzzles, Wooden Sorting & Stacking Toy, and Busy Board.

Scoring

For this one, 0-25 is considered the black area, 30-35 is in the grey area, and 35 - 60 is the desired range. (scroll to the bottom for a picture of the scoring guide)

Personal- Social

1. Does your child feed themselves with a spoon, even though they may spill some food?

2. Does your child help undress themselves by taking of clothes like socks, hats, shoes or mittens?

3. Does your child play with a doll or stuffed animal by hugging it?

4. While looking at themself in the mirror, does your child offer a toy to their own image?

5. Does your child get your attention to try to show you something by pulling on your hand or clothes?

6. Does your child come to you when they need help, such as with winding up a toy or unscrewing a lid from a jar?

Personal - Social Development Tips

These questions are very similar to question 6 on the fine motor portion, and in a way, to question 2 on problem solving. For this, I think consistency is key, find utensils that work for your child to mimic eating with, and encourage and celebrate when they use them. Refer back to fine motor for more on this under "Tips for Improving Hand-Eye Control While Eating".

Provide verbal prompts and praise: Remind your child of the steps involved in dressing and undressing as they go through the process. Offer encouragement and praise for their efforts and accomplishments, even for small milestones. Positive reinforcement can boost their confidence and willingness to continue trying it over her head. For her pants she has not figured that out yet, kind of straight forward and simply when I undress her I show her the band on her pants, and say down as I tug them down. We have a Pete The Kitty Book and in this book that is one of the potty steps so I feel as though she understand even though she hasn't figured this skill out just yet. Despite that, I would still mark her as a yes because she does help with taking off the other clothing. For stuffed animals and mirror interaction, try letting them pick out a soft animal or doll. Cuddle and Kind and Baby Stella are two of my daughters favorites but there are so many great options to choose from. If you are unable to go in person somewhere, try showing them two images and letting them pick that way. Another way if they already have two stuffed animals, use those and simply let them pick that way. Hug the stuffed animal and talk to it, then encourage them to hug it. Stand in front of a mirror, play and make silly faces and just have fun together. Try talking to the mirror version, asking questions and being silly. Addie loves when we touch the mirror and then jump back.

Encourage your child to get your attention by praising them when they do seek your attention. This encourages them to continue to seek your attention. If they pull on you, stop and reach down to their level and make eye contact. Acknowledge that you know they want your attention. Smile and give them attention. Then try to meet the need they are searching for. Another way is to ask your child open ended questions. What was your favorite thing about today? While they may not be able to fully respond in a way you can understand, continuing to ask these questions and listening when they respond shows them you care about what they have to say. Always try to let your child do the task first when possible before stepping in, but if they come to you with applesauce (for example), you may try asking: do you want this opened? Sometimes Addie will say "Open." If she says "open!" I will open it, if she doesn't say open I will say, "Do you want to try to open?" I will then show her the motion for opening it. Sometimes she will try, and sometimes she will hand it back to me. I will usually say open again, and then open it. Figure out what works best for you but the most imporant thing is listening, engaging, and making sure your child knows you are there for them when they need it.

Scoring

For this one, 0-25 is considered the black area, 30-35 is in the grey area, and 40 - 60 is the desired range.

Reminder: If your little one falls into the grey or black category, consider reaching out to a professional.

In conclusion, the 18-months quiz provides valuable insights into a child's development across different areas, including communication, gross motor skills, fine motor skills, problem-solving, and personal-social skills. It is important to remember that each child develops at their own pace, and the quiz serves as a general guideline rather than a definitive assessment. If you have any concerns about your child's development, it is always recommended to consult with your child's healthcare professional for further evaluation and guidance.

Throughout this post, we have provided tips and activities to support your child's development in each area. Encouraging communication skills can involve pointing, labeling objects, engaging in conversations, and expanding their vocabulary. Promoting gross motor skills can include activities like bending over to pick up objects, walking instead of crawling, climbing, and practicing stair descending. To enhance fine motor skills, consider activities such as throwing, stacking blocks, coloring, and self-feeding with utensils. Problem-solving skills can be nurtured through toy drop challenges, reaching for objects, and exploring cause and effect. Finally, personal-social development can be fostered by encouraging self-feeding, supporting dressing skills, engaging in nurturing play with dolls, interacting with mirrors and toys, seeking attention, and promoting collaboration.

If your family is going through a similar situation, and you have any tips to share, please message me. I’d love to learn more about any suggestions that have worked for your family. I will also be sharing more activities and specifics about what we have done in the days to come.

Thank you so much for reading this far,