{"meta":{"version":"1.0.0","built":"2026-09-28","domains":[{"code":"GM","name":"Gross motor","order":1},{"code":"FM","name":"Fine motor","order":2},{"code":"RC","name":"Receptive communication","order":3},{"code":"EC","name":"Expressive communication","order":4},{"code":"CG","name":"Cognitive","order":5},{"code":"SE","name":"Social-emotional","order":6},{"code":"AD","name":"Adaptive / self-care","order":7},{"code":"SR","name":"Sensory regulation","order":8}],"edge_types":["hard_prerequisite","typical_precursor","co_occurring","alternative_path","refines"],"evidence_grades":{"A":"published percentiles including a point at or beyond p10 and p90","B":"published percentiles, mid-range only","C":"constructed from a single threshold age","D":"expert opinion only, no normative data"},"merged_ids":{},"known_limitations":["Sensory & regulation windows are constructed, grade D throughout — the domain has no percentile sources (G-003).","Social-emotional and adaptive / self-care cap at grade C except items with Denver-II-Jimma personal-social coverage (G-001, G-002).","Fine-motor Dosman entries anchor at the 50th percentile (Dosman's stated fine-motor basis) and are constructed_from_median.","Dosman's gross-motor ages from the PDMS-2 reference are 50th-percentile ranges, so stair-climbing, running, kicking and throwing carry no Dosman referral age; CDC mention ages apply where CDC lists the skill (found in the Phase 9f audit).","Worth-raising ages come in two tiers: 40 referral ages (red flags, Dosman 90th percentiles) and 88 CDC 'mention' ages. CDC milestones are what 75% or more of children do by that age, so about 1 in 4 typically developing children miss any given one.","83 of 245 items are grade D (expert opinion only, no normative data); they are shown as such.","Denver-II-Jimma norms come from an Ethiopian sample (n=1597) and WHO windows from five countries including India; no Indian percentile norms were available (TDSC bars could not be sourced from a primary text).","Vocabulary thresholds are computed from American-English MB-CDI (Wordbank) norms; they are descriptive, not a standard for bilingual Indian children.","Citation audit: independent 25-item samples found 12% then 8.7% failures; all found errors were fixed, but not every citation was re-checked.","26 activities are original writing with no formal evidence behind them; they say so."],"screening_schedule":[{"age_months":9,"type":"general","source":"SRC-006"},{"age_months":18,"type":"general + autism (M-CHAT-R)","source":"SRC-013"},{"age_months":24,"type":"general + autism (M-CHAT-R)","source":"SRC-013"},{"age_months":36,"type":"general","source":"SRC-006"}]},"items":[{"id":"GM-001","domain":"GM","title":"Sits without support","observable":"Stays upright on the floor without hands or an adult propping, for at least a few seconds. Trunk upright, head steady.","non_examples":["propped sitting against a cushion","held in a sitting position by an adult"],"percentiles":{"1":3.8,"50":5.9,"99":9.2},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":{"months":8,"basis":"Dosman 2012 90th percentile (AIMS reference): 'Sits well'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (6.5, 8) months for 'Sits well' from the AIMS reference, whose ages are 50th and 90th percentiles; corrected in phase9f (Phase 3 had used the later chart-row age)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","posture"],"why_it_matters":"Sitting without support means the trunk muscles and balance can hold the body upright on their own, leaving both hands free. Later skills build on it directly, including “Gets into a sitting position without help” and “Maintains balance and posture while concentrating on something”. In this checklist it usually comes before “Transfers an object from one hand to the other” and “Pulls up to stand at furniture”.","sources":["SRC-001","SRC-002","SRC-004","SRC-008"]},{"id":"GM-002","domain":"GM","title":"Stands with assistance","observable":"Bears weight on both legs while holding on to a piece of furniture or an adult's hands.","non_examples":["adult holding the child fully upright with no leg loading"],"percentiles":{"1":4.8,"50":7.4,"99":11.4},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","posture"],"why_it_matters":"Standing with support shows the legs can take the body's weight while the hands steady the balance. In this checklist it usually comes before “Stands alone”.","sources":["SRC-001","SRC-006","SRC-008"]},{"id":"GM-003","domain":"GM","title":"Hands-and-knees crawling","observable":"Moves forward on hands and knees with alternating limb pattern.","non_examples":["bottom-shuffling","commando/army crawl on belly","rolling to move"],"percentiles":{"1":5.2,"50":8.3,"99":13.5},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":null,"skippable":true,"skippable_note":"WHO MGRS: a meaningful minority of typically developing children never do hands-and-knees crawling and progress directly to walking or via alternative locomotion.","corrected_age_applies":true,"tags":["motor","locomotion"],"why_it_matters":"Hands-and-knees crawling is one way of getting about that coordinates both sides of the body. “Bottom-shuffles for locomotion” is another route to the same place. Many children never do this and go on to the next skill directly.","sources":["SRC-001","SRC-004"]},{"id":"GM-004","domain":"GM","title":"Walks with assistance","observable":"Takes steps forward while holding on to furniture or an adult's hand.","non_examples":["cruising along furniture without forward locomotion"],"percentiles":{"1":5.9,"50":9.0,"99":13.7},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'Walks, holding on to furniture' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","locomotion"],"why_it_matters":"Walking with support shows the stepping pattern is in place while balance is still borrowed from a hand or furniture. In this checklist it usually comes before “Walks alone”.","sources":["SRC-001","SRC-002","SRC-004"]},{"id":"GM-005","domain":"GM","title":"Stands alone","observable":"Stands upright without holding on to anything, for at least a few seconds.","non_examples":["standing while leaning against furniture","standing while an adult holds a hand"],"percentiles":{"1":6.9,"50":10.8,"99":16.9},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","posture"],"why_it_matters":"Standing alone shows the child can balance the whole body upright over the feet without help. In this checklist it usually comes before “Walks alone”.","sources":["SRC-001","SRC-006","SRC-008"]},{"id":"GM-006","domain":"GM","title":"Walks alone","observable":"Takes several steps forward independently, without holding on.","non_examples":["a single step before falling","walking only while held"],"percentiles":{"1":8.2,"50":12.0,"99":17.6},"percentile_method":"published:SRC-001","evidence_grade":"A","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-003 — Dosman limit-age","sources":["SRC-001","SRC-004","SRC-006"],"note":"From watch-for sign RF-003 (phase9b): By 18 months, the child is not yet taking several steps independently without holding on. Independent walking has not appeared as expected — worth a paediatric review. This flag does not apply to a child who is a confirmed bottom-shuffler (an alternative motor path).","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","locomotion"],"why_it_matters":"Walking alone is independent upright travel: balance, stepping and steering all at once. Later skills build on it directly, including “Walks backwards”, “Shows awareness of drop-offs and other hazards while moving” and “Runs”. In this checklist it usually comes before “Crawls up a few stairs”, “Rises from the floor to standing without support” and “Climbs on and off a couch or chair”.","sources":["SRC-001","SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"GM-007","domain":"GM","title":"Lifts head briefly when on tummy","observable":"Momentarily raises the head off the surface when placed on the stomach. The lift is brief, a second or two, before the head lowers again.","non_examples":["turning the head to the side without lifting"],"percentiles":{"50":0.1,"75":0.4,"90":0.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Holds head up when on tummy (implies the brief lift this item describes)' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","head control"],"why_it_matters":"Lifting the head briefly on the tummy is the first work of the neck and upper back muscles against gravity. The next, finer step is “Lifts head to about 45 degrees in prone”. In this checklist it usually comes before “Head lifts with the body when pulled to sitting”.","sources":["SRC-002","SRC-008"]},{"id":"GM-008","domain":"GM","title":"Lifts head to about 45 degrees in prone","observable":"When on the stomach, lifts the head so the face is angled roughly forty-five degrees off the floor and holds it there briefly.","non_examples":["only lifts the head off the surface momentarily without holding"],"percentiles":{"25":1.6,"50":2.4,"90":2.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","head control"],"why_it_matters":"Holding the head up to about 45 degrees shows growing strength and control in the neck and upper back. The next, finer step is “Lifts head to about 90 degrees in prone”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"GM-009","domain":"GM","title":"Lifts head to about 90 degrees in prone","observable":"When on the stomach, lifts the head so the face is upright, looking straight ahead.","non_examples":["only lifts the head partway (roughly forty-five degrees)"],"percentiles":{"25":2.9,"50":3.2,"75":3.6,"90":3.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"red flag RF-001 — Dosman limit-age","sources":["SRC-004","SRC-006"],"note":"From watch-for sign RF-001 (phase9b): By 4 months, the head still drops back when the child is pulled from lying to sitting, or the head is not held steady when held upright. Head control has not appeared as expected — worth a paediatric review.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","head control"],"why_it_matters":"Lifting the head high on the tummy shows strong neck and upper-back control and gives a wider view of the room. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-008"]},{"id":"GM-010","domain":"GM","title":"Holds head steady when supported upright","observable":"When an adult holds the child upright in their arms or on their lap, the head stays steady rather than wobbling forward or to the side.","non_examples":["head bobs or falls forward when the child is held upright"],"percentiles":{"25":3.0,"50":3.3,"75":3.6,"90":3.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"red flag RF-001 — Dosman limit-age","sources":["SRC-004","SRC-006"],"note":"From watch-for sign RF-001 (phase9b): By 4 months, the head still drops back when the child is pulled from lying to sitting, or the head is not held steady when held upright. Head control has not appeared as expected — worth a paediatric review.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","head control"],"why_it_matters":"A steady head when held upright shows the neck can keep the head balanced while the body moves. In this checklist it usually comes before “Stands with assistance”.","sources":["SRC-002","SRC-008"]},{"id":"GM-011","domain":"GM","title":"Bears weight on legs when held upright","observable":"When an adult holds the child under the arms with feet touching the floor, the legs take some weight and push against the surface.","non_examples":["legs fold or collapse under the child when the feet touch the floor"],"percentiles":{"25":3.1,"50":3.4,"75":3.6,"90":3.8},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","posture"],"why_it_matters":"Bearing weight on the legs when held shows the legs are ready to push against the ground. In this checklist it usually comes before “Stands with assistance”.","sources":["SRC-008"]},{"id":"GM-012","domain":"GM","title":"Pushes chest up on forearms in prone","observable":"When on the stomach, props on the forearms so the chest lifts off the floor and the head is held up to look around.","non_examples":["only lifts the head without lifting the chest"],"percentiles":{"25":3.9,"50":4.3,"75":4.6,"90":4.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","prone"],"why_it_matters":"Pushing up on the forearms brings the shoulders and upper back into play and lifts the chest. The next, finer step is “Pushes up with straight arms in prone”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"GM-013","domain":"GM","title":"Pushes up with straight arms in prone","observable":"When on the stomach, straightens the arms so the chest and upper belly lift clear off the floor.","non_examples":["props on forearms only, elbows bent"],"percentiles":{"10":1.0,"50":3.5,"75":6.0,"90":10.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","prone"],"why_it_matters":"Pushing up on straight arms shows strong shoulders and arms that can hold the chest well off the floor. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"GM-014","domain":"GM","title":"Rolls from tummy to back","observable":"Turns from a face-down position onto the back without help.","non_examples":["rolls from back to side but does not complete a full tummy-to-back turn"],"percentiles":{"25":3.8,"50":4.4,"75":4.9,"90":5.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","rolling"],"why_it_matters":"Rolling from tummy to back is the first way a baby changes position on purpose. In this checklist it usually comes before “Rolls in both directions”.","sources":["SRC-002","SRC-008"]},{"id":"GM-015","domain":"GM","title":"Rolls in both directions","observable":"Rolls back-to-tummy in one attempt and tummy-to-back in another, at will.","non_examples":["only rolls in one direction reliably"],"percentiles":{"50":6,"90":8.5},"percentile_method":"published:SRC-004","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":8.5,"basis":"Dosman 2012 90th percentile (AIMS reference): 'Rolls both ways'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (6, 8.5) months for 'Rolls both ways' from the AIMS reference, whose ages are 50th and 90th percentiles; corrected in phase9f (Phase 3 had used the later chart-row age)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","rolling"],"why_it_matters":"Rolling both ways means the baby can move between positions and across the floor by rolling. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004"]},{"id":"GM-016","domain":"GM","title":"Head lifts with the body when pulled to sitting","observable":"When held by both hands and gently pulled from lying on the back toward sitting, the head lifts with the body rather than lagging back.","non_examples":["head hangs back behind the shoulders when the child is pulled up by the hands"],"percentiles":{"25":4.4,"50":4.9,"75":5.5,"90":6.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":5,"basis":"Dosman 2012 90th percentile (AIMS reference): 'Pulls to sit'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (3.5, 5) months for 'Pulls to sit' from the AIMS reference, whose ages are 50th and 90th percentiles; corrected in phase9f (Phase 3 had used the later chart-row age)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","head control"],"why_it_matters":"The head coming up with the body when pulled to sit shows the neck and tummy muscles working together. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004","SRC-008"]},{"id":"GM-017","domain":"GM","title":"Sits propped on hands (tripod sit)","observable":"Sits on the floor with the hands placed forward on the ground for support, forming a tripod that keeps the trunk upright for a few seconds.","non_examples":["needs an adult or a cushion to stay upright"],"percentiles":{"10":1.0,"50":3.5,"75":6.0,"90":10.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6.0,"basis":"90th percentile, gross motor; Dosman 'sits tripod'","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis outer marker sits at 6.0mo, below the highest published Denver-II-Jimma point p90=10.0mo — kept verbatim per protocol §3.4 rung 4 (no silent averaging)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","sitting"],"why_it_matters":"Sitting propped on the hands is the supported form of sitting, with the arms still helping the balance. The next, finer step is “Sits without support”.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"GM-018","domain":"GM","title":"Gets into a sitting position without help","observable":"Moves from lying on the back or stomach into a sitting position without help from an adult.","non_examples":["needs an adult to place the child upright before they can sit"],"percentiles":{"25":7.4,"50":8.3,"75":9.2,"90":10.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":11,"basis":"Dosman 2012 90th percentile (AIMS reference): 'Gets to sit'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (9, 11) months for 'Gets to sit' from the AIMS reference, whose ages are 50th and 90th percentiles; corrected in phase9f (Phase 3 had used the later chart-row age)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","sitting","transitions"],"why_it_matters":"Getting into sitting alone means the child can change position from lying or crawling to sitting. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"GM-019","domain":"GM","title":"Pulls up to stand at furniture","observable":"From sitting or crawling, uses a couch, low table, or crib rail to pull the body up to a standing position.","non_examples":["stands with an adult lifting the child up"],"percentiles":{"25":7.2,"50":8.0,"75":8.9,"90":9.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":10,"basis":"Dosman 2012 90th percentile (AIMS reference): 'Pulls to stand'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (8, 10) months for 'Pulls to stand' from the AIMS reference, whose ages are 50th and 90th percentiles; corrected in phase9f (Phase 3 had used the later chart-row age)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","standing","transitions"],"why_it_matters":"Pulling up to stand uses the arms and legs together to rise from the floor. In this checklist it usually comes before “Cruises along furniture” and “Stands alone for a couple of seconds”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"GM-020","domain":"GM","title":"Cruises along furniture","observable":"Steps sideways along a couch or low table while holding on with both hands, moving from one end to the other.","non_examples":["stands at furniture but does not step sideways","walks a few steps in the open before cruising"],"percentiles":{"10":7.0,"50":9.5,"75":12.0,"90":16.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'walks, holding on to furniture'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","locomotion"],"why_it_matters":"Cruising along furniture is stepping sideways with the hands for balance. In this checklist it usually comes before “Walks alone”.","sources":["SRC-002","SRC-006"]},{"id":"GM-021","domain":"GM","title":"Bottom-shuffles for locomotion","observable":"Moves across the floor from a sitting position by scooting on the buttocks rather than crawling on the hands and knees.","non_examples":["moves only by rolling","moves only on hands and knees"],"percentiles":{"10":4.0,"50":8.5,"75":13.0,"90":21.0},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":true,"skippable_note":"A meaningful minority of typically developing children move themselves this way instead of hands-and-knees crawling, and some skip floor locomotion altogether before walking (WHO MGRS, cited on GM-003).","corrected_age_applies":true,"tags":["motor","locomotion","alternative_path"],"why_it_matters":"Bottom-shuffling is another way some children get about before walking. “Hands-and-knees crawling” is another route to the same place. Many children never do this and go on to the next skill directly.","sources":["SRC-006"]},{"id":"GM-022","domain":"GM","title":"Crawls up a few stairs","observable":"Climbs up a few stairs on the hands and knees, moving one step at a time.","non_examples":["climbs stairs on foot"],"percentiles":{"10":6.0,"50":10.5,"75":15.0,"90":23.0},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","stairs","locomotion"],"why_it_matters":"Crawling up stairs coordinates the limbs on a slope and changing heights. In this checklist it usually comes before “Walks up stairs holding a hand or railing”.","sources":["SRC-006"]},{"id":"GM-023","domain":"GM","title":"Rises from the floor to standing without support","observable":"Gets from sitting or squatting on the floor up to standing without holding on to furniture or an adult.","non_examples":["needs to pull up on furniture to reach standing"],"percentiles":{"10":10.5,"50":13.0,"75":15.5,"90":19.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","standing","transitions"],"why_it_matters":"Rising from the floor to standing without support uses leg strength and balance through a whole change of position. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004"]},{"id":"GM-024","domain":"GM","title":"Climbs on and off a couch or chair","observable":"Gets up onto a couch or child-sized chair and back down again without help from an adult.","non_examples":["climbs on but needs help getting down"],"percentiles":{"10":13.0,"50":15.5,"75":18.0,"90":22.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","climbing"],"why_it_matters":"Climbing on and off a couch or chair shows the child can plan and control movement up and down. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"GM-025","domain":"GM","title":"Stoops to pick up an object and stands back up","observable":"While standing, bends down to pick up a toy from the floor and returns to standing without sitting down or holding on.","non_examples":["sits down to get the toy","holds on to furniture to get back up"],"percentiles":{"25":11.6,"50":13.2,"75":14.8,"90":16.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","standing","balance"],"why_it_matters":"Stooping to pick something up and standing again shows balance while the body bends and straightens. In this checklist it usually comes before “Balances briefly on one foot”.","sources":["SRC-008"]},{"id":"GM-026","domain":"GM","title":"Walks up stairs holding a hand or railing","observable":"Climbs a flight of stairs on both feet, one step at a time, holding an adult's hand or the railing.","non_examples":["crawls up stairs on hands and knees","walks up stairs alternating feet without support"],"percentiles":{"25":13.9,"50":16.9,"75":19.6,"90":22.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 24mo 'walks (not climbs) up a few stairs with or without help'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","stairs","locomotion"],"why_it_matters":"Walking up stairs with a hand or rail shows the child can lift the body step by step with some help. The next, finer step is “Walks up stairs alternating feet without railing”.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"GM-027","domain":"GM","title":"Walks backwards","observable":"Takes several steps in reverse, walking backwards while standing upright.","non_examples":["takes one step back before losing balance"],"percentiles":{"25":11.9,"50":14.9,"75":17.4,"90":19.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","locomotion","balance"],"why_it_matters":"Walking backwards shows balance and stepping that no longer depend on seeing where the feet go. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-008"]},{"id":"GM-028","domain":"GM","title":"Runs","observable":"Moves forward with a running gait — both feet leaving the ground briefly between steps.","non_examples":["fast walking with both feet always in contact with the ground"],"percentiles":{"25":14.4,"50":16.6,"75":18.9,"90":21.2},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","locomotion"],"why_it_matters":"Running is fast walking with a moment when both feet leave the ground. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"GM-029","domain":"GM","title":"Kicks a ball forward","observable":"Kicks a ball with one foot so that it travels forward at least a short distance.","non_examples":["walks into the ball without swinging a leg"],"percentiles":{"25":14.2,"50":17.6,"75":21.0,"90":24.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","ball skills"],"why_it_matters":"Kicking a ball means balancing on one leg for a moment while the other swings. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"GM-030","domain":"GM","title":"Throws a ball overhand","observable":"Raises a small ball above the shoulder and throws it forward with an overhand motion, so it travels away from the body.","non_examples":["drops or underhand-tosses the ball","releases the ball without any forward movement"],"percentiles":{"25":16.9,"50":22.1,"75":27.2,"90":32.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","ball skills"],"why_it_matters":"Throwing overhand coordinates the arm, trunk and balance to send something forward. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004","SRC-008"]},{"id":"GM-031","domain":"GM","title":"Jumps up with both feet leaving the ground","observable":"Jumps in place with both feet leaving the floor at the same time and landing again.","non_examples":["lifts one foot at a time","steps down from a low surface without a jump"],"percentiles":{"25":24.0,"50":27.0,"75":31.0,"90":35.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","jumping"],"why_it_matters":"Jumping with both feet off the ground takes leg power and landing balance. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"GM-032","domain":"GM","title":"Walks up stairs alternating feet without railing","observable":"Climbs a flight of stairs alternating feet on each step, without holding a railing or a hand.","non_examples":["places both feet on each step before advancing","needs a hand or railing to alternate feet"],"percentiles":{"10":33.0,"50":35.5,"75":38.0,"90":42},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","stairs","locomotion"],"why_it_matters":"Walking up stairs with alternating feet, without a rail, shows adult-like stair climbing. In this checklist it usually comes before “Walks down stairs one step at a time without railing”.","sources":["SRC-004"]},{"id":"GM-033","domain":"GM","title":"Walks down stairs one step at a time without railing","observable":"Walks down a flight of stairs placing both feet on each step, without holding a railing or a hand.","non_examples":["needs an adult hand or the railing to come down"],"percentiles":{"10":23.0,"50":25.5,"75":28.0,"90":32.0},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","stairs","locomotion"],"why_it_matters":"Walking down stairs without a rail shows balance and control while stepping down. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"GM-034","domain":"GM","title":"Pedals a tricycle","observable":"Sits on a small tricycle and pushes the pedals with both feet to move forward.","non_examples":["propels the tricycle by pushing off the ground with the feet"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":36.0,"basis":"90th percentile, gross motor","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","coordination"],"why_it_matters":"Pedalling a tricycle coordinates both legs in turn while steering. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"GM-035","domain":"GM","title":"Balances briefly on one foot","observable":"Stands on one foot for about a second without holding on.","non_examples":["stands on one foot while holding a hand or furniture"],"percentiles":{"25":23.4,"50":28.9,"75":33.0,"90":37.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","balance"],"why_it_matters":"Balancing on one foot briefly shows the body can hold steady on a small base. The next, finer step is “Balances on each foot for two seconds”.","sources":["SRC-008"]},{"id":"GM-036","domain":"GM","title":"Stands alone for a couple of seconds","observable":"Lets go of support and stays standing, without holding on, for about two seconds before sitting down or grabbing hold again.","non_examples":["stands only while holding furniture or a hand","stands alone for ten seconds or more (that is the next skill, standing alone)"],"percentiles":{"25":8.6,"50":9.7,"75":10.7,"90":11.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","standing","balance"],"why_it_matters":"Standing alone for a couple of seconds is the first moment of standing without any support. The next, finer step is “Stands alone”.","sources":["SRC-008"]},{"id":"GM-037","domain":"GM","title":"Balances on each foot for two seconds","observable":"Stands on one foot without holding on for about two seconds, then does the same on the other foot.","non_examples":["lifts a foot only while holding on","balances on one foot but not the other"],"percentiles":{"25":23.9,"50":31.2,"75":36.4,"90":41.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","balance"],"why_it_matters":"Balancing on each foot for two seconds shows steady one-leg balance on both sides. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"GM-038","domain":"GM","title":"Moves both arms and both legs","observable":"Kicks and waves both arms and both legs, with each side moving about as much as the other.","non_examples":["one arm or leg moves much less than the other side","lies mostly still even when awake and alert"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Moves both arms and both legs' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","symmetry"],"why_it_matters":"Moving both arms and both legs actively shows the body's movement system is working on both sides. In this checklist it usually comes before “Swipes at a toy with an arm” and “Lifts head to about 90 degrees in prone”.","sources":["SRC-002"]},{"id":"FM-001","domain":"FM","title":"Holds an object briefly when placed in the hand","observable":"When an adult places a rattle or small toy into the child's open palm, the fingers close around it and the object stays held for at least a few seconds.","non_examples":["object drops immediately once the adult lets go"],"percentiles":{"25":2.4,"50":3.0,"75":3.6,"90":4.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'holds a toy when you put it in his hand'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp"],"why_it_matters":"Holding an object placed in the hand is the first way a baby keeps hold of the world. In this checklist it usually comes before “Reaches for and grasps an offered object”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"FM-002","domain":"FM","title":"Opens the hand from a fist briefly","observable":"The hands, which are often held in a fist in the earliest weeks, open and relax for at least a few seconds at a time.","non_examples":["hands stay tightly closed at every observation"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'opens hands briefly'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","hand posture"],"why_it_matters":"Opening the hand from a fist is the start of hands that can reach, hold and let go. In this checklist it usually comes before “Reaches for and grasps an offered object”.","sources":["SRC-002"]},{"id":"FM-003","domain":"FM","title":"Brings the hands together at the midline","observable":"While lying on the back or being held, brings both hands together in front of the body at the midline, sometimes clasping the fingers.","non_examples":["hands stay to the sides of the body without meeting"],"percentiles":{"25":2.5,"50":3.1,"75":3.7,"90":4.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","midline"],"why_it_matters":"Bringing the hands together at the middle is the first time the two hands work together. In this checklist it usually comes before “Brings the hands to the mouth” and “Reaches for and grasps an offered object”.","sources":["SRC-004","SRC-008"]},{"id":"FM-004","domain":"FM","title":"Brings the hands to the mouth","observable":"Deliberately moves one or both hands to the mouth — often mouthing the fingers or a held object.","non_examples":["only touches the face by accident during flailing"],"percentiles":{"10":1,"50":2.5,"75":4,"90":6},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'brings hands to mouth'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","hand-to-mouth"],"why_it_matters":"Bringing the hands to the mouth is a way of exploring and, for many babies, of calming. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"FM-005","domain":"FM","title":"Reaches for and grasps an offered object","observable":"Extends an arm toward a rattle, toy, or finger held in front of the child, closes the hand around it, and holds on.","non_examples":["swipes at objects without closing the hand","watches the object without reaching"],"percentiles":{"25":4.2,"50":4.7,"75":5.2,"90":5.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","reach","grasp"],"why_it_matters":"Reaching for and grasping an object joins seeing and moving: the hand goes where the eyes look. Later skills build on it directly, including “Holds a small object in each hand at the same time”. The next, finer step is “Rakes a small object toward the self with the fingers”.","sources":["SRC-004","SRC-008"]},{"id":"FM-006","domain":"FM","title":"Shakes a rattle held in the hand","observable":"With a rattle placed in the hand, moves the arm to make the rattle sound, rather than simply holding it still.","non_examples":["holds the rattle but does not move it"],"percentiles":{"10":3.5,"50":6,"75":8.5,"90":12.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","manipulation"],"why_it_matters":"Shaking a rattle shows the baby can hold on while moving the arm, and hear the result. In this checklist it usually comes before “Repeats an action to make something happen again”.","sources":["SRC-004"]},{"id":"FM-007","domain":"FM","title":"Holds a small object in each hand at the same time","observable":"When two blocks or small objects are offered, holds one in each hand at the same time without dropping the first to take the second.","non_examples":["drops the first object when offered a second"],"percentiles":{"25":5.8,"50":6.9,"75":8.2,"90":9.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp","bimanual"],"why_it_matters":"Holding something in each hand shows the two hands can each keep hold at once. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004","SRC-008"]},{"id":"FM-008","domain":"FM","title":"Rakes a small object toward the self with the fingers","observable":"Sweeps a small object — a raisin, cheerio, or small bead placed on a surface — toward the body using the whole hand curled inward, before a pincer grasp has developed.","non_examples":["ignores small objects","grasps only with the whole palm"],"percentiles":{"25":5.3,"50":5.9,"75":6.4,"90":6.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":9,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 9 months (CDC 9mo 'uses fingers to rake food towards himself'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp"],"why_it_matters":"Raking small objects toward the body is the first way to pick up small things. The next, finer step is “Picks up a small object with an early (inferior) pincer”.","sources":["SRC-002","SRC-006","SRC-008"]},{"id":"FM-009","domain":"FM","title":"Transfers an object from one hand to the other","observable":"Passes a small toy or block from one hand into the other at the midline without dropping it.","non_examples":["drops the object between hands","always uses the same hand"],"percentiles":{"25":6.2,"50":7.4,"75":8.5,"90":9.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":9,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 9 months (CDC 9mo 'moves things from one hand to her other hand'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp","bimanual"],"why_it_matters":"Passing an object from hand to hand means both hands can work on the same object in turn. In this checklist it usually comes before “Bangs two small blocks together”.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"FM-010","domain":"FM","title":"Picks up a small object with an early (inferior) pincer","observable":"Picks up a raisin or small bit of food between the thumb and the side of the curled index finger — a first pincer grasp, not yet with the fingertip pads.","non_examples":["picks up only with the whole hand","cannot pick up small objects"],"percentiles":{"25":6.5,"50":7.5,"75":8.7,"90":9.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'picks things up between thumb and pointer finger'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp","pincer"],"why_it_matters":"An early pincer uses the thumb against the side of the fingers to pick up small things. The next, finer step is “Uses a mature pincer with the pads of thumb and index finger”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"FM-011","domain":"FM","title":"Bangs two small blocks together","observable":"Holds a block in each hand and brings them together to make a sound, repeatedly.","non_examples":["holds blocks but does not bring them together"],"percentiles":{"25":7.4,"50":9.3,"75":11.3,"90":13.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","bimanual"],"why_it_matters":"Banging two blocks together means each hand holds something and the two meet on purpose. In this checklist it usually comes before “Stacks a tower of two cubes”.","sources":["SRC-008"]},{"id":"FM-012","domain":"FM","title":"Uses a mature pincer with the pads of thumb and index finger","observable":"Picks up a small object with the tips of the thumb and index finger meeting pad-to-pad — a neat, refined pincer.","non_examples":["still uses the side of the curled index finger"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","grasp","pincer"],"why_it_matters":"A mature pincer uses the fingertips to pick up very small things precisely. In this checklist it usually comes before “Feeds self finger foods reliably”.","sources":["SRC-006"]},{"id":"FM-013","domain":"FM","title":"Releases a small object into a container","observable":"Voluntarily lets go of a block or small object so that it falls into a cup or bowl.","non_examples":["opens the hand only when the adult pries it open","drops the object beside the container"],"percentiles":{"25":8.7,"50":10.2,"75":11.7,"90":13.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'Puts something in a container, like a block in a cup' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","release"],"why_it_matters":"Letting go of an object into a container is controlled release, the other half of grasping. The next, finer step is “Dumps a small object out of a container when shown”. In this checklist it usually comes before “Fills a container and empties it, over and over” and “Fits shapes into a shape sorter or matching holes”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"FM-014","domain":"FM","title":"Dumps a small object out of a container when shown","observable":"After watching an adult tip a small object out of a cup or bottle, tips the container themselves to make it come out.","non_examples":["turns the container over without emptying it","reaches into the container to fish the object out"],"percentiles":{"25":10.9,"50":13.5,"75":16.0,"90":18.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","manipulation"],"why_it_matters":"Tipping objects out of a container means turning the container over on purpose. In this checklist it usually comes before “Fills a container and empties it, over and over”.","sources":["SRC-008"]},{"id":"FM-015","domain":"FM","title":"Scribbles with a crayon or marker","observable":"Makes marks on paper with a crayon or marker held in the hand — the marks may be random loops or lines, not letters.","non_examples":["only bangs the crayon on the paper","only mouths the crayon"],"percentiles":{"25":10.7,"50":13.4,"75":16.0,"90":18.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'scribbles'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","graphomotor"],"why_it_matters":"Scribbling is the first use of a tool to make a mark. In this checklist it usually comes before “Imitates a vertical line on paper”.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"FM-016","domain":"FM","title":"Turns pages in a board book","observable":"Turns board-book pages, sometimes several at a time, when looking at a book with an adult.","non_examples":["opens and closes the cover only","cannot separate pages"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","manipulation"],"why_it_matters":"Turning board-book pages uses the fingers to separate and move a single stiff page. The next, finer step is “Turns book pages one at a time”.","sources":["SRC-006"]},{"id":"FM-017","domain":"FM","title":"Stacks a tower of two cubes","observable":"Places one block on top of another so that the second stays on top for at least a moment.","non_examples":["knocks the first block over when placing the second"],"percentiles":{"25":12.6,"50":15.6,"75":18.3,"90":21.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","construction"],"why_it_matters":"Stacking two cubes means placing one object on another and letting go gently. The next, finer step is “Stacks a tower of four cubes”.","sources":["SRC-004","SRC-008"]},{"id":"FM-018","domain":"FM","title":"Fits shapes into a shape sorter or matching holes","observable":"Fits a simple shape — a circle, square, or triangle — through the matching hole in a shape sorter or lid.","non_examples":["only puts pieces on top of the sorter","forces pieces into the wrong hole"],"percentiles":{"10":15.5,"50":18,"75":20.5,"90":24.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","problem solving"],"why_it_matters":"Fitting shapes into matching holes joins hand control with seeing how shapes match. In this checklist it usually comes before “Twists lids off jars or turns door knobs”.","sources":["SRC-004"]},{"id":"FM-019","domain":"FM","title":"Stacks a tower of four cubes","observable":"Places four blocks on top of one another so the tower stays standing for at least a moment.","non_examples":["tower falls before the fourth block goes on"],"percentiles":{"25":16.4,"50":19.3,"75":22.2,"90":25.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","construction"],"why_it_matters":"Stacking four cubes needs steadier placing and release than two. The next, finer step is “Stacks a tower of six cubes”.","sources":["SRC-008"]},{"id":"FM-020","domain":"FM","title":"Stacks a tower of six cubes","observable":"Places six blocks on top of one another so the tower stays standing for at least a moment.","non_examples":["cannot balance a fifth or sixth block"],"percentiles":{"25":19.7,"50":23.1,"75":26.6,"90":30.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","construction"],"why_it_matters":"Stacking six cubes shows careful placing and steady release. The next, finer step is “Stacks a tower of eight cubes”.","sources":["SRC-004","SRC-008"]},{"id":"FM-021","domain":"FM","title":"Imitates a vertical line on paper","observable":"After watching an adult draw a vertical line, draws one on paper — approximately straight and up-and-down, not just a scribble.","non_examples":["draws a random scribble in response","draws a horizontal or curved line"],"percentiles":{"25":25.9,"50":32.4,"75":37.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","graphomotor"],"why_it_matters":"Imitating a vertical line is the first controlled stroke with a crayon. The next, finer step is “Copies a horizontal line”.","sources":["SRC-004","SRC-008"]},{"id":"FM-022","domain":"FM","title":"Stacks a tower of eight cubes","observable":"Places eight blocks on top of one another so the tower stays standing for at least a moment.","non_examples":["tower falls before the seventh or eighth block goes on"],"percentiles":{"25":22.1,"50":29.4,"75":35.0,"90":40.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","construction"],"why_it_matters":"Stacking eight cubes is a small step up in steadiness from six. The next, finer step is “Stacks a tower of ten cubes”.","sources":["SRC-008"]},{"id":"FM-023","domain":"FM","title":"Stacks a tower of ten cubes","observable":"Places ten blocks on top of one another so the tower stays standing for at least a moment.","non_examples":["tower falls before the ninth or tenth block goes on"],"percentiles":{"10":31.5,"50":36,"75":40.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","construction"],"why_it_matters":"Stacking ten cubes shows very steady placing and release. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"FM-024","domain":"FM","title":"Copies a horizontal line","observable":"After being shown a horizontal line drawn by an adult, draws one on paper — approximately straight and side-to-side.","non_examples":["draws a vertical or curved line instead","draws a random scribble"],"percentiles":{"10":31.5,"50":36,"75":40.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","graphomotor"],"why_it_matters":"Copying a horizontal line is a second controlled stroke direction. The next, finer step is “Copies a circle”.","sources":["SRC-004"]},{"id":"FM-025","domain":"FM","title":"Copies a circle","observable":"After being shown a circle drawn by an adult, draws a roughly closed loop on paper.","non_examples":["draws an open curved line that does not close","draws a scribble"],"percentiles":{"10":31.5,"50":36,"75":40.5},"percentile_method":"constructed_from_median:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","graphomotor"],"why_it_matters":"Copying a circle joins strokes into a closed shape. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"FM-026","domain":"FM","title":"Turns book pages one at a time","observable":"When looking at a book with an adult, turns the pages one at a time rather than in clumps.","non_examples":["turns several pages at once","cannot separate pages"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'turns book pages, one at a time'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","manipulation"],"why_it_matters":"Turning book pages one at a time needs fine finger control on thin pages. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-002","SRC-006"]},{"id":"FM-027","domain":"FM","title":"Twists lids off jars or turns door knobs","observable":"Uses the hands to twist and turn — unscrewing a lid, turning a knob or dial — as a coordinated wrist and finger movement.","non_examples":["pulls at the lid without turning"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'uses hands to twist things, like turning doorknobs or unscrewing lids'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["motor","manipulation"],"why_it_matters":"Twisting lids or turning knobs uses a rotating movement of the wrist and fingers. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-002","SRC-006"]},{"id":"FM-028","domain":"FM","title":"Swipes at a toy with an arm","observable":"Swings an arm toward a toy held or hung within reach, batting at it even if the hand does not close on it.","non_examples":["watches the toy without moving the arms toward it","a reach that ends in a grasp (that is the next skill, FM-005)"],"percentiles":{"10":1,"50":2.5,"75":4,"90":6},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'Uses his arm to swing at toys' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["fine-motor","reaching"],"why_it_matters":"Swiping at a toy is the first aimed arm movement toward something seen. In this checklist it usually comes before “Works to obtain a toy just out of reach” and “Reaches for and grasps an offered object”.","sources":["SRC-002"]},{"id":"FM-029","domain":"FM","title":"Holds something in one hand while working on it with the other","observable":"Steadies an object with one hand while the other hand does a different job on it, such as holding a container and pulling off the lid.","non_examples":["both hands do the same thing at once","puts the object down to use it one-handed"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 24mo 'Holds something in one hand while using the other hand; for example, holding a container and taking the lid off' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["fine-motor","bimanual"],"why_it_matters":"Holding with one hand while working with the other means the two hands do different jobs together. In this checklist it usually comes before “Twists lids off jars or turns door knobs”.","sources":["SRC-002"]},{"id":"RC-001","domain":"RC","title":"Reacts to loud sounds","observable":"Startles, blinks, or otherwise reacts to a sudden loud sound — a clap, a slamming door, a horn — from an early age.","non_examples":["no observable response to any loud sound"],"percentiles":{"25":0.0,"50":0.0,"75":0.0,"90":0.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":3,"basis":"red flag RF-020 — Rourke / CDC milestone","sources":["SRC-006","SRC-002","SRC-004"],"note":"From watch-for sign RF-020 (phase9b): By 3 months, the child does not startle, blink, or otherwise react to sudden loud sounds — a clap, a slammed door, a shout. Response to loud sound has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","hearing"],"why_it_matters":"Reacting to loud sounds shows the baby is hearing. In this checklist it usually comes before “Turns the head toward a sound or a voice”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"RC-002","domain":"RC","title":"Calms when spoken to or picked up","observable":"Quiets, softens crying, or becomes still when a familiar adult picks the child up or speaks gently.","non_examples":["cannot be soothed by adult voice or touch on most occasions"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'calms down when spoken to or picked up'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","social-response"],"why_it_matters":"Calming to a voice or being picked up shows the baby is taking in and responding to caregivers. It tends to appear in the same period as “Shows recognition of a familiar adult” and “Quiets when rocked, held, or swaddled”.","sources":["SRC-002","SRC-005","SRC-006"]},{"id":"RC-003","domain":"RC","title":"Turns the head toward a sound or a voice","observable":"When a rattle sounds out of view or an adult speaks off to one side, the head turns toward the source.","non_examples":["no orienting to sounds coming from outside the visual field"],"percentiles":{"25":3.7,"50":4.3,"75":4.8,"90":5.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","auditory attention"],"why_it_matters":"Turning toward a sound or voice shows the baby can locate where a sound comes from. In this checklist it usually comes before “Looks at the person who is talking” and “Responds to their own name”.","sources":["SRC-002","SRC-006","SRC-008"]},{"id":"RC-004","domain":"RC","title":"Looks at the person who is talking","observable":"When an adult is talking, the child looks at the adult's face — orienting to the speaker rather than just the sound.","non_examples":["gazes past the speaker or looks away when spoken to"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","social-attention"],"why_it_matters":"Looking at the person who is talking links a voice with a face. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004"]},{"id":"RC-005","domain":"RC","title":"Responds to their own name","observable":"Turns, looks up, or stops what they are doing when a familiar adult calls the child's name.","non_examples":["no response to name being called on repeated tries"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"red flag RF-021 — Dosman limit-age","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-021 (phase9b): By 12 months, the child does not turn, look up, or stop what they are doing when a familiar adult calls their name from nearby. Name response has not appeared as expected — this can be a hearing marker or an early autism marker. This sits inside the published range (p90 = 13 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","auditory attention"],"why_it_matters":"Responding to their own name shows the child recognises a sound pattern that means them. In this checklist it usually comes before “Understands 'no' and pauses or stops”, “Follows the adult's gaze to a shared object (joint attention)” and “Looks at a familiar object when it is named”.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"RC-006","domain":"RC","title":"Understands 'no' and pauses or stops","observable":"When an adult says 'no' as the child reaches for something not allowed, the child pauses, looks up, or stops the action.","non_examples":["shows no change in behaviour when 'no' is said clearly"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'understands \"no\" (pauses briefly or stops when you say it)'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Understanding 'no' shows a word can change what the child is about to do. