Vocabulary and Expressive Language:

37-40 Months:

  • Vocabulary continues to grow, with approximately 1,500 to 2,500 words.
  • Uses longer and more complex sentences, consisting of five to six words or more.
  • Demonstrates improved use of pronouns (e.g., “he,” “she,” “they”) and verb tenses (e.g., “I played,” “she is running”).
  • Tells longer and more detailed stories and shares personal experiences.
  • Asks a variety of questions, including “why,” “how,” and “what if.”

40-44 Months:

  • Vocabulary continues to expand, with 2,500 to 3,000 words or more.
  • Uses more complex sentence structures and correct grammar.
  • Engages in conversations with adults and peers, discussing a wider range of topics.
  • Begins to understand and use basic prepositions (e.g., “in,” “on,” “under”).
  • Starts to use descriptive words (e.g., colors, sizes, shapes) to provide details.

44-48 Months:

  • Vocabulary continues to grow, with 3,000 to 3,500 words or more.
  • Uses complex sentences and demonstrates a greater command of language.
  • Expresses ideas, opinions, and emotions more effectively.
  • Begins to use synonyms and antonyms.
  • Shows an increased interest in wordplay, jokes, and rhymes.

Receptive Language:

37-40 Months:

  • Understands and follows more complex instructions and directions.
  • Listens and responds appropriately during conversations.
  • Begins to understand concepts like opposites (e.g., hot/cold, big/small).
  • Enjoys listening to and comprehending longer stories and narratives.

40-44 Months:

  • Understands and follows more abstract and multi-step instructions.
  • Recognizes and understands spatial concepts (e.g., in, on, behind).
  • Demonstrates improved comprehension of stories and shows an interest in retelling them.
  • Asks more detailed questions to seek information and clarification.

44-48 Months:

  • Understands and follows instructions that involve problem-solving and sequencing (e.g., “First, put on your shoes, then brush your teeth”).
  • Shows improved comprehension of complex narratives and stories.
  • Begins to make predictions about stories and events.
  • Recognizes and understands figurative language (e.g., idioms and metaphors).

Speech Sound Development:

37-40 Months:

  • Speech sounds continue to improve, and most sounds are pronounced correctly.
  • May still have difficulty with a few speech sounds (e.g., “r,” “th,” “l”).
  • Speech is highly intelligible to familiar listeners and increasingly clear to strangers.

40-44 Months:

  • Continues to refine speech sound production and articulation.
  • Pronounces all speech sounds accurately.
  • Speech is highly intelligible to both familiar and unfamiliar listeners.

44-48 Months:

  • Demonstrates mastery of speech sounds and clear articulation.
  • Pronounces words and sentences with precision.
  • Strangers can easily understand everything the child says.

Social Communication:

  • Engages in cooperative play with peers and adults.
  • Takes turns in conversations and listens actively.
  • Shows empathy and comfort with emotions, both their own and others’.
  • Demonstrates effective communication in various social situations.

Gross Motor Skills:

37-40 Months:

  • Runs with increased coordination, speed, and agility.
  • Jumps forward with both feet, attempting to jump over small obstacles.
  • Begins to hop on one foot, although balance may be limited.
  • Pedals a tricycle independently with increasing speed and control.

40-44 Months:

  • Hops on one foot with improved balance and control.
  • Climbs more confidently on playground equipment, including ladders and slides.
  • Shows improved ability to throw and catch a ball.
  • Begins to balance on one foot for a few seconds.

44-48 Months:

  • Rides a two-wheeled bicycle with training wheels.
  • Jumps with both feet off the ground, landing with control.
  • Climbs more challenging playground structures, demonstrating increased agility.
  • Throws a ball with more accuracy and catches a ball with both hands.

Fine Motor Skills:

37-40 Months:

  • Draws basic shapes like circles and squares with increasing control.
  • Begins to cut with scissors along straight lines.
  • Shows improved hand-eye coordination when building with small blocks.
  • Dresses and undresses with assistance, putting on simple clothing items.

