A Child's Milestones Between Months 9 - 12
Heather Morris, a Registered General Nurse and a State Certified Midwife of over 25 years, provides an overview of a baby's development during the age range of 9 months and 12 months. The below report details milestones babies may be reaching at this age, advice which may be helpful to parents and, potential red flags to look out for.
Overview of Milestones Expected Between 6 and 9 Months
Motor skills: crawls or shuffles and may start to walk unsteadily.
Cognitive development and fine motor skills: holds a cup with two hands to drink; points at objects of interest.
Hearing, Speech and Language Development: uses two to three recognisable words; responds to their own name; shows recognition of familiar songs; locates sounds from any direction.
Social, Emotional and Behavioural Development: understands and responds to simple instructions; enjoys playing.
An In-depth Review of a Baby’s Development at 12 Months
By 12 months, babies are becoming increasingly active, most will be crawling or shuffling rapidly around the floor. Some may start to take a few unsteady steps, and most will be pulling themselves up to a standing position and sitting down again by holding onto furniture. They will be deliberately dropping a toy, then looking for it, as well as pointing at things of interest – usually with their index finger.
Their interest in their surroundings will be developing and when outside they will watch people, animals and even traffic with growing interest. A one-year old baby will respond to their own name and show recognition of familiar songs by trying to join in. They will babble incessantly in conversational cadences and demonstrate through their behaviour that some words and instructions are understood. At 12 months they will enjoy listening to toys that make a sound and will repeat the appropriate activity to reproduce sounds. They will drink from a lidded cup with little help and may hold a spoon to try and feed themselves (although this may be quite messy!)
Between 9 to 12 months is the peak time for babies to develop nappy rash; and it is estimated that at any one time, one in three babies will have nappy rash. A suitable barrier ointment and advice about good skincare will help protect a baby’s delicate skin.
At one year, it is worth remembering that development does not progress at the same rate in all infants and there is considerable variation in ‘typical’ ages with regard to milestones. However, most babies will follow a similar pattern of development. One example is the milestone of walking independently, children may walk between 13 months (mean age) and 18 months (97th centile). A small group of children never crawl or shuffle but go straight to independent walking, sometimes earlier than their peer group. However, further examination may be needed for infants who are not walking by 18 months to exclude any issues.
Advice which may be useful for parents
At 12 months, a baby may be: standing without help and becoming more mobile, communicating using two or three recognisable words, deliberately dropping toys and looking for them
- Try playing games with stacking toys and putting objects into containers. Playing with building blocks helps to develop their skills.
- By twelve months, a baby may enjoy supervised playing with creative toys like crayons or paints.
- Try a game of pretending to be different animals together while playing with soft toys to help develop their imagination.
- Be on the look-out for nappy rash, change nappies regularly and use a protective barrier ointment.
Health checks / interventions (9-12 months)
The Ages and Stages Questionnaire or ASQ-3, should be completed by the baby’s parents / carers before the 9 to 12-month review. The ASQ-3 is an assessment tool covering five areas: communication, gross motor, fine motor, problem solving, and personal-social. If a baby was born three or more weeks prematurely and is younger than 24 months old, subtract the number of weeks premature from the child’s actual age, to give a corrected age.
At twelve months, a baby should receive the following vaccinations: Hib/Men C booster, Pneumococcal conjugate vaccine (PCV) booster, Meningococcal B booster and
Measles, mumps and rubella (MMR).
Potential ‘red flag’ warnings (12 months)
Any of the following could indicate a ‘red flag’ warning at 12 months:
- Does not make eye contact or use facial expressions.
- Does not notice someone new.
- Does not play simple turn-taking games like peekaboo.
- Does not use gestures like pointing or waving.
- No babbled phrases that sound like talking.
- Does not feed themself with finger foods or hold their own feeding cup.
- Unable to pick up small items using their index finger and thumb.
- Cannot move a toy from one hand to another.
- No response to familiar words.
- No form of independent mobility (e.g. crawling or shuffling).
- Not pulling to stand independently and holding on for support.
It is also worth checking the ‘red flag’ warnings highlighted in previous milestones (newborns to nine months). Allowances need to be made for babies born prematurely, based on their gestational i.e. corrected age.
CF Dosman, D Andrews, KJ Goulden. Evidence-based milestone ages as a framework for developmental surveillance. Paediatr Child Health 2012;17(10):561-568.
Ajay Sharma, 2014, Mary Sheridan's From Birth to Five Years: Children's Developmental Progress 4th Edition
Morris H, The bottom line on nappy rash, British Journal of Midwifery, 2012, Vol 20, No 9
Red Flags early identification guide – birth to five years, Childrens Health Queensland hospital
/Greenbook_chapter_11_UK_Immunisation_schedule.pdf accessed 25th September 2019