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004"]},{"id":"RC-007","domain":"RC","title":"Follows the adult's gaze to a shared object (joint attention)","observable":"When a familiar adult looks or points at something out of reach, the child looks at the same object rather than at the adult's hand or face.","non_examples":["stares at the adult's face without shifting to the referent"],"percentiles":{"10":8,"50":10.5,"75":13,"90":17},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-022 — M-CHAT-R/F screening","sources":["SRC-013"],"note":"From watch-for sign RF-022 (phase9b): By 18 months, the child does not follow an adult's look or point to notice an out-of-reach object, and does not look at the adult, at the object, and back to check attention is shared. Joint attention has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","joint attention"],"why_it_matters":"Following another person's gaze means sharing attention on the same thing (joint attention). In this checklist it usually comes before “Shares interest by giving or showing an object” and “Points to show or share something interesting (declarative pointing)”.","sources":["SRC-005","SRC-006"]},{"id":"RC-008","domain":"RC","title":"Enjoys game routines such as peek-a-boo or pat-a-cake","observable":"Reacts with pleasure — smiles, anticipates the next step, holds out hands — during a familiar routine like peek-a-boo or pat-a-cake.","non_examples":["no anticipation or reaction to repeated game routines"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo (listed in Social/Emotional) 'plays games with you, like pat-a-cake'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","routine"],"why_it_matters":"Enjoying game routines shows the child knows how a familiar exchange goes and looks forward to its parts. It tends to appear in the same period as “Plays clapping and gesture games with an adult” and “Initiates a familiar game routine”.","sources":["SRC-002","SRC-006"]},{"id":"RC-009","domain":"RC","title":"Understands simple routine questions such as 'where is the ball?'","observable":"In response to a familiar routine question (like 'where is the ball?' or 'where is daddy?'), the child looks toward or moves toward the named object or person.","non_examples":["no look or move toward the object even when the question is familiar"],"percentiles":{"10":8,"50":10.5,"75":13,"90":17},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Understanding simple routine questions shows words are linking to things the child knows. In this checklist it usually comes before “Follows a one-step direction paired with a gesture”.","sources":["SRC-004","SRC-006"]},{"id":"RC-010","domain":"RC","title":"Looks at a familiar object when it is named","observable":"When an adult names a familiar object in view — 'look at the dog' — the child looks at that object rather than another.","non_examples":["looks at whatever the adult is looking at rather than what is named"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'looks at a familiar object when you name it'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Looking at a familiar object when it is named shows the child understands its name. In this checklist it usually comes before “Attends to a book while being read to” and “Understands two action words”.","sources":["SRC-002"]},{"id":"RC-011","domain":"RC","title":"Attends to a book while being read to","observable":"Sits with an adult and looks at book pages during a short reading — attending for a few pages rather than turning away immediately.","non_examples":["walks or crawls away as soon as the book opens","only wants to close the book"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo (Social/Emotional section) 'looks at a few pages in a book with you'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","joint attention","book"],"why_it_matters":"Attending to a book being read shows the child can hold attention on pictures and talk together. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"RC-012","domain":"RC","title":"Follows a one-step direction paired with a gesture","observable":"When an adult gives a one-step direction — 'give me the toy' — while also holding out a hand, the child completes the action.","non_examples":["needs the adult to guide the hand to complete the direction"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'follows directions given with both a gesture and words'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Following a direction with a gesture shows the child understands a request with help from the hand signal. The next, finer step is “Follows a one-step direction without a gesture”. In this checklist it usually comes before “Cooperates during daily care routines with help”.","sources":["SRC-002"]},{"id":"RC-013","domain":"RC","title":"Follows a one-step direction without a gesture","observable":"When an adult gives a one-step direction with words only — no pointing or gesture — the child completes the action.","non_examples":["needs a gesture cue every time","guesses the action from context rather than the words"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'follows one-step directions without any gestures, like giving you the toy when you say, \"Give it to me.\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Following a direction without a gesture shows the child understands the words alone. The next, finer step is “Follows a two-step direction”. In this checklist it usually comes before “Cooperates with simple routines when asked”.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"RC-014","domain":"RC","title":"Points to at least two body parts on request","observable":"When asked 'where is your nose?' or similar, the child touches or points to the named body part on themselves, doing this for at least two different body parts.","non_examples":["only touches the body part after the adult demonstrates"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'points to at least two body parts when you ask him to show you'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","body parts"],"why_it_matters":"Pointing to body parts on request shows the child understands their names. The next, finer step is “Points to six body parts on request”.","sources":["SRC-002","SRC-006"]},{"id":"RC-015","domain":"RC","title":"Points to six body parts on request","observable":"When asked in turn 'where is your nose? your ear? your foot? …', the child correctly points to six named body parts.","non_examples":["knows one or two body parts but not six"],"percentiles":{"25":20.3,"50":23.0,"75":25.6,"90":28.2},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","body parts"],"why_it_matters":"Pointing to six body parts shows a wider set of understood names. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004","SRC-008"]},{"id":"RC-016","domain":"RC","title":"Points to two pictures in a book on request","observable":"When an adult points to a page in a picture book and asks 'where is the bear?' (or a similar familiar picture), the child points to the correct picture, doing this for at least two different named pictures.","non_examples":["points at random","always points at the same picture"],"percentiles":{"25":20.8,"50":24.0,"75":27.2,"90":30.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'points to things in a book when you ask, like \"Where is the bear?\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","book"],"why_it_matters":"Pointing to pictures on request shows the child links words to pictures, not only to real things. The next, finer step is “Points to four pictures in a book on request”. In this checklist it usually comes before “Points to a named color”.","sources":["SRC-002","SRC-008"]},{"id":"RC-017","domain":"RC","title":"Points to four pictures in a book on request","observable":"When asked in turn to point to four different named pictures in a familiar book, the child correctly points to each.","non_examples":["can point to one or two but not four different named pictures"],"percentiles":{"25":25.9,"50":31.0,"75":35.9,"90":40.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","book"],"why_it_matters":"Pointing to four pictures on request shows a larger picture vocabulary. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"RC-018","domain":"RC","title":"Understands two action words","observable":"When asked 'who is sleeping?' or 'who is running?' about pictures or dolls, the child points to or acts out the correct action for at least two different action words.","non_examples":["only understands nouns and body parts, not action words"],"percentiles":{"25":24.5,"50":29.5,"75":34.4,"90":39.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","verbs"],"why_it_matters":"Understanding action words shows the child understands words for doing, not only for things. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"RC-019","domain":"RC","title":"Follows a two-step direction","observable":"When an adult gives a two-step direction — 'pick up your shoes and put them in the closet' — the child completes both steps in order.","non_examples":["completes only one of the two steps","needs a second prompt for the second step every time"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo (Cognitive section) 'follows two-step instructions like \"Put the toy down and close the door.\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","multi-step"],"why_it_matters":"Following a two-step direction means holding two parts of a request in mind. In this checklist it usually comes before “Understands common prepositions such as 'in' and 'on'”.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"RC-020","domain":"RC","title":"Points to a named color","observable":"When asked 'which one is red?' about a set of crayons or objects, the child points to the correct colour, for at least one colour.","non_examples":["points at random","always points at the same object regardless of colour named"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo (Cognitive section) 'shows he knows at least one color, like pointing to a red crayon when you ask, \"Which one is red?\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","colour"],"why_it_matters":"Pointing to a named colour shows the child understands colour words. In this checklist it usually comes before “Understands two descriptive words”.","sources":["SRC-002"]},{"id":"RC-021","domain":"RC","title":"Understands common prepositions such as 'in' and 'on'","observable":"When asked 'put the block in the cup' or 'put the toy on the table', the child places the object at the correct location — showing comprehension of the preposition.","non_examples":["places the object anywhere regardless of the preposition"],"percentiles":{"25":30.8,"50":37.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Understanding 'in' and 'on' shows the child understands words for where things are. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"RC-022","domain":"RC","title":"Understands two descriptive words","observable":"When asked 'which one is the big one?' or 'which one is tired?', the child correctly identifies the object matching the adjective, for at least two different adjectives.","non_examples":["points at random","only understands one adjective"],"percentiles":{"25":30.9,"50":35.1,"75":39.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension"],"why_it_matters":"Understanding descriptive words shows the child understands words for what things are like. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"RC-023","domain":"RC","title":"Understands about fifty different words","observable":"By going through a common-words checklist together, a parent can identify roughly fifty different words the child understands — names of family members, familiar objects, routine phrases and simple requests.","non_examples":["parent recognizes only a handful of understood words","child only responds to their own name and one or two phrases"],"percentiles":{"25":8.46,"50":10.84,"75":12.88,"90":15.37},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","vocabulary"],"why_it_matters":"Understanding about fifty words is an early understood vocabulary. The next, finer step is “Understands about one hundred different words”. In this checklist it usually comes before “Vocabulary of about fifty words”.","sources":["SRC-009"]},{"id":"RC-024","domain":"RC","title":"Understands about one hundred different words","observable":"A parent can identify roughly one hundred different words the child understands across daily life — the words they respond to cover most everyday objects, routines and people in the child's world.","non_examples":["understood vocabulary appears limited to family members and a handful of objects"],"percentiles":{"10":8.82,"25":11.1,"50":14.02,"75":15.51},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","vocabulary"],"why_it_matters":"Understanding about a hundred words shows a growing understood vocabulary. The next, finer step is “Understands about two hundred different words”. In this checklist it usually comes before “Says about one hundred different words”.","sources":["SRC-009"]},{"id":"RC-025","domain":"RC","title":"Understands about two hundred different words","observable":"A parent can identify roughly two hundred different words the child understands, well beyond immediate family and objects — includes action words, descriptions, and words used in play and picture books.","non_examples":["understood vocabulary appears limited mostly to nouns"],"percentiles":{"10":12.69,"25":14.57,"50":17.23},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","comprehension","vocabulary"],"why_it_matters":"Understanding about two hundred words shows a broad understood vocabulary. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-009"]},{"id":"EC-001","domain":"EC","title":"Makes sounds other than crying","observable":"Produces vocal sounds — grunts, small vowels, gurgles — beyond a straight cry, from the first weeks of life.","non_examples":["only produces crying sounds"],"percentiles":{"25":0.0,"50":0.0,"75":0.3,"90":1.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'makes sounds other than crying'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization"],"why_it_matters":"Making sounds other than crying is the start of using the voice for more than distress. In this checklist it usually comes before “Coos with open-vowel sounds”.","sources":["SRC-002","SRC-004","SRC-005","SRC-008"]},{"id":"EC-002","domain":"EC","title":"Coos with open-vowel sounds","observable":"Produces sustained open-vowel sounds — 'ooooo', 'aaaah' — often in response to a familiar face or voice.","non_examples":["only makes brief vocal noises without the sustained vowel"],"percentiles":{"25":1.4,"50":1.5,"75":1.6,"90":1.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'makes sounds like ooooo, aaahh (cooing)'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization"],"why_it_matters":"Cooing is play with open vowel sounds. In this checklist it usually comes before “Laughs out loud”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"EC-003","domain":"EC","title":"Laughs out loud","observable":"Produces a full laugh — not just a smile or a chuckle — in response to play or a familiar person.","non_examples":["smiles only","makes a brief chuckle sound but does not sustain a laugh"],"percentiles":{"25":2.0,"50":2.2,"75":2.5,"90":2.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo (Social/Emotional) 'laughs'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization"],"why_it_matters":"Laughing out loud is a vocal way of showing delight. In this checklist it usually comes before “Squeals”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"EC-004","domain":"EC","title":"Squeals","observable":"Produces high-pitched squealing vocalizations — often during play or excitement.","non_examples":["no high-pitched vocalizations produced spontaneously"],"percentiles":{"25":2.2,"50":2.5,"75":2.8,"90":3.2},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'makes squealing noises'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization"],"why_it_matters":"Squealing shows the child is exploring the range of their voice. In this checklist it usually comes before “Blows raspberries”.","sources":["SRC-002","SRC-008"]},{"id":"EC-005","domain":"EC","title":"Blows raspberries","observable":"Sticks the tongue out and blows to make a bilabial buzzing sound.","non_examples":["opens the mouth but does not make the buzzing sound"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'blows raspberries (sticks tongue out and blows)'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization","oral-motor"],"why_it_matters":"Blowing raspberries is play with the lips and breath. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"EC-006","domain":"EC","title":"Vocalizes back and forth in turn-taking","observable":"Takes turns producing vocal sounds with an adult — the adult vocalizes, the child answers, and the exchange continues for at least a few turns.","non_examples":["vocalizes but does not wait for the adult","does not respond vocally to adult sounds"],"percentiles":{"10":1.0,"50":3.5,"75":6.0,"90":10.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'takes turns making sounds with you' (firmer criterion)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization","turn-taking"],"why_it_matters":"Vocal turn-taking is the rhythm of conversation before words. In this checklist it usually comes before “Uses voice to initiate interaction” and “Produces single consonant-vowel syllables”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"EC-007","domain":"EC","title":"Uses voice to initiate interaction","observable":"Vocalizes to start an interaction with an adult — not just in response — using pleased or displeased sounds with eye contact.","non_examples":["only vocalizes when the adult starts the exchange"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization","initiation"],"why_it_matters":"Using their voice to start an interaction shows the child knows sounds can bring people to them. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"EC-008","domain":"EC","title":"Produces single consonant-vowel syllables","observable":"Makes single consonant-vowel syllables — 'ba', 'da', 'ga' — as isolated sounds.","non_examples":["only produces vowel sounds without consonants"],"percentiles":{"25":4.6,"50":5.5,"75":6.3,"90":7.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization","babble"],"why_it_matters":"Consonant-vowel syllables such as 'ba' are the building blocks of words. In this checklist it usually comes before “Imitates speech sounds” and “Babbles repeated consonant strings (mamama, bababa)”.","sources":["SRC-008"]},{"id":"EC-009","domain":"EC","title":"Imitates speech sounds","observable":"When an adult makes a speech sound the child can produce, the child imitates it — turning speech-sound production into a back-and-forth game.","non_examples":["produces sounds but not in imitation"],"percentiles":{"25":5.2,"50":6.5,"75":7.8,"90":9.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization","imitation"],"why_it_matters":"Imitating speech sounds shows the child can hear a sound and try to make it. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-008"]},{"id":"EC-010","domain":"EC","title":"Babbles repeated consonant strings (mamama, bababa)","observable":"Repeats a consonant-vowel syllable in a string — 'mamama', 'bababa', 'dadada' — non-specifically, not yet as a word for a person.","non_examples":["only makes single syllables without repetition"],"percentiles":{"25":5.7,"50":6.7,"75":7.8,"90":8.8},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"red flag RF-030 — Dosman limit-age","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-030 (phase9b): By 12 months, the child is not yet producing strings of consonant-vowel babble like 'mamama', 'bababa', or 'badago'. Babbling has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","babble"],"why_it_matters":"Repeated babble such as 'bababa' is practice with the syllables of speech. In this checklist it usually comes before “Combines different syllables in babble (variegated babble)”.","sources":["SRC-002","SRC-005","SRC-006","SRC-008"]},{"id":"EC-011","domain":"EC","title":"Combines different syllables in babble (variegated babble)","observable":"Babbles strings that use different consonants and vowels together — 'badago', 'muba' — rather than pure repetition of one syllable.","non_examples":["only repeats one syllable (mamamama) without variation"],"percentiles":{"25":6.2,"50":7.5,"75":8.8,"90":10.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"red flag RF-030 — Dosman limit-age","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-030 (phase9b): By 12 months, the child is not yet producing strings of consonant-vowel babble like 'mamama', 'bababa', or 'badago'. Babbling has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","babble"],"why_it_matters":"Mixing different syllables in babble brings speech-like variety. In this checklist it usually comes before “Jabbers with expressive intonation”.","sources":["SRC-008"]},{"id":"EC-012","domain":"EC","title":"Jabbers with expressive intonation","observable":"Produces long strings of babble with the rise-and-fall pattern of real speech — sometimes called 'jargon' — even though the sounds are not words.","non_examples":["babbles without any adult-like intonation"],"percentiles":{"25":7.0,"50":8.5,"75":10.0,"90":11.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"red flag RF-030 — Dosman limit-age","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-030 (phase9b): By 12 months, the child is not yet producing strings of consonant-vowel babble like 'mamama', 'bababa', or 'badago'. Babbling has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","babble","jargon"],"why_it_matters":"Jabbering with intonation carries the tune of sentences before the words. In this checklist it usually comes before “Uses 'mama' or 'dada' specifically for the parent”.","sources":["SRC-006","SRC-008"]},{"id":"EC-013","domain":"EC","title":"Uses 'mama' or 'dada' specifically for the parent","observable":"Uses 'mama' or 'dada' (or a comparable name in the family's language, or the sign) meaningfully — for the specific parent rather than as generalized babble.","non_examples":["says 'mama' or 'dada' but for anyone","uses only non-specific babble"],"percentiles":{"25":8.8,"50":10.2,"75":11.6,"90":12.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'calls a parent mama or dada or another special name'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words"],"why_it_matters":"Using 'mama' or 'papa' for the right person is a sound used as a name. The next, finer step is “Says one word besides 'mama' or 'dada'”.","sources":["SRC-002","SRC-008"]},{"id":"EC-014","domain":"EC","title":"Says one word besides 'mama' or 'dada'","observable":"Produces one word (or sign) that refers to something specific in the world, besides mama or dada — a first true word.","non_examples":["says 'mama' and 'dada' only","only babbles"],"percentiles":{"25":10.1,"50":11.9,"75":13.6,"90":15.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'tries to say one or two words besides mama or dada, like ba for ball'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words"],"why_it_matters":"A first word besides 'mama' or 'papa' is a sound used consistently for one meaning. Later skills build on it directly, including “Says three or more words besides 'mama' or 'dada'”. The next, finer step is “Says at least five different words”, “Says two words besides 'mama' or 'dada'” and “Says three or more words besides 'mama' or 'dada'”.","sources":["SRC-002","SRC-008"]},{"id":"EC-015","domain":"EC","title":"Says at least five different words","observable":"Uses at least five different words meaningfully — the words do not have to be clearly pronounced, as long as the family recognizes what the child means.","non_examples":["uses fewer than five different words consistently"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-032 — Dosman limit-age","sources":["SRC-004"],"note":"From watch-for sign RF-032 (phase9b): By 18 months, the child is using fewer than five different words meaningfully. Expressive vocabulary is not appearing as expected. This sits inside the published range (p90 = 19 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","vocabulary"],"why_it_matters":"Saying five different words is an early spoken vocabulary. The next, finer step is “Says three or more words besides 'mama' or 'dada'”.","sources":["SRC-006"]},{"id":"EC-016","domain":"EC","title":"Says at least six different words","observable":"Uses at least six different words meaningfully.","non_examples":["uses fewer than six different words"],"percentiles":{"25":16.5,"50":19.1,"75":21.8,"90":24.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","vocabulary"],"why_it_matters":"Saying six words is a small step on from five. The next, finer step is “Combines two words together”.","sources":["SRC-008"]},{"id":"EC-017","domain":"EC","title":"Says ten to fifteen different words","observable":"Uses roughly ten to fifteen different words meaningfully — vocabulary is clearly expanding beyond a first handful.","non_examples":["still says only a handful of words"],"percentiles":{"10":9.81,"25":12.06,"50":14.26,"75":15.56},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","vocabulary"],"why_it_matters":"Saying ten to fifteen words shows the spoken vocabulary growing steadily. The next, finer step is “Vocabulary of about fifty words”.","sources":["SRC-004","SRC-006","SRC-009"]},{"id":"EC-018","domain":"EC","title":"Says three or more words besides 'mama' or 'dada'","observable":"Produces at least three different meaningful words beyond mama and dada.","non_examples":["says mama or dada plus at most one or two other words"],"percentiles":{"25":13.5,"50":15.6,"75":17.7,"90":19.8},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'tries to say three or more words besides mama or dada'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","vocabulary"],"why_it_matters":"Saying three words besides 'mama' or 'papa' is a small early vocabulary. The next, finer step is “Says at least six different words”.","sources":["SRC-002","SRC-008"]},{"id":"EC-019","domain":"EC","title":"Combines two words together","observable":"Puts two words together into a short phrase — 'more milk', 'daddy go', 'my ball' — communicating something more than either word alone.","non_examples":["uses only single words in succession without combining"],"percentiles":{"25":18.7,"50":21.3,"75":23.9,"90":26.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"red flag RF-033 — Dosman limit-age","sources":["SRC-004"],"note":"From watch-for sign RF-033 (phase9b): By 24 months, the child is not yet putting two words together into a short phrase — 'more milk', 'daddy go', 'my ball'. Two-word combinations have not appeared as expected. This sits inside the published range (p90 = 26.4 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","sentences"],"why_it_matters":"Putting two words together is the first grammar: two ideas in one phrase. The next, finer step is “Uses two-to-three-word sentences with an action word”. In this checklist it usually comes before “Uses personal pronouns such as 'I', 'me', or 'we'”.","sources":["SRC-002","SRC-004","SRC-005","SRC-006","SRC-008"]},{"id":"EC-020","domain":"EC","title":"Vocabulary of about fifty words","observable":"Uses roughly fifty different words meaningfully.","non_examples":["says only about a dozen different words"],"percentiles":{"50":17.79,"75":20.79,"90":23.31},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":30,"basis":"red flag RF-034 — Dosman limit-age","sources":["SRC-002","SRC-004"],"note":"From watch-for sign RF-034 (phase9b): By 30 months, the child is using fewer than fifty different words meaningfully across daily life. Expressive vocabulary is not appearing as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocabulary"],"why_it_matters":"About fifty spoken words is a vocabulary big enough to name many everyday things. The next, finer step is “Says about one hundred different words”.","sources":["SRC-002","SRC-004","SRC-009"]},{"id":"EC-021","domain":"EC","title":"Uses personal pronouns such as 'I', 'me', or 'we'","observable":"Uses personal pronouns — 'I want', 'me too', 'we go' — rather than referring to themselves only by name.","non_examples":["refers to self only by name","uses no pronouns"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'says words like I, me, or we'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","grammar","pronouns"],"why_it_matters":"Using pronouns such as 'I' and 'me' shows the child can refer to themselves and others in words. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-002"]},{"id":"EC-022","domain":"EC","title":"Uses two-to-three-word sentences with an action word","observable":"Produces short sentences that include an action word — 'doggie run', 'daddy help', 'baby eat' — rather than only naming.","non_examples":["strings two nouns together without any action word","only uses single-word requests"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'says two or more words together, with one action word, like Doggie run'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","grammar","sentences"],"why_it_matters":"Short sentences with an action word describe what is happening. The next, finer step is “Uses three-or-more-word sentences”.","sources":["SRC-002"]},{"id":"EC-023","domain":"EC","title":"Names a picture in a book on request","observable":"When an adult points to a picture and asks 'what is this?', the child names it — 'dog', 'ball', 'car'.","non_examples":["only points but does not name","makes a sound that is not a recognizable word"],"percentiles":{"25":20.1,"50":23.2,"75":26.2,"90":29.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'names things in a book when you point and ask, What is this?'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","book"],"why_it_matters":"Naming a picture on request shows the child can find a word when asked. The next, finer step is “Names four different pictures”.","sources":["SRC-002","SRC-008"]},{"id":"EC-024","domain":"EC","title":"Names four different pictures","observable":"When shown four different pictures in turn, the child names each one correctly.","non_examples":["can name one or two but not four different pictures"],"percentiles":{"25":27.6,"50":32.5,"75":37.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","book"],"why_it_matters":"Naming four pictures shows a quicker, larger naming vocabulary. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"EC-025","domain":"EC","title":"Speech is roughly half understandable to a stranger","observable":"A stranger listening to the child talk can understand about half of what the child says — familiar family members understand more.","non_examples":["a stranger understands almost none of the child's speech at this age"],"percentiles":{"25":20.5,"50":24.2,"75":27.8,"90":31.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","intelligibility"],"why_it_matters":"Speech that strangers half understand shows clearer sounds. The next, finer step is “Speech is roughly seventy-five percent understandable to a stranger”.","sources":["SRC-004","SRC-008"]},{"id":"EC-026","domain":"EC","title":"Uses gestures like waving 'bye-bye'","observable":"Uses conventional gestures — waves 'bye-bye', puts a finger to the lips for 'shh' — to communicate.","non_examples":["does not use any conventional gestures with intent"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'waves bye-bye'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","gesture"],"why_it_matters":"Waving bye-bye is a conventional gesture with a shared meaning. In this checklist it usually comes before “Points to request or ask for help”.","sources":["SRC-002","SRC-004","SRC-006"]},{"id":"EC-027","domain":"EC","title":"Points to request or ask for help","observable":"Points at something the child wants — a toy on a shelf, food out of reach — as a way to ask an adult to get it or help.","non_examples":["reaches with the whole hand without extending a finger","does not communicate wants through gesture"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'points to ask for something or to get help'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","gesture","requesting"],"why_it_matters":"Pointing to ask shows the child can direct another person to what the child wants. In this checklist it usually comes before “Points to show or share something interesting (declarative pointing)”.","sources":["SRC-002","SRC-005","SRC-006"]},{"id":"EC-028","domain":"EC","title":"Points to show or share something interesting (declarative pointing)","observable":"Points at something interesting — a bird, a dog, a picture — to draw an adult's attention to it, not to request it. Different intent from EC-027.","non_examples":["only points when they want to receive something"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo (Social/Emotional) 'points to show you something interesting'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","gesture","joint attention"],"why_it_matters":"Pointing to show something is sharing interest for its own sake. In this checklist it usually comes before “Uses varied gestures beyond waving and pointing”.","sources":["SRC-002","SRC-006"]},{"id":"EC-029","domain":"EC","title":"Uses varied gestures beyond waving and pointing","observable":"Uses gestures like blowing a kiss, nodding yes, shaking head no, giving a high-five — more than just waving and pointing.","non_examples":["only waves or points and uses no other gestures"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'uses more gestures than just waving and pointing, like blowing a kiss or nodding yes'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","gesture"],"why_it_matters":"Using varied gestures, such as nodding or blowing a kiss, widens what the child can say without words. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"EC-030","domain":"EC","title":"Cries to communicate needs (early)","observable":"Cries in a way that a familiar caregiver recognizes as signalling a specific need — hunger, discomfort, tiredness — rather than one undifferentiated cry.","non_examples":["cries always sound the same regardless of need"],"percentiles":{"10":0,"50":0,"75":1,"90":3},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocalization"],"why_it_matters":"Crying is the newborn's first way of signalling a need. In this checklist it usually comes before “Makes sounds other than crying”.","sources":["SRC-004","SRC-005","SRC-006"]},{"id":"EC-031","domain":"EC","title":"Uses three-or-more-word sentences","observable":"Produces sentences of three or more words to describe or request — 'want more milk', 'daddy go work', 'baby fall down'.","non_examples":["combines only two words together"],"percentiles":{"10":31,"50":33.5,"75":36,"90":40},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":36,"basis":"red flag RF-035 — Dosman limit-age","sources":["SRC-004"],"note":"From watch-for sign RF-035 (phase9b): By 36 months, the child is not yet producing sentences of three or more words to describe or request. Three-word sentences have not appeared as expected. This sits inside the published range (p90 = 40 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","grammar","sentences"],"why_it_matters":"Sentences of three or more words carry more detail in one go. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005","SRC-006"]},{"id":"EC-032","domain":"EC","title":"Speech is roughly seventy-five percent understandable to a stranger","observable":"A stranger listening to the child can understand about three-quarters of what the child says.","non_examples":["a stranger understands less than half the child's speech at this age"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","intelligibility"],"why_it_matters":"Speech that strangers mostly understand shows most sounds are clear. The next, finer step is “Speech is fully understandable to a stranger”.","sources":["SRC-004"]},{"id":"EC-033","domain":"EC","title":"Speech is fully understandable to a stranger","observable":"A stranger listening to the child can understand almost everything the child says.","non_examples":["a stranger still misses a meaningful fraction of the child's speech"],"percentiles":{"25":28.4,"50":36.3},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","intelligibility"],"why_it_matters":"Fully understandable speech shows clear sounds throughout. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"EC-034","domain":"EC","title":"Says about one hundred different words","observable":"Uses roughly one hundred different words meaningfully across daily life — beyond immediate family, foods and simple requests, into naming actions, feelings and everyday objects.","non_examples":["speaks in a stock of a few dozen words that rarely grows"],"percentiles":{"25":17.35,"50":20.34,"75":22.98,"90":27.04},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocabulary"],"why_it_matters":"About a hundred spoken words is a fast-growing vocabulary. The next, finer step is “Says about three hundred different words”.","sources":["SRC-009"]},{"id":"EC-035","domain":"EC","title":"Says about three hundred different words","observable":"Uses roughly three hundred different words — enough to combine them into short novel sentences and to describe what happened, what is happening, and what the child wants.","non_examples":["mostly names objects and people; rarely produces action or descriptive words"],"percentiles":{"10":18.87,"25":22.03,"50":24.58,"75":27.62},"percentile_method":"published:SRC-009","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","vocabulary"],"why_it_matters":"About three hundred spoken words is a large vocabulary for this age range. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-009"]},{"id":"EC-036","domain":"EC","title":"Says two words besides 'mama' or 'dada'","observable":"Uses two different words, other than 'mama' and 'dada', each for the same thing every time. Approximations count ('ba' for ball).","non_examples":["babbled syllables with no consistent meaning","one word only"],"percentiles":{"25":11.5,"50":13.8,"75":15.9,"90":18.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","words","vocabulary"],"why_it_matters":"Two words besides 'mama' or 'papa' is a small step on from the first word. The next, finer step is “Says three or more words besides 'mama' or 'dada'”.","sources":["SRC-008"]},{"id":"EC-037","domain":"EC","title":"Joins in with words of a familiar rhyme or song","observable":"Says or signs a word or two of a favourite rhyme, song or repeated story line, often the last word of a line.","non_examples":["listens and moves to a song but joins in with no words or signs"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["language","rhyme","words"],"why_it_matters":"Joining in with a rhyme shows the child remembers familiar words and their place in a song. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"CG-001","domain":"CG","title":"Regards a face","observable":"Looks at a familiar face when held close, especially the eyes; makes brief eye contact from the first weeks of life.","non_examples":["gaze drifts past faces without settling on them"],"percentiles":{"25":0.0,"50":0.0,"75":0.0,"90":0.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"red flag RF-040 — Rourke / CDC milestone","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-040 (phase9b): By 4 months, the child does not look at familiar faces, does not visually track a moving object, and shows little interest in the surroundings. Visual interest has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","social"],"why_it_matters":"Looking at a face is the newborn's first focused attention on people. In this checklist it usually comes before “Follows a moving object with the eyes to the midline” and “Looks happy when a familiar adult comes close”.","sources":["SRC-004","SRC-008"]},{"id":"CG-002","domain":"CG","title":"Follows a moving object with the eyes to the midline","observable":"When a colourful object or the adult's face moves slowly in an arc across the child's line of sight, the eyes track it as far as the midline of the body.","non_examples":["gaze does not follow moving objects at all"],"percentiles":{"25":0.0,"50":0.1,"75":0.1,"90":0.2},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Watches you as you move' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","visual tracking"],"why_it_matters":"Following a moving object to the middle is early control of eye movements. The next, finer step is “Follows a moving object past the midline”.","sources":["SRC-002","SRC-008"]},{"id":"CG-003","domain":"CG","title":"Follows a moving object past the midline","observable":"The eyes track a slowly moving object past the midline of the body, continuing to follow it toward the far side.","non_examples":["eyes stop tracking at the midline"],"percentiles":{"25":1.3,"50":1.5,"75":2.2,"90":2.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"red flag RF-040 — Rourke / CDC milestone","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-040 (phase9b): By 4 months, the child does not look at familiar faces, does not visually track a moving object, and shows little interest in the surroundings. Visual interest has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","visual tracking"],"why_it_matters":"Following past the middle shows the eyes and head can track across the body. The next, finer step is “Follows a moving object through a full one-hundred-eighty degrees”.","sources":["SRC-004","SRC-006","SRC-008"]},{"id":"CG-004","domain":"CG","title":"Follows a moving object through a full one-hundred-eighty degrees","observable":"The eyes track a slowly moving object from one side of the body, past the midline, all the way to the other side — a full one-hundred-eighty-degree sweep.","non_examples":["tracking stops before the object reaches the opposite side"],"percentiles":{"25":3.1,"50":3.7,"75":4.3,"90":4.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","visual tracking"],"why_it_matters":"Following through a full half-circle shows smooth, wide tracking. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-008"]},{"id":"CG-005","domain":"CG","title":"Regards own hands","observable":"Brings the hands into the line of sight and studies them — opening the fingers, watching them move — a self-directed attention behaviour of the early months.","non_examples":["hands move around but the child does not seem to notice them"],"percentiles":{"25":1.6,"50":1.8,"75":3.2,"90":4.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'looks at her hands with interest'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","self-awareness"],"why_it_matters":"Looking at their own hands is noticing their own body. In this checklist it usually comes before “Puts things in the mouth to explore them” and “Regards a very small object”.","sources":["SRC-002","SRC-004","SRC-008"]},{"id":"CG-006","domain":"CG","title":"Regards a very small object","observable":"Notices and looks at a small object — a raisin, a cheerio, a small bead — placed on a plain surface within reach.","non_examples":["ignores small objects at close range"],"percentiles":{"25":4.1,"50":4.5,"75":5.0,"90":5.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention"],"why_it_matters":"Noticing a very small object shows fine visual attention. The next, finer step is “Searches for a partially hidden object”. In this checklist it usually comes before “Works to obtain a toy just out of reach”.","sources":["SRC-008"]},{"id":"CG-007","domain":"CG","title":"Anticipates a familiar feeding routine","observable":"Opens the mouth or leans forward when the bottle or breast comes into sight — showing memory for the routine.","non_examples":["gives no anticipatory response even to a very familiar feeding sequence"],"percentiles":{"10":1,"50":2.5,"75":4,"90":6},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'if hungry, opens mouth when he sees breast or bottle'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","memory","routine"],"why_it_matters":"Anticipating feeding shows the child has learned a routine and what comes next. In this checklist it usually comes before “Uses a cause-and-effect toy intentionally”, “Acts on a familiar routine before it starts” and “Anticipates the next step in a familiar multi-step routine”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"CG-008","domain":"CG","title":"Puts things in the mouth to explore them","observable":"Brings toys and other objects to the mouth deliberately, exploring their shape, weight, and texture by mouthing.","non_examples":["takes objects to the mouth only accidentally"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'puts things in her mouth to explore them'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","exploration"],"why_it_matters":"Mouthing objects is how young babies explore shape and texture. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"CG-009","domain":"CG","title":"Signals fullness by closing the lips or turning the head","observable":"During feeding, actively signals no-more by closing the lips, turning the head away, or pushing the spoon away — a communicative cognitive signal.","non_examples":["continues to accept food long past visible fullness"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'closes lips to show she doesn't want more food'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","self-regulation","feeding"],"why_it_matters":"Signalling fullness shows the child can let you know the child has had enough. It tends to appear in the same period as “Shows a range of facial expressions of feeling”.","sources":["SRC-002"]},{"id":"CG-010","domain":"CG","title":"Works to obtain a toy just out of reach","observable":"Sees a toy placed just past the fingers and adjusts posture — leans, rolls, stretches — to try to reach it.","non_examples":["shows no attempt when a toy is placed just out of reach"],"percentiles":{"25":3.1,"50":4.5,"75":6.0,"90":7.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'Reaches to grab a toy she wants' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","problem solving"],"why_it_matters":"Working to get a toy just out of reach is goal-directed effort. In this checklist it usually comes before “Tries another way when the first way does not work”.","sources":["SRC-002","SRC-004","SRC-005","SRC-008"]},{"id":"CG-011","domain":"CG","title":"Looks toward a dropped object","observable":"When an object drops out of the hand or off the highchair, turns the head or leans over to look for where it went — the beginning of object permanence.","non_examples":["ignores dropped objects as if they no longer exist"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":9,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 9 months (CDC 9mo 'Looks for objects when dropped out of sight (like his spoon or toy)' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","object permanence"],"why_it_matters":"Looking toward a dropped object shows the child expects it to be somewhere. In this checklist it usually comes before “Looks for an object hidden while watching (visible displacement)”.","sources":["SRC-002","SRC-004"]},{"id":"CG-012","domain":"CG","title":"Searches for a partially hidden object","observable":"When part of a favourite toy is left visible under a cloth or a book, the child reaches to uncover it.","non_examples":["ignores the partially hidden object as if it were gone"],"percentiles":{"25":4.9,"50":5.4,"75":6.0,"90":6.6},"percentile_method":"constructed_from_proxy:SRC-008","evidence_grade":"C","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","object permanence"],"why_it_matters":"Finding a partly hidden object shows the child knows it is still there under the cover. The next, finer step is “Looks for an object hidden while watching (visible displacement)”.","sources":["SRC-008"]},{"id":"CG-013","domain":"CG","title":"Looks for an object hidden while watching (visible displacement)","observable":"When an adult hides a favourite toy under a cloth while the child watches, the child lifts the cloth to find it.","non_examples":["gives up as soon as the toy disappears from view"],"percentiles":{"10":7.0,"50":9.5,"75":12.0,"90":16.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'looks for things he sees you hide, like a toy under a blanket' (firmer criterion — under a cover)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","object permanence"],"why_it_matters":"Finding an object hidden while the child watched shows the child remembers where it went. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-005","SRC-006"]},{"id":"CG-014","domain":"CG","title":"Uses a cause-and-effect toy intentionally","observable":"Pushes a button, pulls a string, or turns a knob to make a toy light up, play music, or move — repeating the action to make the effect happen again.","non_examples":["explores the toy but does not repeat the specific action that made the effect"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","cause and effect"],"why_it_matters":"Using a cause-and-effect toy on purpose shows the child knows their action makes the result. In this checklist it usually comes before “Uses common objects the right way” and “Tries to make a toy work using switches or knobs”.","sources":["SRC-004","SRC-005"]},{"id":"CG-015","domain":"CG","title":"Plays clapping and gesture games with an adult","observable":"Actively participates in games like pat-a-cake or open-shut-them — imitating the adult's claps or gestures rather than only watching.","non_examples":["watches the adult but does not join in with claps or gestures"],"percentiles":{"25":6.9,"50":8.1,"75":9.4,"90":10.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'Plays games with you, like pat-a-cake' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","imitation","play"],"why_it_matters":"Clapping and gesture games combine memory, imitation and taking turns with an adult. In this checklist it usually comes before “Uses gestures like waving 'bye-bye'”, “Plays give-and-take with an adult (rolls a ball back)” and “Claps when excited”.","sources":["SRC-002","SRC-004","SRC-005","SRC-008"]},{"id":"CG-016","domain":"CG","title":"Imitates simple adult actions and chores","observable":"Copies what an adult is doing — sweeping with a small broom, wiping with a cloth, stirring in a cup — using the same motion the adult uses.","non_examples":["watches the adult but does not copy the action"],"percentiles":{"25":9.7,"50":11.6,"75":13.4,"90":15.2},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-042 — Dosman limit-age","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-042 (phase9b): By 18 months, the child does not copy simple adult actions — sweeping with a small broom, wiping with a cloth, stirring in a bowl. Imitation of everyday actions has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","imitation"],"why_it_matters":"Imitating adult actions shows the child watches and copies what people do. In this checklist it usually comes before “Copies something seen earlier” and “Pretends to feed a doll or stuffed animal”.","sources":["SRC-002","SRC-004","SRC-005","SRC-008"]},{"id":"CG-017","domain":"CG","title":"Uses common objects the right way","observable":"Uses everyday objects for their real purpose — brings a phone to the ear, tips a cup to the mouth, brushes hair with a brush — even when the object is a toy version.","non_examples":["only bangs or mouths the object without using it as intended"],"percentiles":{"10":10.0,"50":12.5,"75":15.0,"90":19.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'tries to use things the right way, like a phone, cup, or book'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","functional play"],"why_it_matters":"Using objects the right way shows the child knows what things are for. The next, finer step is “Knows what two common objects are used for”.","sources":["SRC-002","SRC-004"]},{"id":"CG-018","domain":"CG","title":"Plays give-and-take with an adult (rolls a ball back)","observable":"Rolls, pushes, or hands a ball back and forth with an adult, taking turns in the exchange.","non_examples":["keeps the ball or drops it without returning"],"percentiles":{"25":10.4,"50":12.2,"75":14.0,"90":15.8},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","turn-taking","play"],"why_it_matters":"Give-and-take play is taking turns with an object. In this checklist it usually comes before “Combines two or more toys in play”.","sources":["SRC-008"]},{"id":"CG-019","domain":"CG","title":"Pretends to feed a doll or stuffed animal","observable":"Uses a spoon, cup, or bottle to pretend-feed a doll or stuffed animal — the first symbolic act of treating a toy as if it were alive.","non_examples":["only mouths the doll or throws it around"],"percentiles":{"25":14.4,"50":19.5,"75":24.5,"90":29.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24,"basis":"red flag RF-043 — M-CHAT-R/F screening","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-043 (phase9b): By 24 months, the child does not use objects in pretend ways — does not pretend-feed a doll, does not use a block as a phone, does not stir with a stick. Pretend play has not appeared as expected. This sits inside the published range (p90 = 29.7 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","symbolic play"],"why_it_matters":"Pretending to feed a doll is early symbolic play: acting out a familiar action on a pretend partner. In this checklist it usually comes before “Uses one object to stand for another in pretend play”.","sources":["SRC-005","SRC-008"]},{"id":"CG-020","domain":"CG","title":"Uses one object to stand for another in pretend play","observable":"Uses a block as a phone, a stick as a spoon, a box as a car — substituting one object for another during pretend play.","non_examples":["uses each toy only for what it looks like"],"percentiles":{"10":15,"50":19.5,"75":24,"90":32},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","symbolic play","substitution"],"why_it_matters":"Using one object to stand for another is symbolic thinking: a block becomes a roti. In this checklist it usually comes before “Acts out a short pretend sequence”.","sources":["SRC-004","SRC-005"]},{"id":"CG-021","domain":"CG","title":"Acts out a short pretend sequence","observable":"Plays out a short pretend scenario — feeds the doll, puts the doll to bed, covers the doll with a blanket — combining more than one pretend step.","non_examples":["single pretend actions only, without linking them"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","symbolic play","sequencing"],"why_it_matters":"Acting out a short pretend sequence links several pretend actions into a story. