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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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By age 8 months, most babies can sit up without support. They also figure out how to roll down to their stomachs and return to a sitting position again. Some babies are in constant motion; they'll arch their necks and look around while on their stomachs and grab at their feet or objects while on their backs. All this activity is preparing them for crawling, which is usually mastered between 7-10 months. Crawling is important for the development of integrated communication between the two sides of the brain. Some babies never crawl but rather scoot on their bottoms or move on their stomachs, like an army crawl.

Babies become increasingly more mobile during this stage; now is the time to childproof so baby can explore and discover without the possibility of injury. Baby gates are important to block off stairs or rooms that could be dangerous (such as bathrooms).

After crawling is mastered, babies begin to pull themselves up to a standing position. They then begin to take some steps while holding on to something for support. This will change into cruising around the furniture. As their balance improves, babies may gradually take a few steps without holding on. Many babies' first steps are taken around 12 months, but earlier or later than this is completely normal.

By the end of this stage, babies begin to use the pincer grasp, using the thumb and first or second finger to pick up small objects. As babies learn how to open fingers, they are able to drop and throw things. Babies also more thoroughly investigate objects by shaking them, banging them, and moving them from hand to hand. Babies are interested in objects with moving parts, such as wheels and things that open and close. They also like to poke their fingers through holes.

Babies also show a lot of growth in their language development during this period. They begin to make recognizable syllables like "ma" or "da," which eventually turn into "mama" or "dada." They can also imitate speech sounds they hear others make. By age 12 months, many babies say at least one word (other than mama and dada) clearly. They understand the meaning of no and begin to follow simple commands. Babies communicate nonverbally by pointing, crawling, or gesturing toward desired objects. They can also initiate and play gesture games, such as peek-a-boo and pat-a-cake.

During this stage, babies also learn object permanence, the concept that an object still exists when taken out of their sight. For example, if a toy is hidden under a blanket, babies will pick up the blanket and search for it. Babies also learn that objects have functions besides being just something to chew on or bang with (such as a hair brush or phone).

Separation anxiety and stranger anxiety usually begin during this period and are a normal part of babies' emotional development. Separation anxiety occurs when parents leave a babies' sight, resulting in great distress with fussing and crying. Separation anxiety usually peaks between ages 9-18 months and fades before their second birthday. Stranger anxiety is a reaction of distress with an infant encounters a stranger.

By the end of this period, most babies have reached the following milestones:

Motor Skills

• Gets in and out of a sitting position independently
• Gets on hands-and-knees position and crawls
• Pulls self up to standing position, walks holding on to furniture, stands without support and, eventually, takes a few steps without support and begins to walk
• Uses pincer grasp (thumb and first finger)
• Places objects into container and takes them out of container
• Begins to do more functional activities, such as hold a spoon or turn pages in a book

Language Skills

• Says "mama" and "dada" and uses these terms specifically referring to a parent
• Uses exclamations such as "oh-oh!"
• Tries to imitate words and may say first word
• Uses simple gestures, such as shaking head for "no" or waving for "bye-bye"
• Plays interactive gesture games, such as pat-a-cake and peek-a-boo

Social/Emotional Skills

• Easily finds hidden objects
• Uses objects correctly such as holding phone up to ear or drinking from a cup
• Is shy around strangers
• Cries when mom or dad leaves

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