This overview covers developmental milestones for newborns to adolescents and offers suggestions for age-appropriate activities suited to the home or hospital environment. Suggested activities are based on standards for normal development. It may be necessary to adjust certain activities for children with temporary limitations due to illness or injury. In addition, children who are overwhelmed by the hospital environment may show signs of regression and therefore respond better to activities generally intended for a younger age group. For information regarding chid development please visit Healthy Steps.

Newborns (birth-6 months)
Young babies are already beginning to discover the world around them. They enjoy focusing on objects and people, especially faces. Babies are alert and will focus on your voice. They respond to sound and begin to babble. First smiles appear. There is progression from reflex to purposeful movements. Babies explore objects with their hands and mouth. It is essential their environment is safe and comforting, so they can feel as secure as possible. A sense of trust is being established at this early age.

You can:

• Comfort a crying baby by holding, rocking, or gently stroking him or her.
• Use proper support when holding the baby, especially their head.
• Talk and sing.
• Let the baby see your face while you smile and speak softly.
• Provide rattles and safe toys for the baby. (Toys with a high color contrast, such as black and white toys, are more visually stimulating to a newborn.)
• Move objects slowly from side to side, so baby's eyes can focus and follow. (Newborns focus best at a distance of 12 inches.)
• Encourage baby to grasp safe objects.
• Move infant around the room when possible, for a variety of visual stimulation.

Babies (6-12 months)
Older babies learn to sit, roll, crawl and stand. They are able to create a wider range of sounds with their voice. Babies still like to hold and mouth objects, so watch them carefully and keep potentially dangerous objects out of reach. Safety and security are very important. At this age, babies can become upset when left alone, especially when a parent leaves them.

You can:

• Provide interesting toys that are safe such as busy boxes, pop-up toys, picture books or jungle gyms.
• Play peek-a-boo or games in which people or objects disappear and then reappear.
• Roll a soft ball.
• Put objects in or take objects out of a larger container.
• Provide music or sing songs.
• Bring familiar objects from home (i.e. their favorite blanket, etc.).
• Stimulate the baby's sense of hearing through various sounds such as rattles, squeeze toys, music, whispering, rustling objects, etc.
• Call attention to noises in the environment (i.e. talking, footsteps, TV).
• Set up an infant gym. (Infants will discover with delight that their own actions cause other objects to move.)
• Repeat simple sounds to see if a baby is ready to repeat.
• Move the baby around the room when possible, for a variety of visual stimulation.

Toddlers (1-2 years)
Toddlers are on the go, exploring their surroundings. Curiosity and a short attention span move them quickly from one thing to the next. They will move about by crawling, then begin to walk and climb. Safety remains important, so provide close supervision. Language skills are improving, as they discover naming objects around them. They enjoy rhyming games and repetition. The hospital can be especially confusing at this age. Providing normal activities helps maintain a routine.

You can:

• Play with push/pull toys, especially those that make sounds.
• Blow soap bubbles to soothe a distraught toddler.
• Use puppets, dolls, and stuffed animals.
• Look at picture books or read short stories.
• Incorporate familiar toys, songs and games from home. (Parents can help provide ideas.)
• Talk with the toddler and name items being used.
• Provide toys with varied textures.
• Create a safe environment for exploration, by removing small items within reach.
• Encourage imitation. (Toddlers love to repeat phrases or mimic actions.)
• Offer several short activities, rather than a single long one.
• Show a toddler how to stack blocks. (Young toddlers may only be able to stack 2 blocks. Older toddlers may be able to stack 3 or more.)
• Encourage the toddler to point to familiar objects, including body parts.
  Have the toddler fit objects one inside of the other.

Preschoolers (3-5 years)
Preschoolers have a wonderful imagination. They continue to explore their world through active involvement. They put words together to express themselves. They seem especially interested in asking "What?" "Why?" and "How?". Many preschoolers are quite social, but very young children can be easily frightened by people they do not know. Use a soft, slow approach.

You can:

• Play actively with a ball, wheeled vehicles, etc.
• Introduce painting, play dough, markers, crayons, blunt scissors and glue. Remember to use close supervision! (This age group loves stickers.)
• Use puppets to "act out" stories.
• Read simple books. (Children this age enjoy rhyme and repetition in stories, verse and song.)
• Encourage the child to make up their own story using a book's pictures.
• Use imaginative play with telephones, dolls, cars, house, etc.
• Build with blocks.
• Put together simple puzzles.
• Listen to music and sing songs.
• Play basic matching games.
• Reinforce basic concepts-letters, sounds, numbers, counting, shapes, and colors-while you play.
• Play simple guessing games.
• Encourage movement (within limitations).
• Promote self-esteem by offering sincere praise.

Early School Age (5-9 years)
The 5 to 9-year-old has developed a relationship with the world and incorporates the skills already learned in new ways. Most times, they accept new people more easily, and are quite social. Some are still timid in new surroundings. Creative art and simple problem solving are stimulating and enjoyable for early school age children.

You can:

• Play board games.
• Teach new card games.
• Create art and crafts.
• Draw pictures, write stories, or encourage the patient to keep a journal.
• Teach a new hobby.
• Complete a more complex puzzle.
• Encourage reading.
• Set up videotapes and Nintendo.
• Build simple models.
• Design paper dolls.
• Decorate the patient's room with art projects, greeting cards, etc.
• Share a few "Knock-Knock" jokes.
• Provide activity sheets (i.e. simple word games, mazes, hidden picture finds, etc.)

Preteen (10 - 12 years)
Ten to twelve-year-olds love company. They are becoming independent, but still need support. They enjoy activities that prevent loneliness or boredom. They are very curious and ask serious questions.

You can:

• Provide arts and crafts (i.e. painting, collage, clay, glitter, ribbons, tissue paper, etc.)
• Play more complex board games, card games, or puzzles such as Uno, Monopoly, Connect 4, Clue, Checkers or Chess.
• Provide word games, mazes, and activity sheets.
• Create models from kits.
• Set up electronic or computer games.
• Teach magic tricks.
• Provide sport-related activities.
• Polish nails, style hair, etc.
• Discuss the latest fads in fashion, entertainment, etc.
• Talk about school, favorite subjects, teachers, etc.
• Inquire about family, friends, general interests and dislikes.

You can: (13-21 years)
Most adolescents love to socialize but do require some privacy. Friends are very important. They are concerned about their appearance and develop an interest in the opposite sex. They are able to think abstractly. Growing freedom and independence gives them new choices in decision-making.

You can:

• Offer arts and crafts reflecting individual interests (i.e. needlepoint, models, etc.)
• Play board games, card games, pinball, pool, video games or computer games.
• Provide music.
• Offer advanced puzzles, word searches and activity sheets.
• Polish nails, style hair, etc.
• Encourage socialization with other teens by setting up a group game, such as cards.
• Have conversations and ask about individual interests.
• Actively listen without being judgmental when talking to teens.