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"CG-022","domain":"CG","title":"Tries to make a toy work using switches or knobs","observable":"Presses buttons, flips switches, and turns knobs on a toy — persistently trying to make the toy respond, using trial-and-error.","non_examples":["gives up after one try","does not seek the cause of the effect"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'tries to use switches, knobs, or buttons on a toy'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","problem solving"],"why_it_matters":"Working switches and knobs shows the child explores how things work. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"CG-023","domain":"CG","title":"Combines two or more toys in play","observable":"Plays with more than one toy at the same time in a related way — puts toy food on a toy plate, sits a doll in a toy chair.","non_examples":["plays with only one toy at a time"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'plays with more than one toy at the same time, like putting toy food on a toy plate'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","combinatorial play"],"why_it_matters":"Combining toys in play shows the child relates objects to each other. In this checklist it usually comes before “Sorts objects into two groups by one characteristic”, “Completes a simple two-to-three-piece puzzle” and “Counts two or three objects”.","sources":["SRC-002","SRC-005"]},{"id":"CG-024","domain":"CG","title":"Anticipates the next step in a familiar multi-step routine","observable":"In a familiar routine — bath time, going out, bedtime — anticipates and starts the next step before the adult prompts (heads to the tub, brings shoes to the door, gets a favourite book).","non_examples":["waits for full adult prompting at every step"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","memory","routine"],"why_it_matters":"Anticipating the next step of a multi-step routine shows memory for sequences. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"CG-025","domain":"CG","title":"Knows what two common objects are used for","observable":"When asked 'which one do you eat with?' or 'which one is for combing hair?', the child selects the correct object from a small set — showing categorical/functional knowledge.","non_examples":["points at random","knows one function but not two"],"percentiles":{"25":30.4,"50":35.6,"75":40.7},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","categorical knowledge"],"why_it_matters":"Knowing what objects are used for shows understanding of function. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-008"]},{"id":"CG-026","domain":"CG","title":"Counts two or three objects","observable":"When shown two or three small objects and asked 'how many?', the child says '1, 2' or '1, 2, 3' — counting rather than reciting.","non_examples":["recites number words in random order","says the same number for any set"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","numeracy"],"why_it_matters":"Counting two or three objects is an early sense of number. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005"]},{"id":"CG-027","domain":"CG","title":"Sorts objects into two groups by one characteristic","observable":"Given a small pile of mixed objects, sorts them into two groups by a single characteristic — the red ones vs. the blue ones, the big ones vs. the small ones.","non_examples":["mixes categories despite an adult's demonstration"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","sorting","categorization"],"why_it_matters":"Sorting by one feature shows the child can group things that are alike. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005"]},{"id":"CG-028","domain":"CG","title":"Completes a simple two-to-three-piece puzzle","observable":"Puts a two- or three-piece puzzle together — inset shapes or a simple picture jigsaw — with limited help.","non_examples":["forces pieces into wrong slots and gives up"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","spatial reasoning"],"why_it_matters":"Doing a simple puzzle joins shape matching with trying and adjusting. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005"]},{"id":"CG-029","domain":"CG","title":"Looks at a toy for several seconds","observable":"Keeps looking at a toy held in view for several seconds rather than glancing away at once.","non_examples":["glances at the toy only for a moment"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Looks at a toy for several seconds' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","attention","vision"],"why_it_matters":"Looking at a toy for several seconds is early sustained attention. In this checklist it usually comes before “Swipes at a toy with an arm”.","sources":["SRC-002"]},{"id":"CG-030","domain":"CG","title":"Repeats an action to make something happen again","observable":"Does the same thing again and again to get the same result, such as dropping a toy from the high chair and waiting for someone to pick it up.","non_examples":["does something once by chance and moves on"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","cause-and-effect"],"why_it_matters":"Repeating an action to make something happen again shows the child connects their action to the result. In this checklist it usually comes before “Uses a cause-and-effect toy intentionally”.","sources":["SRC-005"]},{"id":"CG-031","domain":"CG","title":"Fills a container and empties it, over and over","observable":"Puts things into a container and tips them out again, repeating the cycle as the game itself.","non_examples":["drops one thing in and loses interest"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","exploration","containers"],"why_it_matters":"Filling and emptying over and over is exploring how containers and contents work. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"CG-032","domain":"CG","title":"Uses a word or sign for 'more' or 'all gone'","observable":"Says or signs 'more' to ask for more of something, or 'all gone' (or the family's word for it) when something is used up.","non_examples":["reaches for more food without any word or sign"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","quantity","language"],"why_it_matters":"'More' and 'all gone' are early words for amount. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"CG-033","domain":"CG","title":"Copies something seen earlier","observable":"Later, without being shown again, does an action they watched someone do earlier, such as wiping up a spill or shutting a door.","non_examples":["copies an action only while watching it (that is CG-016)"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","memory","imitation"],"why_it_matters":"Copying something seen earlier shows memory for actions over time. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"CG-034","domain":"CG","title":"Tries another way when the first way does not work","observable":"When blocked, tries a different approach, such as crawling around a table instead of reaching under it, or turning a toy to fit it through a gap.","non_examples":["repeats only the same failed attempt and then gives up"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","problem-solving"],"why_it_matters":"Trying another way when the first does not work is flexible problem-solving. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"CG-035","domain":"CG","title":"Acts on a familiar routine before it starts","observable":"Shows they know what comes next by doing something about it, such as going to the table at mealtime or fetching shoes when it is time to go out.","non_examples":["waits to be carried or led for every step"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["cognitive","memory","routines"],"why_it_matters":"Acting on a routine before it starts shows the child remembers what comes next and acts on it. It tends to appear in the same period as “Cooperates during daily care routines with help”.","sources":["SRC-005"]},{"id":"SE-001","domain":"SE","title":"Looks at familiar faces","observable":"Turns toward and looks at a familiar face — the parent's or caregiver's — from the earliest weeks; briefly holds gaze on the face rather than looking past it.","non_examples":["gaze drifts past familiar faces without settling"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'looks at your face'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attention","recognition"],"why_it_matters":"Looking at familiar faces is the start of social attention. In this checklist it usually comes before “Smiles responsively to an adult (social smile)” and “Enjoys sustained eye contact”.","sources":["SRC-002","SRC-005"]},{"id":"SE-002","domain":"SE","title":"Smiles responsively to an adult (social smile)","observable":"Smiles in response to an adult smiling or talking to the child — a social smile directed at a person, not spontaneous fussiness or gas.","non_examples":["smiles only during sleep or without a social trigger"],"percentiles":{"25":0.8,"50":1.1,"75":1.3,"90":1.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":3,"basis":"red flag RF-050 — Dosman limit-age","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-050 (phase9b): By 3 months, the child does not smile in response to an adult smiling or talking to them. The responsive social smile has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","smile","response"],"why_it_matters":"The social smile is smiling in response to another person. The next, finer step is “Smiles spontaneously”. In this checklist it usually comes before “Shows affection to familiar adults”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"SE-003","domain":"SE","title":"Smiles spontaneously","observable":"Smiles at things the child finds pleasant — a toy, a light pattern, a familiar sound — without a specific social trigger from the adult.","non_examples":["only smiles when directly engaged by an adult"],"percentiles":{"25":1.1,"50":1.4,"75":1.6,"90":1.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'smiles on his own to get your attention'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","smile"],"why_it_matters":"Smiling spontaneously shows pleasure expressed without a prompt. In this checklist it usually comes before “Shows a range of facial expressions of feeling”.","sources":["SRC-002","SRC-008"]},{"id":"SE-004","domain":"SE","title":"Enjoys sustained eye contact","observable":"During feeding, cuddling, or face-to-face play, holds eye contact with the caregiver's face for a sustained period — several seconds at a time — and appears to enjoy it.","non_examples":["gaze slides past the eyes without holding"],"percentiles":{"10":0,"50":1.5,"75":4,"90":8},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Looks at your face' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","eye contact"],"why_it_matters":"Enjoying eye contact is shared attention between two people. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-005","domain":"SE","title":"Shows recognition of a familiar adult","observable":"Brightens, smiles, coos, or reaches when a familiar caregiver comes into view — visibly happy to see the person.","non_examples":["responds to familiar and unfamiliar adults with the same neutral expression"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'seems happy to see you when you walk up to her'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","recognition","attachment"],"why_it_matters":"Recognising a familiar adult shows early attachment to particular people. In this checklist it usually comes before “Raises arms to be picked up”.","sources":["SRC-002","SRC-005"]},{"id":"SE-006","domain":"SE","title":"Chuckles or shows delight during play","observable":"Produces early chuckling sounds and shows visible delight — bright face, kicking legs — when an adult plays a face-making or tickle game.","non_examples":["remains neutral in expression during play attempts"],"percentiles":{"10":1,"50":2.5,"75":4,"90":6},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'chuckles (not yet a full laugh) when you try to make him laugh'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","delight"],"why_it_matters":"Chuckling in play shows shared enjoyment. In this checklist it usually comes before “Uses sounds and movements to keep an adult engaged”.","sources":["SRC-002"]},{"id":"SE-007","domain":"SE","title":"Uses sounds and movements to keep an adult engaged","observable":"Uses coos, small sounds, kicks, or arm movements to keep an adult in play — visibly working to hold the adult's attention.","non_examples":["falls quiet as soon as the adult pauses"],"percentiles":{"10":1,"50":2.5,"75":4,"90":6},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":4,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 4 months (CDC 4mo 'looks at you, moves, or makes sounds to get or keep your attention'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attention-seeking"],"why_it_matters":"Using sounds and movements to keep an adult playing shows the child can influence the interaction. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-005","SRC-006"]},{"id":"SE-008","domain":"SE","title":"Shows a range of facial expressions of feeling","observable":"Shows visibly different facial expressions for joy, anger, sadness, distress, and surprise — not just a single expression for everything.","non_examples":["one flat expression across all interactions"],"percentiles":{"10":0,"50":1.5,"75":4,"90":8},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":12,"basis":"red flag RF-054 — CDC milestone","sources":["SRC-002"],"note":"From watch-for sign RF-054 (phase9b): By 12 months, the child shows few or no facial expressions of feeling — no visible happiness, sadness, anger or surprise across situations. A range of facial expressions has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","emotion expression"],"why_it_matters":"A range of facial expressions shows emotions becoming visible to others. It tends to appear in the same period as “Signals fullness by closing the lips or turning the head”.","sources":["SRC-004","SRC-005"]},{"id":"SE-009","domain":"SE","title":"Prefers familiar people over strangers","observable":"Reacts differently to familiar family members and to strangers — smiles, reaches, or vocalises more with family; may quiet or look away from a stranger.","non_examples":["responds the same way to any adult, familiar or not"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","recognition"],"why_it_matters":"Preferring familiar people shows attachment to their own caregivers. In this checklist it usually comes before “Shows wariness of strangers”.","sources":["SRC-004","SRC-005","SRC-006"]},{"id":"SE-010","domain":"SE","title":"Reacts when a familiar caregiver leaves the room","observable":"Looks after, reaches for, or cries when a familiar caregiver walks out of the room — signalling attachment.","non_examples":["shows no visible reaction when the caregiver leaves"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":9,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 9 months (CDC 9mo 'reacts when you leave (looks, reaches for you, or cries)'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","separation"],"why_it_matters":"Reacting when a caregiver leaves shows the attachment bond at work. In this checklist it usually comes before “Shows wariness of strangers”.","sources":["SRC-002","SRC-004","SRC-005","SRC-006"]},{"id":"SE-011","domain":"SE","title":"Shows wariness of strangers","observable":"Becomes wary or clings to a familiar caregiver when an unfamiliar person approaches — 'stranger anxiety' — often paired with looking to the caregiver for reassurance.","non_examples":["approaches any adult without any wariness"],"percentiles":{"10":8,"50":10.5,"75":13,"90":17},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","stranger response"],"why_it_matters":"Wariness of strangers shows the child tells familiar people from unfamiliar ones. In this checklist it usually comes before “Separates more easily from a primary caregiver”.","sources":["SRC-005","SRC-006"]},{"id":"SE-012","domain":"SE","title":"Raises arms to be picked up","observable":"Reaches up toward a familiar adult with both arms as a signal to be picked up.","non_examples":["waits to be picked up without any arm signal"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":9,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 9 months (CDC 9mo 'lifts arms up to be picked up' — deferred from EC to SE per G-032 (attachment signalling more than expressive communication)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","gesture"],"why_it_matters":"Raising their arms to be picked up is a clear request to a caregiver. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-005"]},{"id":"SE-013","domain":"SE","title":"Shares interest by giving or showing an object","observable":"Extends an object toward an adult to share it — not to hand it over for use, but to draw the adult's attention to it or comment on it.","non_examples":["holds objects close without showing them to others"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-052 — M-CHAT-R/F screening","sources":["SRC-004","SRC-013"],"note":"From watch-for sign RF-052 (phase9b): By 18 months, the child does not extend objects toward an adult to share interest — does not show a toy, does not bring items over to share the moment. Sharing of interest has not appeared as expected. This sits inside the published range (p90 = 19 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","joint attention","sharing"],"why_it_matters":"Showing or giving an object is sharing interest with another person. In this checklist it usually comes before “Shows off new skills to a familiar adult” and “Cooperates with simple routines when asked”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-014","domain":"SE","title":"Copies another child during play","observable":"Watches another child and copies the play — takes toys out of a container after another child does, runs after another child, waves or claps in response to another child.","non_examples":["ignores other children's play"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo (Social/Emotional) 'copies other children while playing, like taking toys out of a container when another child does'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","imitation","peer"],"why_it_matters":"Copying another child shows interest in other children. In this checklist it usually comes before “Uses social referencing (checks caregiver's face in a new situation)” and “Plays alongside other children (parallel play)”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-015","domain":"SE","title":"Uses a comfort object to self-calm","observable":"Reaches for a favourite blanket, stuffed animal, or thumb to calm themselves when tired or upset.","non_examples":["can only be calmed by an adult"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","self-regulation"],"why_it_matters":"Using a comfort object is one way of calming themselves. It tends to appear in the same period as “Brings hand or fingers to mouth to calm self”.","sources":["SRC-004","SRC-005"]},{"id":"SE-016","domain":"SE","title":"Has tantrums when frustrated","observable":"Melts down — crying, throwing, dropping to the floor — when frustrated by a limit, a hard task, or a strong emotion. Tantrums are a developmentally-expected behaviour of the second year, not a deficit.","non_examples":["never expresses frustration at strong emotions or unmet wants"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","emotion","self-regulation"],"why_it_matters":"Tantrums show strong feelings that the child cannot yet manage alone. In this checklist it usually comes before “Uses assertive words like 'no' and 'mine'”.","sources":["SRC-004","SRC-005"]},{"id":"SE-017","domain":"SE","title":"Uses social referencing (checks caregiver's face in a new situation)","observable":"In an unfamiliar or ambiguous situation, looks at a familiar caregiver's face to gauge how to react — will they smile or look worried?","non_examples":["responds to new situations without checking with a caregiver"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 24 months (CDC 2yr 'looks at your face to see how to react in a new situation'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment"],"why_it_matters":"Social referencing is checking a trusted face to decide how to feel about something new. In this checklist it usually comes before “Notices when others are hurt or upset” and “Recognizes themselves in a mirror or photo”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-018","domain":"SE","title":"Notices when others are hurt or upset","observable":"Pauses, looks concerned, or seeks the person out when another child or adult is crying, hurt, or upset — an early empathic response.","non_examples":["ignores obvious distress in others"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":24,"basis":"red flag RF-053 — Dosman limit-age","sources":["SRC-004"],"note":"From watch-for sign RF-053 (phase9b): By 24 months, the child does not pause, look concerned, or seek out someone in distress. Noticing others' emotions has not appeared as expected. This sits inside the published range (p90 = 28 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","empathy"],"why_it_matters":"Noticing when others are upset is early empathy. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-019","domain":"SE","title":"Plays alongside other children (parallel play)","observable":"Plays next to another child with similar toys — building alongside, drawing alongside — without necessarily interacting or sharing.","non_examples":["plays only in solitude even when other children are nearby"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'plays next to other children and sometimes plays with them'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","peer play"],"why_it_matters":"Parallel play is playing next to other children with interest in what they do. In this checklist it usually comes before “Names a preferred playmate” and “Engages in simple cooperative play with another child”.","sources":["SRC-002","SRC-004","SRC-005"]},{"id":"SE-020","domain":"SE","title":"Uses assertive words like 'no' and 'mine'","observable":"Uses words or signs to assert wishes — 'no', 'mine', 'me do it' — as part of expressing an emerging self.","non_examples":["accepts every adult request without protest at any age"],"percentiles":{"10":19,"50":21.5,"75":24,"90":28},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","autonomy"],"why_it_matters":"Assertive words such as 'no' and 'mine' show a growing sense of self. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-004","SRC-005"]},{"id":"SE-021","domain":"SE","title":"Shows off new skills to a familiar adult","observable":"Calls attention to a new skill — running to show a caregiver what they just built, saying 'Look at me!' when climbing something, or bringing over a drawing to display.","non_examples":["performs new skills without seeking any adult attention"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'shows you what she can do by saying, \"Look at me!\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","confidence"],"why_it_matters":"Showing off new skills is seeking a familiar adult's attention and pleasure. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-002","SRC-005"]},{"id":"SE-022","domain":"SE","title":"Cooperates with simple routines when asked","observable":"Helps with a simple routine when asked — puts a toy in the box at clean-up time, brings a diaper when it is time for a change — following the routine without a struggle.","non_examples":["refuses every routine request","does the routine only if physically guided each step"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'follows simple routines when told, like helping to pick up toys when you say, \"It clean-up time.\"'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","cooperation","routine"],"why_it_matters":"Cooperating with routines when asked shows the child accepts simple expectations. In this checklist it usually comes before “Understands and mostly follows simple rules”.","sources":["SRC-002"]},{"id":"SE-023","domain":"SE","title":"Names a preferred playmate","observable":"Names a specific friend or playmate — 'my friend Ada', 'I want Rohan' — and shows preference for playing with that child.","non_examples":["treats all other children the same, with no named preference"],"percentiles":{"25":22.8,"50":28.3,"75":33.4,"90":38.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","peer","preference"],"why_it_matters":"Naming a preferred playmate shows early friendship. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005","SRC-008"]},{"id":"SE-024","domain":"SE","title":"Engages in simple cooperative play with another child","observable":"Plays with another child around a shared goal — building block towers together, pretending to cook and eat together, taking turns pushing a truck along a track.","non_examples":["can only play alongside without a shared activity"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","peer play","cooperation"],"why_it_matters":"Simple cooperative play is playing together toward the same aim. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005"]},{"id":"SE-025","domain":"SE","title":"Recognizes themselves in a mirror or photo","observable":"When shown a mirror or a photo of themselves, points to or names themselves — not another person or 'baby'.","non_examples":["treats the mirror image or photo as another person"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","self-awareness"],"why_it_matters":"Recognising themselves in a mirror or photo shows self-awareness. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SE-026","domain":"SE","title":"Separates more easily from a primary caregiver","observable":"Manages a brief separation from the primary caregiver — going with another familiar adult, staying at a play group — with initial protest that settles rather than continuing throughout.","non_examples":["separation distress continues throughout the separation"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","self-regulation"],"why_it_matters":"Separating more easily shows trust that the caregiver will return. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"SE-027","domain":"SE","title":"Understands and mostly follows simple rules","observable":"Understands and mostly follows a small set of family or child-care rules — 'we walk indoors', 'we share the toys' — even when the adult is not right there.","non_examples":["ignores rules unless the adult is directly enforcing each time"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","rule-following","self-regulation"],"why_it_matters":"Following simple rules shows the child understands shared expectations. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004","SRC-005"]},{"id":"SE-028","domain":"SE","title":"Offers or gives an object to another child","observable":"Offers a toy or a snack to another child — hands it over, or holds it out — an early sharing behaviour.","non_examples":["holds all objects and does not offer them to others"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","empathy","sharing"],"why_it_matters":"Offering something to another child is early sharing. The next, finer step is “Shares interest by giving or showing an object”.","sources":["SRC-004","SRC-005"]},{"id":"SE-029","domain":"SE","title":"Initiates a familiar game routine","observable":"Starts a familiar game — puts a blanket over their own head to start peek-a-boo, holds up hands to start pat-a-cake, gives the ball to start rolling.","non_examples":["only reciprocates when the adult begins the game"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_opinion:SRC-004","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","initiation","play"],"why_it_matters":"Starting a familiar game shows the child knows the game and wants to play it. It tends to appear in the same period as “Enjoys game routines such as peek-a-boo or pat-a-cake” and “Plays clapping and gesture games with an adult”.","sources":["SRC-004"]},{"id":"SE-030","domain":"SE","title":"Looks happy when a familiar adult comes close","observable":"Brightens, wriggles, smiles or quiets and watches when a parent or other familiar adult walks up.","non_examples":["no change in face or body when a familiar adult approaches"],"percentiles":{"10":0,"50":0.5,"75":2,"90":4},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":2,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 2 months (CDC 2mo 'Seems happy to see you when you walk up to her' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment"],"why_it_matters":"Looking happy when a familiar adult approaches is early recognition shown as pleasure. It tends to appear in the same period as “Shows recognition of a familiar adult”.","sources":["SRC-002"]},{"id":"SE-031","domain":"SE","title":"Enjoys looking at themselves in a mirror","observable":"Looks at their own reflection with interest: smiles at it, pats it or makes sounds to it.","non_examples":["no interest in the mirror image","knowing the reflection is themselves (that comes later, SE-025)"],"percentiles":{"10":1,"50":3.5,"75":6,"90":10},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":6,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 6 months (CDC 6mo 'Likes to look at self in a mirror' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","self"],"why_it_matters":"Enjoying the mirror is interest in a face that responds, before the child knows it is their own. In this checklist it usually comes before “Recognizes themselves in a mirror or photo”.","sources":["SRC-002"]},{"id":"SE-032","domain":"SE","title":"Claps when excited","observable":"Claps hands spontaneously to show excitement or pleasure, not only when asked to clap.","non_examples":["claps only when copying a clapping game"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'Claps when excited' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","emotional-expression","gesture"],"why_it_matters":"Clapping when excited is expressing joy with a gesture. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"SE-033","domain":"SE","title":"Hugs a stuffed toy or doll","observable":"Holds a soft toy or doll close in a hug, with affection, during play.","non_examples":["carries the toy only by one limb","hugging an adult only"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'Hugs stuffed doll or other toy' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","play","affection"],"why_it_matters":"Hugging a soft toy is showing affection in play. In this checklist it usually comes before “Pretends to feed a doll or stuffed animal”.","sources":["SRC-002"]},{"id":"SE-034","domain":"SE","title":"Shows affection to familiar adults","observable":"Offers hugs, cuddles or kisses to a parent or other familiar adult without being prompted.","non_examples":["accepts cuddles but never offers them"],"percentiles":{"10":10,"50":12.5,"75":15,"90":19},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":15,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 15 months (CDC 15mo 'Shows you affection (hugs, cuddles, or kisses you)' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","affection"],"why_it_matters":"Offering affection shows the warmth of the attachment going both ways. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002"]},{"id":"SE-035","domain":"SE","title":"Explores away from a caregiver while checking back","observable":"Moves off to explore a room or garden, then looks back, returns or calls to make sure the caregiver is still close by.","non_examples":["stays pressed to the caregiver and does not explore","wanders off without ever checking back"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'Moves away from you, but looks to make sure you are close by' (phase9d)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","attachment","exploration"],"why_it_matters":"Exploring while checking back is using the caregiver as a safe base. It tends to appear in the same period as “Goes to a familiar adult for comfort when upset”.","sources":["SRC-002"]},{"id":"SE-036","domain":"SE","title":"Leads an adult by the hand to something wanted","observable":"Takes a familiar adult's hand and pulls or walks them to something the child wants or needs help with.","non_examples":["reaches or cries without guiding the adult","points only (that is EC-027)"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["social-emotional","communication","help-seeking"],"why_it_matters":"Leading an adult by the hand is getting help by bringing the adult to the problem. It tends to appear in the same period as “Points to request or ask for help”.","sources":["SRC-005"]},{"id":"AD-001","domain":"AD","title":"Brings food to the mouth by self","observable":"Takes finger food from a plate or highchair tray and brings it to the mouth without adult help — early self-feeding.","non_examples":["waits for the adult to place food in the mouth"],"percentiles":{"25":4.0,"50":5.9,"75":8.2,"90":10.5},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","self-care"],"why_it_matters":"Bringing food to the mouth is the beginning of feeding themselves. In this checklist it usually comes before “Feeds self finger foods reliably” and “Holds own bottle”.","sources":["SRC-008"]},{"id":"AD-002","domain":"AD","title":"Feeds self finger foods reliably","observable":"Eats a snack of small pieces of finger food independently — brings each piece to the mouth, chews, and swallows without adult help.","non_examples":["needs the adult to hand each piece to the mouth"],"percentiles":{"10":13.0,"50":15.5,"75":18.0,"90":22.0},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18.0,"basis":"90th percentile, self-care; Dosman 18mo 'self-feeds (fingers)'","sources":["SRC-004"],"note":"Dosman self-care 90th-percentile basis is Level A high-quality evidence (G-049); this age is the outer marker used as the clinical late-flag."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","self-care"],"why_it_matters":"Reliable finger-feeding means the child can feed themselves a good part of a meal. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-002","SRC-004"]},{"id":"AD-003","domain":"AD","title":"Holds own bottle","observable":"Holds a bottle or sippy cup at the mouth without an adult supporting it — for at least most of a feed.","non_examples":["the adult holds the bottle for the whole feed"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":12.0,"basis":"90th percentile, self-care; Dosman 12mo 'holds bottle'","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding"],"why_it_matters":"Holding their own bottle is an early self-feeding skill. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"AD-004","domain":"AD","title":"Drinks from a cup held by an adult","observable":"Drinks from an open cup that an adult holds — sips or swallows without pushing the cup away or spilling most of the contents.","non_examples":["cannot yet coordinate a swallow from a cup"],"percentiles":{"10":7,"50":9.5,"75":12,"90":16},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":12,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 12 months (CDC 12mo 'drinks from a cup without a lid, as you hold it'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","cup"],"why_it_matters":"Drinking from a cup held by an adult is learning to sip from an open edge. The next, finer step is “Drinks from an open cup independently, with some spilling”.","sources":["SRC-002"]},{"id":"AD-005","domain":"AD","title":"Drinks from an open cup independently, with some spilling","observable":"Picks up an open cup, brings it to the mouth, and takes a drink without adult help — spilling is expected at this stage.","non_examples":["needs the adult to hold the cup at every sip"],"percentiles":{"25":9.7,"50":11.8,"75":13.9,"90":16.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'drinks from a cup without a lid and may spill sometimes'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","cup"],"why_it_matters":"Drinking from an open cup themselves is managing the cup and the flow. The next, finer step is “Drinks well from an open cup”.","sources":["SRC-002","SRC-008"]},{"id":"AD-006","domain":"AD","title":"Drinks well from an open cup","observable":"Drinks from an open cup with control — few spills, cup returned to the surface without knocking over.","non_examples":["consistent spilling with every attempt at this age"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":30,"basis":"Dosman 2012 90th percentile, self-care: 'drinks from open cup'","sources":["SRC-004"],"tier":"referral","note":"Dosman gives (<18, 30) months; the 36 used before was the chart row. Corrected in phase9f."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","cup"],"why_it_matters":"Drinking well from an open cup is a fully managed skill. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"AD-007","domain":"AD","title":"Tries to use a spoon","observable":"Picks up a spoon and attempts to bring it to the mouth with food on it — often loses the food along the way.","non_examples":["uses fingers only and rejects the spoon"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'tries to use a spoon'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","spoon"],"why_it_matters":"Trying to use a spoon is the start of eating with a tool. The next, finer step is “Eats with a spoon, mostly independently”.","sources":["SRC-002"]},{"id":"AD-008","domain":"AD","title":"Eats with a spoon, mostly independently","observable":"Scoops food with a spoon and brings most of it to the mouth without adult help — some loss on the way is still expected.","non_examples":["loses most of the food off the spoon","needs the adult to guide the spoon each time"],"percentiles":{"25":11.7,"50":14.5,"75":17.2,"90":20.0},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":{"months":24.0,"basis":"90th percentile, self-care; Dosman 24mo 'uses spoon, helps dress'","sources":["SRC-004"],"note":"Dosman self-care 90th-percentile basis is Level A high-quality evidence (G-049); this age is the outer marker used as the clinical late-flag."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","spoon"],"why_it_matters":"Eating with a spoon mostly alone is using a tool to feed themselves. The next, finer step is “Uses a spoon and fork well”.","sources":["SRC-002","SRC-004","SRC-006","SRC-008"]},{"id":"AD-009","domain":"AD","title":"Uses a spoon and fork well","observable":"Uses a spoon and a fork with control — food reaches the mouth reliably, spilling is rare.","non_examples":["still uses fingers for most meals at this age"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":36.0,"basis":"90th percentile, self-care; Dosman 36mo 'uses spoon well and fork, drinks from open cup, removes socks and shoes, undresses, indicates voided'","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","utensils"],"why_it_matters":"Using a spoon and fork well is skilled tool use at meals. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"AD-010","domain":"AD","title":"Removes a hat or socks","observable":"Takes off a hat, socks, or another easy piece of clothing without adult help.","non_examples":["needs adult help for every item of clothing"],"percentiles":{"25":15.5,"50":20.4,"75":24.5,"90":28.6},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","dressing","undressing"],"why_it_matters":"Removing a hat or socks is the first step in undressing. The next, finer step is “Takes off loose clothing”.","sources":["SRC-006","SRC-008"]},{"id":"AD-011","domain":"AD","title":"Takes off loose clothing","observable":"Takes off loose pants, an open jacket, or a shirt with an open front without adult help.","non_examples":["can only remove socks, not loose garments"],"percentiles":{"10":25,"50":27.5,"75":30,"90":34},"percentile_method":"constructed_from_threshold:SRC-002","evidence_grade":"C","median_unavailable":false,"limit_age":{"months":30,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 30 months (CDC 30mo 'takes some clothes off by himself, like loose pants or an open jacket'). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","dressing","undressing"],"why_it_matters":"Taking off loose clothing is a bigger step in undressing. The next, finer step is “Removes socks and shoes; undresses”.","sources":["SRC-002"]},{"id":"AD-012","domain":"AD","title":"Removes socks and shoes; undresses","observable":"Removes socks, shoes, and other clothing (undresses more fully) without adult help.","non_examples":["still needs adult help to undress most items"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":36.0,"basis":"90th percentile, self-care; Dosman 36mo 'removes socks and shoes, undresses' (part of the larger 36mo cluster in AD-009's source_age note)","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","dressing","undressing"],"why_it_matters":"Removing socks and shoes and undressing shows more independence in dressing. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"AD-013","domain":"AD","title":"Cooperates with dressing (extends arm, moves foot)","observable":"Helps the adult during dressing — extends an arm for a sleeve, lifts a leg for a pant, holds a foot for a sock — rather than being fully passive or resistive.","non_examples":["is fully passive during dressing"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":24.0,"basis":"90th percentile, self-care; Dosman 24mo 'uses spoon, helps dress'","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","dressing","cooperation"],"why_it_matters":"Cooperating with dressing shows the child takes part in the routine. In this checklist it usually comes before “Puts on some clothing (hat, coat, shoes)” and “Indicates when they have voided”.","sources":["SRC-004"]},{"id":"AD-014","domain":"AD","title":"Puts on some clothing (hat, coat, shoes)","observable":"Puts on some articles of clothing without adult help — often a hat, a loose coat, or shoes (sometimes on the wrong foot).","non_examples":["cannot yet manage any clothing to put on"],"percentiles":{"25":25.3,"50":31.8,"75":38.1},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","dressing"],"why_it_matters":"Putting on some clothing is the start of dressing themselves. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005","SRC-008"]},{"id":"AD-015","domain":"AD","title":"Cooperates during daily care routines with help","observable":"Cooperates during daily care routines — hand washing, nose blowing, tooth brushing, hair combing, bathing — by holding still, holding a tool, or performing part of the routine with adult support.","non_examples":["consistently resists or actively refuses every care routine"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'Puts hands out for you to wash them' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene","cooperation"],"why_it_matters":"Cooperating with care routines shows the child takes part in their own care. In this checklist it usually comes before “Blows nose with help” and “Washes hands with adult support”.","sources":["SRC-002","SRC-005"]},{"id":"AD-016","domain":"AD","title":"Washes hands with adult support","observable":"Rubs hands under water and with soap, then dries them with a towel — with an adult guiding or reminding through the steps.","non_examples":["will not put hands under water","needs the adult to do the whole routine"],"percentiles":{"25":22.9,"50":27.4,"75":32.4,"90":37.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene"],"why_it_matters":"Washing hands with support is learning a hygiene routine. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005","SRC-008"]},{"id":"AD-017","domain":"AD","title":"Holds a toothbrush during tooth-brushing routine","observable":"Holds the toothbrush while an adult brushes, or makes brushing motions themselves while the adult supervises and finishes the job.","non_examples":["will not tolerate the toothbrush at all"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene","tooth-brushing"],"why_it_matters":"Holding a toothbrush is joining in the tooth-brushing routine. In this checklist it usually comes before “Brushes teeth with adult supervision”.","sources":["SRC-005"]},{"id":"AD-018","domain":"AD","title":"Brushes teeth with adult supervision","observable":"Brushes their own teeth for a short time with an adult supervising or finishing the job — makes back-and-forth motions across most surfaces.","non_examples":["only opens the mouth for the adult to brush"],"percentiles":{"10":31,"50":33.5,"75":36,"90":40},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene","tooth-brushing"],"why_it_matters":"Brushing teeth with supervision is taking on more of the routine. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"AD-019","domain":"AD","title":"Blows nose with help","observable":"Cooperates with nose blowing — allows a caregiver to hold a tissue and blows out, or attempts to hold the tissue themselves.","non_examples":["always resists or refuses nose care"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene"],"why_it_matters":"Blowing their nose with help is learning a care routine. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"AD-020","domain":"AD","title":"Wipes mouth or has mouth washed after eating","observable":"Wipes their own mouth with a napkin after eating, or cooperates while an adult wipes it — without resisting through the whole routine.","non_examples":["always resists mouth cleaning"],"percentiles":{"25":20.4,"50":24.8,"75":29.1,"90":33.4},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","hygiene"],"why_it_matters":"Wiping their mouth after eating is part of mealtime self-care. In this checklist it usually comes before “Communicates when hungry, thirsty, or full”.","sources":["SRC-008"]},{"id":"AD-021","domain":"AD","title":"Helps with household activities","observable":"Joins in household activities — carries a light item to the table, puts a napkin at a place, tidies up small objects — when the adult invites participation.","non_examples":["ignores every invitation to help with household activities"],"percentiles":{"25":12.9,"50":15.9,"75":18.4,"90":20.9},"percentile_method":"published:SRC-008","evidence_grade":"B","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","cooperation","household"],"why_it_matters":"Helping with household tasks is taking part in family life. It tends to appear in the same period as “Imitates simple adult actions and chores”.","sources":["SRC-008"]},{"id":"AD-022","domain":"AD","title":"Shows preferences for or against foods","observable":"Shows clear preferences at meals — accepts favourite foods eagerly, refuses others, may try new foods after several exposures.","non_examples":["accepts anything offered with the same reaction"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","preferences"],"why_it_matters":"Showing food preferences shows the child recognises and chooses foods. In this checklist it usually comes before “Communicates when hungry, thirsty, or full”.","sources":["SRC-005"]},{"id":"AD-023","domain":"AD","title":"Communicates when hungry, thirsty, or full","observable":"Uses words, signs, or clear gestures to signal hunger, thirst, or 'all done' at meals.","non_examples":["only cries generally without signalling a specific need"],"percentiles":{"10":31,"50":33.5,"75":36,"90":40},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","feeding","communication"],"why_it_matters":"Communicating hunger, thirst or fullness is telling others about their body's needs. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"AD-024","domain":"AD","title":"Accepts adult guidance in unsafe situations","observable":"Responds to a caregiver's warning or redirection in an unsafe moment — pauses at 'hot!' or 'careful!' — and accepts help to move to safety.","non_examples":["ignores all safety warnings from familiar adults"],"percentiles":{"10":31,"50":33.5,"75":36,"90":40},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","safety","cooperation"],"why_it_matters":"Accepting guidance in unsafe situations shows the child responds to safety limits. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"AD-025","domain":"AD","title":"Shows awareness of some unsafe situations","observable":"Names or acts on some unsafe situations without a warning — turns away from a hot stove after a family rule about it, avoids a step they know is high.","non_examples":["repeats the same unsafe action after multiple warnings and consequences"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","safety"],"why_it_matters":"Awareness of some dangers shows the child is beginning to judge risk. In this checklist it usually comes before “Accepts adult guidance in unsafe situations”.","sources":["SRC-005"]},{"id":"AD-026","domain":"AD","title":"Indicates when they have voided","observable":"Signals — by pointing, saying a word, or coming to the adult — that they have wet or soiled the diaper or the toilet.","non_examples":["gives no signal of voiding at any point"],"percentiles":{},"percentile_method":"constructed_from_limit:SRC-004","evidence_grade":"D","median_unavailable":true,"limit_age":{"months":36.0,"basis":"90th percentile, self-care; Dosman 36mo 'indicates voided'","sources":["SRC-004"],"note":"Dosman's 90th-percentile-basis limit is the only sourced age for this item; no percentile source available, so the item runs median_unavailable=true and the app relies on the limit_age for its late-flag rather than a constructed window (protocol §Phase-3 Step 3-4)."},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["adaptive","toileting"],"why_it_matters":"Indicating a wet or dirty nappy is awareness of their body. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-004"]},{"id":"SR-001","domain":"SR","title":"Coordinates sucking, swallowing, and breathing during feeds","observable":"During breastfeeding or bottle-feeding, produces a rhythmic pattern of two or more sucks in a row before pausing to swallow and breathe — an organized suck-swallow-breathe cycle rather than choking, coughing, or repeatedly losing the latch.","non_examples":["chokes or coughs at almost every feed after the newborn period","cannot sequence more than one suck before losing the latch"],"percentiles":{"10":0,"50":0,"75":0,"90":2},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":0,"basis":"red flag RF-061 — Rourke visit marker","sources":["SRC-006"],"note":"From watch-for sign RF-061 (phase9b): In a newborn, sucking, swallowing, and breathing during feeding do not coordinate into a rhythmic pattern; feeding is prolonged, weak, or interrupted by choking. Newborn feeding coordination has not appeared as expected. This sits inside the published range (p90 = 2 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","feeding-state","newborn"],"why_it_matters":"Coordinating sucking, swallowing and breathing is the basis of safe feeding. In this checklist it usually comes before “Quiets when rocked, held, or swaddled”.","sources":["SRC-006"]},{"id":"SR-002","domain":"SR","title":"Quiets when rocked, held, or swaddled","observable":"When distressed, settles in response to gentle rocking, being held close, or being wrapped — the crying softens and the body relaxes within a minute or two of the physical input, rather than escalating.","non_examples":["physical contact and rocking make no difference to distress once it begins","arches and pulls away from being held every time"],"percentiles":{"10":0,"50":0,"75":1,"90":5},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-070 — Rourke visit marker","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-070 (phase9b): By 18 months, the child is rarely soothed by familiar caregivers — not calmed by holding, a gentle voice, rocking or a comfort object, across weeks — and does not come to a familiar adult for comfort when upset. Being soothed by caregivers has not appeared as expected.