40-44 Months:

  • Draws more complex shapes, such as triangles and crosses.
  • Cuts with scissors along curved lines and may attempt to cut out simple shapes.
  • Displays improved precision in stacking and building with blocks.
  • Buttons and unbuttons clothing with some assistance.

44-48 Months:

  • Draws recognizable pictures like people and animals.
  • Cuts out more complex shapes and follows lines accurately with scissors.
  • Develops better control and precision in block construction.
  • Dresses and undresses independently, including fastening buttons and zippers.

Balance and Coordination:

  • Balances on one foot for a few seconds or longer.
  • Shows improved control and confidence in activities that require balance, such as walking along narrow surfaces.
  • Enjoys activities that involve jumping, hopping, and skipping, with increased skill and coordination.
  • Demonstrates better hand-eye coordination in activities like catching and throwing.

Self-Care and Independence:

  • Becomes more independent in self-care tasks like dressing and undressing.
  • Shows improved self-feeding skills with utensils.
  • Washes hands and brushes teeth with minimal assistance.
  • May be able to use the toilet independently, although some assistance may still be needed.

Social and Play Skills:

  • Engages in imaginative and pretend play, creating scenarios and stories with toys.
  • Plays cooperatively with peers and understands basic rules in games.
  • Demonstrates improved sharing, taking turns, and problem-solving in play.
  • Enjoys active and creative play, such as role-playing and building.

Fine Motor Skills:

37-40 Months:

  • Builds more complex structures with building toys, demonstrating improved hand-eye coordination.
  • Draws basic shapes with increasing precision, such as circles and squares.
  • Begins to use scissors more effectively, cutting along curved lines.
  • Enjoys threading beads onto a string or lacing cards.

40-44 Months:

  • Shows improved hand strength and dexterity for tasks like cutting along complex lines.
  • Draws recognizable pictures like simple animals and people.
  • Begins to copy letters or numbers with increasing accuracy.
  • Demonstrates better control and precision when using small tools and utensils.

44-48 Months:

  • Draws more detailed pictures with greater precision and control.
  • Copies more complex shapes, letters, and numbers.
  • Shows improved hand-eye coordination and finger control in activities like threading and lacing.
  • Demonstrates increased skill in manipulating small objects and tools.

Visual-Motor Skills:

37-40 Months:

  • Enjoys completing simple puzzles with smaller pieces.
  • Begins to follow more complex mazes and tracing activities.
  • Shows an understanding of basic spatial concepts like in/on, under/over, and next to/beside.

40-44 Months:

  • Tries more challenging puzzles with smaller pieces and increased complexity.
  • Engages in activities that involve connecting dots to create pictures.
  • Demonstrates better hand-eye coordination when completing complex mazes or tracing.

44-48 Months:

  • Completes puzzles with increasing complexity and precision.
  • Connects dots to create more detailed pictures and letters.
  • Shows improved visual-motor integration skills, drawing complex shapes and patterns.
  • Demonstrates an understanding of more advanced spatial concepts.

Self-Care Skills:

37-40 Months:

  • Dresses and undresses with assistance, putting on and taking off simple clothing items.
  • Begins to show greater independence in self-feeding with utensils.
  • Washes hands and brushes teeth with assistance, demonstrating interest and cooperation.
  • May be able to use the toilet independently with some assistance.

40-44 Months:

  • Dresses and undresses independently, including fastening buttons and zippers.
  • Demonstrates improved self-feeding skills with utensils, including cutting with supervision.
  • Washes hands and brushes teeth more effectively with minimal assistance.
  • Shows an interest in toilet training and may achieve greater independence.

44-48 Months:

  • Becomes more proficient in self-care tasks, including fastening buttons, zippers, and shoelaces.
  • Self-feeds with increased independence, using utensils effectively.
  • Washes hands and brushes teeth independently with minimal supervision.
  • Achieves greater independence in toileting and may no longer require assistance.

Play and Social Skills:

  • Engages in imaginative and pretend play, creating scenarios and stories with toys.
  • Plays cooperatively with peers, sharing and following rules in games.
  • Demonstrates improved problem-solving and conflict resolution skills in play.
  • Enjoys creative and active play, such as building, role-playing, and organizing play activities.

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.