Vocabulary and Expressive Language:

49-52 Months:

  • Vocabulary continues to expand, with approximately 3,000 to 4,000 words.
  • Uses complex sentences with more conjunctions (e.g., “because,” “although”).
  • Demonstrates an improved ability to express ideas, feelings, and thoughts clearly.
  • Engages in more detailed and extended conversations with adults and peers.

52-56 Months:

  • Vocabulary continues to grow, with 4,000 to 5,000 words or more.
  • Uses even more complex sentence structures with correct grammar.
  • Expresses ideas, opinions, and emotions with increasing precision.
  • Tells longer, more elaborate stories with a clear beginning, middle, and end.

56-60 Months:

  • Vocabulary continues to expand, with 5,000 to 6,000 words or more.
  • Engages in more advanced conversations, discussing abstract topics and concepts.
  • Begins to understand and use more advanced language features, such as sarcasm and humor.
  • Shows an interest in wordplay, jokes, and storytelling.

Receptive Language:

49-52 Months:

  • Understands and follows more complex instructions and directions.
  • Listens and responds appropriately during conversations.
  • Demonstrates an understanding of basic spatial concepts (e.g., in, on, under).
  • Enjoys listening to and comprehending longer stories and narratives.

52-56 Months:

  • Understands and follows instructions that involve problem-solving and sequencing.
  • Recognizes and understands more advanced spatial concepts (e.g., next to, between, above).
  • Shows an improved comprehension of complex narratives and stories.
  • Asks more detailed questions to seek information and clarification.

56-60 Months:

  • Understands and follows instructions that involve abstract or hypothetical thinking.
  • Demonstrates an advanced understanding of spatial relationships and concepts.
  • Shows an ability to make predictions about stories and events.
  • Recognizes and understands figurative language, such as idioms and metaphors.

Speech Sound Development:

49-52 Months:

  • Speech sounds continue to improve, and articulation is highly accurate.
  • Pronounces all speech sounds correctly.
  • Speech is highly intelligible to both familiar and unfamiliar listeners.

52-56 Months:

  • Demonstrates continued precision and clarity in speech sound production.
  • Uses a variety of speech sounds effectively and accurately.
  • Conversational speech is easily understood by all listeners.

56-60 Months:

  • Mastered speech sound development with clear articulation.
  • Uses more complex speech sounds and blends in words.
  • Speech is highly intelligible and easily understood by all listeners.

Social Communication:

  • Engages in cooperative play with peers and adults.
  • Initiates conversations and maintains them for longer periods.
  • Shows empathy and comfort with emotions, both their own and others’.
  • Demonstrates effective communication in various social situations.

Gross Motor Skills:

49-52 Months:

  • Demonstrates improved running and jumping skills with agility.
  • Climbs confidently on playground equipment, including more challenging structures.
  • Shows improved throwing and catching skills with greater accuracy.
  • Enjoys activities that involve hopping and skipping with increased coordination.

52-56 Months:

  • Rides a two-wheeled bicycle without training wheels.
  • Demonstrates improved jumping and hopping skills with better balance and control.
  • Climbs more complex playground structures, showcasing agility.
  • Throws a ball with precision and catches with both hands consistently.

56-60 Months:

  • Runs with increased speed and coordination.
  • Performs advanced activities that require balance and coordination, such as cartwheels or somersaults.
  • Demonstrates greater control and accuracy in throwing and catching.
  • Engages in organized sports and activities with peers.

Fine Motor Skills:

49-52 Months:

  • Draws recognizable pictures with greater detail and precision.
  • Cuts with scissors along complex lines and may attempt to cut out intricate shapes.
  • Builds intricate structures with building toys, demonstrating improved hand-eye coordination.
  • Begins to tie shoelaces with assistance.

52-56 Months:

  • Copies letters and numbers with increased accuracy.
  • Demonstrates better control and precision in fine motor tasks, such as threading and lacing.
  • Enjoys intricate arts and crafts activities, such as making detailed collages.
  • Begins to tie shoelaces independently with practice.

56-60 Months:

  • Draws complex pictures, including people, animals, and scenes, with improved detail and control.
  • Writes letters and numbers independently with recognizable forms.
  • Demonstrates advanced fine motor skills, such as intricate beadwork and detailed painting.
  • Becomes more proficient in tying shoelaces independently.

Balance and Coordination:

  • Balances on one foot for an extended duration, demonstrating improved balance.
  • Shows greater control and precision in activities that require balance, such as walking along narrow surfaces.
  • Engages in activities that involve jumping, hopping, skipping, and dancing with advanced skill and coordination.
  • Demonstrates improved hand-eye coordination in activities like catching and throwing.

Self-Care and Independence:

  • Becomes highly independent in self-care tasks like dressing and undressing.
  • Demonstrates proficiency in self-feeding with utensils, including cutting food.
  • Washes hands and brushes teeth independently with minimal supervision.
  • Achieves full independence in toileting and personal hygiene routines.

Play and Social Skills:

  • Engages in imaginative and pretend play with peers and toys, creating complex scenarios and stories.
  • Plays cooperatively with peers, sharing and following rules in games.
  • Demonstrates improved problem-solving, conflict resolution, and negotiation skills in play.
  • Enjoys a wide range of creative and active play activities, including role-playing and organized group games.

Fine Motor Skills:

49-52 Months:

  • Draws recognizable pictures with greater detail and precision.
  • Demonstrates improved hand-eye coordination in activities like building with small blocks.
  • Cuts with scissors along complex lines and may attempt to cut out intricate shapes.
  • Shows increased dexterity and control in manipulating small objects.

52-56 Months:

  • Copies letters and numbers with increased accuracy.
  • Demonstrates advanced fine motor skills, such as intricate beadwork and detailed painting.
  • Shows improved precision in threading and lacing activities.
  • Begins to write letters and numbers independently with recognizable forms.

56-60 Months:

  • Writes letters and numbers independently with improved legibility.
  • Demonstrates advanced fine motor skills in activities like sewing and using small tools.
  • Shows greater control and precision when completing intricate tasks like puzzles and construction projects.
  • Engages in activities that involve more complex manipulation of small objects and tools.

Visual-Motor Skills:

49-52 Months:

  • Enjoys completing puzzles with smaller and more complex pieces.
  • Shows improved visual-motor integration skills in activities like connecting dots and tracing.
  • Begins to understand more advanced spatial concepts and relationships.

52-56 Months:

  • Completes puzzles with greater complexity and precision.
  • Engages in activities that involve more intricate visual-motor integration, such as drawing detailed pictures.
  • Demonstrates an understanding of more advanced spatial concepts and relationships.

56-60 Months:

  • Continues to excel in visual-motor integration tasks, including complex drawing and tracing activities.
  • Enjoys activities that require planning and execution of intricate visual-motor tasks.
  • Shows proficiency in understanding and applying advanced spatial concepts.

Self-Care Skills:

49-52 Months:

  • Dresses and undresses independently, including fastening buttons, zippers, and shoelaces.
  • Demonstrates independence in self-feeding with utensils, including cutting food.
  • Washes hands and brushes teeth independently with minimal supervision.
  • Achieves full independence in toileting and personal hygiene routines.

52-56 Months:

  • Shows proficiency in self-care tasks, including dressing and undressing, with greater speed and accuracy.
  • Demonstrates improved self-feeding skills, including cutting food more effectively.
  • Washes hands and brushes teeth more effectively and independently.
  • Achieves full independence in toileting and personal hygiene routines.

56-60 Months:

  • Continues to excel in self-care tasks, with advanced skills in dressing, grooming, and personal hygiene.
  • Demonstrates independence in all aspects of self-feeding and meal preparation.
  • Achieves full mastery of toileting and personal hygiene routines, including wiping, flushing, and handwashing.

Play and Social Skills:

  • Engages in imaginative and pretend play with peers and toys, creating complex scenarios and stories.
  • Plays cooperatively with peers, sharing, following rules, and demonstrating leadership in games.
  • Demonstrates advanced problem-solving, conflict resolution, and negotiation skills in play.
  • Enjoys a wide range of creative and active play activities, including role-playing, organized group games, and sports.

These therapy milestones are general guidelines, and children develop at their own pace. If you have concerns about your child’s development, please reach out to the clinic to schedule an evaluation. Early intervention can be beneficial in addressing any concerns.