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","state-regulation","self-soothing"],"why_it_matters":"Quieting when held or rocked shows the child can be calmed by a caregiver. In this checklist it usually comes before “Is usually easy to soothe and everyday behavior is manageable”.","sources":["SRC-005","SRC-006"]},{"id":"SR-003","domain":"SR","title":"Brings hand or fingers to mouth to calm self","observable":"When distressed or overexcited, brings a hand, fingers, thumb, or fist to the mouth and sucks — a self-directed calming behavior distinct from feeding.","non_examples":["hand-to-mouth occurs only during feeds","distress escalates without any self-directed soothing action"],"percentiles":{"10":9,"50":13.5,"75":18,"90":26},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":true,"skippable_note":"A meaningful minority of children never develop finger or thumb sucking as a self-calming strategy; they may use a comfort object, a caregiver, or another self-directed behavior instead. Absence of this specific pattern is not a delay when other self-soothing routes are in place.","corrected_age_applies":true,"tags":["sensory-regulation","self-soothing"],"why_it_matters":"Bringing their hand to their mouth is one way some children calm themselves. In this checklist it usually comes before “Goes to a familiar adult for comfort when upset”. Many children never do this and go on to the next skill directly.","sources":["SRC-005"]},{"id":"SR-004","domain":"SR","title":"Orients head or body toward a new sound, sight, or event","observable":"When a new sensory event happens — a sound off to the side, a bright object entering the visual field, an interesting movement in the room — turns the head or repositions the body to take it in.","non_examples":["does not turn or shift attention when something new occurs in the immediate environment"],"percentiles":{"10":0,"50":0,"75":1,"90":5},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","orienting","attention"],"why_it_matters":"Orienting to something new shows the child notices changes around them. In this checklist it usually comes before “Filters background stimulation to focus on a person or object”.","sources":["SRC-005","SRC-006"]},{"id":"SR-005","domain":"SR","title":"Filters background stimulation to focus on a person or object","observable":"Even with other things happening in the room — background talk, other movement, ambient noise — settles gaze and attention on one person or object at a time with adult support.","non_examples":["attention jumps from one stimulus to the next with no sustained focus at all","any background noise or movement fully disrupts every attempt to engage"],"percentiles":{"10":0,"50":4.5,"75":9,"90":17},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","attention-regulation"],"why_it_matters":"Filtering out background stimulation lets them focus on one thing. In this checklist it usually comes before “Sustains attention on a simple task for a short period”.","sources":["SRC-005"]},{"id":"SR-006","domain":"SR","title":"Notices and explores differences in how things feel","observable":"During play, examines objects with hands and mouth in a way that reflects their texture — pats a soft blanket, gnaws a hard teether, presses a squishy toy — engaging different materials with different actions.","non_examples":["handles all objects with the same motion regardless of what they are made of","avoids touching any object with an unfamiliar texture"],"percentiles":{"10":4,"50":6.5,"75":9,"90":13},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","tactile","exploration"],"why_it_matters":"Noticing how things feel is exploring through touch. In this checklist it usually comes before “Adjusts how they handle fragile, messy, or sticky materials”.","sources":["SRC-005"]},{"id":"SR-007","domain":"SR","title":"Adjusts how they handle fragile, messy, or sticky materials","observable":"Handles play dough with a different pressure than clay, or approaches something sticky or messy in a different way from something dry and firm — the action changes based on how the material feels.","non_examples":["uses the same grip and pressure regardless of the material","refuses to touch any messy, wet, or sticky material at all"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","tactile","modulation"],"why_it_matters":"Adjusting how the child handles delicate or messy things shows sensitivity to touch and control. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-008","domain":"SR","title":"Adjusts walking or running to different ground surfaces","observable":"Changes pace or footing when moving from a smooth floor to a rocky path, from grass to sand, or from a dry to a slippery surface — slows down, plants feet more carefully, or leans forward for balance.","non_examples":["walks at the same pace and posture on every surface, tripping repeatedly on uneven ground"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","proprioception","vestibular"],"why_it_matters":"Adjusting walking to different surfaces joins balance with feeling the ground. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-009","domain":"SR","title":"Sustains attention on a simple task for a short period","observable":"Sticks with one activity — building a small tower, looking at a picture book, listening to a story — for several minutes at a time, staying engaged rather than moving on within seconds.","non_examples":["shifts from one object to another every few seconds with no sustained engagement in any activity"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","attention-regulation","sustained-attention"],"why_it_matters":"Sustaining attention on a task is early focus. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005","SRC-006"]},{"id":"SR-010","domain":"SR","title":"Shifts attention from one activity to another when needed","observable":"When an activity ends or a new one is offered, moves attention over rather than staying stuck on the previous focus — sets down one toy to pick up another, or looks over when called from across the room.","non_examples":["cannot disengage from one activity to shift attention to something new, even with adult help"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","attention-regulation","flexibility"],"why_it_matters":"Shifting attention when needed is flexible focus. In this checklist it usually comes before “Adjusts to routine changes when told about them beforehand”.","sources":["SRC-005"]},{"id":"SR-011","domain":"SR","title":"Adjusts to routine changes when told about them beforehand","observable":"When a change to the usual routine — a different nap time, a visit to a new place, a substitute caregiver — is described ahead of time, moves through the transition with only brief protest rather than prolonged distress.","non_examples":["any change to the usual routine triggers extended distress even with advance warning"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","transition","flexibility"],"why_it_matters":"Coping with a routine change the child was told about shows the child can adjust to change with preparation. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-012","domain":"SR","title":"Goes to a familiar adult for comfort when upset","observable":"When distressed, moves toward a familiar caregiver, reaches up, or otherwise seeks physical closeness for help managing the feeling — rather than shutting down or thrashing without engagement.","non_examples":["does not orient toward familiar caregivers for comfort even when strongly distressed and the caregiver is right there"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-070 — Rourke visit marker","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-070 (phase9b): By 18 months, the child is rarely soothed by familiar caregivers — not calmed by holding, a gentle voice, rocking or a comfort object, across weeks — and does not come to a familiar adult for comfort when upset. Being soothed by caregivers has not appeared as expected. This sits inside the published range (p90 = 22 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","comfort-seeking","attachment-based-regulation"],"why_it_matters":"Going to a familiar adult for comfort is using others to help manage feelings. In this checklist it usually comes before “Uses simple independent strategies to manage strong feelings”.","sources":["SRC-005","SRC-006"]},{"id":"SR-013","domain":"SR","title":"Uses simple independent strategies to manage strong feelings","observable":"When something is too much — a loud noise, an unwanted interaction, a crowded room — takes a self-directed action to lower the input: covers ears or eyes, moves a short distance away, hugs a comfort object, or asks to leave.","non_examples":["any strong feeling escalates without any self-directed coping action"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","emotion-regulation","coping"],"why_it_matters":"Using simple strategies alone to manage feelings is growing self-regulation. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-014","domain":"SR","title":"Is usually easy to soothe and everyday behavior is manageable","observable":"Over a typical day, is generally reachable when upset — settles with familiar strategies — and behavior at home and in familiar settings is manageable with usual caregiving, rather than a series of prolonged unresolvable meltdowns.","non_examples":["distress persists for long periods most days despite every attempt to soothe","everyday behavior is so dysregulated that ordinary caregiving cannot get through the day"],"percentiles":{"10":9,"50":13.5,"75":18,"90":26},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"red flag RF-070 — Rourke visit marker","sources":["SRC-006","SRC-002"],"note":"From watch-for sign RF-070 (phase9b): By 18 months, the child is rarely soothed by familiar caregivers — not calmed by holding, a gentle voice, rocking or a comfort object, across weeks — and does not come to a familiar adult for comfort when upset. Being soothed by caregivers has not appeared as expected. This sits inside the published range (p90 = 26 mo), as a referral age may.","tier":"referral"},"skippable":false,"skippable_note":"Rourke's own wording 'usually' acknowledges that no child is always easy to soothe or always manageable; the marker asks about the typical pattern, not perfection.","corrected_age_applies":true,"tags":["sensory-regulation","temperament","behavior-regulation"],"why_it_matters":"Being usually easy to soothe shows the child can return to calm with help. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-006"]},{"id":"SR-015","domain":"SR","title":"Shows awareness of drop-offs and other hazards while moving","observable":"As an established crawler or walker, notices a step, a couch edge, a stair, or a steep slope and hesitates, backs up, or scans before continuing — rather than moving over the edge with no adjustment.","non_examples":["crawls or walks straight off a bed, couch, or stair edge with no pause or scan"],"percentiles":{"10":13,"50":15.5,"75":18,"90":22},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","depth-perception","safety-awareness"],"why_it_matters":"Awareness of drops and hazards while moving joins movement with caution. Nothing later in this checklist is linked to it as a direct next step; it is a small step in its own right.","sources":["SRC-005"]},{"id":"SR-016","domain":"SR","title":"Maintains balance and posture while concentrating on something","observable":"While sitting to look at a book, work with clay or blocks, or use markers, keeps upright posture without slumping or tipping over — postural control holds while attention is elsewhere.","non_examples":["cannot sit steadily long enough to focus on a book or table-top activity, tipping or collapsing repeatedly"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","postural-control","attention"],"why_it_matters":"Keeping balance while concentrating shows posture that runs without attention. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-017","domain":"SR","title":"Uses body awareness to fit through small openings and spaces","observable":"When crawling through a tunnel, climbing into a box, or ducking under a table, gauges the size of the opening and adjusts the body — turning sideways, ducking, or backing out — rather than getting stuck the same way each time.","non_examples":["repeatedly tries to move through an opening that is clearly too small without adjusting"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","body-awareness","proprioception"],"why_it_matters":"Fitting through small spaces uses awareness of their body's size and shape. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]},{"id":"SR-018","domain":"SR","title":"Cooperates during dressing, diapering, and bath with adult support","observable":"During routine daily care — being dressed, having a nappy changed, having a bath — participates cooperatively with an adult, tolerating the handling and the sensory input rather than struggling or fleeing every time.","non_examples":["every dressing, diapering, or bath episode ends in extended distress with no accommodation over time"],"percentiles":{"10":9,"50":13.5,"75":18,"90":26},"percentile_method":"constructed_from_opinion:SRC-006","evidence_grade":"D","median_unavailable":false,"limit_age":{"months":18,"basis":"CDC LTSAE milestone (>=75% of children); 'talk with your child's doctor' if not met","sources":["SRC-002","SRC-003"],"note":"CDC (phase9b): most children (3 in 4 or more) do this by 18 months (CDC 18mo 'Helps you dress him by pushing arm through sleeve or lifting up foot' (matched phase9b)). CDC advises talking with the child's doctor if a milestone is not met. About 1 in 4 typically developing children are not doing a given milestone yet at this age, so this is a prompt to mention it, not a referral threshold.","tier":"mention"},"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","handling-tolerance","co-regulation"],"why_it_matters":"Cooperating in dressing and bathing shows the child tolerates and joins care routines. In this checklist it usually comes before “Manages a short delay in getting needs met with adult support”.","sources":["SRC-002","SRC-005","SRC-006"]},{"id":"SR-019","domain":"SR","title":"Manages a short delay in getting needs met with adult support","observable":"When hungry, tired, or wanting something, waits briefly — a minute or two — while an adult explains and prepares, rather than escalating to full distress the moment the need is not immediately met.","non_examples":["any short delay in meeting a physical need triggers immediate escalation, with no capacity to wait even with adult support"],"percentiles":{"10":27,"50":31.5,"75":36,"90":42},"percentile_method":"constructed_from_opinion:SRC-005","evidence_grade":"D","median_unavailable":false,"limit_age":null,"skippable":false,"skippable_note":null,"corrected_age_applies":true,"tags":["sensory-regulation","delay-tolerance","co-regulation"],"why_it_matters":"Managing a short wait with support is early patience. Nothing in this checklist is recorded as coming after it, so it marks the far end of its line up to 36 months.","sources":["SRC-005"]}],"edges":[{"from":"GM-006","to":"SR-008","type":"hard_prerequisite","edge_rationale":"Adjusting walking or running to different ground surfaces presupposes independent walking (G-054).","confidence":"high","sources":[]},{"from":"GM-006","to":"SR-015","type":"hard_prerequisite","edge_rationale":"Showing hazard-awareness while moving (drop-offs, etc.) presupposes independent locomotion; GM-006 (walks alone) is the safe anchor since the crawling alternative GM-003 is skippable (G-054).","confidence":"high","sources":[]},{"from":"GM-001","to":"SR-016","type":"hard_prerequisite","edge_rationale":"Maintaining balance and posture while concentrating requires the foundational postural control demonstrated by sitting without support (G-054; postural anchor).","confidence":"high","sources":[]},{"from":"GM-006","to":"SR-017","type":"hard_prerequisite","edge_rationale":"Body awareness for fitting through small openings and spaces requires independent locomotion (G-054).","confidence":"high","sources":[]},{"from":"GM-006","to":"GM-028","type":"hard_prerequisite","edge_rationale":"Running is a faster gait built on independent walking; a child cannot run before walking.","confidence":"high","sources":[]},{"from":"GM-006","to":"GM-027","type":"hard_prerequisite","edge_rationale":"Walking backwards requires the base walking motor pattern first.","confidence":"high","sources":[]},{"from":"GM-006","to":"GM-031","type":"hard_prerequisite","edge_rationale":"Jumping with both feet leaving the ground requires the standing / propulsion strength demonstrated by independent walking.","confidence":"high","sources":[]},{"from":"GM-001","to":"GM-018","type":"hard_prerequisite","edge_rationale":"Getting into a sitting position independently presupposes the ability to hold sitting once there (GM-001).","confidence":"high","sources":[]},{"from":"FM-005","to":"FM-007","type":"hard_prerequisite","edge_rationale":"Holding a small object in each hand simultaneously requires the voluntary grasp demonstrated by reaching-and-grasping (FM-005).","confidence":"high","sources":[]},{"from":"EC-014","to":"EC-018","type":"hard_prerequisite","edge_rationale":"Saying three or more words besides 'mama' or 'dada' presupposes the child has already produced at least one such word (EC-014).","confidence":"high","sources":[]},{"from":"FM-005","to":"FM-008","type":"refines","edge_rationale":"Rake refines the earlier full-hand reach-and-grasp.","confidence":"medium","sources":[]},{"from":"FM-008","to":"FM-010","type":"refines","edge_rationale":"Inferior pincer refines the rake grasp.","confidence":"medium","sources":[]},{"from":"FM-010","to":"FM-012","type":"refines","edge_rationale":"Mature pad-to-pad pincer refines the inferior pincer.","confidence":"medium","sources":[]},{"from":"FM-017","to":"FM-019","type":"refines","edge_rationale":"Four-cube tower refines the two-cube tower.","confidence":"medium","sources":[]},{"from":"FM-019","to":"FM-020","type":"refines","edge_rationale":"Six-cube tower refines the four-cube tower.","confidence":"medium","sources":[]},{"from":"FM-020","to":"FM-022","type":"refines","edge_rationale":"Eight-cube tower refines the six-cube tower.","confidence":"medium","sources":[]},{"from":"FM-022","to":"FM-023","type":"refines","edge_rationale":"Ten-cube tower refines the eight-cube tower.","confidence":"medium","sources":[]},{"from":"FM-016","to":"FM-026","type":"refines","edge_rationale":"Turning pages one at a time refines the earlier multi-page-at-a-time page turning.","confidence":"medium","sources":[]},{"from":"FM-013","to":"FM-014","type":"refines","edge_rationale":"Dumping an object out of a container refines the voluntary release into a container.","confidence":"medium","sources":[]},{"from":"FM-021","to":"FM-024","type":"refines","edge_rationale":"Copying a horizontal line refines imitating a vertical line — both are single controlled strokes.","confidence":"medium","sources":[]},{"from":"FM-024","to":"FM-025","type":"refines","edge_rationale":"Copying a circle refines line-copying (closed curve rather than a single stroke).","confidence":"medium","sources":[]},{"from":"CG-006","to":"CG-012","type":"refines","edge_rationale":"Searching for a partially hidden object refines the visual regard for small objects (object-permanence ladder).","confidence":"medium","sources":[]},{"from":"CG-012","to":"CG-013","type":"refines","edge_rationale":"Finding a fully hidden object under visible displacement (Stage 5) refines partial-hidden search.","confidence":"medium","sources":[]},{"from":"CG-002","to":"CG-003","type":"refines","edge_rationale":"Following past midline refines following to midline.","confidence":"medium","sources":[]},{"from":"CG-003","to":"CG-004","type":"refines","edge_rationale":"Full 180° tracking refines past-midline following.","confidence":"medium","sources":[]},{"from":"AD-004","to":"AD-005","type":"refines","edge_rationale":"Drinking from a cup held by self (with spills) refines drinking from a cup held by an adult.","confidence":"medium","sources":[]},{"from":"AD-005","to":"AD-006","type":"refines","edge_rationale":"Drinking well from an open cup refines the earlier spill-prone independent cup use.","confidence":"medium","sources":[]},{"from":"AD-007","to":"AD-008","type":"refines","edge_rationale":"Eating mostly independently with a spoon refines the earlier tries-to-use-a-spoon.","confidence":"medium","sources":[]},{"from":"AD-008","to":"AD-009","type":"refines","edge_rationale":"Using a spoon and fork well refines the earlier mostly-independent spoon use.","confidence":"medium","sources":[]},{"from":"AD-010","to":"AD-011","type":"refines","edge_rationale":"Taking off loose clothing refines removing a hat or socks.","confidence":"medium","sources":[]},{"from":"AD-011","to":"AD-012","type":"refines","edge_rationale":"Fully undressing (removes socks and shoes; undresses) refines taking off loose clothing.","confidence":"medium","sources":[]},{"from":"SE-002","to":"SE-003","type":"refines","edge_rationale":"Smiling spontaneously refines the earlier social smile in response to an adult.","confidence":"medium","sources":[]},{"from":"EC-013","to":"EC-014","type":"refines","edge_rationale":"Saying one word besides 'mama'/'dada' refines the specific 'mama'/'dada' use.","confidence":"medium","sources":[]},{"from":"EC-014","to":"EC-018","type":"refines","edge_rationale":"Saying three or more words refines the earlier single-word production.","confidence":"medium","sources":[]},{"from":"EC-018","to":"EC-016","type":"refines","edge_rationale":"Saying six or more words refines the three-word vocabulary threshold.","confidence":"medium","sources":[]},{"from":"EC-016","to":"EC-019","type":"refines","edge_rationale":"Combining two words refines single-word production into early syntax.","confidence":"medium","sources":[]},{"from":"EC-019","to":"EC-022","type":"refines","edge_rationale":"Two-to-three-word action sentences refine early two-word combining.","confidence":"medium","sources":[]},{"from":"EC-022","to":"EC-031","type":"refines","edge_rationale":"Three-or-more-word sentences refine two-to-three-word sentences.","confidence":"medium","sources":[]},{"from":"EC-017","to":"EC-020","type":"refines","edge_rationale":"50-word vocabulary refines the 10-15-word vocabulary threshold.","confidence":"medium","sources":[]},{"from":"EC-020","to":"EC-034","type":"refines","edge_rationale":"100-word vocabulary refines the 50-word threshold.","confidence":"medium","sources":[]},{"from":"EC-034","to":"EC-035","type":"refines","edge_rationale":"300-word vocabulary refines the 100-word threshold.","confidence":"medium","sources":[]},{"from":"EC-025","to":"EC-032","type":"refines","edge_rationale":"Speech ~75% understandable refines the earlier ~50% understandable-to-stranger threshold.","confidence":"medium","sources":[]},{"from":"EC-032","to":"EC-033","type":"refines","edge_rationale":"Fully understandable speech refines the 75% threshold.","confidence":"medium","sources":[]},{"from":"RC-023","to":"RC-024","type":"refines","edge_rationale":"Understanding 100 words refines the 50-word comprehension threshold.","confidence":"medium","sources":[]},{"from":"RC-024","to":"RC-025","type":"refines","edge_rationale":"Understanding 200 words refines the 100-word comprehension threshold.","confidence":"medium","sources":[]},{"from":"RC-014","to":"RC-015","type":"refines","edge_rationale":"Pointing to six body parts refines pointing to two body parts on request.","confidence":"medium","sources":[]},{"from":"RC-016","to":"RC-017","type":"refines","edge_rationale":"Pointing to four pictures refines pointing to two pictures on request.","confidence":"medium","sources":[]},{"from":"RC-012","to":"RC-013","type":"refines","edge_rationale":"Following a one-step direction without a gesture refines following the same with a gesture.","confidence":"medium","sources":[]},{"from":"RC-013","to":"RC-019","type":"refines","edge_rationale":"Following a two-step direction refines following a single one-step direction.","confidence":"medium","sources":[]},{"from":"GM-007","to":"GM-008","type":"refines","edge_rationale":"Lifting head to ~45° refines the earlier brief prone head lift.","confidence":"medium","sources":[]},{"from":"GM-008","to":"GM-009","type":"refines","edge_rationale":"Lifting head to ~90° refines the 45° prone head lift.","confidence":"medium","sources":[]},{"from":"GM-012","to":"GM-013","type":"refines","edge_rationale":"Pushing up with straight arms refines the earlier forearm push-up in prone.","confidence":"medium","sources":[]},{"from":"GM-026","to":"GM-032","type":"refines","edge_rationale":"Walking up stairs alternating feet without a rail refines the earlier walks-up-stairs-holding-a-hand.","confidence":"medium","sources":[]},{"from":"GM-017","to":"GM-001","type":"refines","edge_rationale":"Sitting without support refines the earlier tripod (propped-on-hands) sit.","confidence":"medium","sources":[]},{"from":"SE-028","to":"SE-013","type":"refines","edge_rationale":"Sharing by giving or showing an object refines the earlier offer-or-give behavior toward another child.","confidence":"medium","sources":[]},{"from":"GM-011","to":"GM-002","type":"typical_precursor","edge_rationale":"Bearing weight on legs when held upright typically precedes standing with assistance.","confidence":"medium","sources":[]},{"from":"GM-002","to":"GM-005","type":"typical_precursor","edge_rationale":"Standing with assistance typically precedes standing alone.","confidence":"medium","sources":[]},{"from":"GM-019","to":"GM-020","type":"typical_precursor","edge_rationale":"Pulling up to stand at furniture typically precedes cruising along furniture.","confidence":"medium","sources":[]},{"from":"GM-020","to":"GM-006","type":"typical_precursor","edge_rationale":"Cruising along furniture typically precedes walking alone.","confidence":"medium","sources":[]},{"from":"GM-004","to":"GM-006","type":"typical_precursor","edge_rationale":"Walking with assistance typically precedes walking alone.","confidence":"medium","sources":[]},{"from":"GM-005","to":"GM-006","type":"typical_precursor","edge_rationale":"Standing alone typically precedes walking alone (some children walk before standing solo, so not a hard prereq).","confidence":"medium","sources":[]},{"from":"GM-001","to":"GM-019","type":"typical_precursor","edge_rationale":"Sitting without support typically precedes pulling up to stand.","confidence":"medium","sources":[]},{"from":"GM-007","to":"GM-016","type":"typical_precursor","edge_rationale":"Brief prone head lift typically precedes the head lifting with the body when pulled to sit.","confidence":"medium","sources":[]},{"from":"GM-010","to":"GM-002","type":"typical_precursor","edge_rationale":"Holding head steady when supported upright typically precedes bearing weight standing.","confidence":"medium","sources":[]},{"from":"GM-014","to":"GM-015","type":"typical_precursor","edge_rationale":"Rolling tummy-to-back typically precedes rolling in both directions.","confidence":"medium","sources":[]},{"from":"GM-022","to":"GM-026","type":"typical_precursor","edge_rationale":"Crawling up a few stairs typically precedes walking up stairs holding a hand or railing.","confidence":"medium","sources":[]},{"from":"GM-025","to":"GM-035","type":"typical_precursor","edge_rationale":"Stooping to pick up an object and standing back up typically precedes brief one-foot balance.","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-024","type":"typical_precursor","edge_rationale":"Walking alone typically precedes climbing on and off a couch or chair.","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-029","type":"typical_precursor","edge_rationale":"Walking alone typically precedes kicking a ball forward (kick requires stance on one leg).","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-030","type":"typical_precursor","edge_rationale":"Walking alone typically precedes throwing a ball overhand while standing.","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-022","type":"typical_precursor","edge_rationale":"Walking alone typically precedes crawling up a few stairs (many children stair-crawl after walking).","confidence":"medium","sources":[]},{"from":"FM-005","to":"FM-006","type":"typical_precursor","edge_rationale":"Reaching and grasping typically precedes shaking a rattle held in the hand.","confidence":"medium","sources":[]},{"from":"FM-005","to":"FM-009","type":"typical_precursor","edge_rationale":"Reaching and grasping typically precedes transferring an object from one hand to the other.","confidence":"medium","sources":[]},{"from":"FM-009","to":"FM-011","type":"typical_precursor","edge_rationale":"Object transfer typically precedes banging two small blocks together.","confidence":"medium","sources":[]},{"from":"FM-011","to":"FM-017","type":"typical_precursor","edge_rationale":"Banging two small blocks together typically precedes stacking a tower of two cubes.","confidence":"medium","sources":[]},{"from":"FM-015","to":"FM-021","type":"typical_precursor","edge_rationale":"Spontaneous scribbling typically precedes imitating a vertical line on paper.","confidence":"medium","sources":[]},{"from":"FM-013","to":"FM-018","type":"typical_precursor","edge_rationale":"Voluntary release into a container typically precedes fitting shapes into a shape sorter.","confidence":"medium","sources":[]},{"from":"RC-003","to":"RC-005","type":"typical_precursor","edge_rationale":"Turning the head toward a sound typically precedes responding to one's own name.","confidence":"medium","sources":[]},{"from":"RC-005","to":"RC-010","type":"typical_precursor","edge_rationale":"Responding to name typically precedes looking at a familiar named object.","confidence":"medium","sources":[]},{"from":"RC-009","to":"RC-012","type":"typical_precursor","edge_rationale":"Understanding routine questions typically precedes following a one-step direction paired with a gesture.","confidence":"medium","sources":[]},{"from":"EC-001","to":"EC-002","type":"typical_precursor","edge_rationale":"Non-cry vocalizations typically precede open-vowel cooing.","confidence":"medium","sources":[]},{"from":"EC-002","to":"EC-003","type":"typical_precursor","edge_rationale":"Cooing typically precedes laughing out loud.","confidence":"medium","sources":[]},{"from":"EC-003","to":"EC-004","type":"typical_precursor","edge_rationale":"Laughing typically precedes squealing.","confidence":"medium","sources":[]},{"from":"EC-006","to":"EC-008","type":"typical_precursor","edge_rationale":"Vocal turn-taking typically precedes single consonant-vowel syllables.","confidence":"medium","sources":[]},{"from":"EC-008","to":"EC-010","type":"typical_precursor","edge_rationale":"Single CV syllables typically precede repeated-consonant babble.","confidence":"medium","sources":[]},{"from":"EC-010","to":"EC-011","type":"typical_precursor","edge_rationale":"Repeated-consonant babble typically precedes variegated babble.","confidence":"medium","sources":[]},{"from":"EC-011","to":"EC-012","type":"typical_precursor","edge_rationale":"Variegated babble typically precedes jargon with expressive intonation.","confidence":"medium","sources":[]},{"from":"EC-012","to":"EC-013","type":"typical_precursor","edge_rationale":"Jargon typically precedes the first specific use of 'mama' or 'dada'.","confidence":"medium","sources":[]},{"from":"EC-026","to":"EC-027","type":"typical_precursor","edge_rationale":"Waving 'bye-bye' typically precedes pointing to request.","confidence":"medium","sources":[]},{"from":"EC-027","to":"EC-028","type":"typical_precursor","edge_rationale":"Pointing to request typically precedes declarative pointing to share interest.","confidence":"medium","sources":[]},{"from":"EC-028","to":"EC-029","type":"typical_precursor","edge_rationale":"Declarative pointing typically precedes varied gestures beyond waving and pointing.","confidence":"medium","sources":[]},{"from":"CG-001","to":"CG-002","type":"typical_precursor","edge_rationale":"Regarding a face typically precedes following a moving object to midline.","confidence":"medium","sources":[]},{"from":"CG-005","to":"CG-006","type":"typical_precursor","edge_rationale":"Regarding own hands typically precedes regarding a very small object.","confidence":"medium","sources":[]},{"from":"CG-014","to":"CG-022","type":"typical_precursor","edge_rationale":"Using a cause-and-effect toy typically precedes operating a toy with switches or knobs.","confidence":"medium","sources":[]},{"from":"CG-014","to":"CG-017","type":"typical_precursor","edge_rationale":"Cause-and-effect play typically precedes using common objects the right way (functional use).","confidence":"medium","sources":[]},{"from":"CG-015","to":"CG-018","type":"typical_precursor","edge_rationale":"Playing gesture games with an adult typically precedes give-and-take (rolls a ball back).","confidence":"medium","sources":[]},{"from":"CG-016","to":"CG-019","type":"typical_precursor","edge_rationale":"Imitating adult actions typically precedes pretend-feeding a doll (imitation → symbolic play).","confidence":"medium","sources":[]},{"from":"CG-019","to":"CG-020","type":"typical_precursor","edge_rationale":"Pretending to feed a doll typically precedes using one object to stand for another.","confidence":"medium","sources":[]},{"from":"CG-020","to":"CG-021","type":"typical_precursor","edge_rationale":"Object substitution in pretend play typically precedes acting out a short pretend sequence.","confidence":"medium","sources":[]},{"from":"CG-018","to":"CG-023","type":"typical_precursor","edge_rationale":"Give-and-take play typically precedes combining two or more toys in play.","confidence":"medium","sources":[]},{"from":"SE-001","to":"SE-002","type":"typical_precursor","edge_rationale":"Looking at familiar faces typically precedes the responsive social smile.","confidence":"medium","sources":[]},{"from":"SE-006","to":"SE-007","type":"typical_precursor","edge_rationale":"Chuckling during play typically precedes using sounds and movements to keep an adult engaged.","confidence":"medium","sources":[]},{"from":"SE-009","to":"SE-011","type":"typical_precursor","edge_rationale":"Preferring familiar people typically precedes wariness of strangers.","confidence":"medium","sources":[]},{"from":"SE-010","to":"SE-011","type":"typical_precursor","edge_rationale":"Reacting when a caregiver leaves typically precedes stranger wariness.","confidence":"medium","sources":[]},{"from":"SE-014","to":"SE-019","type":"typical_precursor","edge_rationale":"Copying another child during play typically precedes parallel play alongside other children.","confidence":"medium","sources":[]},{"from":"SE-019","to":"SE-024","type":"typical_precursor","edge_rationale":"Parallel play typically precedes simple cooperative play with another child.","confidence":"medium","sources":[]},{"from":"SE-016","to":"SE-020","type":"typical_precursor","edge_rationale":"Frustration tantrums typically precede using assertive words like 'no' and 'mine' to protest.","confidence":"medium","sources":[]},{"from":"AD-001","to":"AD-002","type":"typical_precursor","edge_rationale":"Bringing food to the mouth typically precedes reliable self-feeding of finger foods.","confidence":"medium","sources":[]},{"from":"AD-013","to":"AD-014","type":"typical_precursor","edge_rationale":"Cooperating with dressing typically precedes putting on some clothing independently.","confidence":"medium","sources":[]},{"from":"AD-017","to":"AD-018","type":"typical_precursor","edge_rationale":"Holding a toothbrush during the routine typically precedes brushing teeth with adult supervision.","confidence":"medium","sources":[]},{"from":"AD-015","to":"AD-016","type":"typical_precursor","edge_rationale":"Cooperating during daily care routines typically precedes washing hands with adult support.","confidence":"medium","sources":[]},{"from":"AD-025","to":"AD-024","type":"typical_precursor","edge_rationale":"Awareness of unsafe situations typically precedes accepting adult guidance in unsafe situations.","confidence":"medium","sources":[]},{"from":"AD-020","to":"AD-023","type":"typical_precursor","edge_rationale":"Having one's mouth wiped/washed after eating typically precedes communicating hungry / thirsty / full.","confidence":"medium","sources":[]},{"from":"SR-005","to":"SR-009","type":"typical_precursor","edge_rationale":"Filtering background stimulation to focus typically precedes sustained attention on a simple task.","confidence":"medium","sources":[]},{"from":"SR-010","to":"SR-011","type":"typical_precursor","edge_rationale":"Shifting attention between activities typically precedes adjusting to routine changes with warning.","confidence":"medium","sources":[]},{"from":"SR-002","to":"SR-014","type":"typical_precursor","edge_rationale":"Quieting when rocked or held typically precedes being easy to soothe overall.","confidence":"medium","sources":[]},{"from":"SR-003","to":"SR-012","type":"typical_precursor","edge_rationale":"Bringing hand or fingers to mouth to self-calm typically precedes going to a familiar adult for comfort.","confidence":"medium","sources":[]},{"from":"SR-012","to":"SR-013","type":"typical_precursor","edge_rationale":"Going to an adult for comfort typically precedes using simple independent strategies to manage strong feelings.","confidence":"medium","sources":[]},{"from":"SR-018","to":"SR-019","type":"typical_precursor","edge_rationale":"Cooperating during dressing / diapering / bath typically precedes managing a short delay in getting needs met.","confidence":"medium","sources":[]},{"from":"SR-006","to":"SR-007","type":"typical_precursor","edge_rationale":"Noticing texture differences typically precedes adjusting handling of fragile, messy, or sticky materials.","confidence":"medium","sources":[]},{"from":"RC-002","to":"SE-005","type":"co_occurring","edge_rationale":"Calming to a familiar voice and recognizing a familiar adult are the same early social-attention phenomenon seen from the RC and SE lenses.","confidence":"medium","sources":[]},{"from":"SE-005","to":"RC-002","type":"co_occurring","edge_rationale":"Calming to a familiar voice and recognizing a familiar adult are the same early social-attention phenomenon seen from the RC and SE lenses.","confidence":"medium","sources":[]},{"from":"RC-005","to":"SE-009","type":"co_occurring","edge_rationale":"Responding to name and preferring familiar people share the same underlying capacity to distinguish and orient to known others.","confidence":"medium","sources":[]},{"from":"SE-009","to":"RC-005","type":"co_occurring","edge_rationale":"Responding to name and preferring familiar people share the same underlying capacity to distinguish and orient to known others.","confidence":"medium","sources":[]},{"from":"RC-008","to":"CG-015","type":"co_occurring","edge_rationale":"Enjoying peek-a-boo / pat-a-cake (RC) and playing clapping and gesture games (CG) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"CG-015","to":"RC-008","type":"co_occurring","edge_rationale":"Enjoying peek-a-boo / pat-a-cake (RC) and playing clapping and gesture games (CG) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"RC-008","to":"SE-029","type":"co_occurring","edge_rationale":"Enjoying game routines (RC) and initiating a familiar game routine (SE) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"SE-029","to":"RC-008","type":"co_occurring","edge_rationale":"Enjoying game routines (RC) and initiating a familiar game routine (SE) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"CG-015","to":"SE-029","type":"co_occurring","edge_rationale":"Playing gesture games (CG) and initiating a familiar game routine (SE) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"SE-029","to":"CG-015","type":"co_occurring","edge_rationale":"Playing gesture games (CG) and initiating a familiar game routine (SE) are the same phenomenon seen from different domain lenses (G-042 game-routine trio).","confidence":"medium","sources":[]},{"from":"AD-021","to":"CG-016","type":"co_occurring","edge_rationale":"Helping with household activities (AD) and imitating simple adult actions and chores (CG) are related observables of the same imitation-and-participation behavior (G-052).","confidence":"medium","sources":[]},{"from":"CG-016","to":"AD-021","type":"co_occurring","edge_rationale":"Helping with household activities (AD) and imitating simple adult actions and chores (CG) are related observables of the same imitation-and-participation behavior (G-052).","confidence":"medium","sources":[]},{"from":"SR-002","to":"RC-002","type":"co_occurring","edge_rationale":"Quieting when rocked / held / swaddled (SR) and calming when spoken to or picked up (RC) are early regulation observables that co-occur (G-055).","confidence":"medium","sources":[]},{"from":"RC-002","to":"SR-002","type":"co_occurring","edge_rationale":"Quieting when rocked / held / swaddled (SR) and calming when spoken to or picked up (RC) are early regulation observables that co-occur (G-055).","confidence":"medium","sources":[]},{"from":"SR-003","to":"SE-015","type":"co_occurring","edge_rationale":"Early self-soothing (hand to mouth) and comfort-object use are two related self-comfort strategies in early toddlerhood (G-055).","confidence":"medium","sources":[]},{"from":"SE-015","to":"SR-003","type":"co_occurring","edge_rationale":"Early self-soothing (hand to mouth) and comfort-object use are two related self-comfort strategies in early toddlerhood (G-055).","confidence":"medium","sources":[]},{"from":"GM-003","to":"GM-021","type":"alternative_path","edge_rationale":"Bottom-shuffling is an alternative locomotion pattern to hands-and-knees crawling; children who bottom-shuffle often skip crawling and still meet the walking milestone on schedule (both items skippable).","confidence":"medium","sources":[]},{"from":"GM-021","to":"GM-003","type":"alternative_path","edge_rationale":"Hands-and-knees crawling is the alternative locomotion pattern to bottom-shuffling (both items skippable).","confidence":"medium","sources":[]},{"from":"AD-001","to":"AD-003","type":"typical_precursor","edge_rationale":"Bringing food to the mouth typically precedes holding one's own bottle.","confidence":"medium","sources":[]},{"from":"AD-015","to":"AD-019","type":"typical_precursor","edge_rationale":"Cooperating during daily care typically precedes blowing the nose with help.","confidence":"medium","sources":[]},{"from":"AD-022","to":"AD-023","type":"typical_precursor","edge_rationale":"Showing food preferences typically precedes communicating hunger, thirst, or fullness with words.","confidence":"medium","sources":[]},{"from":"AD-013","to":"AD-026","type":"typical_precursor","edge_rationale":"Cooperating with dressing and diapering typically precedes indicating when one has voided.","confidence":"medium","sources":[]},{"from":"CG-007","to":"CG-014","type":"typical_precursor","edge_rationale":"Anticipating a familiar feeding routine (early prediction) typically precedes intentional cause-and-effect toy use.","confidence":"medium","sources":[]},{"from":"CG-005","to":"CG-008","type":"typical_precursor","edge_rationale":"Regarding own hands typically precedes putting things in the mouth to explore them.","confidence":"medium","sources":[]},{"from":"CG-011","to":"CG-013","type":"typical_precursor","edge_rationale":"Looking toward a dropped object typically precedes finding an object hidden under visible displacement.","confidence":"medium","sources":[]},{"from":"CG-006","to":"CG-010","type":"typical_precursor","edge_rationale":"Regarding small objects typically precedes working to obtain a toy just out of reach.","confidence":"medium","sources":[]},{"from":"CG-007","to":"CG-024","type":"typical_precursor","edge_rationale":"Anticipating a familiar routine typically precedes anticipating the next step in a multi-step routine.","confidence":"medium","sources":[]},{"from":"CG-017","to":"CG-025","type":"refines","edge_rationale":"Knowing what two common objects are used for refines the functional use of common objects (CG-017).","confidence":"medium","sources":[]},{"from":"CG-023","to":"CG-027","type":"typical_precursor","edge_rationale":"Combining two or more toys in play typically precedes sorting objects into groups by one characteristic.","confidence":"medium","sources":[]},{"from":"CG-023","to":"CG-028","type":"typical_precursor","edge_rationale":"Combining two or more toys in play typically precedes completing a simple two-to-three-piece puzzle.","confidence":"medium","sources":[]},{"from":"CG-023","to":"CG-026","type":"typical_precursor","edge_rationale":"Combining two or more toys in play typically precedes counting two or three objects.","confidence":"medium","sources":[]},{"from":"CG-009","to":"SE-008","type":"co_occurring","edge_rationale":"Signalling fullness (CG) and showing a range of facial expressions of feeling (SE) are the same early affect-signalling capacity from different domain lenses.","confidence":"medium","sources":[]},{"from":"SE-008","to":"CG-009","type":"co_occurring","edge_rationale":"Signalling fullness (CG) and showing a range of facial expressions of feeling (SE) are the same early affect-signalling capacity from different domain lenses (paired direction).","confidence":"medium","sources":[]},{"from":"EC-004","to":"EC-005","type":"typical_precursor","edge_rationale":"Squealing typically precedes blowing raspberries in the same pre-linguistic play cluster.","confidence":"medium","sources":[]},{"from":"EC-006","to":"EC-007","type":"typical_precursor","edge_rationale":"Vocal turn-taking typically precedes using voice deliberately to initiate an interaction.","confidence":"medium","sources":[]},{"from":"EC-008","to":"EC-009","type":"typical_precursor","edge_rationale":"Producing single CV syllables typically precedes imitating speech sounds.","confidence":"medium","sources":[]},{"from":"EC-014","to":"EC-015","type":"refines","edge_rationale":"Saying at least five different words refines the earlier single-word production threshold.","confidence":"medium","sources":[]},{"from":"EC-015","to":"EC-018","type":"refines","edge_rationale":"Saying three or more words besides mama/dada refines the five-word threshold.","confidence":"medium","sources":[]},{"from":"EC-019","to":"EC-021","type":"typical_precursor","edge_rationale":"Combining two words typically precedes using personal pronouns such as I, me, or we.","confidence":"medium","sources":[]},{"from":"EC-014","to":"EC-023","type":"typical_precursor","edge_rationale":"Having a spoken vocabulary typically precedes naming a picture in a book on request.","confidence":"medium","sources":[]},{"from":"EC-023","to":"EC-024","type":"refines","edge_rationale":"Naming four different pictures refines the earlier single-picture naming.","confidence":"medium","sources":[]},{"from":"EC-030","to":"EC-001","type":"typical_precursor","edge_rationale":"Crying to communicate needs (the earliest signal) typically precedes non-cry vocalizations.","confidence":"medium","sources":[]},{"from":"FM-001","to":"FM-005","type":"typical_precursor","edge_rationale":"Briefly holding a placed object typically precedes voluntary reaching and grasping.","confidence":"medium","sources":[]},{"from":"FM-002","to":"FM-005","type":"typical_precursor","edge_rationale":"Opening the hand from a fist typically precedes voluntary reaching and grasping.","confidence":"medium","sources":[]},{"from":"FM-003","to":"FM-005","type":"typical_precursor","edge_rationale":"Bringing hands to midline typically precedes bimanual reaching and grasping.","confidence":"medium","sources":[]},{"from":"FM-003","to":"FM-004","type":"typical_precursor","edge_rationale":"Midline hand play typically precedes bringing hands to the mouth.","confidence":"medium","sources":[]},{"from":"FM-018","to":"FM-027","type":"typical_precursor","edge_rationale":"Fitting shapes into a shape sorter (spatial-manipulation control) typically precedes twisting lids off jars or turning knobs.","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-023","type":"typical_precursor","edge_rationale":"Walking alone typically precedes rising from the floor to standing without support.","confidence":"medium","sources":[]},{"from":"GM-032","to":"GM-033","type":"typical_precursor","edge_rationale":"Walking up stairs alternating feet without a rail typically precedes walking down stairs one step at a time without a rail.","confidence":"medium","sources":[]},{"from":"GM-006","to":"GM-034","type":"typical_precursor","edge_rationale":"Walking alone typically precedes pedalling a tricycle.","confidence":"medium","sources":[]},{"from":"RC-001","to":"RC-003","type":"typical_precursor","edge_rationale":"Reacting to loud sounds typically precedes turning the head toward a sound or voice.","confidence":"medium","sources":[]},{"from":"RC-003","to":"RC-004","type":"typical_precursor","edge_rationale":"Turning the head toward a sound typically precedes looking at the person who is talking.","confidence":"medium","sources":[]},{"from":"RC-005","to":"RC-006","type":"typical_precursor","edge_rationale":"Responding to name typically precedes understanding the word no and pausing or stopping.","confidence":"medium","sources":[]},{"from":"RC-005","to":"RC-007","type":"typical_precursor","edge_rationale":"Responding to name typically precedes following the adult's gaze to a shared object (joint attention).","confidence":"medium","sources":[]},{"from":"RC-010","to":"RC-011","type":"typical_precursor","edge_rationale":"Looking at a familiar named object typically precedes attending to a book while being read to.","confidence":"medium","sources":[]},{"from":"RC-010","to":"RC-018","type":"typical_precursor","edge_rationale":"Looking at named objects typically precedes understanding action words.","confidence":"medium","sources":[]},{"from":"RC-016","to":"RC-020","type":"typical_precursor","edge_rationale":"Pointing to pictures on request typically precedes pointing to a named color.","confidence":"medium","sources":[]},{"from":"RC-019","to":"RC-021","type":"typical_precursor","edge_rationale":"Following a two-step direction typically precedes understanding common prepositions such as in and on.","confidence":"medium","sources":[]},{"from":"RC-020","to":"RC-022","type":"typical_precursor","edge_rationale":"Pointing to a named color typically precedes understanding two descriptive words.","confidence":"medium","sources":[]},{"from":"SE-001","to":"SE-004","type":"typical_precursor","edge_rationale":"Looking at familiar faces typically precedes sustained enjoyable eye contact.","confidence":"medium","sources":[]},{"from":"SE-003","to":"SE-008","type":"typical_precursor","edge_rationale":"Spontaneous smiling typically precedes showing a range of facial expressions of feeling.","confidence":"medium","sources":[]},{"from":"SE-005","to":"SE-012","type":"typical_precursor","edge_rationale":"Recognizing a familiar adult typically precedes raising arms to be picked up.","confidence":"medium","sources":[]},{"from":"SE-014","to":"SE-017","type":"typical_precursor","edge_rationale":"Copying another child during play typically precedes social referencing (checking caregiver's face in new situations).","confidence":"medium","sources":[]},{"from":"SE-017","to":"SE-018","type":"typical_precursor","edge_rationale":"Social referencing typically precedes noticing when others are hurt or upset.","confidence":"medium","sources":[]},{"from":"SE-013","to":"SE-021","type":"typical_precursor","edge_rationale":"Sharing interest by giving or showing typically precedes showing off new skills to a familiar adult.","confidence":"medium","sources":[]},{"from":"SE-013","to":"SE-022","type":"typical_precursor","edge_rationale":"Sharing interest with caregivers typically precedes cooperating with simple routines when asked.","confidence":"medium","sources":[]},{"from":"SE-019","to":"SE-023","type":"typical_precursor","edge_rationale":"Parallel play alongside other children typically precedes naming a preferred playmate.","confidence":"medium","sources":[]},{"from":"SE-017","to":"SE-025","type":"typical_precursor","edge_rationale":"Social referencing (a marker of self/other differentiation) typically precedes recognizing oneself in a mirror or photo.","confidence":"medium","sources":[]},{"from":"SE-011","to":"SE-026","type":"typical_precursor","edge_rationale":"Peak stranger wariness typically precedes easier separation from a primary caregiver.","confidence":"medium","sources":[]},{"from":"SE-022","to":"SE-027","type":"typical_precursor","edge_rationale":"Cooperating with simple routines typically precedes understanding and mostly following simple rules.","confidence":"medium","sources":[]},{"from":"SR-001","to":"SR-002","type":"typical_precursor","edge_rationale":"Coordinating sucking, swallowing, and breathing (the earliest regulation demand) typically precedes quieting when rocked, held, or swaddled.","confidence":"medium","sources":[]},{"from":"SR-004","to":"SR-005","type":"typical_precursor","edge_rationale":"Orienting head or body toward a new stimulus typically precedes filtering background stimulation to focus on a person or object.","confidence":"medium","sources":[]},{"from":"GM-001","to":"FM-009","type":"typical_precursor","edge_rationale":"Sitting without support frees both hands, and passing an object hand to hand typically follows once the child can sit. (phase9c)","confidence":"medium","sources":[]},{"from":"GM-006","to":"SE-035","type":"typical_precursor","edge_rationale":"Moving off to explore and checking back on the caregiver depends on getting about independently, which walking provides. (phase9c)","confidence":"medium","sources":[]},{"from":"FM-028","to":"CG-010","type":"typical_precursor","edge_rationale":"Batting at a toy is the motor route by which the child later works to get a toy that is just out of reach. (phase9c)","confidence":"medium","sources":[]},{"from":"FM-012","to":"AD-002","type":"typical_precursor","edge_rationale":"A mature pincer lets the child pick up small bits of food one by one, which reliable finger-feeding uses. (phase9c)","confidence":"medium","sources":[]},{"from":"FM-013","to":"CG-031","type":"typical_precursor","edge_rationale":"Releasing objects into a container comes before the repeated fill-and-empty game ELOF describes. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"FM-014","to":"CG-031","type":"typical_precursor","edge_rationale":"Tipping objects out of a container is the other half of the fill-and-empty cycle. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"RC-007","to":"EC-028","type":"typical_precursor","edge_rationale":"Following another person's gaze to a shared object (joint attention) typically comes before pointing to show something interesting. (phase9c)","confidence":"medium","sources":[]},{"from":"RC-007","to":"SE-013","type":"typical_precursor","edge_rationale":"Joint attention typically comes before showing or giving objects to share interest. (phase9c)","confidence":"medium","sources":[]},{"from":"RC-023","to":"EC-020","type":"typical_precursor","edge_rationale":"Children understand about fifty words months before they say about fifty (Wordbank comprehension vs production norms). (phase9c)","confidence":"high","sources":["SRC-009"]},{"from":"RC-024","to":"EC-034","type":"typical_precursor","edge_rationale":"Understanding about one hundred words comes months before saying about one hundred (Wordbank comprehension vs production norms). (phase9c)","confidence":"high","sources":["SRC-009"]},{"from":"RC-012","to":"AD-015","type":"typical_precursor","edge_rationale":"Following simple directions with a gesture typically comes before cooperating with the steps of care routines. (phase9c)","confidence":"low","sources":[]},{"from":"RC-013","to":"SE-022","type":"typical_precursor","edge_rationale":"Following one-step directions without a gesture comes before cooperating with routines when simply asked. (phase9c)","confidence":"medium","sources":[]},{"from":"CG-015","to":"EC-026","type":"typical_precursor","edge_rationale":"Clapping and gesture games with an adult typically come before using conventional gestures such as waving bye-bye. (phase9c)","confidence":"medium","sources":[]},{"from":"SE-033","to":"CG-019","type":"typical_precursor","edge_rationale":"Hugging a soft toy or doll typically comes before pretending to feed it. (phase9c)","confidence":"medium","sources":[]},{"from":"EC-014","to":"CG-032","type":"typical_precursor","edge_rationale":"Saying a first word comes before using words for quantity such as 'more' or 'all gone'. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"CG-001","to":"SE-030","type":"typical_precursor","edge_rationale":"Looking at faces comes first; brightening when a familiar face approaches builds on it. (phase9c)","confidence":"medium","sources":[]},{"from":"EC-027","to":"SE-036","type":"co_occurring","edge_rationale":"Pointing to request and leading an adult by the hand are two strategies for the same thing, getting help with something wanted, and appear in the same period. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"SE-036","to":"EC-027","type":"co_occurring","edge_rationale":"Pointing to request and leading an adult by the hand are two strategies for the same thing, getting help with something wanted, and appear in the same period. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"CG-029","to":"FM-028","type":"typical_precursor","edge_rationale":"Holding attention on a toy for several seconds comes before swiping at it. (phase9c)","confidence":"medium","sources":[]},{"from":"GM-038","to":"FM-028","type":"typical_precursor","edge_rationale":"Active, even movement of both arms comes before directed swipes at a toy. (phase9c)","confidence":"low","sources":[]},{"from":"CG-015","to":"SE-032","type":"typical_precursor","edge_rationale":"Clapping in games with an adult typically comes before clapping on one's own to show excitement. (phase9c)","confidence":"medium","sources":[]},{"from":"FM-006","to":"CG-030","type":"typical_precursor","edge_rationale":"Shaking a rattle to hear it is an early case of repeating an action for its result, which the child then uses on purpose. (phase9c)","confidence":"low","sources":["SRC-005"]},{"from":"CG-035","to":"AD-015","type":"co_occurring","edge_rationale":"Acting on a routine before it starts and cooperating with care routines both rest on knowing the routine, and ELOF places them in the same band. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"AD-015","to":"CG-035","type":"co_occurring","edge_rationale":"Acting on a routine before it starts and cooperating with care routines both rest on knowing the routine, and ELOF places them in the same band. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"SE-035","to":"SR-012","type":"co_occurring","edge_rationale":"Exploring away while checking back and going to a familiar adult for comfort are the two sides of using the caregiver as a secure base. (phase9c)","confidence":"medium","sources":[]},{"from":"SR-012","to":"SE-035","type":"co_occurring","edge_rationale":"Exploring away while checking back and going to a familiar adult for comfort are the two sides of using the caregiver as a secure base. (phase9c)","confidence":"medium","sources":[]},{"from":"EC-028","to":"SE-013","type":"co_occurring","edge_rationale":"Pointing to show and giving or showing an object are the same act of sharing interest, by gesture or by object. (phase9c)","confidence":"medium","sources":[]},{"from":"SE-013","to":"EC-028","type":"co_occurring","edge_rationale":"Pointing to show and giving or showing an object are the same act of sharing interest, by gesture or by object. (phase9c)","confidence":"medium","sources":[]},{"from":"FM-028","to":"FM-005","type":"typical_precursor","edge_rationale":"Swiping comes before a reach that ends in a grasp. (phase9c)","confidence":"high","sources":[]},{"from":"FM-029","to":"FM-027","type":"typical_precursor","edge_rationale":"Holding with one hand while working with the other comes before twisting lids off or turning knobs. (phase9c)","confidence":"medium","sources":[]},{"from":"CG-016","to":"CG-033","type":"typical_precursor","edge_rationale":"Copying an action while watching it comes before copying it later from memory. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"EC-014","to":"EC-037","type":"typical_precursor","edge_rationale":"Saying single words comes before joining in with words of a rhyme. (phase9c)","confidence":"medium","sources":[]},{"from":"GM-038","to":"GM-009","type":"typical_precursor","edge_rationale":"Active movement of all four limbs precedes lifting the head high on the tummy. (phase9c)","confidence":"low","sources":[]},{"from":"GM-019","to":"GM-036","type":"typical_precursor","edge_rationale":"Pulling up to stand comes before letting go and standing unsupported for a moment. (phase9c)","confidence":"high","sources":[]},{"from":"GM-036","to":"GM-005","type":"refines","edge_rationale":"Standing alone for a couple of seconds is the brief form of standing alone. (phase9c)","confidence":"high","sources":[]},{"from":"GM-035","to":"GM-037","type":"refines","edge_rationale":"Balancing on each foot for two seconds refines balancing for one second. (phase9c)","confidence":"high","sources":[]},{"from":"SE-031","to":"SE-025","type":"typical_precursor","edge_rationale":"Interest in the mirror image comes long before recognising it as oneself. (phase9c)","confidence":"medium","sources":[]},{"from":"SE-002","to":"SE-034","type":"typical_precursor","edge_rationale":"Responsive smiling comes before offering hugs and kisses. (phase9c)","confidence":"medium","sources":[]},{"from":"CG-030","to":"CG-014","type":"typical_precursor","edge_rationale":"Repeating an action for its effect comes before using a cause-and-effect toy on purpose. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"CG-010","to":"CG-034","type":"typical_precursor","edge_rationale":"Working to get a toy just out of reach comes before trying a different way when the first one fails. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"CG-007","to":"CG-035","type":"typical_precursor","edge_rationale":"Anticipating a feeding routine comes before acting on a routine before it starts. (phase9c)","confidence":"medium","sources":["SRC-005"]},{"from":"EC-014","to":"EC-036","type":"refines","edge_rationale":"Two words refines one word (Denver LA14 then LA15). (phase9c)","confidence":"high","sources":["SRC-008"]},{"from":"EC-036","to":"EC-018","type":"refines","edge_rationale":"Three words refines two words (Denver LA15 then LA16). (phase9c)","confidence":"high","sources":["SRC-008"]},{"from":"SE-005","to":"SE-030","type":"co_occurring","edge_rationale":"Recognising a familiar adult and brightening when they approach are the same early recognition. (phase9c)","confidence":"medium","sources":[]},{"from":"SE-030","to":"SE-005","type":"co_occurring","edge_rationale":"Recognising a familiar adult and brightening when they approach are the same early recognition. (phase9c)","confidence":"medium","sources":[]}],"activities":[{"id":"ACT-0001","title":"Chest-to-chest tummy time","targets":["GM-007","GM-008","GM-012"],"supports":["GM-013","GM-010"],"type":"routine","age_window":{"from_months":0,"to_months":3},"duration_minutes":5,"frequency":"a few times a day","materials":["adult chest and a firm supportive surface (bed edge or sofa) for the adult to recline against"],"cost_tier":"free","how_to":["Recline at roughly a 30-45 degree angle on a bed or sofa.","Place the baby tummy-down on your chest with the baby cheek near your chin.","Talk softly or sing so the baby has a reason to lift the head toward your face.","Support the baby hips with one hand for stability."],"signs_it_is_working":"Baby briefly lifts the head off the caregiver chest and turns toward the face or voice; hands come toward midline; breathing stays steady.","signs_to_stop":"Subtle: gaze aversion or a yawn/hiccough burst. Potent: crying, colour change to red or mottled, arching away or finger splay. Return the baby upright against the shoulder and pause for 30-60 seconds before offering more.","adult_role":"Provide the face-and-voice reason to lift the head. Do not push the baby head up.","safety":"Never leave the baby unattended in prone. Chest tummy time only when the caregiver is awake and reclined, never lying flat on the back with the baby, which risks the baby rolling off.","derivation":"adopted","evidence_note":"Tummy time from birth is CDC and AAP core guidance; chest-to-chest is the earliest form tolerated by newborns.","sources":["SRC-002"]},{"id":"ACT-0002","title":"Floor tummy time with a face-toy","targets":["GM-008","GM-009","GM-012","GM-013"],"supports":["GM-017","GM-014"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":5,"frequency":"a few times a day","materials":["firm thin mat or folded dupatta on the floor","a small unbreakable mirror or a soft toy with a face"],"cost_tier":"free","india_sourcing_note":"A folded cotton dupatta or bedsheet on a clean floor works; a stainless-steel thali held upright is a low-cost mirror substitute if placed just out of grasp.","how_to":["Place the mat on a flat uncluttered floor.","Lay the baby tummy-down with arms free and forward of the shoulders.","Set the mirror or face-toy about 20-25 cm from the baby face.","Get down at the baby eye level and talk to them from just behind the toy."],"signs_it_is_working":"Baby pushes up on forearms, later on straight arms; head lifts to 45 then 90 degrees; eyes track the mirror or toy.","signs_to_stop":"Subtle: gaze aversion, cheek turning fully to the mat, dull face. Potent: full cry, floppy collapse, red face. Roll the baby to their back, hold them quietly for 30-60 seconds, and offer again only after they re-engage.","adult_role":"Stay at eye level and provide the reason to look up. Session length grows naturally as head control improves.","safety":"Awake and supervised only. Not for babies with unmanaged reflux immediately after a feed.","derivation":"adapted","evidence_note":"Adapted from Pathways.org tummy-time activities. Face-toy placement distance and eye-level positioning are common recommendations across CDC, Pathways, and NHS RSB.","sources":["SRC-018","SRC-002"]},{"id":"ACT-0003","title":"Upright shoulder-hold with head practice","targets":["GM-010"],"supports":["GM-011","GM-016"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":3,"frequency":"a few times a day","materials":["adult shoulder"],"cost_tier":"free","how_to":["Hold the baby upright against your shoulder with a hand supporting the head at first.","Slowly ease the supporting hand for a moment so the baby has to steady the head themselves.","Sway gently side to side; the small vestibular input encourages head-steadying.","Return the support the instant you see wobble or fatigue."],"signs_it_is_working":"Baby holds the head steady for a few seconds without the supporting hand; eyes stay open and alert; small self-corrections rather than lolling.","signs_to_stop":"Subtle: head bobbing, gaze becoming dull, hiccoughs, hand-to-ear. Potent: fussing, arching backward, colour change. Reseat the head against your shoulder and pause; try again later after a rest.","adult_role":"Ease support briefly; never withdraw it entirely at this age.","safety":"Support the head at all times when carrying up or down stairs, into a car seat, or when interrupted.","derivation":"adapted","evidence_note":"Common carrying-position guidance; the brief support-release is a Vroom-style micro-moment applied to gross-motor practice.","sources":["SRC-017"]},{"id":"ACT-0004","title":"Gentle pull-to-sit practice","targets":["GM-016"],"supports":["GM-001","GM-017"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":2,"frequency":"daily","materials":["firm flat surface (bed or mat)"],"cost_tier":"free","how_to":["Lay the baby on the back on a firm surface.","Offer both index fingers for the baby to grasp; wrap your thumbs gently around their hands.","Pull very slowly through 30-45 degrees so the baby has time to bring the head with the body.","Return the baby to lying just as slowly. Two or three cycles is a full session."],"signs_it_is_working":"Head lifts with the body rather than lagging behind; the chin comes toward the chest; forearms flex against the pull.","signs_to_stop":"Subtle: head-lag returns after a good rep, jerky pull-back. Potent: crying, floppy shoulders, colour change. Return the baby to lying flat and hold them quietly; skip further pulls this session.","adult_role":"Pull slowly enough for the head to catch up; the baby does the work, not you.","safety":"Never pull by the wrists or forearms; the baby grasps your fingers. Do not attempt if the baby has any known cervical concern.","derivation":"adapted","evidence_note":"Pull-to-sit is a standard Denver and NCAST clinical observation; framed here as a supervised parent activity per Pathways and RSB descriptions.","sources":["SRC-018","SRC-015"]},{"id":"ACT-0005","title":"Rolling invitation with side-placed toy","targets":["GM-014","GM-015"],"supports":["FM-005"],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":5,"frequency":"daily","materials":["a colourful rattle or a soft cloth ball"],"cost_tier":"free","india_sourcing_note":"A small cotton potli filled with a spoon of dry moong makes a safe washable rattle.","how_to":["Lay the baby on the back on a mat.","Show the rattle in the midline, then move it slowly to one side, just past the shoulder.","Wait. Let the baby reach, shift weight, and try to twist toward it.","Only assist by placing a gentle hand under the far hip if the baby is genuinely stuck and has not yet given up on the toy."],"signs_it_is_working":"Baby follows the toy with the eyes, twists shoulders and hips toward it, and completes a roll to the side or all the way to tummy or back.","signs_to_stop":"Subtle: gaze aversion, letting the arm fall back. Potent: fussing, crying, arching. Bring the toy back to midline and celebrate whatever movement did happen; try again after a break.","adult_role":"Wait. Rolling is a discovery, not a manoeuvre; the adult provides motivation, not the roll itself.","safety":"Only on a firm mat with clear space to either side. Do not place the toy over the baby face.","derivation":"adopted","evidence_note":"NHS Ready Steady Baby: there are lots of things you can do to help your baby gradually learn how to start rolling. Placement-and-wait is the specific pattern.","sources":["SRC-015"]},{"id":"ACT-0006","title":"Midline hands and reach play","targets":["FM-003","FM-005"],"supports":["GM-014","GM-017"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":5,"frequency":"daily","materials":["light rattle, soft ring, or teether the baby can grasp with one hand"],"cost_tier":"free","how_to":["With the baby on the back or in a supported semi-reclined position, hold a rattle above the chest in midline.","Wait for the baby to bring both hands together toward it.","Once the baby grasps, let them keep the toy for as long as they stay engaged.","Occasionally shift the toy 5-10 cm to either side to encourage weight-shift and early rolling."],"signs_it_is_working":"Hands come to midline and both meet the toy; grasp is voluntary; eyes stay on the toy through the reach.","signs_to_stop":"Subtle: hand-to-ear, arm falling to the side, gaze aversion. Potent: crying, back-arching, dropping the toy repeatedly with a cry.","adult_role":"Present at midline; the baby does the reaching.","safety":"Toy small enough to hold, large enough not to fit in the mouth beyond the lips.","derivation":"adapted","evidence_note":"Reach-in-midline is standard early manipulation guidance across CCD and Pathways; the wait-then-shift structure is our composition.","sources":["SRC-016","SRC-018"]},{"id":"ACT-0007","title":"Cushion-ringed sitting practice","targets":["GM-017","GM-001"],"supports":["FM-007"],"type":"play","age_window":{"from_months":4,"to_months":8},"duration_minutes":8,"frequency":"daily","materials":["two firm cushions or rolled dupattas","one or two safe toys"],"cost_tier":"free","india_sourcing_note":"Two firm bed pillows or a rolled cotton razai make a safe C-ring around a young sitter.","how_to":["Sit the baby on the floor with the cushions arranged in a C behind and around them so a topple lands on padding.","Place a toy at hand-height in front. Let the baby prop on hands (tripod) or sit hands-free as their control grows.","As the baby holds the position, slide the toy slightly to the side so they have to shift weight to keep it.","End before frustration; a few minutes done well beats a long tired session."],"signs_it_is_working":"Baby holds tripod sit for several seconds, then progresses to hands-free sitting; recovers small wobbles without falling.","signs_to_stop":"Subtle: hunched slump, hands white-knuckling the floor. Potent: toppling with a cry, refusing to reach. Lay the baby down, quiet play for 30-60 seconds, then only re-try if they re-engage.","adult_role":"Set the safe ring and the target toy; do not prop the trunk yourself.","safety":"Cushions only, not the sofa arm. Hard floors: add a rug or mat under the cushions.","derivation":"adapted","evidence_note":"Adapted from Pathways.org sitting activities and CCD low-resource sitting guidance.","sources":["SRC-018","SRC-016"]},{"id":"ACT-0008","title":"Lap bounce for leg weight-bearing","targets":["GM-011"],"supports":["GM-002","GM-019"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":3,"frequency":"a few times a day","materials":["adult lap"],"cost_tier":"free","how_to":["Sit on the floor or a firm chair; hold the baby under the armpits, facing you.","Let the baby feet touch your thighs.","Wait for the baby to push through their legs; bounce very gently in reply.","Stop each round the moment the baby legs go soft or knees buckle repeatedly."],"signs_it_is_working":"Legs push actively rather than dangling; the baby smiles or vocalises in reply to the bounce.","signs_to_stop":"Subtle: legs going soft, gaze aversion. Potent: crying, arching, colour change. Hold the baby against your chest quietly and try later.","adult_role":"Follow the baby push; do not force weight through soft legs.","safety":"Support fully under the armpits so the shoulders bear no strain. Not on a slippery surface.","derivation":"adapted","evidence_note":"Weight-bearing play as an early standing precursor is common across Vroom-style short-tip content; wording and structure here are original.","sources":["SRC-017"]},{"id":"ACT-0009","title":"Toy just out of reach on the mat","targets":["GM-003","GM-021","GM-020"],"supports":["FM-005","CG-010"],"type":"play","age_window":{"from_months":6,"to_months":12},"duration_minutes":10,"frequency":"daily","materials":["one or two motivating toys (a ball, a rattle, a light plastic cup)"],"cost_tier":"free","how_to":["Place the toys about half a metre beyond the baby reach on a firm floor.","Point, name, encourage; but do not slide the toy closer.","Give the baby time to try any locomotion pattern that works for them: crawling, bottom-shuffling, or rolling to close the distance.","Move the toy to the reached spot only after they arrive; the toy is the reward for the movement."],"signs_it_is_working":"Baby uses any locomotion pattern to close the gap; the pattern used matters less than the intention.","signs_to_stop":"Subtle: giving up and turning away, dropping to fussing. Potent: cry that does not stop when the toy is brought closer. Bring the toy in; comfort; try later with a shorter distance.","adult_role":"Set distance and cheer arrival. Do not carry the baby or slide the toy; the whole point is the child initiative.","safety":"Clear the floor of small items. Not on stairs or near hard edges.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): place toys on the ground or on a play mat a little out of reach and encourage your baby to crawl, scoot, or roll to get them. Note that bottom-shuffling is an accepted alternative pattern; do not push a bottom-shuffler onto hands and knees.","sources":["SRC-002"]},{"id":"ACT-0010","title":"Sit-and-play with two-toy exchange","targets":["GM-001"],"supports":["FM-007","FM-009","CG-018"],"type":"play","age_window":{"from_months":5,"to_months":10},"duration_minutes":10,"frequency":"daily","materials":["two small toys the baby can grasp (blocks, plastic keys, small cups)"],"cost_tier":"free","how_to":["Sit the baby unsupported on a mat with clear floor around them.","Hand them one toy; wait until they are holding it steadily.","Offer the second toy toward the same hand; watch what they do: transfer, drop, or reach with the other hand.","Let the play unfold; do not correct grip or hand choice."],"signs_it_is_working":"Baby holds one toy while accepting another; either transfers between hands or holds one in each; trunk stays upright without prop.","signs_to_stop":"Subtle: slumping to prop on hands, dropping both toys with a stare. Potent: toppling with a cry. Return to cushion-ringed sit or lap-sit for the rest of the session.","adult_role":"Provide the two-toy problem; do not solve it.","safety":"Toys too large to swallow, no strings or long ribbons.","derivation":"adapted","evidence_note":"Two-toy exchange is a standard clinical observation for bimanual manipulation; framing here draws on CCD play-with-household-objects guidance.","sources":["SRC-016"]},{"id":"ACT-0011","title":"Cruising along a low sturdy surface","targets":["GM-020"],"supports":["GM-019","GM-005","GM-006"],"type":"play","age_window":{"from_months":8,"to_months":14},"duration_minutes":10,"frequency":"daily","materials":["a low heavy piece of furniture with a smooth stable edge (sofa, coffee table, low bed)"],"cost_tier":"free","india_sourcing_note":"A low takht or a diwan works well; check that the surface is stable and not on wheels.","how_to":["Stand the baby holding the edge of the furniture.","Place a favourite toy along the edge a metre away.","Wait for the baby to side-step along the edge toward the toy.","Repeat with the toy at different positions along the length."],"signs_it_is_working":"Baby side-steps along the edge holding on, uses both hands to move the grip, reaches the toy without letting go.","signs_to_stop":"Subtle: single-step stops, staring at the toy without moving. Potent: sitting down abruptly, crying. Sit with them; try later.","adult_role":"Stay close but do not lift the baby along the edge; movement is the point.","safety":"Use furniture heavy enough not to tip; corners padded if sharp; clear floor for a fall.","derivation":"adapted","evidence_note":"Adapted from a Pathways.org motor activity (sit-to-stand and cruising).","sources":["SRC-018"]},{"id":"ACT-0012","title":"Pull-to-stand at a low target","targets":["GM-019"],"supports":["GM-002","GM-020"],"type":"play","age_window":{"from_months":7,"to_months":12},"duration_minutes":8,"frequency":"daily","materials":["a low stable surface at chest-height when the baby is sitting (a firm cushion pile, a small stool, a low takht)"],"cost_tier":"free","how_to":["Sit the baby on the floor next to the low surface.","Place a toy on top of the surface, just out of reach from sitting.","Let the baby work out that they need to grip and pull to reach the toy.","Wait through the effort; a few attempts a day is enough."],"signs_it_is_working":"Baby grips the edge, pulls the trunk up through the arms, and gets one or both knees under to stand.","signs_to_stop":"Subtle: falling back to sit repeatedly and looking away. Potent: crying, refusing to try. Sit with them; move on to something they already own.","adult_role":"Wait; the effort is the point.","safety":"Use a heavy, non-tipping surface. Nothing sharp on top or nearby.","derivation":"adapted","evidence_note":"Standard cruising-precursor activity; wording our own.","sources":["SRC-018"]},{"id":"ACT-0013","title":"Supervised stair-crawl practice","targets":["GM-022"],"supports":["GM-003"],"type":"play","age_window":{"from_months":9,"to_months":15},"duration_minutes":5,"frequency":"weekly","materials":["a set of stairs with an adult positioned one step below the baby throughout"],"cost_tier":"free","india_sourcing_note":"Indian stairs are often steeper than Western norms; a single low step (like the drop from a raised takht to floor) is a safer starting point.","how_to":["Place the baby at the bottom of two or three steps.","Stand or kneel one step below the baby, hands ready.","Let the baby crawl up on hands and knees at their own pace.","Practice coming down feet-first backwards on hands and knees each time; this is safer than head-first."],"signs_it_is_working":"Baby moves up one step at a time; backs down feet-first safely; looks up or back to check for you but keeps moving.","signs_to_stop":"Subtle: freezing on a step, looking away from the stair. Potent: crying, sudden collapse. Lift them off and try again another day.","adult_role":"Stay one step below; never in front where a fall lands on you and a step. Teach the feet-first descent explicitly; children default to going down head-first.","safety":"Stair gates when unsupervised. Never leave the child on stairs alone. Practice on stairs with a wall or railing on both sides.","derivation":"adapted","evidence_note":"Stair safety and feet-first descent is standard AAP and CDC guidance echoed by CDC LTSAE and Pathways.","sources":["SRC-002","SRC-018"]},{"id":"ACT-0014","title":"Push-along walker for early steps","targets":["GM-004","GM-006"],"supports":["GM-005","GM-020"],"type":"toy","age_window":{"from_months":9,"to_months":15},"duration_minutes":15,"frequency":"daily","materials":["a stable push-toy or a heavy cardboard box the child can lean on and push"],"cost_tier":"under_2000_inr","india_sourcing_note":"Weighted push-toys sold in Indian toy shops usually work; a filled 5-kg atta box on a smooth floor is a free alternative for a child of the right size.","how_to":["Set the push-toy on a smooth floor with clear space ahead.","Stand the child at the handle and place their hands on it.","Let them push at their own pace; the toy provides the arm-height support that free walking has not yet earned.","Retrieve and restart at the far side; a session is a few crossings."],"signs_it_is_working":"Child takes several steps behind the toy, keeps the trunk mostly upright, stops and turns rather than collapsing when the toy slows.","signs_to_stop":"Subtle: sitting down abruptly, hunching over the handle. Potent: crying, falling forward over the toy. Comfort and let free floor play resume.","adult_role":"Set up and stand back. Do not walk the child yourself with hands overhead; that lifts the shoulders and unloads the legs.","safety":"Choose a push-toy that moves at a controlled pace on the surface; not on a slope, not on tile at speed, not near stairs.","derivation":"adapted","evidence_note":"Push-toy walking is standard early-walking guidance across Pathways and RCN. Sit-in baby walkers (jhoola-style) are separately discouraged and not included here.","sources":["SRC-018","SRC-014"]},{"id":"ACT-0015","title":"Two-hand-held walking practice","targets":["GM-004","GM-006"],"supports":["GM-005"],"type":"play","age_window":{"from_months":9,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["adult two hands"],"cost_tier":"free","how_to":["Stand the baby facing away from you.","Offer both your hands at the baby shoulder height, not overhead.","Let the baby take the hands and walk forward at their pace.","As comfort grows, offer one hand only, then follow-alongside without contact."],"signs_it_is_working":"Baby leans forward slightly and steps with alternating feet; grip on your hands is a support, not a hang.","signs_to_stop":"Subtle: heavy weight on your hands, dragging feet. Potent: sitting down and crying. Sit with them.","adult_role":"Offer support at shoulder height; do not lift the arms overhead, which unloads the legs and delays independent standing.","safety":"Clear level floor. Do not walk with the baby down steps or over cables while hand-holding.","derivation":"adapted","evidence_note":"Paraphrased from UNICEF and WHO Care for Child Development counselling cards for 9-12 months.","sources":["SRC-016"]},{"id":"ACT-0016","title":"Ball rolling back and forth on the floor","targets":["GM-001"],"supports":["GM-020","CG-018","SE-028"],"type":"play","age_window":{"from_months":6,"to_months":18},"duration_minutes":8,"frequency":"daily","materials":["one soft ball, roughly the size of a small football (15-20 cm)"],"cost_tier":"under_500_inr","india_sourcing_note":"Any soft cloth or rubber ball from a local kirana; a rolled-up dupatta tied into a soft bundle is a free alternative.","how_to":["Sit on the floor facing the child a metre or two apart, both with legs open forming a V.","Roll the ball slowly toward the child.","Wait for them to catch and, if they can, roll it back.","Keep the pace slow; give a lot of eye contact and language (ready, here it comes)."],"signs_it_is_working":"Child catches the ball, then intentionally sends it back; the give-and-take is the milestone here, not the trajectory.","signs_to_stop":"Subtle: eyes leaving the ball, letting it roll past. Potent: pushing the ball away with a fuss. Pause; try another game.","adult_role":"Model the return roll. Wait for their turn rather than filling it.","safety":"Soft ball only. Do not throw at the child.","derivation":"adapted","evidence_note":"Turn-taking with an object is a foundational give-and-take game across CDC, CCD, and ELOF Social and Emotional. Wording original.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0017","title":"Basket stoop-and-drop","targets":["GM-025"],"supports":["GM-006","FM-008","FM-013"],"type":"play","age_window":{"from_months":12,"to_months":20},"duration_minutes":8,"frequency":"daily","materials":["one shallow open basket or box","5-10 small safe objects (blocks, plastic lids, wooden spoons)"],"cost_tier":"free","india_sourcing_note":"A steel dabba, small tokri, or a plastic paranda box all work; kitchen items are ideal because they connect to the daily household routine.","how_to":["Scatter the objects on the floor.","Set the basket a few steps away.","Ask the child to pick up the objects and drop them in.","Praise the stooping, standing, and walking; not the pace."],"signs_it_is_working":"Child stoops without holding on, stands back up with the object, and walks it to the basket.","signs_to_stop":"Subtle: sitting down to collect, refusing to stand. Potent: throwing the basket, crying. Pack up; try later.","adult_role":"Set up; do not collect for them. Turn-taking a few pieces is fine.","safety":"Objects too large to swallow, nothing sharp.","derivation":"adapted","evidence_note":"Stoop-and-recover as a whole-body strength activity is standard toddler gross-motor guidance; framing our own.","sources":["SRC-018"]},{"id":"ACT-0018","title":"Walking on varied surfaces","targets":["GM-006"],"supports":["SR-008","SR-015"],"type":"outing","age_window":{"from_months":12,"to_months":30},"duration_minutes":20,"frequency":"weekly","materials":["access to a mix of surfaces: floor tile, rug, grass, sand, gravel"],"cost_tier":"free","how_to":["Take the child on a slow walk that crosses several surface types in one outing.","Slow at the boundary of each surface; let them look, feel underfoot, and adjust.","Name the surface in your language (ghas, ret, pathar).","Barefoot on safe surfaces once; shoes back on for gravel or hot ground."],"signs_it_is_working":"Child adjusts step length or gait between surfaces; slows at the boundary without stopping altogether; keeps balance on the softer surface.","signs_to_stop":"Subtle: freezing at a boundary, gripping hard on your hand. Potent: sitting down and refusing, crying. Carry across; try again a week later.","adult_role":"Slow the pace; hold a hand near boundaries; let the child do the adjusting.","safety":"Check the ground temperature and for glass or sharp gravel before barefoot walking. Not near traffic without a firm hand-hold.","derivation":"original","evidence_note":"Original activity constructed from the SR-008 hard-prerequisite from GM-006 recorded in edges.json. Surface-varying walks feature in Head Start ELOF Perception guidance and Pathways.org motor tracks; adapting them into a single outing here.","sources":["SRC-005","SRC-018"]},{"id":"ACT-0019","title":"Climb on and off a low sofa","targets":["GM-024","GM-023"],"supports":["GM-022","GM-025"],"type":"play","age_window":{"from_months":13,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["a low sofa, diwan, or firm mattress on the floor"],"cost_tier":"free","how_to":["Let the child climb up onto the sofa, sit or stand, then climb back down.","Teach going down feet-first, on the belly, sliding down; not head-first.","Adult sits on the floor beside as a spotter, not a helper.","Two or three climbs is a full round."],"signs_it_is_working":"Child climbs up using coordinated arms and legs; comes down feet-first safely; can rise from the floor without pulling on you.","signs_to_stop":"Subtle: slower climbs, wobbly descent. Potent: falling with a cry, refusing to try. Stop for the day.","adult_role":"Spot from the floor; do not lift the child up.","safety":"No hard edges below. Soft flooring under the sofa. Do not use a high bed.","derivation":"adapted","evidence_note":"Climb-on-and-off routine adapted from Pathways.org motor activities.","sources":["SRC-018"]},{"id":"ACT-0020","title":"Backwards walking game","targets":["GM-027"],"supports":["GM-006","GM-035"],"type":"play","age_window":{"from_months":13,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["a clear stretch of floor 2-3 metres long"],"cost_tier":"free","how_to":["Face the child a metre away.","Take a slow step backward yourself and invite the child to do the same.","Alternate: walk backward together, then forward, then backward again.","Sing a slow rhyme to keep the pace steady."],"signs_it_is_working":"Child takes two or more backward steps without turning to look, keeps balance, and enjoys the game enough to repeat it.","signs_to_stop":"Subtle: turning to look after every step, hesitant weight-shift. Potent: falling, refusing to try. Return to forward walking.","adult_role":"Model, mirror, slow.","safety":"Clear space behind the child; ideally against a wall or with an adult behind as a soft spotter.","derivation":"adapted","evidence_note":"Backwards walking as an early balance activity is common across Pathways and Raising Children.","sources":["SRC-018","SRC-014"]},{"id":"ACT-0021","title":"Chase and run in open space","targets":["GM-028"],"supports":["GM-006","GM-027"],"type":"play","age_window":{"from_months":15,"to_months":30},"duration_minutes":15,"frequency":"daily","materials":["safe open space (park, garden, empty room)"],"cost_tier":"free","how_to":["In a clear open space, invite the child to chase you.","Move at a pace they can keep up with; let them catch you frequently.","Switch roles: pretend to chase them so they run toward a wall or across the room.","Two or three rounds per session; laughter is the metric."],"signs_it_is_working":"Child breaks into a true run with both feet off the ground briefly, changes direction without falling, stops on cue.","signs_to_stop":"Subtle: flushed face, panting harder than the exertion warrants. Potent: falling, crying, refusing. Sit and rest; offer water.","adult_role":"Set the pace; be the reason to run.","safety":"No traffic, no water hazards, no hard corners at running-child head height.","derivation":"adapted","evidence_note":"Chase-and-catch play is a universal toddler gross-motor activity; framing draws on Raising Children Network get-moving guidance.","sources":["SRC-014"]},{"id":"ACT-0022","title":"Kick a big soft ball forward","targets":["GM-029"],"supports":["GM-006","GM-028"],"type":"play","age_window":{"from_months":15,"to_months":28},"duration_minutes":10,"frequency":"daily","materials":["one soft ball roughly 20-25 cm across"],"cost_tier":"under_500_inr","how_to":["Put the ball on the floor in front of the standing child, close to their foot.","Show them once: swing your leg and kick the ball forward.","Reset the ball in front of them and wait.","Celebrate any forward movement of the ball; the aimed kick comes later."],"signs_it_is_working":"Child kicks the ball forward while keeping balance on the standing leg; does not fall after the kick.","signs_to_stop":"Subtle: kicking then sitting down repeatedly. Potent: refusal, kicking things other than the ball. Pack up.","adult_role":"Model once, then be a target for the ball to roll toward.","safety":"Soft ball only, indoors or a fenced outdoor space.","derivation":"adopted","evidence_note":"Kick-a-ball as a toddler activity appears in CDC 18-24 month age band tips.","sources":["SRC-002"]},{"id":"ACT-0023","title":"Soft-ball overhand throw at a target","targets":["GM-030"],"supports":["FM-005"],"type":"play","age_window":{"from_months":18,"to_months":30},"duration_minutes":10,"frequency":"daily","materials":["a small soft ball or a rolled sock","a large open target: a laundry basket, a cardboard box, a chalked spot on the wall"],"cost_tier":"under_500_inr","how_to":["Put the basket a metre from the child.","Model an overhand throw with a rolled sock: watch, over the shoulder.","Hand the ball to the child and let them throw at the basket.","Fetch and repeat; six throws is a round."],"signs_it_is_working":"Child raises the arm above the shoulder before releasing; the ball goes forward, roughly toward the target.","signs_to_stop":"Subtle: throwing sideways or backward. Potent: throwing at people or objects other than the target. Stop; put the ball away for the day.","adult_role":"Model the arm path; do not correct the release mid-throw.","safety":"Soft ball only. Establish that throwing is a game for balls and this basket, not for other objects.","derivation":"adapted","evidence_note":"Overhand throwing is CDC-milestone-associated and appears in Pathways motor activities.","sources":["SRC-002","SRC-018"]},{"id":"ACT-0024","title":"Stairs up holding an adult hand","targets":["GM-026"],"supports":["GM-022"],"type":"routine","age_window":{"from_months":14,"to_months":30},"duration_minutes":3,"frequency":"daily","materials":["stairs with a railing, and an adult hand"],"cost_tier":"free","how_to":["Approach the stairs and stop at the bottom.","Offer one hand at the child shoulder height; the other hand of the child can hold the railing.","Let the child go up one step at a time, both feet meeting on each step (marking time).","Come down feet-first on hands and knees at this age unless the child is confident on the railing."],"signs_it_is_working":"Child goes up step by step with steady grip, keeps eyes on the next step, stops at the top.","signs_to_stop":"Subtle: hesitation, gripping tightly, looking at your face rather than the step. Potent: sitting down mid-flight, crying. Carry up and try later.","adult_role":"Hand at shoulder height; do not lift the child by the hand.","safety":"Never rush. Do not use a stroller or hold anything else on the stairs.","derivation":"adapted","evidence_note":"Standard stair-safety guidance echoed across Pathways and NHS RSB.","sources":["SRC-018"]},{"id":"ACT-0025","title":"Stairs down holding an adult hand","targets":["GM-026"],"supports":["GM-033"],"type":"routine","age_window":{"from_months":15,"to_months":30},"duration_minutes":3,"frequency":"daily","materials":["stairs with a railing, and an adult hand"],"cost_tier":"free","how_to":["At the top of the stairs, offer one hand at the child shoulder height; the child other hand goes on the railing.","Descend one step at a time, both feet meeting on each step.","Say one foot, other foot out loud; language paces the descent.","Never carry another item down the stairs while hand-holding a toddler."],"signs_it_is_working":"Child descends step by step without pulling on your hand, keeps grip on the railing, stops at the bottom.","signs_to_stop":"Subtle: sitting on the top step and looking away. Potent: bump-down on the bottom, crying. Sit with them on the step; wait; try later.","adult_role":"Steady hand at shoulder height. Pace the descent with language.","safety":"Downstairs is riskier than up; the fall path is longer. Never carry another child at the same time.","derivation":"adapted","evidence_note":"Downstairs guidance parallel to ACT-0024; feet-first-holding-a-hand is safer than head-first crawling once the child can grip a railing.","sources":["SRC-018"]},{"id":"ACT-0026","title":"Two-foot jump from a floor line","targets":["GM-031"],"supports":["GM-006","GM-035"],"type":"play","age_window":{"from_months":22,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["a chalk line, a length of tape, or a dupatta laid on the floor"],"cost_tier":"free","how_to":["Lay the line on the floor.","Stand on one side; invite the child to jump over the line to your side.","Model with both feet together; a small hop.","As it becomes easy, jump over two parallel lines a hand-width apart."],"signs_it_is_working":"Both of the child feet leave the ground at the same time and land together; child lands upright and does not fall.","signs_to_stop":"Subtle: stepping over rather than jumping, one foot leading. Potent: falling forward, refusing. Pack the game away; a two-foot jump is a maturational milestone and cannot be trained.","adult_role":"Model the two-foot takeoff; do not lift the child through the jump.","safety":"Non-slip surface. Not on a bed or sofa (falls are farther and harder).","derivation":"adapted","evidence_note":"Two-foot jumping is CDC 2y and 30mo age-band content; framing draws on Pathways motor activities.","sources":["SRC-002","SRC-018"]},{"id":"ACT-0027","title":"One-foot balance game","targets":["GM-035"],"supports":["GM-031"],"type":"play","age_window":{"from_months":24,"to_months":36},"duration_minutes":5,"frequency":"daily","materials":["a mat or rug for cushioned falls"],"cost_tier":"free","how_to":["Stand facing the child with your feet together.","Lift one foot slightly; ask can you stand like a stork.","Count out loud together; two seconds is the win at first, five seconds later.","Switch feet; both sides are the practice."],"signs_it_is_working":"Child lifts one foot clear of the ground and holds for at least a full second without hopping or falling.","signs_to_stop":"Subtle: swaying and immediately putting the foot down, gripping your leg. Potent: falling, refusing. Sit; play something else.","adult_role":"Model; count; celebrate small wins.","safety":"On a cushioned surface at first. Never near a hard corner.","derivation":"adapted","evidence_note":"Simple one-foot balance activity; standard toddler motor content of the kind Pathways.org publishes for 24-36 mo; wording here is original.","sources":["SRC-018"]},{"id":"ACT-0028","title":"Stairs alternating feet without a rail","targets":["GM-032"],"supports":["GM-026","GM-033"],"type":"routine","age_window":{"from_months":28,"to_months":42},"duration_minutes":3,"frequency":"daily","materials":["stairs, ideally a short flight for practice"],"cost_tier":"free","how_to":["Once the child is confident up with a hand, invite them to go up without holding on to the railing on a short flight.","Adult walks alongside within reach; do not touch unless a stumble.","Encourage alternating feet: left foot up, right foot up; most children learn this on the way up before the way down.","Slower is safer than tidier."],"signs_it_is_working":"Child places one foot then the other on the next step (not the same step), maintains balance without the railing.","signs_to_stop":"Subtle: reverting to marking-time. Potent: falling, crying. Return to hand-holding for a few weeks and try again.","adult_role":"Present, within reach, not touching.","safety":"Practice on a short flight first (three steps). Never in a hurry. Not near an open landing.","derivation":"adapted","evidence_note":"Alternating stair-climbing progresses from hand-held to independent; standard preschool motor progression.","sources":["SRC-018"]},{"id":"ACT-0029","title":"Downstairs step-at-a-time practice","targets":["GM-033"],"supports":["GM-032"],"type":"routine","age_window":{"from_months":28,"to_months":42},"duration_minutes":3,"frequency":"daily","materials":["stairs"],"cost_tier":"free","how_to":["At the top of a short flight, invite the child to go down one step at a time.","Both feet on each step is fine for now; alternating comes later than for going up.","Adult stays one to two steps below, hands ready but not touching.","Slower is safer than tidier."],"signs_it_is_working":"Child descends confidently step by step, chooses whether to hold the railing, does not bump-slide down.","signs_to_stop":"Subtle: sitting down on a step and bumping. Potent: refusing, crying at the top. Carry down; try later.","adult_role":"Stay below and slightly to the side. Never in front centred, which puts you in the fall line.","safety":"Do not carry anything else while spotting a stair-descending toddler.","derivation":"adapted","evidence_note":"Downstairs alternating is later than upstairs; standard preschool motor guidance.","sources":["SRC-018"]},{"id":"ACT-0030","title":"Tricycle pedalling practice","targets":["GM-034"],"supports":["GM-006","GM-031"],"type":"toy","age_window":{"from_months":24,"to_months":42},"duration_minutes":15,"frequency":"weekly","materials":["a low tricycle sized so the child feet rest on the pedals with a small knee bend when seated"],"cost_tier":"over_2000_inr","india_sourcing_note":"Indian brands (BSA, Toyzone, Luvlap) sell small tricycles in the INR 1500-3000 range. Ensure a low seat that lets the child sit with feet on the pedals; adult-push trikes without pedal-reach are not the same activity.","how_to":["Seat the child on the trike on a flat smooth surface (a corridor, a driveway, a park path).","Place their feet on the pedals; show pushing one pedal down.","Push the trike gently from behind for a few metres so they feel the pedal rotate under their foot.","Then step back and let them try to push the pedals themselves. It takes many sessions."],"signs_it_is_working":"Child pushes each pedal down in turn, the trike moves forward under their own power for a metre or more, they steer roughly straight.","signs_to_stop":"Subtle: feet slipping off the pedals repeatedly, no forward motion after help. Potent: falling off, refusing. Park the trike; try again in a month.","adult_role":"Start the rotation once; then step back and be the destination.","safety":"Helmet on any hard surface. Not near traffic, water, or drops. Not down slopes.","derivation":"adapted","evidence_note":"Tricycle pedalling appears in Pathways.org motor activities for 24-36 mo.","sources":["SRC-018"]},{"id":"ACT-0031","title":"Standing with support at a low sofa edge","targets":["GM-002"],"supports":["GM-011","GM-005","GM-019","GM-020"],"type":"play","age_window":{"from_months":5,"to_months":10},"duration_minutes":5,"frequency":"daily","materials":["a low stable sofa or firm ottoman"],"cost_tier":"free","india_sourcing_note":"A firm takht edge or a filled cardboard box weighted with books works as a low support.","how_to":["Sit the baby facing the sofa edge.","Bring the baby to standing with your hands under the armpits and place both hands on the sofa edge for support.","Let the baby take their own weight through their legs while you keep light hands at the hips as a spotter.","Return to sitting after a few seconds; repeat only if the baby stays alert and interested."],"signs_it_is_working":"Baby stands with weight through both legs, holding the sofa edge; hips stay under the shoulders rather than sagging or arching.","signs_to_stop":"Subtle: legs going soft, hips dropping. Potent: crying, arching, refusing to look at the edge. Return to sitting and offer floor play.","adult_role":"Spot at the hips; do not carry the child weight in your hands.","safety":"Use heavy, non-tipping support. Never leave the standing baby unsupervised.","derivation":"adapted","evidence_note":"Standing-with-support is standard pre-pull-to-stand practice noted in CDC 9mo tips and Pathways cruising activities.","sources":["SRC-002","SRC-018"]},{"id":"ACT-0032","title":"Standing alone practice","targets":["GM-005"],"supports":["GM-020","GM-006","GM-035"],"type":"play","age_window":{"from_months":9,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["two motivating toys and clear floor space"],"cost_tier":"free","how_to":["Once the baby cruises confidently, help them stand facing you a hand-width away from the furniture.","Offer a toy in each of your hands, one high and one low, so both of the baby hands come off the furniture to reach.","Wait; do not rush to catch. Balance is discovered in the wobble.","A soft landing when they sit down is expected and safe."],"signs_it_is_working":"Baby lets go with both hands and holds standing for a moment before sitting down safely; the standing gets longer over days.","signs_to_stop":"Subtle: refusing to let go of the furniture. Potent: crying after a fall. Cushion the space and try later.","adult_role":"Provide the reason to let go. Do not lift or hold the baby at this moment.","safety":"Soft flooring under the baby. Nothing sharp within a fall radius.","derivation":"adapted","evidence_note":"Standing-alone practice with a two-hand toy reach is standard early-walking guidance in Pathways and RSB.","sources":["SRC-018","SRC-015"]},{"id":"ACT-0033","title":"Sit-up-from-lying self-transition","targets":["GM-018"],"supports":["GM-001","GM-014"],"type":"play","age_window":{"from_months":6,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["a firm mat with clear space"],"cost_tier":"free","how_to":["Lay the baby on their side on the mat with a motivating toy just in front.","Wait for the baby to push up on the lower arm and rotate into a sitting position.","If they roll to tummy first, that is also part of the transition; let it happen.","Repeat from the other side so both directions get practice."],"signs_it_is_working":"Baby pushes up on one arm, twists the trunk, and lands in a stable sitting position without your help.","signs_to_stop":"Subtle: staying on the side and looking away. Potent: crying, flopping face-down. Sit them up manually just this once, comfort, and try again another day.","adult_role":"Wait. This is a self-transition; the practice is the discovery, not the position at the end.","safety":"Firm mat, no sharp edges within reach.","derivation":"adapted","evidence_note":"Getting into a sitting position independently is a Denver-tracked milestone at ~8mo; the side-lie starting position is a common physiotherapy scaffold.","sources":["SRC-018"]},{"id":"ACT-0040","title":"Face-to-face tummy chats","targets":["GM-007","GM-009"],"supports":["GM-008","GM-038"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":5,"frequency":"a few times a day","materials":["a firm mat, bed or dhurrie"],"cost_tier":"free","how_to":["Lie on the floor or bed on your tummy, facing him while he lies on his tummy on a firm surface.","Bring your face to his eye level about 25 cm away and talk or sing softly.","Move your face slowly a little higher so he has a reason to lift his head to find you.","Stop after a minute or two, or sooner if he tires; several short turns a day beat one long one."],"signs_it_is_working":"Over a week or two he lifts his head for longer and higher, first briefly, later to look straight at you.","signs_to_stop":"Face pressed into the surface with no attempt to lift. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be the reason to look up. Do not lift his head for him or prop it.","safety":"Never leave him on his tummy unattended; tummy play only when he is awake and someone is watching.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0041","title":"Free kicking time on the floor","targets":["GM-038"],"supports":[],"type":"environment","age_window":{"from_months":0,"to_months":5},"duration_minutes":10,"frequency":"a few times a day","materials":["a mat or folded dhurrie on the floor"],"cost_tier":"free","how_to":["Lay him on his back on a clean mat or dhurrie, with loose clothing and bare feet if the room is warm.","Stay close and talk to him; let him kick and wave freely.","Now and then hold a soft cloth or your palm where his feet can push against it."],"signs_it_is_working":"Both arms and both legs move often and about equally; kicks grow stronger over the weeks.","signs_to_stop":"Limbs stiffen or go still with a worried face. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Arrange the space and let him move. Do not swaddle him for these awake times.","safety":"Floor only, away from edges, fans at head height and siblings' feet.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0042","title":"Gentle limb play at nappy change","targets":["GM-038"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["While he lies on his back after a nappy change, hold his feet and do slow 'cycling' three or four times.","Bring his hands together over his chest, then open them wide, while you sing.","Pause and let him move on his own before the next round."],"signs_it_is_working":"He starts to join in the movements and moves both sides smoothly on his own.","signs_to_stop":"Resisting the movement or crying when you hold a limb. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Move slowly and follow his lead. Never force a joint or pull on an arm.","safety":"Keep one hand on him on any raised changing surface.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0043","title":"Lap bounce and supported sit","targets":["GM-010","GM-011"],"supports":["GM-016"],"type":"play","age_window":{"from_months":2,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Sit him on your lap facing you, holding him under the arms.","Let his feet touch your thighs and lift him so he can push down and take some weight.","Sing a bouncing rhyme and give small bounces, pausing so he can hold his head steady.","Hold him upright against your chest to look around the room between bounces."],"signs_it_is_working":"His head stays steady during movement and his legs push against your lap.","signs_to_stop":"Head bobbing that he cannot correct, or legs going limp. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Support his trunk firmly; let him hold his own head and push with his own legs.","safety":"Hold securely under the arms; no tossing or shaking.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0044","title":"Slow pull-to-sit hello","targets":["GM-016"],"supports":[],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Lay him on his back facing you and offer your thumbs for him to grip.","With your hands around his forearms, very slowly bring him toward sitting while you say hello.","Watch his head: stop and lower him back if the head drops back.","Do it two or three times, not more."],"signs_it_is_working":"His chin tucks and his head comes up with his body instead of lagging.","signs_to_stop":"Head falling back each time. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Go slowly enough that he can do the head work. Do not jerk him up by the arms.","safety":"Pull by the forearms, not the hands alone; stop if the head lags.","derivation":"original","evidence_note":"Common practice, no formal evidence; mirrors the Denver pull-to-sit item. (phase9a)","sources":["SRC-008"]},{"id":"ACT-0045","title":"Toy just out of reach on the tummy","targets":["GM-013","GM-014"],"supports":[],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["During tummy time, put a favourite toy in front of him, a little out of reach.","Next time, place it slightly to one side so he turns and shifts his weight to look.","When he pushes up on straight arms or rolls, hand him the toy and celebrate."],"signs_it_is_working":"He pushes up on straight arms to see, and sometimes rolls onto his back reaching sideways.","signs_to_stop":"Face down with no effort to push up, or crying from the start. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Put the toy where it is just hard enough. Do not roll him over yourself.","safety":"Never leave him on his tummy unattended; tummy play only when he is awake and someone is watching.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0046","title":"Cushion-ring floor sitting","targets":["GM-017","GM-018"],"supports":[],"type":"environment","age_window":{"from_months":4,"to_months":10},"duration_minutes":10,"frequency":"daily","materials":["2-3 cushions or a rolled bedsheet"],"cost_tier":"free","how_to":["Sit him on the floor with a rolled bedsheet or cushions in a ring around him.","Put a toy in front so he props on his hands to look at it.","When he sits well, place toys to the side so he twists, goes down to his tummy and works his way back up."],"signs_it_is_working":"He props on his hands, then sits with hands free, and later gets himself into sitting.","signs_to_stop":"Slumping forward with a worried face, or toppling repeatedly. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set up the ring and the toys; let him wobble and catch himself. Do not sit him in a seat that holds him upright.","safety":"Soft floor around him; no hard toys where he may fall.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0047","title":"Standing at the sofa","targets":["GM-002","GM-019"],"supports":[],"type":"play","age_window":{"from_months":6,"to_months":11},"duration_minutes":5,"frequency":"daily","materials":["a low sofa, diwan or bed edge"],"cost_tier":"free","how_to":["Put a toy on a low, stable sofa, diwan or bed edge.","Kneel at his back and let him hold the edge while you steady his hips.","Once he stands holding on, let him pull himself up from sitting to reach the toy."],"signs_it_is_working":"He stands holding the furniture, then pulls himself up to stand on his own.","signs_to_stop":"Legs buckling repeatedly, or fussing to be picked up. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Choose stable furniture and put the toy up there; let him do the pulling.","safety":"Only furniture that cannot tip; move glass tables and sharp corners away. Baby walkers are not recommended.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0048","title":"Let-go moments at the sofa","targets":["GM-036","GM-005"],"supports":[],"type":"play","age_window":{"from_months":8,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is standing at the sofa, offer a toy with both your hands, held just in front of him.","He has to let go of the sofa for a moment to take it.","Count 'one, two' cheerfully while he stands free, then let him sit or grab hold."],"signs_it_is_working":"He lets go for a second or two, then longer, before sitting down on purpose.","signs_to_stop":"Grabbing back at once with a frightened face, or sitting down every time. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Hold the toy, not him. Let him decide when to let go.","safety":"Soft floor around him; stay within arm's reach.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0049","title":"Standing play at a low table","targets":["GM-036","GM-005"],"supports":[],"type":"environment","age_window":{"from_months":9,"to_months":15},"duration_minutes":10,"frequency":"daily","materials":["a low stool or chowki"],"cost_tier":"free","how_to":["Put a few toys on a low stool or table at his chest height.","Let him stand and play there; move one toy to the far edge so he shifts along or lets go.","Sit nearby and talk about what he does."],"signs_it_is_working":"He stands and plays with both hands free for longer stretches.","signs_to_stop":"Leaning his whole weight on the table and fretting. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Arrange the table and toys; stay close without holding him.","safety":"Stable table or stool; nothing hot or breakable within reach.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0050","title":"Chase the rolling ball","targets":["GM-003","GM-021"],"supports":[],"type":"play","age_window":{"from_months":6,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["a soft ball or rolled-up socks"],"cost_tier":"free","how_to":["Roll a soft ball slowly across the floor, a little beyond his reach.","Let him crawl, shuffle on his bottom or roll to get it, whichever way he moves.","Celebrate when he gets there and roll it again."],"signs_it_is_working":"He moves further and more purposefully to get the ball, by whichever route he uses.","signs_to_stop":"Lying down and crying, or losing interest in the ball. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make it worth moving. Do not push him onto hands and knees; crawling and bottom-shuffling are both fine ways to get about.","safety":"Clear floor; close doors to stairs and the kitchen.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0051","title":"Cushion climbing hill","targets":["GM-022","GM-024"],"supports":[],"type":"environment","age_window":{"from_months":9,"to_months":18},"duration_minutes":10,"frequency":"daily","materials":["firm cushions or folded quilts"],"cost_tier":"free","how_to":["Pile firm cushions or folded quilts into a low step or hill on the floor.","Put a toy on top and let him crawl or climb up; show him how to come down backwards, feet first.","Later let him practise getting on and off a low diwan or sofa the same way."],"signs_it_is_working":"He climbs up and turns to come down feet first without help.","signs_to_stop":"Freezing at the top or trying to come down head first again and again. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Stay beside him with a hand ready but not holding. Teach feet-first coming down.","safety":"Only on the floor or low furniture, with soft landing space; gate real stairs.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0052","title":"Tidy-up walk","targets":["GM-025"],"supports":[],"type":"routine","age_window":{"from_months":12,"to_months":18},"duration_minutes":5,"frequency":"daily","materials":["a basket or bucket"],"cost_tier":"free","how_to":["Scatter a few toys on the floor at clean-up time.","Hold out a basket and ask him to bring them; he has to squat or bend, pick up and stand again.","Sing a clean-up song while you both work."],"signs_it_is_working":"He stoops to pick things up and stands up again without falling or holding on.","signs_to_stop":"Sitting down to pick up every time and staying down, or wandering off. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make it a shared job. Do not hand him the toys.","safety":"Only light, safe toys.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0053","title":"Pull-along toy walks","targets":["GM-027"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":20},"duration_minutes":10,"frequency":"daily","materials":["a small box or dabba and a short string"],"cost_tier":"free","how_to":["Tie a string to a small box, steel dabba with a few spoons inside, or a toy car.","Let him pull it along; when he wants to watch it, he will start to step backwards.","Walk backwards yourself, pulling one too, and let him copy."],"signs_it_is_working":"He takes a few steps backwards watching the toy.","signs_to_stop":"Tripping on the string, or crying when the toy tips over. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make the toy; walk alongside. Keep the string short.","safety":"String no longer than 30 cm and never round the neck; supervise.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0054","title":"Chasing game","targets":["GM-028"],"supports":[],"type":"outing","age_window":{"from_months":13,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["a park, courtyard or open room"],"cost_tier":"free","how_to":["In a safe open space, say 'I'm going to catch you!' and chase slowly.","Let him get away, then switch: he chases you.","Stop for a hug and a breath between rounds."],"signs_it_is_working":"His walking speeds up into running with both feet briefly off the ground.","signs_to_stop":"Stumbling repeatedly, or crying when chased. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep it slow and playful; let him win. Do not chase if he looks frightened.","safety":"Open, flat space away from roads, water and stairs.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0055","title":"Kick the ball to me","targets":["GM-029"],"supports":[],"type":"play","age_window":{"from_months":15,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["a light ball"],"cost_tier":"under_500_inr","how_to":["Put a light ball in front of his foot and say 'kick!'.","Show him once, then let him try; stand a short way off so it comes to you.","Kick it back gently so it stops near his feet."],"signs_it_is_working":"He swings a leg and sends the ball forward without holding on.","signs_to_stop":"Trying and falling repeatedly, or picking the ball up and walking off. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set the ball up and wait. Do not hold his leg.","safety":"Light ball, flat ground, away from roads.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0056","title":"Throw into the big basket","targets":["GM-030"],"supports":[],"type":"play","age_window":{"from_months":18,"to_months":30},"duration_minutes":5,"frequency":"daily","materials":["a bucket or basket","soft balls or rolled socks"],"cost_tier":"free","how_to":["Put a large basket or bucket a short step away.","Give him soft balls or rolled socks to throw in; show an overhand throw once.","Move the basket a little further back when he gets most in."],"signs_it_is_working":"He throws overhand, with the ball going forward toward the basket.","signs_to_stop":"Throwing at people, or walking off after one try. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set up the target and keep count cheerfully. Do not correct every throw.","safety":"Only soft things to throw.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0057","title":"Roll-over reach","targets":["GM-015"],"supports":[],"type":"play","age_window":{"from_months":4,"to_months":9},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["During floor play on his back, hold a toy to one side, just beyond his reach, so he turns and rolls toward it.","Next time, from his tummy, offer the toy to the other side.","Let him roll both ways across the mat to reach things."],"signs_it_is_working":"He rolls from back to tummy and tummy to back, on both sides.","signs_to_stop":"Stuck half-way and fretting; help him finish the roll gently. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Place the toy; let him do the rolling.","safety":"Floor only, never on a bed or sofa once he rolls.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month tip 'Place toys out of reach to encourage rolling and reaching' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0058","title":"Up from the floor","targets":["GM-023"],"supports":[],"type":"play","age_window":{"from_months":10,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Put a toy on a low stool, out of reach from sitting, with no furniture nearby to pull up on.","Let him work out how to get from the floor to standing on his own (hands down, bottom up, then straighten).","Play games that go down and up: sit to roll a ball, stand to fetch it."],"signs_it_is_working":"He gets from the floor to standing without holding anything.","signs_to_stop":"Toppling over again and again; move the toy nearer furniture for a while. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set up the reason to stand; do not lift him.","safety":"Clear, soft floor.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-004"]},{"id":"ACT-0100","title":"Palm-stroke and finger uncurling","targets":["FM-002"],"supports":["FM-001","FM-004"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["adult hand only"],"cost_tier":"free","how_to":["During a diaper change or after a feed, gently stroke the outside of the baby fisted hand from wrist to fingertips.","Wait for the palm to open on its own; do not pry the fingers apart.","When the hand opens, place your finger against the palm and let the baby grip and release.","Try the other hand next; both sides need practice."],"signs_it_is_working":"The fist opens briefly, the fingers uncurl, and the baby holds your finger for a moment before letting go.","signs_to_stop":"Subtle: the hand pulls back into the fist and the baby looks away. Potent: fussing, arm-pull-away, arching. Return to holding the baby against you; try again another time.","adult_role":"Invite the opening; never force it. A closed fist at this age is a typical reflex, not resistance.","safety":"No nails against the palm. No prying. Skin-to-skin only; no oils on the hand.","derivation":"adapted","evidence_note":"Palm stimulation to encourage voluntary hand opening is a common early-manipulation cue in Pathways.org sensory guidance and in NHS RSB early-play material.","sources":["SRC-018","SRC-015"]},{"id":"ACT-0101","title":"Rattle placed in the palm","targets":["FM-001"],"supports":["FM-002","FM-005"],"type":"play","age_window":{"from_months":1,"to_months":5},"duration_minutes":3,"frequency":"daily","materials":["a very light rattle with a slim handle the baby fingers can wrap around"],"cost_tier":"free","india_sourcing_note":"A small stainless-steel spoon (baby-safe) or a light plastic teether from a kirana works; test that it fits the baby palm without stretching the fingers.","how_to":["With the baby lying on the back or in a semi-reclined seat, catch a moment when the hand is open.","Place the rattle handle across the baby palm; wrap the fingers gently around it.","Let go. The baby will hold it for a few seconds and then drop.","Retrieve the rattle, share a smile, and offer again."],"signs_it_is_working":"Baby grips the rattle briefly, brings it toward the eye line, or turns the wrist so the sound moves.","signs_to_stop":"Subtle: dropping the rattle immediately every try, turning the head away. Potent: crying, arching. Put the rattle away for now.","adult_role":"Place, release, retrieve. The grip is voluntary and short at this age.","safety":"Rattle small enough to fit the palm, large enough not to fit past the lips. No strings, no long ribbons.","derivation":"adapted","evidence_note":"Placing an object in the palm to elicit early grasp is a classic Denver observation; framed here as a supervised parent play episode per Pathways.","sources":["SRC-018"]},{"id":"ACT-0102","title":"Hand-to-mouth exploration time","targets":["FM-004"],"supports":["FM-003","FM-002"],"type":"routine","age_window":{"from_months":1,"to_months":5},"duration_minutes":5,"frequency":"a few times a day","materials":["adult body only, or a clean cloth to lay under the baby"],"cost_tier":"free","how_to":["Give the baby unrestricted arm time: no mittens, no swaddled arms during awake alert periods.","Lay them on the back on a firm surface, or hold them in a reclined position.","Let the baby bring their own hands to the mouth on their own timing; do not offer a pacifier that pre-empts it.","This is not a task; it is a permission — clear the environment and step back."],"signs_it_is_working":"Baby brings one or both hands to the mouth, sucks or gums the fingers, and self-soothes.","signs_to_stop":"Subtle: hand-to-mouth becomes frantic rather than exploratory. Potent: gagging, crying, spitting up. Pick up and comfort.","adult_role":"Free the arms; do not direct.","safety":"Bare hands only; no fabric loops around wrists, no oils on the fingers.","derivation":"adopted","evidence_note":"Head Start ELOF Perceptual, Motor, and Physical Development Do guide: give infants ample floor time and unrestricted arm movement so they can explore their hands and objects.","sources":["SRC-005"]},{"id":"ACT-0103","title":"Midline dangle rattle","targets":["FM-003"],"supports":["FM-005","GM-014"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":5,"frequency":"daily","materials":["a light rattle or soft toy on a short string"],"cost_tier":"free","india_sourcing_note":"A cotton potli with a spoon of dry moong tied to a short ribbon works; keep the ribbon short (under 15 cm) so it never wraps.","how_to":["Lay the baby on the back on a firm mat.","Dangle the rattle in the midline above the chest, about 25-30 cm above the eyes.","Wait for the baby to bring both hands up together toward it.","Lower it into reach once both hands are meeting; let them bat, grasp, and swipe."],"signs_it_is_working":"Both hands come together in the midline reaching for the rattle; the arms move symmetrically.","signs_to_stop":"Subtle: one hand drops, gaze aversion. Potent: crying, arching. Bring the rattle down onto the chest for a moment of quiet contact.","adult_role":"Hold the rattle still; the baby closes the distance.","safety":"Ribbon under 15 cm. Never leave the baby alone with a suspended toy.","derivation":"adapted","evidence_note":"Midline reach is a classic Denver observation and appears in Pathways.org early-motor guidance; adapted here as a hold-and-wait play episode.","sources":["SRC-018"]},{"id":"ACT-0104","title":"Reach-and-grasp offered toy","targets":["FM-005"],"supports":["FM-006","FM-007","GM-017"],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"daily","materials":["a range of light graspable objects (a small rattle, a soft ring, a wooden spoon, a plastic curler)"],"cost_tier":"free","india_sourcing_note":"Rotate five or six safe household objects rather than buying grasp toys: a wooden chapati spoon handle, a plastic bangle, a cotton ring, a small silver katori.","how_to":["Sit or hold the baby in a supported semi-reclined position.","Offer one object at the midline, at arm distance from the baby chest.","Wait for the reach; do not put it in the hand.","Change the object each session so the reach is a fresh problem, not a habit."],"signs_it_is_working":"Baby reaches out, opens the hand in advance, and closes on the object; the grasp is aimed rather than swipey.","signs_to_stop":"Subtle: arm flops, no opening. Potent: crying, arching. Try later.","adult_role":"Offer, wait, celebrate. Do not chase a missed grasp with the toy.","safety":"Objects too large to swallow, nothing with a small removable part.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6 mo): give your baby toys that are safe for chewing and let them explore with their hands. Reach-and-grasp practice is central across CDC, ELOF and Pathways.","sources":["SRC-002"]},{"id":"ACT-0105","title":"Shake-the-rattle self-play","targets":["FM-006"],"supports":["FM-005","CG-014"],"type":"play","age_window":{"from_months":4,"to_months":9},"duration_minutes":5,"frequency":"daily","materials":["one rattle with a distinct sound the baby can grasp and hold"],"cost_tier":"free","how_to":["Once the baby is holding a rattle steadily, shake it once yourself to draw attention to the sound.","Return the rattle to their hand and pause.","Wait for the baby to move their arm and discover that the rattle makes sound.","Trade the rattle with another (different sound) after a minute so the discovery renews."],"signs_it_is_working":"Baby shakes the rattle intentionally, listens, and shakes again with growing anticipation.","signs_to_stop":"Subtle: dropping the rattle after one shake, looking away. Potent: crying. Put the rattle down; offer a face-and-voice game instead.","adult_role":"Model once; then let discovery do the work.","safety":"Standard small-object safety: check for loose parts monthly.","derivation":"adapted","evidence_note":"Rattle-cause-and-effect is a foundational Piagetian secondary-circular-reaction activity; standard across Pathways and CCD.","sources":["SRC-018","SRC-016"]},{"id":"ACT-0106","title":"Two-object simultaneous hold","targets":["FM-007"],"supports":["FM-005","FM-009","CG-018"],"type":"play","age_window":{"from_months":5,"to_months":10},"duration_minutes":8,"frequency":"daily","materials":["two identical small blocks or two katoris"],"cost_tier":"free","india_sourcing_note":"Two small steel katoris or two wooden dolna beads make an ideal pair; matching pairs are easier than mismatched at this age.","how_to":["Sit the baby with cushion support if needed.","Hand them one block; wait until it is settled in the hand.","Offer the second block to the empty hand.","Watch what they do: hold both, drop one, or try to grab both with one hand."],"signs_it_is_working":"Baby holds one block in each hand at the same time, at least for a few seconds; may bang, transfer, or drop and pick up again.","signs_to_stop":"Subtle: dropping both and looking away. Potent: fussing, crying. Put the blocks away and try again after some floor play.","adult_role":"Offer to the empty hand. Do not put the second block in the same hand.","safety":"Blocks too large to swallow. No painted surfaces that flake.","derivation":"adapted","evidence_note":"Denver FM11 (take 2 cubes) is the origin of this observation; adapted as a parent play episode.","sources":["SRC-016"]},{"id":"ACT-0107","title":"Object transfer game","targets":["FM-009"],"supports":["FM-005","FM-007"],"type":"play","age_window":{"from_months":6,"to_months":10},"duration_minutes":5,"frequency":"daily","materials":["one small object that fits comfortably in the baby palm (a wooden block, a cloth ring, a small teether)"],"cost_tier":"free","how_to":["Hand the baby one object, then offer a second identical object to the SAME hand.","The full hand often prompts the baby to transfer the first to the other hand and take the second.","Repeat a few times; the transfer becomes smoother across sessions.","Change the object to keep interest."],"signs_it_is_working":"Baby moves an object from one hand to the other deliberately; the transfer is smooth rather than a drop-and-pick-up.","signs_to_stop":"Subtle: dropping both objects, staring. Potent: fussing. Pause; try later.","adult_role":"Set up the two-object problem. Do not model the transfer.","safety":"Objects too large to swallow.","derivation":"adapted","evidence_note":"Object transfer is Denver FM10; framing here draws on CCD low-resource household-object play.","sources":["SRC-016"]},{"id":"ACT-0108","title":"Rake pickup with small safe pieces","targets":["FM-008"],"supports":["FM-010","FM-005"],"type":"play","age_window":{"from_months":5,"to_months":9},"duration_minutes":5,"frequency":"daily","materials":["5-10 small safe pieces (a spoon of puffed rice, tiny bits of soft banana, or short cooked pasta)"],"cost_tier":"free","india_sourcing_note":"Murmura (puffed rice) is the classic Indian starter for rake practice; each grain is soft and dissolves on the tongue.","how_to":["Sit the baby in a high chair or supported sitting on the floor with a wipeable surface.","Scatter 5-10 pieces on the tray.","Let the baby explore; the rake grasp — closing all fingers together to sweep a piece into the palm — will emerge.","Feed a small handful of your own to model, not the baby fingers."],"signs_it_is_working":"Baby closes all fingers together to sweep a piece into the palm; sometimes brings it to the mouth.","signs_to_stop":"Subtle: sweeping the pieces off the tray without trying to grasp. Potent: coughing, gagging, crying. Clear the tray and take a break.","adult_role":"Supervise; do not pop pieces into the baby mouth. The choice of what to eat is theirs.","safety":"Sit-up-and-supervised only. Use pieces that dissolve or squash between two fingers. Never grapes, whole nuts, chunks of raw carrot, or anything that resists compression.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): offer safe finger foods so your baby can practice picking up small pieces with their fingers.","sources":["SRC-002"]},{"id":"ACT-0109","title":"Inferior pincer practice with soft foods","targets":["FM-010"],"supports":["FM-008","FM-012","AD-002"],"type":"play","age_window":{"from_months":6,"to_months":11},"duration_minutes":8,"frequency":"daily","materials":["small soft food pieces (banana bits, boiled paneer cubes, cooked matar / peas)"],"cost_tier":"free","india_sourcing_note":"Boiled matar (green peas) and small cubes of paneer are ideal — same size as a Cheerio, softer than raw fruit.","how_to":["Sit the baby in a high chair with a small handful of pieces on the tray.","The child moves naturally from a rake (whole hand) to an inferior pincer (thumb + side of index finger) at 7-9 months.","Do not pinch pieces for them; let the pinch emerge.","Session ends when they stop eating or start throwing."],"signs_it_is_working":"Baby picks a piece up between the thumb and the side of the index finger; the piece stays gripped as the hand comes to the mouth.","signs_to_stop":"Subtle: pieces slipping repeatedly. Potent: gagging, throwing pieces. Clear the tray.","adult_role":"Supervise, wipe as needed; keep out of the pinch itself.","safety":"Choking-safe sizes only. Sit-up-and-supervised only.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): give your baby chances to practice picking up food with their fingers.","sources":["SRC-002"]},{"id":"ACT-0110","title":"Bang two blocks together","targets":["FM-011"],"supports":["FM-007","SE-007"],"type":"play","age_window":{"from_months":8,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["two small wooden blocks, two katoris, or a small wooden spoon and a metal cup"],"cost_tier":"free","india_sourcing_note":"Two steel katoris or a wooden belan cut short and a small kadhai handle both work; the sound is part of the point.","how_to":["Give the seated baby one block; give them the second block for the other hand.","Bring your own hands together with two spare blocks and clap them once at midline.","Wait. The baby will imitate the midline clap.","A minute of banging is a full round. Take the blocks away when the round ends."],"signs_it_is_working":"Baby brings both blocks to the midline and taps them together, sometimes with a delighted look at the sound they made.","signs_to_stop":"Subtle: dropping one block, looking away. Potent: throwing the blocks, crying. Pack up.","adult_role":"Model once at the start; then let the imitation carry it.","safety":"Softer materials (wood, plastic) rather than metal for the first weeks; metal is fine once control is good.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): give your baby toys that they can bang together.","sources":["SRC-002"]},{"id":"ACT-0111","title":"Drop into a container","targets":["FM-013"],"supports":["FM-014","GM-025"],"type":"play","age_window":{"from_months":9,"to_months":15},"duration_minutes":8,"frequency":"daily","materials":["one open cup or small container","5-10 small objects (blocks, plastic keys, wooden pegs)"],"cost_tier":"free","india_sourcing_note":"A small steel dabba or plastic paranda box with an open top works well; the sound of the drop is part of the reward.","how_to":["Sit the baby on the floor with the container in front.","Show them once: pick up one object, hold it over the container, and drop.","Hand them one object at a time; wait for them to imitate the release.","Empty the container together at the end and start again if they want to."],"signs_it_is_working":"Baby holds an object over the container and lets go on purpose; the release becomes cleaner and more deliberate over sessions.","signs_to_stop":"Subtle: dropping objects randomly rather than into the container. Potent: throwing the container, crying. Pack up.","adult_role":"Model the release; hand pieces one at a time so the pace stays calm.","safety":"Container walls low enough to see over. Objects too large to swallow.","derivation":"adapted","evidence_note":"Denver FM14 (put block in cup); adapted with the deliberate-release framing from Pathways.org.","sources":["SRC-018"]},{"id":"ACT-0112","title":"Pincer pickup with murmura and Cheerio-size pieces","targets":["FM-012"],"supports":["FM-010","AD-002"],"type":"play","age_window":{"from_months":10,"to_months":16},"duration_minutes":8,"frequency":"daily","materials":["small soft food pieces sized to pinch (Cheerios, murmura, small cooked pasta, moong dal that has been well-cooked and dried)"],"cost_tier":"free","india_sourcing_note":"Murmura is the classic Indian pincer trainer; a spoonful on a plate lets the child practice for as long as they stay interested.","how_to":["Put a spoonful of small soft pieces on the tray.","Sit next to the child and eat a few pieces yourself, using a clear thumb-index pinch.","Let the child pick up pieces at their own pace.","A session ends when they stop eating or start scattering."],"signs_it_is_working":"Child uses the tips of thumb and index finger (not the side of the index) to pick up single pieces; the wrist stays neutral rather than curled.","signs_to_stop":"Subtle: reverting to a whole-hand rake for a whole session. Potent: gagging, throwing. Clear the tray.","adult_role":"Eat alongside as the model. Do not correct grip mid-pinch.","safety":"Use non-choking sizes. Supervised sitting only.","derivation":"adopted","evidence_note":"CDC and AAP both cite pincer practice through self-feeding; framed as a shared eating moment per CCD.","sources":["SRC-002","SRC-016"]},{"id":"ACT-0113","title":"Dump-out-and-fill-up basket play","targets":["FM-014"],"supports":["FM-013","CG-023"],"type":"play","age_window":{"from_months":11,"to_months":20},"duration_minutes":10,"frequency":"daily","materials":["one container about 15-20 cm across","5-10 medium-sized objects (small toys, blocks, plastic lids)"],"cost_tier":"free","how_to":["Fill the container with the objects and set it in front of the child.","Model: tip the container over; the objects tumble out.","Wait. Most children immediately want to fill it back up.","Repeat the fill-dump cycle for as long as it holds interest."],"signs_it_is_working":"Child dumps the container deliberately, sometimes shakes it to help pieces out, then refills piece by piece.","signs_to_stop":"Subtle: dumping but not refilling for several rounds. Potent: throwing the container, crying. Put it away.","adult_role":"Set up and demonstrate the dump. Refill only if the child asks.","safety":"Container not glass. Objects too large to swallow.","derivation":"adapted","evidence_note":"Denver FM16 (dump coffee bean); framing draws on Pathways.org fine-motor container play.","sources":["SRC-018"]},{"id":"ACT-0114","title":"Chunky board book with an adult","targets":["FM-016"],"supports":["RC-011","EC-023"],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":8,"frequency":"daily","materials":["one board book with thick cardboard pages"],"cost_tier":"under_500_inr","india_sourcing_note":"Indian publishers (Tulika, Karadi Path, Pratham Books) have thick-page baby books in regional languages; Amazon and local children shops both stock them.","how_to":["Sit with the child on your lap or beside them.","Open the book; let the child hold and try to turn pages.","Do not correct if two or three pages turn together at this age.","Read what you see on whatever page they land on; the sequence is theirs."],"signs_it_is_working":"Child reaches for the page edge, grasps it, and turns it; sometimes flips two or three together, sometimes one at a time.","signs_to_stop":"Subtle: tearing at pages rather than turning, losing interest after one page. Potent: throwing the book, crying. Save the book for later.","adult_role":"Read what they choose. Do not turn the pages for them.","safety":"Board books only at this age; paper pages tear and become choking-size pieces.","derivation":"adapted","evidence_note":"Shared reading is universal early-literacy guidance across CDC, ELOF, RCN, and CCD. Wording our own.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0115","title":"First scribble with a chunky crayon","targets":["FM-015"],"supports":["FM-021","FM-024"],"type":"play","age_window":{"from_months":12,"to_months":22},"duration_minutes":10,"frequency":"daily","materials":["one chunky crayon (a triangular or thumb-sized crayon)","a large sheet of newsprint or an old newspaper page"],"cost_tier":"under_500_inr","india_sourcing_note":"Faber-Castell or Camlin sell chunky beginner crayons at low cost in every stationery shop; a discarded newspaper sheet is a free canvas.","how_to":["Tape the paper down so it does not slip.","Show the child once: grip the crayon in your fist and make a mark.","Let them scribble; grip develops later, marks are what matters now.","End before the crayon becomes a chew toy."],"signs_it_is_working":"Child holds the crayon (any grip), makes marks on the paper on purpose, and enjoys the trace.","signs_to_stop":"Subtle: putting the crayon in the mouth repeatedly. Potent: throwing the crayon, crying. Save for another day.","adult_role":"Set up; do not guide the marks. Enthusiasm about the marks is fine.","safety":"Non-toxic crayons only. Never leave the child alone with a crayon. Cover the surface below the paper: crayon on wooden furniture is hard to remove.","derivation":"adopted","evidence_note":"CDC Milestone Moments (15-18 mo): give your child crayons and paper and encourage scribbling.","sources":["SRC-002"]},{"id":"ACT-0116","title":"Two-cube tower build","targets":["FM-017"],"supports":["FM-019","FM-013"],"type":"play","age_window":{"from_months":13,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["four small wooden or plastic blocks about 3-4 cm on a side"],"cost_tier":"under_500_inr","india_sourcing_note":"Lightweight wooden blocks from Channapatna toy makers (available online) or budget plastic blocks from any toy shop; four is enough for the two-cube tower stage.","how_to":["Sit on the floor with the child, blocks between you.","Show them: place one block, then carefully balance the second on top.","Knock it down together (celebrating the knock-down is part of the game).","Hand them two blocks and wait. The first attempts will topple; that is the practice."],"signs_it_is_working":"Child balances the second block on the first so that both stay in place for at least a second before they knock it over.","signs_to_stop":"Subtle: sweeping the blocks around rather than stacking. Potent: throwing, crying. Pack up.","adult_role":"Model, hand pieces, celebrate the try. Do not build the tower for them.","safety":"Blocks large enough not to swallow, no sharp corners.","derivation":"adopted","evidence_note":"Denver FM17 (tower of 2 cubes) and CDC 18 mo tips both name block-stacking as a target activity.","sources":["SRC-002"]},{"id":"ACT-0117","title":"Two-shape shape sorter","targets":["FM-018"],"supports":["CG-023","FM-013"],"type":"toy","age_window":{"from_months":14,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["a shape sorter with only 2-3 basic shapes (circle, square, triangle) to start"],"cost_tier":"under_2000_inr","india_sourcing_note":"Fisher-Price and local brands sell simple shape sorters in the INR 400-1200 range. A homemade version: cut circle and square holes in the lid of a plastic box, use bottle caps and wooden squares as shapes.","how_to":["Sit on the floor with the sorter and 2-3 pieces.","Start with only the round hole and the round shape; success is quicker than adult intuition expects.","Add the square once the round is reliable.","Empty and start over as many times as the child wants."],"signs_it_is_working":"Child rotates the shape to fit the hole, sometimes tries wrong ones first; eventually chooses the right hole from a glance.","signs_to_stop":"Subtle: forcing the wrong shape repeatedly. Potent: throwing pieces, crying. Reduce to one shape or pack up.","adult_role":"Set up with fewer shapes than the sorter can hold. Do not solve.","safety":"Piece too large to swallow. Sorter walls without sharp edges.","derivation":"adapted","evidence_note":"Shape sorter play is standard 18-24 month fine-motor content across CDC and Pathways.","sources":["SRC-002","SRC-018"]},{"id":"ACT-0118","title":"Four-cube tower","targets":["FM-019"],"supports":["FM-017","FM-020"],"type":"play","age_window":{"from_months":17,"to_months":26},"duration_minutes":5,"frequency":"daily","materials":["6-8 small wooden or plastic blocks"],"cost_tier":"under_500_inr","how_to":["Sit with the child, blocks between you.","Model a four-cube tower once; knock it down together.","Hand them the blocks one at a time; let them stack.","If they knock it down early, that is fine; the release-and-place is the practice."],"signs_it_is_working":"Child stacks four blocks such that all four stay balanced together for at least a second.","signs_to_stop":"Subtle: tower keeps collapsing at the second block. Potent: throwing blocks, frustrated cry. Return to a two-cube tower for a while.","adult_role":"Hand blocks one at a time. Do not steady the tower.","safety":"Blocks large, non-choking, no sharp edges.","derivation":"adapted","evidence_note":"Denver FM18 (tower of 4 cubes); adapted as parent activity.","sources":["SRC-018"]},{"id":"ACT-0119","title":"Six-cube tower","targets":["FM-020"],"supports":["FM-019","FM-022"],"type":"play","age_window":{"from_months":20,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["10 small blocks"],"cost_tier":"under_500_inr","how_to":["Sit with the child, blocks between you.","Model six blocks stacked, then knock it down.","Let the child try; the placement gets more careful past four blocks.","Count each block as it lands ('one, two, three ...'); early counting shows up here."],"signs_it_is_working":"Child stacks six blocks so they stay standing together; the placement becomes deliberate on blocks 4, 5, 6.","signs_to_stop":"Subtle: giving up at four blocks. Potent: throwing. Return to a four-cube tower.","adult_role":"Model, count out loud, hand pieces.","safety":"As above.","derivation":"adapted","evidence_note":"Denver FM19 (tower of 6 cubes); adapted as parent activity.","sources":["SRC-018"]},{"id":"ACT-0120","title":"Turning book pages one at a time","targets":["FM-026"],"supports":["FM-016","RC-011"],"type":"routine","age_window":{"from_months":22,"to_months":32},"duration_minutes":8,"frequency":"daily","materials":["a paper-page picture book with thinner pages than a board book"],"cost_tier":"under_500_inr","india_sourcing_note":"Tulika, Pratham Books, and Karadi Path publish age 2-3 picture books with paper pages that turn one at a time.","how_to":["Sit with the child; hand them the book.","Point out a corner of the page ('grab here') as they finish looking.","Wait; the pinch-and-lift is a mature-pincer skill and matures with practice.","Say what is on the next page as soon as it turns; the language reward reinforces the turn."],"signs_it_is_working":"Child pinches the top corner of the page and lifts one page at a time, sometimes going back to a favourite.","signs_to_stop":"Subtle: still flipping several pages at once. Potent: tearing pages, throwing the book. Return to board books for another few weeks.","adult_role":"Cue the corner; do not turn the page.","safety":"Paper-page books only when the child has stopped mouthing pages.","derivation":"adapted","evidence_note":"Denver-style FM26 (page turning one at a time); framing our own.","sources":["SRC-002"]},{"id":"ACT-0121","title":"Jar-lid twist play","targets":["FM-027"],"supports":["FM-018","CG-014"],"type":"play","age_window":{"from_months":22,"to_months":32},"duration_minutes":10,"frequency":"daily","materials":["3-4 empty plastic jars with wide screw-lids (one big, one medium, one small)","one small object to hide inside each jar"],"cost_tier":"free","india_sourcing_note":"Empty MTR spice jars, old cold-cream jars, or peanut-butter jars all have grippable lids; wash and dry first.","how_to":["Put one small object inside each jar; close the lids so the child sees.","Line the jars up in front of the child.","Model unscrewing one lid: 'turn, turn, turn'.","Let the child try; the wrist-turning is the practice, the hidden object is the reward."],"signs_it_is_working":"Child twists the lid with two hands (or one hand once wrist strength grows), removes it, and takes the object out.","signs_to_stop":"Subtle: prying at the lid rather than twisting. Potent: throwing the jar, crying. Model once more; if still stuck, pack up.","adult_role":"Model; start with the loosest lid so the first success comes quickly.","safety":"Plastic jars only, no glass. No jars small enough to swallow.","derivation":"adapted","evidence_note":"Jar-twisting is a common 24-30 month fine-motor activity in Pathways and RCN.","sources":["SRC-018","SRC-014"]},{"id":"ACT-0122","title":"Eight-cube tower","targets":["FM-022"],"supports":["FM-020","FM-023"],"type":"play","age_window":{"from_months":24,"to_months":34},"duration_minutes":10,"frequency":"daily","materials":["12 small blocks"],"cost_tier":"under_500_inr","how_to":["Sit with the child on a flat non-slippy surface.","Model an eight-cube tower slowly, one block at a time.","Let the child try; the placement past six blocks is careful and slow.","Count together as blocks go on."],"signs_it_is_working":"Child stacks eight blocks so they stay standing; the placement is careful and centred.","signs_to_stop":"Subtle: giving up at six blocks. Potent: swiping the tower, throwing. Return to six.","adult_role":"Count aloud; do not steady.","safety":"As above.","derivation":"adapted","evidence_note":"Denver FM21 (tower of 8 cubes); adapted as parent activity.","sources":["SRC-018"]},{"id":"ACT-0123","title":"Vertical-line imitation","targets":["FM-021"],"supports":["FM-015","FM-024"],"type":"play","age_window":{"from_months":22,"to_months":32},"duration_minutes":8,"frequency":"daily","materials":["one chunky crayon or triangular pencil","a large sheet of paper"],"cost_tier":"under_500_inr","how_to":["Sit beside the child at a table.","Draw one clear vertical line on your side of the paper — top to bottom.","Hand the child the crayon and say 'you try'.","The child will imitate what they just watched; do not draw a model that stays on the paper as a template — that is 'copy', which comes later."],"signs_it_is_working":"Child makes a roughly vertical mark on the paper, top-to-bottom or bottom-to-top; it does not have to be straight to count.","signs_to_stop":"Subtle: scribbling instead of a line, no vertical intent. Potent: throwing the crayon. Return to open scribbling.","adult_role":"Model each round; watch, wait, hand back.","safety":"Non-toxic crayons; protect the surface below.","derivation":"adapted","evidence_note":"Denver FM20 (imitate vertical line) at p50 32.4mo; framing our own.","sources":["SRC-018"]},{"id":"ACT-0124","title":"Ten-cube tower with counting","targets":["FM-023"],"supports":["FM-022","CG-026"],"type":"play","age_window":{"from_months":28,"to_months":40},"duration_minutes":10,"frequency":"weekly","materials":["15 small blocks"],"cost_tier":"under_500_inr","how_to":["Sit with the child on a firm flat surface.","Model ten blocks stacked slowly; count each one aloud as it lands.","Let the child try; the placement past eight is very slow and requires two-hand control.","Celebrate the try; ten-cube towers routinely collapse."],"signs_it_is_working":"Child stacks ten blocks so they stay standing at least for a second; the counting language rides along the placement.","signs_to_stop":"Subtle: reverting to six blocks. Potent: swiping. Return to eight.","adult_role":"Count, hand blocks, celebrate.","safety":"As above.","derivation":"adapted","evidence_note":"Dosman FM 36mo 50th percentile tower-of-10; framing our own.","sources":["SRC-004"]},{"id":"ACT-0125","title":"Horizontal-line copy","targets":["FM-024"],"supports":["FM-021","FM-025"],"type":"play","age_window":{"from_months":28,"to_months":40},"duration_minutes":8,"frequency":"daily","materials":["chunky crayon or pencil","paper with a horizontal line pre-drawn"],"cost_tier":"under_500_inr","how_to":["Draw a clear horizontal line on the paper before you sit down with the child.","Point to your line and say 'can you make one like this'.","The child copies from the model that stays on the paper.","Praise the attempt regardless of straightness."],"signs_it_is_working":"Child produces a horizontal-oriented mark below or beside yours; the direction (left-right rather than up-down) is the achievement.","signs_to_stop":"Subtle: scribble that ignores the model. Potent: throwing the crayon. Return to imitation of your live drawing (ACT-0123).","adult_role":"Pre-draw the model; do not draw again during their turn.","safety":"Non-toxic materials.","derivation":"adapted","evidence_note":"Dosman FM 36mo 50th percentile copies-horizontal-line; framing our own.","sources":["SRC-004"]},{"id":"ACT-0126","title":"Circle copy","targets":["FM-025"],"supports":["FM-024"],"type":"play","age_window":{"from_months":28,"to_months":40},"duration_minutes":8,"frequency":"daily","materials":["chunky crayon or pencil","paper with a circle pre-drawn"],"cost_tier":"under_500_inr","how_to":["Draw a clear circle on the paper before sitting down with the child.","Point and say 'can you make a round one'.","The child attempts a closed curved shape; the closure is what matures over months.","First circles are often open on one side; that is common."],"signs_it_is_working":"Child produces a roughly round mark, closed or nearly-closed; the wrist rotates rather than the crayon just going back and forth.","signs_to_stop":"Subtle: scribbling. Potent: refusing. Return to line copying.","adult_role":"Pre-draw the model; watch and wait.","safety":"Non-toxic materials.","derivation":"adapted","evidence_note":"Dosman FM 36mo 50th percentile copies-circle; framing our own.","sources":["SRC-004"]},{"id":"ACT-0127","title":"Atta dough kneading and squeezing","targets":["FM-005"],"supports":["FM-011","FM-012","FM-015","SR-006"],"type":"play","age_window":{"from_months":12,"to_months":36},"duration_minutes":15,"frequency":"weekly","materials":["a fistful of atta or maida dough (soft, no salt-heavy content) or store-bought playdough"],"cost_tier":"free","india_sourcing_note":"A small ball of soft atta from the kitchen (do not salt heavily; keep on a plate, discard after play). Store-bought Play-Doh works but costs INR 200+.","how_to":["Give the child a small ball of soft dough on a plate.","Show squeezing it in one fist; then pinching a piece off; then rolling a snake.","Let the child work the dough at their own pace.","Discard the used dough after the session."],"signs_it_is_working":"Child squeezes, pinches, rolls, and re-forms the dough; grip strength and hand muscles get worked without any tool.","signs_to_stop":"Subtle: putting the dough in the mouth repeatedly. Potent: throwing pieces, crying. Pack away.","adult_role":"Model actions once. Do not shape it for them.","safety":"Never leave the child alone with dough. Discard after play so no salt-heavy piece is eaten later.","derivation":"adapted","evidence_note":"Dough play is universal toddler fine-motor guidance across CDC, ELOF and Pathways.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0128","title":"Water pouring between cups","targets":["FM-013"],"supports":["FM-014","AD-005","AD-006","SR-007"],"type":"play","age_window":{"from_months":18,"to_months":36},"duration_minutes":15,"frequency":"weekly","materials":["two small unbreakable cups, one filled with water; a tray or a bathroom floor to catch spills"],"cost_tier":"free","india_sourcing_note":"Two small steel katoris or plastic cups; do this on the bathroom floor at bath time, or on a tray in the kitchen.","how_to":["Fill one cup half full with water.","Show pouring from one cup into the other, slowly.","Hand the cups over and let the child try.","Refill from a jug as needed; spills are the point."],"signs_it_is_working":"Child holds one cup, tilts to pour into the other, and gets most of the water across; the tilt and stop become controlled.","signs_to_stop":"Subtle: pouring on the floor deliberately after a few good pours. Potent: throwing the cup, tantrum. Pack up.","adult_role":"Refill; do not steady the cup for them.","safety":"Water, not hot. Bathroom or wipeable floor. Never leave a young child alone with a container of water.","derivation":"adapted","evidence_note":"Water pouring as a fine-motor pre-self-feeding activity is common across Pathways and CCD low-resource routines.","sources":["SRC-018","SRC-016"]},{"id":"ACT-0140","title":"Finger in the palm","targets":["FM-001","FM-002"],"supports":["FM-004"],"type":"play","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["a light cloth or wooden ring"],"cost_tier":"free","how_to":["When he is calm and awake, stroke the back of his fist gently; the hand often opens.","Place your finger or a light cloth ring in his open palm and let him close on it.","Say what is happening: 'you've got my finger'."],"signs_it_is_working":"His hand opens more often, and he holds the finger or ring for a few seconds.","signs_to_stop":"Fist clenched tighter, or turning away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer and wait. Do not prise the fingers open.","safety":"Only objects too big to fit in the mouth.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0141","title":"Hands free, awake","targets":["FM-004"],"supports":["FM-002","SR-003"],"type":"environment","age_window":{"from_months":0,"to_months":4},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is awake and supervised, leave his hands uncovered: no mittens, no tight swaddle.","Let him find his hands and bring them to his mouth.","Wash his hands in the routine bath; keep nails short so he does not scratch."],"signs_it_is_working":"He brings his hands to his mouth on purpose and sucks on them to settle or explore.","signs_to_stop":"Scratching his face repeatedly, or crying with hands flailing. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep the hands free and the nails short. Do not pull his hands away from his mouth.","safety":"Short nails; swaddle only for sleep if at all, and never tight.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip on supporting self-soothing with the fingers (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0142","title":"Batting line","targets":["FM-028"],"supports":[],"type":"environment","age_window":{"from_months":1,"to_months":5},"duration_minutes":10,"frequency":"daily","materials":["a dupatta or strong string","2-3 light household objects"],"cost_tier":"free","how_to":["Tie a dupatta or string across two chair legs above where he lies, out of his face.","Hang two or three light things from it: a cloth ring, a steel spoon on a ribbon, a small bell tied shut in cloth.","Lay him underneath on his back and let him swipe at them; change the objects every few days."],"signs_it_is_working":"His swipes get more frequent and more on target; he starts watching his own hand hit the object.","signs_to_stop":"Staring past the objects, or startling at each noise. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set it up and step back; let him discover it. Do not move the objects for him.","safety":"Everything tied tightly, well above his face, and removed when you leave the room. No long loose strings.","derivation":"adapted","evidence_note":"Adapted from the CDC 4-month tip 'Provide safe opportunities for your baby to reach for toys, kick at toys' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"a dupatta tied between two chairs works as well as a baby gym"},{"id":"ACT-0143","title":"Held rattle to swipe","targets":["FM-028"],"supports":[],"type":"play","age_window":{"from_months":2,"to_months":5},"duration_minutes":3,"frequency":"daily","materials":["a rattle or a bright cloth"],"cost_tier":"free","how_to":["Hold a rattle or bright cloth about 20 cm above his chest, a little to one side.","Shake it gently and wait for him to swing his arm toward it.","When he hits it, let it make a sound; then switch sides."],"signs_it_is_working":"He swings at the rattle more often, from either side.","signs_to_stop":"Looking away from the rattle and staying away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Hold it still after the first shake so his swipe is what makes the sound.","safety":"Use a rattle too large to fit in the mouth and in one piece.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0144","title":"Rattle for each hand","targets":["FM-006","FM-007"],"supports":[],"type":"play","age_window":{"from_months":4,"to_months":9},"duration_minutes":5,"frequency":"daily","materials":["2 small sealed containers with dal or rice inside"],"cost_tier":"free","how_to":["Offer a rattle to one hand; once he holds it, offer a second to the other hand.","Shake your own rattle and wait to see if he shakes his.","Use two different household sounds: a small closed steel container with dal, a plastic bottle with rice (lids taped)."],"signs_it_is_working":"He shakes a rattle on purpose and holds one in each hand at the same time.","signs_to_stop":"Dropping both and turning away. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer and wait; let him find the sound. Do not shake his hand for him.","safety":"Lids taped shut; check for cracks every time.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"a small steel dabba with a few grains of dal, lid taped"},{"id":"ACT-0145","title":"Soft food pieces on the tray","targets":["FM-008","FM-010","FM-012"],"supports":["AD-001","AD-002"],"type":"routine","age_window":{"from_months":6,"to_months":15},"duration_minutes":10,"frequency":"a few times a day","materials":["soft finger foods from the family meal"],"cost_tier":"free","how_to":["Once he is eating solids, put a few soft pieces (well-cooked carrot, banana, soft idli bits) on a clean tray.","Let him rake them in with his whole hand at first; later he picks them up with thumb and fingers.","Offer smaller pieces as his pincer grows finer."],"signs_it_is_working":"He rakes food toward himself, then picks up pieces between thumb and fingers, and later with fingertips.","signs_to_stop":"Gagging or coughing, or pushing the tray away. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Put the food down and let him work it out. Do not put the pieces into his hand.","safety":"Only soft, squashable pieces; he sits upright and an adult watches the whole meal. No whole nuts, grapes or hard raw pieces.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on exploring foods with varied textures and self-feeding (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0146","title":"Two katoris: bang and pass","targets":["FM-009","FM-011"],"supports":[],"type":"play","age_window":{"from_months":6,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["2 steel katoris or small cups"],"cost_tier":"free","how_to":["Give him one steel katori or small cup in each hand, or offer the second to the hand already holding one.","Bang your two together and say 'bang bang'; wait for him to try.","When he has one, hold out your hand and ask for it, then give it back to the other hand."],"signs_it_is_working":"He bangs two things together and passes one from hand to hand.","signs_to_stop":"Dropping both and looking away. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show once, then wait. Do not move his hands for him.","safety":"Katoris with no sharp edges; stay close.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"steel katoris are ideal — unbreakable and loud"},{"id":"ACT-0147","title":"Tip-out box","targets":["FM-014"],"supports":["CG-031"],"type":"play","age_window":{"from_months":10,"to_months":18},"duration_minutes":5,"frequency":"daily","materials":["a small box or dabba","3-4 blocks or large spoons"],"cost_tier":"free","how_to":["Put three or four blocks or spoons into a small box or dabba.","Show him how to turn it upside down and tip them out.","Let him fill it (or you fill it) and tip again."],"signs_it_is_working":"He turns the container over on purpose to tip things out.","signs_to_stop":"Throwing the box, or walking off. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show once; then leave it to him.","safety":"Objects large enough not to swallow.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on block dumping and retrieval (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0148","title":"Big crayon on floor paper","targets":["FM-015"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["paper taped down","1 chunky crayon"],"cost_tier":"under_500_inr","how_to":["Tape a large sheet of paper (an old newspaper or the back of a calendar) to the floor.","Give him one thick crayon and make a mark yourself.","Let him scribble; say what colours and lines you see."],"signs_it_is_working":"He makes marks on purpose and keeps scribbling.","signs_to_stop":"Putting the crayon in the mouth repeatedly or tearing the paper. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Provide the paper and crayon. Do not guide his hand or ask him to draw something.","safety":"Non-toxic chunky crayons; supervise.","derivation":"adapted","evidence_note":"Adapted from CDC 'What you can do' tips for this age (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0149","title":"Board book page turns","targets":["FM-016"],"supports":["RC-011"],"type":"routine","age_window":{"from_months":10,"to_months":18},"duration_minutes":5,"frequency":"daily","materials":["a board book or a thick card photo album"],"cost_tier":"free","how_to":["At bedtime, sit with a thick board book on your lap.","Lift the corner of the next page slightly so he can grab and turn it.","Talk about the picture on each page he turns."],"signs_it_is_working":"He turns the stiff pages himself, sometimes several at once.","signs_to_stop":"Pushing the book away or trying to climb off. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Lift the corner; let him turn. It is fine to skip pages.","safety":"Board books only; no staples.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip ''Read' books with your baby. Reading can be talking about pictures.' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0150","title":"Towers from boxes and cups","targets":["FM-017","FM-019","FM-020"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":26},"duration_minutes":10,"frequency":"daily","materials":["small boxes, upside-down steel glasses or blocks"],"cost_tier":"free","how_to":["Collect small boxes, steel glasses turned upside down, or wooden blocks.","Build a tower of two and knock it down together; then let him build.","Add one more piece as he manages the height; let him knock it down every time."],"signs_it_is_working":"He stacks two, then four, then six pieces before they fall.","signs_to_stop":"Swiping the pieces away before building, over and over, with a frown. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Build alongside him. Do not rebuild his tower for him.","safety":"Nothing heavy that can fall on toes.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip 'Encourage block play and stacking' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0151","title":"Carton posting box","targets":["FM-018"],"supports":[],"type":"toy","age_window":{"from_months":14,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["a shoe box","a small ball","a card"],"cost_tier":"free","how_to":["Cut a round hole and a slot in the lid of a shoe box.","Give him a ball that fits the round hole and a card or old ID-sized card for the slot.","Show once, then let him post; empty the box together."],"signs_it_is_working":"He fits objects through the matching hole, turning them to fit.","signs_to_stop":"Banging the object on the lid with growing frustration. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show once and wait. If he struggles, make the hole bigger rather than helping him push.","safety":"Smooth edges on the holes; objects too big to swallow.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0152","title":"Lids and containers","targets":["FM-029"],"supports":[],"type":"play","age_window":{"from_months":16,"to_months":30},"duration_minutes":5,"frequency":"daily","materials":["a tiffin or dabba with an easy lid"],"cost_tier":"free","how_to":["Put a small toy inside a container with an easy lid (a dabba, a tiffin, a jar with a wide lid).","Show him how to hold the bottom with one hand and pull the lid with the other.","Offer different containers over the weeks."],"signs_it_is_working":"He holds the container steady with one hand while the other opens it.","signs_to_stop":"Throwing the container or handing it back crying. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Loosen the lid a little at first. Do not open it for him unless he asks.","safety":"No glass; nothing small enough to swallow inside.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year milestone example 'holding a container and taking the lid off' and its tip on problem-solving toys (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"a steel tiffin box works well"},{"id":"ACT-0153","title":"Unwrap the parcel","targets":["FM-029"],"supports":[],"type":"play","age_window":{"from_months":16,"to_months":30},"duration_minutes":5,"frequency":"daily","materials":["newspaper or cloth","a small toy"],"cost_tier":"free","how_to":["Wrap a toy loosely in newspaper or cloth and tie it with a loose knot.","Let him hold the parcel with one hand and pull the wrapping off with the other.","Wrap it again together."],"signs_it_is_working":"He steadies the parcel with one hand and pulls with the other.","signs_to_stop":"Tearing at it with both hands and giving up in tears. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep the wrapping loose. Let him take his time.","safety":"No plastic bags; tape and string removed afterwards.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0200","title":"Notice how the baby responds to sound","targets":["RC-001","RC-002"],"supports":["SR-002","SR-004"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["everyday household sounds and the caregiver voice"],"cost_tier":"free","how_to":["In everyday moments (a door closing, a spoon dropping, your voice calling them), notice how the baby reacts.","Look for a startle at loud sounds and a settling or turn toward familiar voices.","Talk to the baby in a warm even voice during feeds and diaper changes; note whether they quiet, look, or vocalise back.","Keep a running mental log of what kinds of sound get a reaction and which do not."],"signs_it_is_working":"Baby startles or blinks at loud unexpected sounds; calms when picked up and spoken to; turns eyes or head toward a familiar voice.","signs_to_stop":"Subtle: consistent lack of response to loud unexpected sound after 2 months of age. Potent: no calming to any adult voice by 3 months. Neither is a stop-the-activity cue — both are reasons to bring it up with a paediatrician for a hearing check.","adult_role":"Observe and note; do not test with loud sounds on purpose.","safety":"Never test hearing by making an intentionally loud sound near the baby.","derivation":"adopted","evidence_note":"CDC Milestone Moments (2 mo): note whether your baby reacts to loud noises. This is an observation routine, not an intervention.","sources":["SRC-002"]},{"id":"ACT-0201","title":"Rattle-and-turn orientation play","targets":["RC-003"],"supports":["SR-004","GM-010"],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["a light rattle or a small container with a spoon of dry rice"],"cost_tier":"free","how_to":["Hold the baby in a supported upright position or lay them on the back on a mat.","Sound the rattle out of the baby direct line of sight, to one side about arm distance away.","Wait for the baby to turn the head toward the sound.","Try the other side next. Keep the sound short (1-2 seconds) and quiet."],"signs_it_is_working":"Baby turns the head or eyes toward the sound within 2-3 seconds and holds attention briefly on the source.","signs_to_stop":"Subtle: baby looks past the sound, dulled expression. Potent: crying, arching. Put the rattle down and offer face-and-voice contact.","adult_role":"Sound and wait; do not repeat rapidly.","safety":"Volume soft — the goal is orientation, not startle.","derivation":"adapted","evidence_note":"Rattle-and-turn is a classic Denver LG observation (LA6); framed here as a play episode.","sources":["SRC-018"]},{"id":"ACT-0202","title":"Face-to-face talking during care","targets":["RC-004"],"supports":["RC-002","SE-004","EC-007"],"type":"routine","age_window":{"from_months":1,"to_months":6},"duration_minutes":5,"frequency":"a few times a day","materials":["caregiver face and voice"],"cost_tier":"free","how_to":["During diaper changes, feeds, or baths, hold your face 20-30 cm from the baby.","Talk in a slow warm voice about what you are doing ('I am wiping your hands now').","Pause after each phrase; the baby will study your face and mouth.","Wait for a look, a coo, or a mouth movement in reply."],"signs_it_is_working":"Baby looks steadily at your face while you talk; the gaze shifts to your mouth when you form words; sometimes coos or mouths back.","signs_to_stop":"Subtle: baby looks past you, yawns, hand-to-ear. Potent: crying, arching. Stop talking, finish the care, pause.","adult_role":"Slow. Aim for a pace of roughly one phrase every 3-4 seconds so the baby can process.","safety":"Not while carrying up or down stairs.","derivation":"adopted","evidence_note":"CDC Milestone Moments (2 mo): talk with your baby; give your baby time to look at your face.","sources":["SRC-002"]},{"id":"ACT-0203","title":"Name call and wait","targets":["RC-005"],"supports":["SE-009","SR-005"],"type":"routine","age_window":{"from_months":5,"to_months":12},"duration_minutes":2,"frequency":"a few times a day","materials":["the baby name in your family voice"],"cost_tier":"free","how_to":["When the baby is quietly engaged with a toy, call their name from a step away in a warm even voice.","Wait several seconds without adding anything else. The pause is the whole game.","If they turn or look, smile and acknowledge with their name.","Do not call the name repeatedly if there is no response; try again in a few minutes."],"signs_it_is_working":"Baby turns the head or eyes toward you within a few seconds of hearing their name.","signs_to_stop":"Subtle: no turn most tries at 9-12 months. Potent: overuse — calling the name over and over — trains them to ignore it. Save the name-call for moments they can respond.","adult_role":"Call once; wait; acknowledge. Save the name from becoming background noise by not saying it constantly.","safety":"Do not use the name to scold; children who hear their name as a warning stop turning toward it.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6 mo): responds to their name.","sources":["SRC-002"]},{"id":"ACT-0204","title":"The 'no' pause and redirect","targets":["RC-006"],"supports":["SE-016","SR-013"],"type":"routine","age_window":{"from_months":8,"to_months":15},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments when the baby heads for something unsafe"],"cost_tier":"free","how_to":["When the baby is about to touch or take something you would rather they did not, say 'no' in a firm but low even voice.","Pause for a moment; the baby learns that 'no' signals a pause.","Then redirect to something they can do: hand them a safe alternative, or move them away.","Save 'no' for a few things you really mean; overused, it stops mattering."],"signs_it_is_working":"Baby pauses their hand for a moment when they hear 'no'; sometimes looks up at you for confirmation.","signs_to_stop":"Subtle: baby ignores 'no' completely — usually because it is overused or paired with laughter. Potent: crying, tantrum. Pick up and comfort; the message got through.","adult_role":"Say once, mean it, redirect. Do not lecture.","safety":"'No' is a pause word, not a punishment. If it does not stop unsafe reaching, physically move the child.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): understands 'no'. Standard early-limit-setting content across CDC, ELOF and CCD.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0205","title":"Peek-a-boo and pat-a-cake","targets":["RC-008"],"supports":["CG-015","SE-029","SE-013"],"type":"play","age_window":{"from_months":6,"to_months":15},"duration_minutes":5,"frequency":"daily","materials":["your hands and a light cloth (dupatta or napkin)"],"cost_tier":"free","how_to":["Cover your face with a cloth or your hands; say 'where is amma / papa'.","Uncover suddenly with 'peek-a-boo' or 'here'.","Once the game is familiar, cover the baby face with the cloth; wait for them to pull it off.","Pat-a-cake: clap your hands together with a rhythm, then take the baby hands and help them clap along."],"signs_it_is_working":"Baby smiles, laughs, or vocalises in anticipation of the reveal; later begins to initiate the game (pulls the cloth over their own face, offers their hands to clap).","signs_to_stop":"Subtle: gaze aversion, dulled response after a few rounds. Potent: crying, arching. Uncover and hold them quietly.","adult_role":"Play with rhythm; pause for anticipation; keep it playful. Let them initiate when they can.","safety":"Do not fully cover the baby head with a heavy cloth. Light cloth over the face for 1-2 seconds only.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): play games such as peek-a-boo. Universal across CDC, CCD, ELOF and RCN.","sources":["SRC-002","SRC-016"]},{"id":"ACT-0206","title":"Look-where-I-look joint-attention play","targets":["RC-007"],"supports":["EC-028","CG-018"],"type":"play","age_window":{"from_months":8,"to_months":15},"duration_minutes":3,"frequency":"a few times a day","materials":["any interesting object or person in the room"],"cost_tier":"free","how_to":["When the baby is facing you, say 'look' and turn your head clearly to look at something across the room (a fan, a photo, a family member).","Wait for the baby to follow your gaze.","When they look, name what they see ('the fan, the fan is spinning').","Repeat with different targets across the day."],"signs_it_is_working":"Baby follows the direction of your gaze to the object you are looking at; sometimes looks back to check with you.","signs_to_stop":"Subtle: no gaze-following by 12-15 months. Potent: none — this is a low-intensity game. Persistent absence of joint attention past 18 months is worth mentioning to a paediatrician.","adult_role":"Turn your whole head, not just your eyes, at this age — the head turn is what the baby can follow.","safety":"No safety concerns.","derivation":"adapted","evidence_note":"Joint attention (gaze-following) is a foundational ELOF Attending sub-domain skill; the head-turn framing draws on Vroom Chat + Follow tips.","sources":["SRC-005","SRC-017"]},{"id":"ACT-0207","title":"Where-is-the-ball routine question","targets":["RC-009"],"supports":["RC-010","CG-013"],"type":"play","age_window":{"from_months":9,"to_months":16},"duration_minutes":5,"frequency":"daily","materials":["one or two familiar objects (ball, cup, shoe) in a familiar location"],"cost_tier":"free","how_to":["Put a familiar ball in its usual spot (the toy basket, on the floor).","Ask 'where is the ball'.","Wait; the baby will look toward the ball, later point.","Once the look happens, say 'yes, there is the ball' and hand it over as reward."],"signs_it_is_working":"Baby looks or points toward the named object within a few seconds of the question.","signs_to_stop":"Subtle: baby looks at your face rather than the object — the routine has become a language guessing game rather than an object hunt. Move the ball to a slightly different spot and try again.","adult_role":"Ask once and wait. Do not point to the ball yourself.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Head Start ELOF Attending and Understanding Do guide: ask simple 'where is' questions about familiar objects and people so infants can begin to link words to what they see.","sources":["SRC-005"]},{"id":"ACT-0208","title":"Narrated play with 50-word target vocabulary","targets":["RC-023"],"supports":["RC-010","EC-013","EC-014"],"type":"language","age_window":{"from_months":7,"to_months":14},"duration_minutes":15,"frequency":"daily","materials":["daily-life household items and family members"],"cost_tier":"free","how_to":["Aim to name 15-20 core objects and 5-10 core actions repeatedly across the day: family members, body parts, animals, foods, first-verbs (eat, sleep, come, go, sit).","Use the same word each time for the same thing (not synonyms) at this stage.","Pair naming with pointing or handling: 'this is a spoon' as you hand a spoon.","Recycle the same words during bath, meals, walks, book time — repetition builds comprehension."],"signs_it_is_working":"Baby looks at a named object or person; later points to it on request; vocabulary understood grows across weeks.","signs_to_stop":"Subtle: baby tunes out during heavy narration. Potent: crying or refusal. Reduce to just naming the object of joint attention; drop background narration.","adult_role":"Repeat the same core words; do not chase novelty. Comprehension is built by repetition, not vocabulary breadth.","safety":"Not during nap or feeding — quiet time is also language time.","derivation":"adapted","evidence_note":"Wordbank comprehension medians say 50 words are understood by ~11 months; concentrated repetition of a stable core vocabulary is the mechanism. Adapted from ELOF Attending and Understanding Do guide.","sources":["SRC-005","SRC-009"]},{"id":"ACT-0209","title":"Name-and-look object routine","targets":["RC-010"],"supports":["RC-023","EC-014"],"type":"play","age_window":{"from_months":10,"to_months":18},"duration_minutes":5,"frequency":"daily","materials":["3-5 familiar objects at hand (spoon, cup, ball, shoe, book)"],"cost_tier":"free","how_to":["Place 2-3 familiar objects in the baby line of sight (say, on a low table).","Ask 'where is the shoe'.","Wait for the look; celebrate with the object name repeated.","Change out the objects across days so the vocabulary grows."],"signs_it_is_working":"Baby looks at the correctly-named object out of several present.","signs_to_stop":"Subtle: baby looks at whichever object is nearest regardless of the name. Reduce to two objects far apart from each other.","adult_role":"Wait for the look before naming again. Do not overprompt.","safety":"No safety concerns.","derivation":"adapted","evidence_note":"Denver LA15 (looks at named object) with a home-scaffolding wrap.","sources":["SRC-002"]},{"id":"ACT-0210","title":"Interactive shared reading","targets":["RC-011"],"supports":["FM-016","EC-023","SE-013"],"type":"routine","age_window":{"from_months":12,"to_months":30},"duration_minutes":10,"frequency":"daily","materials":["one age-appropriate picture book (thick pages 0-18mo, paper pages 18mo+)"],"cost_tier":"under_500_inr","india_sourcing_note":"Tulika, Pratham Books, Karadi Path and Duckbill publish age-appropriate books in Hindi, English and regional languages at low cost.","how_to":["Sit with the child on your lap or beside them; hold the book together.","Point to what you name; let the child point too.","Read the same book many times — repetition builds comprehension.","Follow their interest: if they linger on a page, stay there; if they flip, follow."],"signs_it_is_working":"Child attends to the book for at least a few pages, points at pictures, sometimes asks 'what is this' by pointing.","signs_to_stop":"Subtle: throwing the book, wandering off. Potent: refusing books for several days. Save reading for a calmer moment (before nap, after bath).","adult_role":"Follow their attention; do not force page-by-page completion.","safety":"Board books until the child stops mouthing paper.","derivation":"adopted","evidence_note":"Head Start ELOF Emergent Literacy Do guide: read the same books many times; talk about the pictures; follow the child interest as they turn pages.","sources":["SRC-005"]},{"id":"ACT-0211","title":"One-step direction with gesture","targets":["RC-012"],"supports":["RC-013","EC-027"],"type":"routine","age_window":{"from_months":10,"to_months":18},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments and everyday objects"],"cost_tier":"free","how_to":["During everyday activity, ask the child to do a simple thing paired with a clear gesture: 'give me the spoon' (hold your hand out), 'come here' (open arms), 'sit down' (pat the seat).","Wait for the action; do not repeat the request three times.","Praise the doing, not the perfection.","Rotate which requests you ask so the language load grows."],"signs_it_is_working":"Child does the requested action when the gesture is present; the response is quicker over weeks.","signs_to_stop":"Subtle: child ignores the request repeatedly. Potent: none — one-step-with-gesture is scaffolding, not a test.","adult_role":"Ask, wait, celebrate. Do not scold non-response at this age.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): follows simple directions paired with gestures.","sources":["SRC-002"]},{"id":"ACT-0212","title":"One-step direction without gesture","targets":["RC-013"],"supports":["RC-019","EC-014"],"type":"routine","age_window":{"from_months":13,"to_months":22},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments and everyday objects"],"cost_tier":"free","how_to":["Once one-step-with-gesture is reliable, ask the same requests without the gesture: 'give me the spoon' with your hands quiet.","Wait longer than feels natural; the child needs a beat to parse without the visual cue.","If they miss, add the gesture the second try; do not scold.","Choose things they usually enjoy doing — the reward is built in."],"signs_it_is_working":"Child does the requested action without seeing your gesture; response times shorten over weeks.","signs_to_stop":"Subtle: child looks at your hand and waits for the gesture. That is fine; add the gesture and try again a week later without.","adult_role":"Slow, single request, wait.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"CDC Milestone Moments (18 mo): follows one-step directions without gestures.","sources":["SRC-002"]},{"id":"ACT-0213","title":"Language-rich narration through the day","targets":["RC-024"],"supports":["RC-023","RC-025","EC-017"],"type":"language","age_window":{"from_months":12,"to_months":20},"duration_minutes":30,"frequency":"ambient","materials":["everyday routines"],"cost_tier":"free","how_to":["Talk out loud about what you are doing while the child is nearby: 'now I am cutting the sabzi, this is a tomato, red tomato'.","Name and describe rather than testing ('is this a tomato'). Description builds vocabulary faster than quizzing at this age.","Use short clear sentences; the child needs to hear the words in real context.","Include your home language and English mixed as feels natural — bilingual exposure grows both."],"signs_it_is_working":"Child looks at objects you name; comprehension vocabulary crosses 100 words around 14 months on average; the child begins to point to objects when they hear them named.","signs_to_stop":"Subtle: child covers ears, moves away. Potent: none — this is ambient. Drop volume to whisper or pause when they need quiet.","adult_role":"Narrate for the child, not to the child. Description over interrogation.","safety":"Not while operating machinery or driving.","derivation":"adopted","evidence_note":"Head Start ELOF Vocabulary Do guide: use rich descriptive language throughout daily routines; repeat and expand on the words infants and toddlers hear.","sources":["SRC-005"]},{"id":"ACT-0214","title":"Body-parts naming with mirror","targets":["RC-014","RC-015"],"supports":["EC-016","SE-025"],"type":"play","age_window":{"from_months":15,"to_months":30},"duration_minutes":5,"frequency":"daily","materials":["a mirror large enough for the child to see themselves","or a doll with a face and identifiable parts"],"cost_tier":"free","how_to":["Sit with the child in front of the mirror.","Point to your own eye and say 'eye'. Then touch the child eye ('your eye'), then the mirror eye ('your eye in the mirror').","Start with two body parts (eyes, nose). Add more once those are reliable: mouth, ears, hands, feet, tummy, head.","Later, ask 'where is your nose' and wait for the child to touch."],"signs_it_is_working":"Child touches or points to the named body part on their own body when asked; first two body parts by 21 months on average, six by 23 months.","signs_to_stop":"Subtle: child names a different part or refuses. Reduce to just two body parts for a few weeks and try again.","adult_role":"Model then ask; do not correct wrong touches at first.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Head Start ELOF Vocabulary and CDC 18-24 mo tips both call out body-parts naming as a routine language activity.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0215","title":"Point-to-the-picture book game","targets":["RC-016"],"supports":["RC-017","FM-016"],"type":"play","age_window":{"from_months":18,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["a picture book with clear single-object images per page (fruits, animals, vehicles)"],"cost_tier":"under_500_inr","how_to":["Open the book to a page with two familiar pictures (say, a ball and a dog).","Ask 'where is the ball'.","Wait for the child to point.","Progress to four-picture pages once two is reliable."],"signs_it_is_working":"Child points to the named picture correctly on a two-picture page; later on a four-picture page.","signs_to_stop":"Subtle: child points randomly. Reduce to a single-picture page and name first, ask later.","adult_role":"Ask once, wait, celebrate.","safety":"Board books at younger ages.","derivation":"adopted","evidence_note":"Denver LA18 (points to 2 pictures) at p50 24mo; framing our own.","sources":["SRC-002"]},{"id":"ACT-0216","title":"Nursery rhymes and simple songs routine","targets":["RC-025"],"supports":["EC-016","EC-020","SE-013"],"type":"language","age_window":{"from_months":12,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["a small repertoire of 5-8 songs in home language and English"],"cost_tier":"free","india_sourcing_note":"Hindi bal-geet (Machli jal ki rani hai, Chanda mama, Aloo kachaloo), English rhymes (Twinkle twinkle, Wheels on the bus, Row row row your boat), Kannada / Tamil / Marathi rhymes depending on family languages.","how_to":["Sing the same 5-8 songs on repeat across days.","Add hand gestures for each song; the gesture-word pairing helps comprehension.","Pause partway through a familiar song; wait for the child to fill in the next word.","Sing at predictable times (bath, bedtime, in the car) so the routine anchors the language."],"signs_it_is_working":"Child anticipates lyric moments (rocks to the beat, fills in a word, does the gesture); vocabulary understood grows toward 200 words by 17 months.","signs_to_stop":"Subtle: child covers ears, walks off. Try a different song; save music for calmer moments.","adult_role":"Sing yourself. Do not put on a screen version and leave the room.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"NHS Ready Steady Baby: cuddling up with a story, song or rhyme is a great way for you to bond. Songs and rhymes for babies and toddlers are also a core Head Start ELOF Vocabulary practice.","sources":["SRC-015","SRC-005"]},{"id":"ACT-0217","title":"Two-step directions in daily routines","targets":["RC-019"],"supports":["RC-013","AD-015"],"type":"routine","age_window":{"from_months":22,"to_months":36},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments"],"cost_tier":"free","how_to":["Give a two-step request in the flow of everyday life: 'pick up the ball and put it in the basket'; 'take off your shoes and put them by the door'.","Keep the two steps naturally linked so the memory load is a real sequence, not a puzzle.","Wait; the child needs a beat to hold both steps.","If they do only the first, prompt the second quietly: 'and then'."],"signs_it_is_working":"Child does both steps in order on a familiar two-step request.","signs_to_stop":"Subtle: child does only the first step reliably. Break down to two one-step requests for a few weeks.","adult_role":"Speak once. Do not repeat the whole two-step; prompt the missing half.","safety":"Do not chain safety steps as a two-step request until the child is reliable ('open the gate and come inside' is unsafe if the second step is missed).","derivation":"adopted","evidence_note":"CDC Milestone Moments (30 mo): follows two-step instructions.","sources":["SRC-002"]},{"id":"ACT-0218","title":"Colour hunt around the house","targets":["RC-020"],"supports":["CG-027","EC-016"],"type":"play","age_window":{"from_months":22,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["everyday coloured objects around the home"],"cost_tier":"free","how_to":["Pick one colour for the day: 'today we are looking for red things'.","Point to a few red things yourself first (a red cushion, a red tomato).","Ask 'can you find something red'.","Start with primary colours one at a time (red, blue, yellow); mix them only once each is reliable."],"signs_it_is_working":"Child points to or brings you an object of the named colour; the reliable match grows from one colour to several across weeks.","signs_to_stop":"Subtle: child brings the same object every time. Introduce a new example of the same colour.","adult_role":"Model with a few examples; then ask.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Denver LA27 (name 1 color, past scope for RC) and CDC 30-36 mo tips: talk about colours and shapes.","sources":["SRC-002"]},{"id":"ACT-0219","title":"Action-word game with a doll or picture book","targets":["RC-018"],"supports":["EC-018","EC-022"],"type":"play","age_window":{"from_months":22,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["a doll or stuffed animal","or a book with action pictures"],"cost_tier":"free","how_to":["Model an action with a doll: 'the doll is sleeping' (lay the doll down); 'the doll is eating' (mime feeding).","Ask the child to show or say: 'show me sleeping'; 'show me eating'.","Add walking, running, jumping, drinking, crying, laughing.","Later, ask about actions in a book: 'what is the boy doing' pointing at a running-boy picture."],"signs_it_is_working":"Child demonstrates or names the action; understands 2 or more action words on request.","signs_to_stop":"Subtle: child names the object rather than the action ('the doll' when asked 'what is she doing'). Model more first; ask less.","adult_role":"Model the action; do not correct a mis-word aggressively.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Denver LA25 (know 2 actions) at p50 29.5mo; framing our own.","sources":["SRC-002"]},{"id":"ACT-0220","title":"Four-picture pointing routine","targets":["RC-017"],"supports":["RC-016","FM-026"],"type":"play","age_window":{"from_months":24,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["picture book with 4+ recognisable objects per page (animal books, vehicle books work well)"],"cost_tier":"under_500_inr","how_to":["Open the book to a page with 4-6 clear pictures.","Ask 'where is the cat', 'where is the dog', 'where is the bus', 'where is the flower'.","The child points; you name what they point at, whether right or wrong ('you found the tree').","Reward correct pointing warmly; do not scold wrong."],"signs_it_is_working":"Child points to the named picture correctly on a four-picture page.","signs_to_stop":"Subtle: child gets distracted after 2-3 questions. Stop; try later.","adult_role":"Ask, wait, name what they chose.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Denver LA22 (points to 4 pictures) at p50 31mo; framing our own.","sources":["SRC-002"]},{"id":"ACT-0221","title":"Descriptive-words play with everyday objects","targets":["RC-022"],"supports":["EC-016","CG-027"],"type":"play","age_window":{"from_months":28,"to_months":40},"duration_minutes":8,"frequency":"daily","materials":["pairs of everyday objects that vary on one dimension (big spoon and small spoon, hot roti and cool water, hard cube and soft ball, tall glass and short cup)"],"cost_tier":"free","how_to":["Show the pair and name the contrast: 'this is a BIG spoon, this is a SMALL spoon'.","Ask 'give me the big one'.","Rotate through pairs across days: big/small, hot/cold, hard/soft, wet/dry, tall/short.","Two dimensions at a time is enough; do not test all descriptors at once."],"signs_it_is_working":"Child hands over the object described by the named descriptor; understands two or more descriptive contrasts.","signs_to_stop":"Subtle: child hands the wrong one repeatedly. Model more; test less.","adult_role":"Present pair, name the contrast, ask for one. Do not lecture on adjectives.","safety":"Hot things: use safely-warm, not scalding.","derivation":"adopted","evidence_note":"Denver LA26 (know 2 adjectives) at p50 35.1mo; framing our own.","sources":["SRC-002"]},{"id":"ACT-0222","title":"Preposition play with a box and a small toy","targets":["RC-021"],"supports":["EC-022","CG-023"],"type":"play","age_window":{"from_months":28,"to_months":42},"duration_minutes":8,"frequency":"daily","materials":["one small toy and one open box (or basket)"],"cost_tier":"free","how_to":["Model each preposition: 'the toy is IN the box' (put it in); 'the toy is ON the box' (put it on the lid); 'the toy is UNDER the box' (turn the box over, hide it beneath).","Ask the child: 'put the toy in the box'.","Start with in and on; add under, behind, next to once the first two are reliable.","Reverse: ask 'where is the toy' — child answers with a word or a gesture."],"signs_it_is_working":"Child places the toy according to the named preposition; later answers 'where' with the preposition word.","signs_to_stop":"Subtle: child puts the toy in every time regardless of preposition. Reduce to a two-preposition contrast (in vs on) and repeat until reliable.","adult_role":"Model first, then ask; do not chain more than one preposition per request.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Denver LA33 (understand 4 prepositions, p50 37.5mo, past ship scope but in-corpus).","sources":["SRC-002"]},{"id":"ACT-0223","title":"Bilingual naming during play","targets":["RC-023"],"supports":["RC-024","RC-025","EC-014","EC-020"],"type":"language","age_window":{"from_months":10,"to_months":36},"duration_minutes":10,"frequency":"daily","materials":["everyday objects, in whichever family languages are spoken"],"cost_tier":"free","how_to":["For core objects, name them in each family language: 'pani, water'; 'seb, apple'; 'ghar, house'.","Do not correct the child if they use one language for a word; both count as vocabulary.","One parent one language works for some families; mixed use works for others. Consistency helps but is not essential.","Bilingual exposure does not delay speech; two vocabularies grow in parallel."],"signs_it_is_working":"Child understands the object in either language; may prefer one word over the other early, and use both later.","signs_to_stop":"Subtle: child seems confused during rapid switching. Give each language a longer stretch (a whole activity or meal in one).","adult_role":"Use your natural language. Do not fake accents or use a language you are not fluent in.","safety":"No safety concerns.","derivation":"adopted","evidence_note":"Head Start ELOF Vocabulary Do guide and Raising Children Network both confirm bilingual exposure supports comprehension growth; no delay evidence.","sources":["SRC-005","SRC-014"]},{"id":"ACT-0224","title":"Cooking-time labeling routine","targets":["RC-024"],"supports":["RC-023","AD-021","AD-022"],"type":"routine","age_window":{"from_months":12,"to_months":36},"duration_minutes":15,"frequency":"daily","materials":["your regular cooking session, with the child in a safe seat or standing on a stool nearby"],"cost_tier":"free","india_sourcing_note":"Indian kitchens have rich named-object density: dal, chawal, sabzi, roti, atta, jeera, haldi, mirchi. Each cooking session is a language event.","how_to":["Position the child safely away from stove and knives.","Talk out loud as you cook: 'I am chopping the onion, pyaaz, look how it makes my eyes water'.","Name every ingredient as you use it; hand safe items over for the child to hold.","Ask them to bring you something safe: 'get me the bowl please'."],"signs_it_is_working":"Child recognizes cooking-vocabulary words; may bring named safe items; comprehension of kitchen and food nouns grows quickly.","signs_to_stop":"Subtle: child moves toward stove or knives. Potent: crying at hot pans or spicy smells. Move them out of the kitchen and continue narration from a distance.","adult_role":"Cook and narrate. Do not require attention or response.","safety":"Child stays away from stove, knives, boiling pots. Never leave the child unattended in the kitchen.","derivation":"adapted","evidence_note":"Named-routine narration is the highest-leverage form of language exposure per ELOF Vocabulary Do guide; kitchen framing our own.","sources":["SRC-005"]},{"id":"ACT-0225","title":"Bath-time body-and-action narration","targets":["RC-014"],"supports":["RC-018","EC-016","AD-015","AD-020"],"type":"routine","age_window":{"from_months":10,"to_months":30},"duration_minutes":10,"frequency":"daily","materials":["bath tub or bathing bucket, water, soap"],"cost_tier":"free","how_to":["During bath, name body parts as you wash: 'washing your feet, your knees, your tummy, your back'.","Name water actions: 'pouring, splashing, wiping'.","Sing a repetitive bath song across days ('this is the way we wash our hands').","Talk about temperature: 'the water is warm'."],"signs_it_is_working":"Child anticipates the next body part to be washed; may touch a body part when named; enjoys the routine.","signs_to_stop":"Subtle: child grows anxious in the bath. Potent: crying, refusing bath. Return to a shorter bath in a small tub; narrate less.","adult_role":"Never leave the child alone in the bath even for a second.","safety":"Water temperature warm not hot. Non-slip surface under the tub. Constant hands-on supervision.","derivation":"adapted","evidence_note":"Head Start ELOF Vocabulary Do guide: use daily care routines (bathing, dressing, feeding) as opportunities for rich language.","sources":["SRC-005"]},{"id":"ACT-0226","title":"Sabzi-mandi outing labeling","targets":["RC-023"],"supports":["RC-020","RC-022","AD-022"],"type":"outing","age_window":{"from_months":12,"to_months":36},"duration_minutes":30,"frequency":"weekly","materials":["a trip to a vegetable or general market"],"cost_tier":"free","india_sourcing_note":"Sabzi mandi outings expose the child to a huge named-object density (bhindi, karela, palak, tamatar, aloo, adrak) plus colour, texture, size, and family-money-exchange context.","how_to":["Carry the child in your arms or a carrier, or use a stroller if the market is stroller-friendly.","Name vegetables as you pick them up: 'this is a tomato, tamatar, look it is red and round'.","Point out colours, sizes, and textures.","Let the child hold a light safe vegetable to bring home."],"signs_it_is_working":"Child names or reaches for familiar vegetables next visit; comprehension of colour-and-size vocabulary grows from the outing.","signs_to_stop":"Subtle: child overwhelmed by noise or crowd; overtired. Cut the outing short; try a quieter time of day.","adult_role":"Talk about what you see. Do not require the child to name.","safety":"Hold the child hand or use a carrier in a crowded market. Watch for traffic at the edge of the mandi.","derivation":"original","evidence_note":"Community outings as language events are a core Head Start ELOF Vocabulary Do guide practice; the sabzi-mandi framing is our own.","sources":["SRC-005"]},{"id":"ACT-0227","title":"Bedtime story routine","targets":["RC-011"],"supports":["RC-024","RC-025","SE-015","SR-013"],"type":"routine","age_window":{"from_months":6,"to_months":42},"duration_minutes":10,"frequency":"daily","materials":["one or two picture books kept for bedtime"],"cost_tier":"under_500_inr","india_sourcing_note":"A small stack of Pratham Books, Tulika or Karadi Path near the bed becomes the bedtime routine anchor. Two-three regulars beat a big shelf of unreads.","how_to":["Every night before sleep, sit or lie with the child and read.","Keep the same books in rotation; repetition is the point at this age.","Read at a calm pace; slower than daytime reading.","End with the same closing ('goodnight to the moon, goodnight to us') so the routine anchors sleep."],"signs_it_is_working":"Child asks for a book at bedtime, requests the same book many nights, fills in words, calms toward sleep during the routine.","signs_to_stop":"Subtle: child too wound up after a long book. Potent: crying, refusing bed. Cut to one short book; save the rest for daytime.","adult_role":"Read; do not perform. The voice-and-book combination is the calm signal.","safety":"Do not fall asleep with a book propped against the child.","derivation":"adopted","evidence_note":"Head Start ELOF Emergent Literacy Do guide and NHS Ready Steady Baby both frame bedtime reading as the highest-leverage single language routine.","sources":["SRC-005","SRC-015"]},{"id":"ACT-0240","title":"Soft voice first, then close","targets":["RC-002","RC-004"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":5},"duration_minutes":2,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he fusses, start talking softly from where you are before picking him up.","Bring your face into his view as you talk, about 25 cm away.","Pick him up and keep talking in the same calm voice."],"signs_it_is_working":"He quiets to your voice and turns to look at your face while you talk.","signs_to_stop":"Crying that climbs with every word. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let your voice arrive first. Do not raise your voice over his cry.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tips on responding to the baby and on soothing (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0241","title":"Everyday sound spotting","targets":["RC-001","RC-003"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":7},"duration_minutes":1,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When a household sound happens — the pressure cooker whistle, the doorbell, a spoon on a plate — pause.","Watch his reaction; say what it was: 'that's the cooker!'.","Later, make a gentle sound (a bell, your voice) to one side, out of his view, and wait for him to turn."],"signs_it_is_working":"He startles or stills to loud sounds early on, and later turns his head to find the sound.","signs_to_stop":"Startling and crying at every sound; move him away from loud sounds. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name the sound; let him search. Do not make sudden loud noises close to his ears.","safety":"Keep sounds gentle and at a distance; no loud noises near the ear.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0242","title":"Name from the side","targets":["RC-005"],"supports":[],"type":"routine","age_window":{"from_months":4,"to_months":10},"duration_minutes":1,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is playing calmly, say his name clearly from one side, not too loudly.","When he looks, smile and say something to him.","Use his name often in everyday talk, not only to call or stop him."],"signs_it_is_working":"He turns to his name more often, even when he is busy.","signs_to_stop":"Ignoring every call while clearly absorbed; try when he is less busy. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make his name mean something nice. Do not use it only for 'no'.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 4-month tip on using the baby's name (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0243","title":"Calm 'no' with a redirect","targets":["RC-006"],"supports":[],"type":"routine","age_window":{"from_months":7,"to_months":14},"duration_minutes":1,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he reaches for something unsafe, say 'no' calmly once with a small head-shake.","Straight away give him something he can have, or move him.","Say what he can do: 'you can bang this one'."],"signs_it_is_working":"He pauses or stops briefly when he hears 'no'.","signs_to_stop":"Laughing and repeating the action as a game; remove the object instead of repeating 'no'. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be brief and calm; the redirect does the work. Do not shout or explain at length.","safety":"Move genuinely dangerous things out of reach; 'no' is not a safety system.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Redirect your baby quickly and consistently...' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0244","title":"Look where I look","targets":["RC-007","RC-010"],"supports":["EC-028"],"type":"outing","age_window":{"from_months":8,"to_months":16},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["When something interesting is in view (a cow, a bus, the fan), look at it clearly and say 'look, a cow!'.","Wait for him to follow your look; point too.","Name familiar things at home and see if he looks at them."],"signs_it_is_working":"He looks where you look and point, and looks at familiar things when you name them.","signs_to_stop":"Looking only at your finger or face after several tries; try again another day. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Look first, then point, then name. Do not turn his head for him.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Point to interesting things you see, such as a truck, bus, or animals.' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0245","title":"Dupatta peek-a-boo","targets":["RC-008"],"supports":["CG-012","SE-029"],"type":"play","age_window":{"from_months":5,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["a light dupatta"],"cost_tier":"free","how_to":["Put a light dupatta over your face, then pull it off: 'peek-a-boo!'.","Later put it lightly over his head and let him pull it off.","Pause before the reveal so he anticipates it."],"signs_it_is_working":"He laughs, anticipates the reveal and pulls the cloth himself.","signs_to_stop":"Crying under the cloth; stop covering him and cover yourself only. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Play his rhythm; stop at the first sign he has had enough.","safety":"Light, breathable cloth; never leave it on his face.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on peek-a-boo with cloth (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0246","title":"Where's the ball? hunts","targets":["RC-009"],"supports":[],"type":"play","age_window":{"from_months":8,"to_months":15},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["With two or three familiar things in sight, ask 'where's the ball?'.","Wait; if he does not look, look at it yourself and point.","Swap the things and the question over the days."],"signs_it_is_working":"He looks at or goes to the thing you asked about.","signs_to_stop":"Wandering off after the first question. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Ask once and wait. Do not quiz him with question after question.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0247","title":"Little helper directions","targets":["RC-012","RC-013"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":1,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Give one simple direction in the middle of a routine: 'give me the spoon' with your hand out.","Once he does that with the gesture, try the same words without holding out your hand.","Thank him warmly each time."],"signs_it_is_working":"He follows the direction with the gesture, then without it.","signs_to_stop":"Turning away or saying 'no' each time; wait for a better moment. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"One direction at a time, with time to respond. Do not repeat it five times.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month milestone example and tip on letting the child help (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0248","title":"Bath-time body-part song","targets":["RC-015"],"supports":["RC-014"],"type":"routine","age_window":{"from_months":14,"to_months":26},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["While washing, name each body part: 'wash your nose, wash your toes'.","Ask him to show you: 'where's your tummy?' and wait.","Add one new body part every few days."],"signs_it_is_working":"He points to more body parts when you ask.","signs_to_stop":"Splashing away from you or wanting out. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name, then ask, then wait. Do not correct him.","safety":"Never leave him alone in water, even for a moment.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Start to teach your child the names for body parts' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0249","title":"Point to the picture","targets":["RC-016"],"supports":[],"type":"play","age_window":{"from_months":16,"to_months":28},"duration_minutes":5,"frequency":"daily","materials":["a picture book or magazine"],"cost_tier":"free","how_to":["With a picture book, ask 'where's the dog?' and wait for him to point.","If he does not, point yourself and say 'there's the dog'.","Ask about two different pictures on the same page."],"signs_it_is_working":"He points to the named pictures on his own.","signs_to_stop":"Turning pages fast or closing the book. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Ask, wait, then help. Keep it a conversation, not a test.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Read books and talk about the pictures using simple words' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0250","title":"Talk through the day","targets":["RC-025"],"supports":["EC-034"],"type":"routine","age_window":{"from_months":10,"to_months":24},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["As you cook, dress him or walk, say what you are doing and what things are called.","Use the real names: 'bhindi', 'kurta', 'auto'.","Leave pauses for him to look, point or answer."],"signs_it_is_working":"He understands many new words: he looks, fetches or points when you use them.","signs_to_stop":"Turning away from constant talk; talk less and wait more. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Narrate, then pause. Talk in the family's own languages.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Talk or sing to your baby about what you're doing' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0300","title":"Answer every cry with warm talk","targets":["EC-030"],"supports":["EC-006","SE-005","SR-002"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["caregiver voice"],"cost_tier":"free","how_to":["When the baby cries, come close and talk in a warm even voice as you begin to attend to them.","Say what you are noticing: 'you are hungry, food is coming'; 'you need a fresh diaper, I am picking you up now'.","Do not rush the sound of the cry into silence; the baby is learning that their voice brings a response.","Every cry answered is a data point in 'signals work' — the foundation of all later communication."],"signs_it_is_working":"Baby quiets somewhat on hearing your voice before you have solved the need; the cry has different tones for hunger, tiredness, discomfort over time.","signs_to_stop":"Subtle: baby stops crying but stays tense. Potent: cry becomes inconsolable. Reassess the underlying need (hungry, hurt, wet, tired) rather than the response.","adult_role":"Respond. Do not train silence.","safety":"Cries lasting hours or becoming high-pitched and inconsolable warrant a paediatrician call.","derivation":"adopted","evidence_note":"Head Start ELOF Communicating and Speaking Do guide: respond promptly and warmly to infant cries and vocalizations; this is the earliest form of communicative turn-taking.","sources":["SRC-005"]},{"id":"ACT-0301","title":"Coo-back turn-taking","targets":["EC-001","EC-002"],"supports":["EC-006","RC-004"],"type":"play","age_window":{"from_months":1,"to_months":5},"duration_minutes":5,"frequency":"a few times a day","materials":["caregiver face and voice"],"cost_tier":"free","how_to":["During a calm alert moment (after a feed, at a diaper change), hold the baby face 20-30 cm from yours.","When the baby makes any sound — a coo, an oo, an ah — echo it back.","Pause and wait for the next sound.","Each coo you give back is a 'turn'; two or three turns is a conversation."],"signs_it_is_working":"Baby makes a sound, waits, and vocalises again after your echo; the exchange stretches to three or more turns.","signs_to_stop":"Subtle: baby looks away, mouth stills. Potent: fussing, arching. Bring the baby to your shoulder and hold quietly.","adult_role":"Echo, pause, wait. Do not fill the silence.","safety":"Not while carrying up or down stairs.","derivation":"adopted","evidence_note":"CDC Milestone Moments (2 mo): coo and use your voice back and forth with your baby.","sources":["SRC-002"]},{"id":"ACT-0302","title":"Face-play for laughs and squeals","targets":["EC-003","EC-004"],"supports":["SE-006","EC-005"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":5,"frequency":"daily","materials":["caregiver face and voice; light tickles"],"cost_tier":"free","how_to":["Make exaggerated face-play: wide eyes, big smiles, gentle raspberry sounds on the baby tummy.","Time tickles and sound-effects unpredictably; the surprise is the point.","Wait after each round for the baby response — belly laughs and squeals come with repetition.","Stop when the laughter shows the first hint of overload."],"signs_it_is_working":"Baby laughs out loud, squeals, and starts to anticipate the tickle or sound before it lands.","signs_to_stop":"Subtle: laughter becomes higher-pitched, gaze aversion, hiccoughs. Potent: crying after a laugh, arching. Hold quietly for 30-60 seconds before starting anything else.","adult_role":"Follow the baby's reaction. Do not overplay.","safety":"Gentle tickles only, no shaking. Never toss.","derivation":"adopted","evidence_note":"CDC Milestone Moments (4-6 mo): make different sounds and expressions and let your baby watch you.","sources":["SRC-002"]},{"id":"ACT-0303","title":"Blow raspberries and mouth-play","targets":["EC-005"],"supports":["EC-008","FM-004"],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["caregiver mouth"],"cost_tier":"free","how_to":["Sit or lie facing the baby.","Blow a soft raspberry (lips loose, tongue out slightly) so the baby sees your mouth.","Wait. The baby will study your mouth and try.","Repeat; imitation of mouth movements is the point, not any specific sound."],"signs_it_is_working":"Baby tries to make similar mouth movements; produces a raspberry-like sound of their own within a few sessions.","signs_to_stop":"Subtle: baby closes mouth, looks away. Potent: crying. Change to a gentler face-play.","adult_role":"Model with your mouth exaggerated; wait; do not correct the baby imitation.","safety":"No touching the baby lips.","derivation":"adopted","evidence_note":"CDC 4-6 mo: babies begin to blow raspberries and imitate mouth sounds; encourage by modelling.","sources":["SRC-002"]},{"id":"ACT-0304","title":"Respond to every vocal bid","targets":["EC-007"],"supports":["EC-006","SE-005"],"type":"routine","age_window":{"from_months":2,"to_months":6},"duration_minutes":1,"frequency":"a few times a day","materials":["caregiver ear and voice"],"cost_tier":"free","how_to":["When the baby vocalises to get your attention — a coo across the room, a call from the crib after nap — respond within a few seconds.","Come close, look at the baby, and answer what they 'said'.","The response teaches: my voice works to bring you.","Do not selectively ignore vocal bids; that trains silence."],"signs_it_is_working":"Baby increasingly uses voice (not just crying) to summon you across a room; vocal bids get longer and more varied.","signs_to_stop":"Subtle: baby stops bidding. Potent: baby only cries, never vocalises to call. Increase your daily face-time and voice-time; consider a hearing check if it persists past 6 months.","adult_role":"Come. Do not wait until the vocal becomes a cry.","safety":"None specific.","derivation":"adopted","evidence_note":"ELOF Communicating and Speaking Do guide: notice and respond to the infant vocal bids for social interaction; the response builds intentional communication.","sources":["SRC-005"]},{"id":"ACT-0305","title":"Vocal turn-taking with an echo","targets":["EC-006"],"supports":["EC-007","RC-002"],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"a few times a day","materials":["caregiver voice"],"cost_tier":"free","how_to":["Wait for the baby to make a sound.","Echo it back with the same tone.","Pause and wait for the baby to reply.","Extend the game a few turns; end while it is still fun."],"signs_it_is_working":"Baby waits after making a sound, listens for your echo, and vocalises again in reply; several rounds sustained.","signs_to_stop":"Subtle: baby looks away, sound peters out. Potent: fussing. End the round.","adult_role":"Match the baby tone; do not upgrade to real words yet.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6 mo): takes turns making sounds with you.","sources":["SRC-002"]},{"id":"ACT-0306","title":"Model single consonant-vowel syllables","targets":["EC-008"],"supports":["EC-010","EC-011"],"type":"play","age_window":{"from_months":4,"to_months":8},"duration_minutes":3,"frequency":"daily","materials":["caregiver mouth and voice"],"cost_tier":"free","how_to":["Face the baby; say a clear single syllable slowly: 'ba', 'da', 'ma', 'ga'.","Wait; watch the baby mouth work as they try.","Change syllables across sessions; do not test on one syllable.","Celebrate any attempt at a CV shape, even if the vowel or consonant is not right."],"signs_it_is_working":"Baby produces 'ba', 'da', 'ma', 'ga' style syllables (a consonant plus a vowel), often in isolation before combining.","signs_to_stop":"Subtle: baby covers ears with hands, hand-to-ear. Potent: crying. Try again later.","adult_role":"Model, wait, celebrate; do not correct attempts.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6-9 mo): baby makes different sounds — babbling with consonants; parents can model single syllables.","sources":["SRC-002"]},{"id":"ACT-0307","title":"Speech-sound imitation game","targets":["EC-009"],"supports":["EC-010","EC-013"],"type":"play","age_window":{"from_months":5,"to_months":10},"duration_minutes":5,"frequency":"daily","materials":["caregiver mouth and voice"],"cost_tier":"free","how_to":["Say a familiar syllable ('ba', 'ma', 'pa'); wait for the baby to imitate.","If they do, imitate their imitation back — creating a call-and-response chain.","If they add a new syllable, follow their lead.","The point is the imitation, not word production."],"signs_it_is_working":"Baby imitates a syllable you just made; imitation is prompt and correct within a couple of sessions.","signs_to_stop":"Subtle: baby does not imitate over several sessions. Potent: turning away. Return to modelling without expecting imitation yet.","adult_role":"Model, wait, imitate their imitation, chain.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA9 (imitate speech, p50 6.5); framing draws on CCD play with sounds guidance.","sources":["SRC-002","SRC-016"]},{"id":"ACT-0308","title":"Repeated-syllable babble routine","targets":["EC-010"],"supports":["EC-011","EC-013"],"type":"play","age_window":{"from_months":5,"to_months":10},"duration_minutes":5,"frequency":"daily","materials":["caregiver voice"],"cost_tier":"free","how_to":["Say a repeated CV string: 'ma-ma-ma-ma', 'ba-ba-ba-ba', 'da-da-da'.","Wait for the baby to try.","Repeat the same string across the day so the baby has many chances.","Vary the vowel across sessions: 'mi-mi-mi', 'moo-moo-moo'."],"signs_it_is_working":"Baby produces long strings of a repeated consonant-vowel pair — the classic 'bababa' or 'mamama'.","signs_to_stop":"Subtle: baby vocalises but with single syllables only. Potent: fussing. That is fine; keep modelling.","adult_role":"Say the string clearly and evenly. Do not correct the baby vowel.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): baby makes repeated sounds (mamama, bababa).","sources":["SRC-002"]},{"id":"ACT-0309","title":"Variegated-babble modelling","targets":["EC-011"],"supports":["EC-012","EC-014"],"type":"play","age_window":{"from_months":6,"to_months":11},"duration_minutes":5,"frequency":"daily","materials":["caregiver voice"],"cost_tier":"free","how_to":["Model babbles that switch consonants: 'ba-da-ma', 'mi-ba-goo'.","Wait for the baby to try switching too.","This is a transition step from single-CV strings toward real words.","Add rising intonation at the end of a string; that turns babble into a question."],"signs_it_is_working":"Baby produces babble strings that mix different consonants — 'ba-di-goo' rather than 'ba-ba-ba' — often with varied pitch.","signs_to_stop":"Subtle: baby returns to single-CV strings. Potent: none — this stage develops gradually.","adult_role":"Model varied strings; do not repeat the same string every time.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA11 (combine syllables, p50 7.5); framing our own.","sources":["SRC-002"]},{"id":"ACT-0310","title":"Jabber-conversation practice","targets":["EC-012"],"supports":["EC-013","EC-014","EC-018"],"type":"play","age_window":{"from_months":7,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["caregiver voice and time"],"cost_tier":"free","how_to":["When the baby breaks into a long babble string with intonation ('bagoo di dabababa!'), respond as if it were a real conversation.","Say 'oh, really? and then what?' with matching interest.","Wait for the baby to reply; hold your face attentive.","Do not correct the babble into a real word yet."],"signs_it_is_working":"Baby extends babble strings, uses rising and falling intonation, and treats them like a conversation.","signs_to_stop":"Subtle: baby stops responding. Potent: crying. End the round.","adult_role":"Respond as if their babble is meaningful — because to them, it is.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): baby jabbers or babbles in long strings. Standard across CDC and ELOF.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0311","title":"Wave bye-bye routine","targets":["EC-026"],"supports":["EC-027","SE-013","RC-008"],"type":"routine","age_window":{"from_months":7,"to_months":14},"duration_minutes":1,"frequency":"a few times a day","materials":["your hand"],"cost_tier":"free","how_to":["Every time someone leaves the house or the room, say 'bye-bye' and wave your hand.","Take the baby hand and wave it too, gently.","Do the same for 'hi' when someone arrives.","The gesture is learned by repetition across many farewells and hellos."],"signs_it_is_working":"Baby waves back — first prompted, later spontaneously — when someone leaves or arrives.","signs_to_stop":"Subtle: baby cries at goodbye (age-appropriate separation distress). Potent: none. Say bye-bye anyway; predictability helps.","adult_role":"Every farewell is a lesson. Do not skip 'bye' just because it feels formal at home.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): waves bye-bye.","sources":["SRC-002"]},{"id":"ACT-0312","title":"Naming the primary caregivers","targets":["EC-013"],"supports":["EC-014","SE-005"],"type":"routine","age_window":{"from_months":8,"to_months":14},"duration_minutes":1,"frequency":"ambient","materials":["family voices and family names in your home language"],"cost_tier":"free","how_to":["In every family interaction, use the names family members are called: mama, dada, amma, papa, dadi, nana.","Say the name as the person arrives or as the baby looks at them.","When the baby says 'mama' or 'dada' non-specifically, respond warmly to any adult being addressed — over time, the specific meaning locks in.","First specific use is a milestone worth celebrating."],"signs_it_is_working":"Baby says 'mama' specifically when looking at or reaching for the mother; 'dada' likewise; specific use is the milestone, not the sound itself.","signs_to_stop":"Subtle: non-specific use continues past 14 months. Potent: none. Keep modelling.","adult_role":"Say and celebrate. Do not correct non-specific 'mama' for the neighbour; the baby will refine it.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): says mama or dada specifically for a parent.","sources":["SRC-002"]},{"id":"ACT-0313","title":"First-word invitation with a routine object","targets":["EC-014"],"supports":["EC-013","EC-015"],"type":"routine","age_window":{"from_months":9,"to_months":15},"duration_minutes":1,"frequency":"a few times a day","materials":["one or two objects the baby wants (bottle, ball, favourite toy)"],"cost_tier":"free","how_to":["Hold the object slightly out of reach.","Say the object name clearly: 'bottle... bottle'.","Wait. The baby will point, reach, and sometimes vocalise a word-attempt.","Reward any word-shaped attempt (even a partial word) by handing over the object."],"signs_it_is_working":"Baby produces at least one word besides mama/dada — often the name of a favourite object or a family member.","signs_to_stop":"Subtle: baby uses gestures only. Potent: crying at the wait. Hand over the object with the word, do not hold out.","adult_role":"Say the word; wait a beat; reward attempts.","safety":"Never withhold a real need (like a full bottle at a hungry moment) to force a word. Waiting is for play, not for hunger.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): says one or two words besides mama and dada.","sources":["SRC-002"]},{"id":"ACT-0314","title":"Five-word vocabulary check-in play","targets":["EC-015"],"supports":["EC-014","EC-018"],"type":"play","age_window":{"from_months":11,"to_months":16},"duration_minutes":5,"frequency":"daily","materials":["everyday objects and family members"],"cost_tier":"free","how_to":["Keep an informal count in your head of the words the child produces consistently across a week.","When new words show up in real use (not just imitation), that counts.","By 12-14 months most children say at least five different words: mama, dada, one object, one action, one social word (bye, hi).","Repeat the words the child does say back to them warmly to reinforce."],"signs_it_is_working":"Child spontaneously produces five or more different words across a week in everyday contexts.","signs_to_stop":"Subtle: fewer than five words at 15 months. Potent: no words at all at 15 months. Consider a paediatric review; this is a Phase 6 red-flag threshold.","adult_role":"Track passively; celebrate each new word.","safety":"None specific.","derivation":"adopted","evidence_note":"Rourke 15 month expert marker for 'says a few real words'. Framing our own.","sources":["SRC-006"]},{"id":"ACT-0315","title":"Pointing-to-request encouragement","targets":["EC-027"],"supports":["EC-028","EC-014","RC-007"],"type":"routine","age_window":{"from_months":10,"to_months":16},"duration_minutes":2,"frequency":"a few times a day","materials":["everyday moments when the baby wants something out of reach"],"cost_tier":"free","how_to":["When the baby reaches or fusses for something out of reach, model the point.","Say 'you want the ball' as you point.","Wait for the baby to point too, or use the finger to touch the item they want.","Give them the item as soon as they point; the point is instrumental communication."],"signs_it_is_working":"Baby extends a single index finger toward the desired object or a picture, sometimes with vocalisation.","signs_to_stop":"Subtle: baby uses whole-hand reach only. Potent: crying at the wait. Hand over faster.","adult_role":"Model the point; do not force the finger shape.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): points to show you something they want.","sources":["SRC-002"]},{"id":"ACT-0316","title":"Vocabulary-building narration (10-15 word target)","targets":["EC-017"],"supports":["EC-014","EC-020","RC-023"],"type":"language","age_window":{"from_months":12,"to_months":18},"duration_minutes":15,"frequency":"daily","materials":["everyday routines"],"cost_tier":"free","how_to":["Aim to name and use 15-20 core words repeatedly across the day: family members, body parts, food names, animal names, action verbs.","Repeat the same words in different contexts across days.","When the child produces a partial word attempt, say the full word warmly ('yes, ball, that is a ball') rather than correcting the pronunciation.","Bilingual families: same repeated core vocabulary in both languages; the child will pick one for each object first."],"signs_it_is_working":"Child says 10-15 different words consistently by 15-16 months (Wordbank median).","signs_to_stop":"Subtle: no new words for several weeks. Potent: fewer than 5 words at 18 months warrants a paediatric review.","adult_role":"Narrate for the child. Do not test.","safety":"None specific.","derivation":"adopted","evidence_note":"Wordbank Words & Sentences production percentiles; 10-15 words median ~14 months. ELOF Communicating and Speaking Do guide supports the immersion pattern.","sources":["SRC-005","SRC-009"]},{"id":"ACT-0317","title":"Declarative pointing prompts","targets":["EC-028"],"supports":["EC-027","EC-029","RC-007"],"type":"play","age_window":{"from_months":12,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["walks or window-time with things worth noticing (birds, cars, cows)"],"cost_tier":"free","how_to":["During a walk or window-time, point to something interesting and say 'look, a bird!'.","Wait for the child to look and then to point too.","Declarative pointing is 'look at that, isn't it interesting' — different from the requesting point.","Show shared delight when they point at something: 'yes, a bird!'."],"signs_it_is_working":"Child spontaneously points at interesting things to draw your attention, sometimes with vocalisation, and checks your face for shared interest.","signs_to_stop":"Subtle: no declarative pointing by 15 months. Potent: none — persistent absence past 18 months is a screening concern noted in Phase 6.","adult_role":"Notice, name, share. Your reaction is the reward.","safety":"Watch for the child pulling toward a road when pointing.","derivation":"adapted","evidence_note":"ELOF Attending and Understanding Do guide: declarative pointing is a joint-attention milestone; parents scaffold by responding to the shared gaze.","sources":["SRC-005"]},{"id":"ACT-0318","title":"Three-word threshold play with routine questions","targets":["EC-018"],"supports":["EC-014","EC-015","EC-019"],"type":"play","age_window":{"from_months":13,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["familiar objects and questions"],"cost_tier":"free","how_to":["Ask familiar questions with a clear answer: 'what does the cow say' (moo); 'what does the dog say' (bhow); 'what is that' (tomato, roti, ball).","Give the answer if the child does not, and repeat the pair 'cow — moo'.","Over sessions the child fills in the answer.","Track the different words the child uses across the day; the target is 3+ words beyond mama/dada."],"signs_it_is_working":"Child produces at least three or four different words besides mama/dada, at least sometimes on request.","signs_to_stop":"Subtle: same word every time. Try a new question pair.","adult_role":"Ask, wait, model. Do not drill.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA16 (3 words, p50 15.6). Framing our own.","sources":["SRC-002"]},{"id":"ACT-0319","title":"50-word vocabulary immersion (all-day narration)","targets":["EC-020"],"supports":["EC-017","EC-034","RC-024"],"type":"language","age_window":{"from_months":14,"to_months":22},"duration_minutes":30,"frequency":"ambient","materials":["everyday life"],"cost_tier":"free","how_to":["Talk out loud across the day about what you are seeing and doing.","Give the child words for the emotions on your face and theirs: happy, sad, tired, hungry.","Name every part of a favourite routine (bath, mealtime): the objects, the actions, the sequence.","Repeat words in different sentences: 'the water is warm; feel the warm water; is the water warm'."],"signs_it_is_working":"Child accumulates a spoken vocabulary of ~50 words by 18 months on average (Wordbank median).","signs_to_stop":"Subtle: vocabulary plateau for weeks. Potent: 20 or fewer words at 24 months warrants a paediatric review.","adult_role":"Narrate rich; do not quiz.","safety":"None specific.","derivation":"adopted","evidence_note":"Wordbank median ~18 months for 50-word production. ELOF Vocabulary Do guide supports the immersion pattern.","sources":["SRC-005","SRC-009"]},{"id":"ACT-0320","title":"Six-word variety check with everyday things","targets":["EC-016"],"supports":["EC-014","EC-018","EC-020"],"type":"play","age_window":{"from_months":15,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["everyday objects and family members"],"cost_tier":"free","how_to":["Point out objects one at a time and name them; wait for the child to imitate.","Aim across the week for the child to say at least six different words spontaneously (not just on request).","Rotate the objects — food, family, body parts, animals — so the vocabulary spreads.","Record (mentally or in a note on your phone) the growing list of unique words."],"signs_it_is_working":"Child produces six or more different words in the past week without prompting.","signs_to_stop":"Subtle: vocabulary is stuck. Give more exposure and less pressure.","adult_role":"Track; encourage; do not push production.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA17 (6 words, p50 19.1). Framing our own.","sources":["SRC-002"]},{"id":"ACT-0321","title":"100-word vocabulary consolidation","targets":["EC-034"],"supports":["EC-020","EC-035","RC-025"],"type":"language","age_window":{"from_months":17,"to_months":26},"duration_minutes":30,"frequency":"ambient","materials":["everyday life and books"],"cost_tier":"free","how_to":["Continue the naming pattern of ACT-0319 with slightly more complex sentences.","Add descriptive words as they come up naturally: big, small, hot, cold, red, wet.","Read the same books repeatedly and pause for the child to fill in words.","Bilingual families: the child's total vocabulary counts both languages together."],"signs_it_is_working":"Child accumulates a spoken vocabulary of ~100 words by 20 months on average.","signs_to_stop":"Subtle: vocabulary plateau past 3-4 weeks. Add novelty (a new toy, a new outing) rather than pressure.","adult_role":"Sustain the immersion.","safety":"None specific.","derivation":"adopted","evidence_note":"Wordbank median ~20 months for 100-word production.","sources":["SRC-005","SRC-009"]},{"id":"ACT-0322","title":"Two-word combining prompts","targets":["EC-019"],"supports":["EC-016","EC-020","EC-022"],"type":"play","age_window":{"from_months":18,"to_months":26},"duration_minutes":5,"frequency":"daily","materials":["everyday objects"],"cost_tier":"free","how_to":["When the child says one word for a request, model the two-word version: child says 'ball' — you say 'ball fell' or 'big ball' as you hand it over.","Ask questions that call for two-word answers: 'whose shoe?' — 'mama shoe'.","Do not correct; expand.","The child begins to combine two words spontaneously by 20-22 months on average."],"signs_it_is_working":"Child produces two-word combinations like 'more milk', 'daddy come', 'my ball', with meaning.","signs_to_stop":"Subtle: still one word at 24 months. Potent: no two-word combinations by 24 months warrants a paediatric review (Phase 6 red flag).","adult_role":"Expand what they say; do not merely repeat.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (24 mo): says at least two words together (like 'more milk').","sources":["SRC-002"]},{"id":"ACT-0323","title":"Gesture variety expansion","targets":["EC-029"],"supports":["EC-026","EC-027","EC-028"],"type":"play","age_window":{"from_months":15,"to_months":26},"duration_minutes":3,"frequency":"daily","materials":["your face and hands and everyday interactions"],"cost_tier":"free","how_to":["Beyond waving and pointing, model varied gestures: shake head no, nod yes, shrug shoulders, put finger to lips for quiet, hand out for stop.","Pair each gesture with the word it stands for.","Play games using several gestures in one exchange (peek-a-boo, itsy-bitsy spider with the finger walk).","The child accumulates a repertoire of 5-10 gestures by 22 months on average."],"signs_it_is_working":"Child uses several different gestures beyond waving and pointing to communicate meaning: shake head, nod, hand out for stop, finger to lips.","signs_to_stop":"Subtle: only 1-2 gestures at 22 months. Potent: none. Continue modelling.","adult_role":"Model varied gestures. Use them yourself in daily life.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (18 mo): uses more than four gestures like waving bye-bye, pointing, or shaking head no.","sources":["SRC-002"]},{"id":"ACT-0324","title":"Picture-book naming","targets":["EC-023"],"supports":["EC-024","EC-020","RC-016"],"type":"routine","age_window":{"from_months":18,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["a picture book with clear single-object images per page"],"cost_tier":"under_500_inr","how_to":["Sit with the child and open the book to a single-object page.","Point to the picture and ask 'what is this'.","Wait; the child names it (correctly or approximately).","Fill in the name warmly if they do not; celebrate the attempt."],"signs_it_is_working":"Child names a picture in a book on request; the words are recognisable if not perfectly formed.","signs_to_stop":"Subtle: child prefers to hear you name rather than name themselves. Read together instead; ask less.","adult_role":"Ask once; wait; fill in.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA20 (name 1 picture, p50 23.2).","sources":["SRC-002"]},{"id":"ACT-0325","title":"Fifty-percent intelligible speech check","targets":["EC-025"],"supports":["EC-032","EC-016"],"type":"routine","age_window":{"from_months":20,"to_months":30},"duration_minutes":1,"frequency":"weekly","materials":["a non-family listener (a grandparent visiting, a neighbour)"],"cost_tier":"free","how_to":["Ask a person who spends less time with the child than you do to tell you what they think the child said in a given exchange.","By 24 months on average, a stranger understands ~50% of the words.","Do not test formally; use natural moments.","This is a check on the child speech development, not a family game."],"signs_it_is_working":"A non-family adult can understand about half of the child speech in a familiar context by 24 months.","signs_to_stop":"Subtle: fewer than a quarter understood at 24 months. Potent: unintelligible speech at 30 months warrants a paediatric review.","adult_role":"Ask kindly; do not put the child on the spot.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA23 (speech 50% understandable, p50 24.2).","sources":["SRC-002"]},{"id":"ACT-0326","title":"300-word vocabulary consolidation","targets":["EC-035"],"supports":["EC-034","EC-020"],"type":"language","age_window":{"from_months":20,"to_months":30},"duration_minutes":30,"frequency":"ambient","materials":["everyday life"],"cost_tier":"free","how_to":["Continue the immersion pattern with slightly more abstract vocabulary: emotions (angry, tired, excited), time (now, later, soon), position (up, down, inside, outside).","Sing new songs; add finger plays with more verse counts.","Play word games in the family language: 'I spy something red'.","Read chapter picture books rather than only single-object books."],"signs_it_is_working":"Child accumulates a spoken vocabulary of ~300 words by 25 months on average (Wordbank median).","signs_to_stop":"Subtle: plateau over 3-4 weeks. Add novelty.","adult_role":"Sustain the immersion.","safety":"None specific.","derivation":"adopted","evidence_note":"Wordbank median ~25 months for 300-word production.","sources":["SRC-005","SRC-009"]},{"id":"ACT-0327","title":"Personal-pronoun modelling","targets":["EC-021"],"supports":["EC-022","SE-025"],"type":"routine","age_window":{"from_months":22,"to_months":32},"duration_minutes":2,"frequency":"a few times a day","materials":["everyday moments"],"cost_tier":"free","how_to":["Use 'I', 'me', 'my', 'we' in your own speech clearly and slowly.","When the child speaks in the third person about themselves ('Aditi ball'), model back with 'I': 'yes, my ball; you say I want the ball'.","Ask questions that call for pronouns: 'whose is this? — mine'.","Do not correct; expand and model."],"signs_it_is_working":"Child uses 'I', 'me', 'we' at least sometimes in everyday speech instead of only using their own name.","signs_to_stop":"Subtle: continues in third person past 30 months. Continue modelling.","adult_role":"Use the pronouns yourself. Model, do not lecture.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (30 mo): uses words like I, me, we.","sources":["SRC-002"]},{"id":"ACT-0328","title":"Two-to-three-word sentence expansion","targets":["EC-022"],"supports":["EC-019","EC-031"],"type":"play","age_window":{"from_months":22,"to_months":32},"duration_minutes":5,"frequency":"daily","materials":["everyday moments and toys"],"cost_tier":"free","how_to":["When the child says two words, expand to three: child says 'more milk', you say 'more milk please'.","Ask questions that need a short sentence answer: 'what is dog doing' — 'dog running'.","Add an action word (verb) into every expansion — action words are the growth edge here.","Two-to-three-word sentences become spontaneous around 24-28 months on average."],"signs_it_is_working":"Child produces two-to-three-word sentences with an action word (verb) in everyday speech.","signs_to_stop":"Subtle: single words only at 30 months. Potent: no phrases by 30 months warrants a paediatric review.","adult_role":"Expand what they say; do not correct.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (30 mo): says about 50 words; uses phrases with 2 or 3 words.","sources":["SRC-002"]},{"id":"ACT-0329","title":"75-percent intelligible speech routine","targets":["EC-032"],"supports":["EC-025","EC-033"],"type":"routine","age_window":{"from_months":26,"to_months":36},"duration_minutes":1,"frequency":"weekly","materials":["a non-family listener"],"cost_tier":"free","how_to":["Repeat the ACT-0325 check with a non-family adult at older ages.","By 30-33 months on average, a stranger understands ~75% of the child speech.","Improvement comes from more speech practice, not from correction.","If a specific sound (say, 'r') is delayed, that is common; do not drill."],"signs_it_is_working":"A non-family adult understands about three-quarters of the child speech.","signs_to_stop":"Subtle: less than half understood at 33 months. Potent: less than a third at 36 months warrants a paediatric review with a speech-language check.","adult_role":"Ask kindly.","safety":"None specific.","derivation":"adopted","evidence_note":"Dosman 36 mo speech-intelligibility marker (~75%). Wording our own.","sources":["SRC-004"]},{"id":"ACT-0330","title":"Four-picture naming game","targets":["EC-024"],"supports":["EC-023","RC-017"],"type":"play","age_window":{"from_months":26,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["a picture book or a set of picture cards with familiar objects"],"cost_tier":"under_500_inr","how_to":["Show a page with four familiar objects (cat, cup, spoon, ball).","Ask 'what is this' pointing to each in turn.","The child names each; correct approximations are fine.","Rotate through different four-picture sets across days."],"signs_it_is_working":"Child names all four pictures on request; corrections are minor.","signs_to_stop":"Subtle: child names only 1-2. Reduce to two-picture pages first.","adult_role":"Ask, wait, fill in gently.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA24 (name 4 pictures, p50 32.5).","sources":["SRC-002"]},{"id":"ACT-0331","title":"Three-plus-word sentence extension","targets":["EC-031"],"supports":["EC-022","EC-033"],"type":"play","age_window":{"from_months":28,"to_months":42},"duration_minutes":5,"frequency":"daily","materials":["conversations at meals and during play"],"cost_tier":"free","how_to":["Ask open questions that need a longer answer: 'what did you do today at nani's house'.","Model longer sentences yourself; the child imitates length.","Extend the child sentence with a natural continuation: child says 'dog run park' — you say 'yes, the dog is running in the park'.","Read stories with longer sentences and pause for the child to fill in."],"signs_it_is_working":"Child produces three-or-more-word sentences with recognisable grammar structure.","signs_to_stop":"Subtle: two-word sentences only at 36 months. Potent: no three-word sentences at 36 months warrants a paediatric review.","adult_role":"Expand; model length; do not correct grammar aggressively.","safety":"None specific.","derivation":"adopted","evidence_note":"Rourke 36 mo (3+ word sentences). Framing our own.","sources":["SRC-006"]},{"id":"ACT-0332","title":"Fully-understandable speech routine","targets":["EC-033"],"supports":["EC-032","EC-025"],"type":"routine","age_window":{"from_months":30,"to_months":42},"duration_minutes":1,"frequency":"weekly","materials":["a non-family listener"],"cost_tier":"free","how_to":["By 36-42 months on average, a stranger understands almost all of the child speech.","Some specific sounds (r, th, l blends) may still be immature; that is common into the pre-school years.","Do not correct pronunciation; model the correct version in your own response.","If concerns persist, a speech-language pathologist assessment at 36-42 months is worthwhile."],"signs_it_is_working":"A non-family adult understands nearly all of the child speech in ordinary context.","signs_to_stop":"Subtle: still substantially unintelligible at 42 months. Potent: seek a speech-language pathologist review; do not wait past 42 months.","adult_role":"Model, do not correct.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA32 (speech fully understandable, p50 36.3). Wording our own.","sources":["SRC-002"]},{"id":"ACT-0340","title":"Face-to-face sound chats","targets":["EC-001","EC-002","EC-006"],"supports":[],"type":"play","age_window":{"from_months":0,"to_months":6},"duration_minutes":3,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is alert, hold him about 25 cm from your face.","When he makes a sound, copy it back, then wait with an interested face.","Keep the exchange going as long as he takes turns."],"signs_it_is_working":"He makes more sounds, coos, and waits for your reply before sounding again.","signs_to_stop":"Looking away and staying away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Copy and wait; the pause is his turn. Do not fill every silence.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip on echoing vocalizations back and forth (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0341","title":"Gentle tickles and squeals","targets":["EC-003","EC-004"],"supports":["SE-006"],"type":"play","age_window":{"from_months":2,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Blow softly on his tummy, or walk your fingers up his arm with a rising 'I'm coming...'.","Pause before the tickle so he anticipates it.","Copy his laugh or squeal back to him."],"signs_it_is_working":"He laughs out loud and squeals with excitement.","signs_to_stop":"Stiffening or a worried face; tickling can tip into overload fast. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep it light and stop at the first sign it is too much.","safety":"Gentle touch only.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0342","title":"Raspberry trade","targets":["EC-005"],"supports":[],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Blow a raspberry with your lips close to his face.","Wait; when he blows one, blow one back.","Try raspberries on his tummy for a laugh."],"signs_it_is_working":"He blows raspberries back to you.","signs_to_stop":"Turning away from your face. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model, then wait for his turn.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month milestone 'Blows raspberries' and the tip on back-and-forth play (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0343","title":"Let him start the chat","targets":["EC-007"],"supports":[],"type":"play","age_window":{"from_months":2,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Sit where he can see you, with a relaxed face, but do not start talking.","Wait for him to call out, kick or make a sound to get your attention.","The moment he does, turn and answer warmly."],"signs_it_is_working":"He makes sounds on purpose to get you to look and talk.","signs_to_stop":"Fussing that grows; answer straight away rather than waiting longer. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be available but quiet so he has room to start.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0344","title":"Babble echo, then a word","targets":["EC-008","EC-009","EC-010"],"supports":[],"type":"play","age_window":{"from_months":4,"to_months":11},"duration_minutes":3,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he babbles 'ba', 'da' or 'bababa', say it back.","Then add a real word that uses the sound: 'bababa — ball!'.","Offer a new sound for him to copy: 'ma-ma-ma'."],"signs_it_is_working":"He makes more consonant sounds, repeats strings, and copies sounds you make.","signs_to_stop":"Going quiet and looking away. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Echo, add a word, wait.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip 'Repeat your baby's sounds and say simple words using those sounds' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0345","title":"Sing-song conversations","targets":["EC-011","EC-012"],"supports":[],"type":"language","age_window":{"from_months":6,"to_months":13},"duration_minutes":3,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he babbles, answer as if it were real talk: 'Oh really? And then what?'.","Use lots of rise and fall in your voice.","Pause long enough for his 'reply'."],"signs_it_is_working":"His babble mixes different syllables and sounds like sentences with tunes.","signs_to_stop":"Stopping and turning away. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Treat his babble as conversation; do not correct it.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month tip 'Read to your baby daily... respond to babbling' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0346","title":"Who's that? family greetings","targets":["EC-013"],"supports":["RC-010"],"type":"routine","age_window":{"from_months":7,"to_months":14},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["When a parent comes in, the other says 'here's Papa!' or 'here's Mama!'.","Wait and see if he says the name; cheer if he does.","Use family photos: 'who's this?'."],"signs_it_is_working":"He uses 'mama' or 'papa' (or the family's words) for the right person.","signs_to_stop":"Losing interest in the photos. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name, then wait. Accept any approximation.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0347","title":"Build on his word","targets":["EC-014","EC-036","EC-015"],"supports":[],"type":"language","age_window":{"from_months":9,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he says a word or part of one ('ta'), answer with the full word: 'Yes, a truck!'.","Add one more word: 'a big truck'.","Keep a list on the fridge of the words he uses; the app's Words tab does the same."],"signs_it_is_working":"New words appear every few weeks.","signs_to_stop":"Going silent when you expand; expand less and just respond. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Respond to meaning, model the word, never make him repeat it.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Build on what your baby tries to say' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0348","title":"Name it, then wait","targets":["EC-036","EC-018","EC-017"],"supports":[],"type":"language","age_window":{"from_months":11,"to_months":20},"duration_minutes":1,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he points to or reaches for something, name it: 'water?'.","Hold it a moment and wait to see if he makes a sound or says it.","Hand it over whether he says it or not."],"signs_it_is_working":"He tries to say more words when he wants things.","signs_to_stop":"Frustrated crying when you pause; hand it over sooner. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give a short pause, not a test. Never withhold something he needs.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip on pointing and waiting for sounds before handing items over (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0349","title":"Add one word","targets":["EC-019","EC-016"],"supports":[],"type":"language","age_window":{"from_months":15,"to_months":26},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he says one word ('milk'), say it back with one more: 'more milk', 'milk hot'.","Use short two-word phrases yourself during routines: 'shoes on', 'daddy gone'.","Celebrate when he joins two words."],"signs_it_is_working":"He uses more words and starts putting two together.","signs_to_stop":"Turning away from constant expansion; respond simply for a while. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model the next step; do not ask him to say it.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Teach your child more words by adding to the words she says' and the 2-year 'or nana' example (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0350","title":"Family picture album","targets":["EC-020","EC-023"],"supports":["RC-016"],"type":"play","age_window":{"from_months":12,"to_months":26},"duration_minutes":5,"frequency":"daily","materials":["printed photos","a small album or card"],"cost_tier":"under_500_inr","how_to":["Put 10-15 photos of family, pets and familiar things in a small album or stick them on card.","Look through it together; name each picture, then ask 'who's that?'.","Add new photos as his interest grows."],"signs_it_is_working":"He names more of the pictures.","signs_to_stop":"Flipping pages without looking. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name, ask, wait. Accept pointing as an answer.","safety":"Card edges smooth; no loose plastic sleeves he can chew.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip on picture books of family members and pets (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0351","title":"Rhyme gaps","targets":["EC-037"],"supports":[],"type":"language","age_window":{"from_months":12,"to_months":24},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Sing a rhyme he knows well (Machli jal ki rani hai, Twinkle twinkle).","Stop just before the last word of a line and look at him expectantly.","Whatever sound he makes, sing on happily."],"signs_it_is_working":"He fills in a word or sound at the gap.","signs_to_stop":"Losing interest in the song; sing it through without gaps. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Leave the gap; do not insist on the word.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"],"india_sourcing_note":"any rhyme in the family's language works; repetition matters more than the rhyme"},{"id":"ACT-0352","title":"Action songs","targets":["EC-037","EC-029"],"supports":["SE-032"],"type":"play","age_window":{"from_months":12,"to_months":26},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Sing songs with actions (Chanda mama, Wheels on the bus, clapping songs).","Do the actions each time so he learns to join in with gestures and words.","Let him choose the next song by doing its action."],"signs_it_is_working":"He joins in with actions and some words, and uses new gestures in daily life.","signs_to_stop":"Walking away mid-song. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Sing and act; let him join when he wants.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip on action songs with gestures (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0353","title":"Bye-bye and head-shake","targets":["EC-026"],"supports":[],"type":"routine","age_window":{"from_months":7,"to_months":14},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Every time someone leaves, wave and say 'bye-bye' with him watching.","Shake your head with 'no, no more' at the end of meals.","Pause after waving to let him wave back."],"signs_it_is_working":"He waves bye-bye and shakes his head to mean 'no'.","signs_to_stop":"Hiding his face; do it yourself and let him watch. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model in real moments; do not drill.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip 'Teach your baby to wave 'bye-bye' or shake his head 'no.'' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0354","title":"Answer every point","targets":["EC-027","EC-028"],"supports":["RC-007","SE-013"],"type":"language","age_window":{"from_months":9,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he points, look where he points and put it into words: 'Yes, a dog! Big dog.'","If he points to ask for something, name it and help.","Point to things yourself to share them with him."],"signs_it_is_working":"He points more, both to ask and to show you things.","signs_to_stop":"Pointing with growing frustration; help sooner. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Respond to every point. Do not ignore a point because you are busy — a quick word counts.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Respond with words when your baby points. Babies point to ask for things.' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0355","title":"Answer the cry","targets":["EC-030"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Go to him soon when he cries; say what you think he needs ('are you hungry?').","Check the usual things: hunger, wet nappy, too hot, tired.","Notice the different cries over the weeks."],"signs_it_is_working":"His cries become easier to read, and he settles faster once answered.","signs_to_stop":"Crying that does not settle after the usual checks; hold him close and keep calm. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Respond promptly and calmly.","safety":"If crying ever feels overwhelming, put him down somewhere safe and step away for a few minutes. Never shake a baby.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tips on learning the baby's signals and never shaking the baby (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0356","title":"Word-rich chores","targets":["EC-034"],"supports":["AD-021"],"type":"routine","age_window":{"from_months":15,"to_months":26},"duration_minutes":10,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Let him join a chore — sorting sabzi, folding clothes — and name each thing.","Ask simple questions: 'is this big or small?', 'what's this?'.","Repeat the words he says, correctly and warmly."],"signs_it_is_working":"His spoken vocabulary grows quickly; he names things during chores.","signs_to_stop":"Wandering off; let him go and invite him to the next chore. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Talk with him while you work; keep questions few.","safety":"Keep knives and hot things out of reach.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0400","title":"Face-in-view visual regard","targets":["CG-001","CG-002"],"supports":["CG-003","RC-004","SE-001"],"type":"routine","age_window":{"from_months":0,"to_months":3},"duration_minutes":3,"frequency":"a few times a day","materials":["your face"],"cost_tier":"free","how_to":["Hold the baby with their face 20-30 cm from yours during any awake calm moment.","Let the baby regard your face; do not move your head at first.","Once regard is steady, move your head slowly a few centimetres left or right; the baby eyes track.","Bring your head back to the midline. That is one round."],"signs_it_is_working":"Baby looks steadily at your face; eyes track your face slowly to the side and back.","signs_to_stop":"Subtle: gaze aversion, glazed look. Potent: fussing, arching. Return the baby to your shoulder quietly.","adult_role":"Be a still target first; then a slow moving one.","safety":"Not while carrying up or down stairs.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Do guide (Exploration and Discovery): give infants many opportunities to look at faces and to follow slow-moving people or objects with their eyes.","sources":["SRC-005"]},{"id":"ACT-0401","title":"Slow-moving toy tracking through midline","targets":["CG-003","CG-004"],"supports":["CG-002","CG-006"],"type":"play","age_window":{"from_months":1,"to_months":6},"duration_minutes":3,"frequency":"daily","materials":["a high-contrast toy (a red ball, a striped rattle, a small unbreakable mirror)"],"cost_tier":"free","how_to":["Lay the baby on the back on a mat or hold in a supported semi-reclined position.","Hold the toy in the baby line of sight about 25 cm from the face.","Move it slowly to one side, then back through midline, then to the other side.","Full 180 degrees (ear to ear) is the target by 4 months."],"signs_it_is_working":"Baby eyes and later the head follow the toy past the midline, and eventually all the way from side to side.","signs_to_stop":"Subtle: eyes give up tracking, gaze drifts. Potent: crying. Slow the movement or take a break.","adult_role":"Move slowly; a smooth pace is easier to track than a fast one.","safety":"Toy small enough to hold, no small parts. Do not dangle over the face.","derivation":"adapted","evidence_note":"Denver FM1/FM2/FM5 visual tracking sequence. Pathways.org has parallel visual-tracking activity guidance.","sources":["SRC-018"]},{"id":"ACT-0402","title":"Discovering-my-hands time","targets":["CG-005"],"supports":["FM-003","FM-004"],"type":"routine","age_window":{"from_months":1,"to_months":4},"duration_minutes":5,"frequency":"a few times a day","materials":["baby own hands and unrestricted arm freedom"],"cost_tier":"free","how_to":["Give the baby awake alert time with arms free (no mittens, no swaddled arms).","Lay them on the back or hold in a semi-reclined position where they can see their own hands.","Do not direct their attention; the hands are discovered on their own.","This is Piaget's earliest secondary-circular reaction — the baby learns 'these are mine and I can move them'."],"signs_it_is_working":"Baby brings hands to midline, stares at them, opens and closes fingers while watching.","signs_to_stop":"Subtle: fussy overtired baby. Potent: crying. Hold them upright and quiet for a while.","adult_role":"Provide the setting; do not point out the hands.","safety":"No fabric loops around the wrists.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Exploration and Discovery Do guide: infants explore their own bodies through sight and touch — allow unrestricted arm time.","sources":["SRC-005"]},{"id":"ACT-0403","title":"Feeding-routine anticipation cues","targets":["CG-007"],"supports":["AD-001","SE-005"],"type":"routine","age_window":{"from_months":1,"to_months":5},"duration_minutes":2,"frequency":"a few times a day","materials":["your feeding routine"],"cost_tier":"free","how_to":["Before each feed, do the same small preparatory ritual: pick up the baby, say 'time to eat', sit in the same chair.","Watch the baby response: with repetition, they begin to open the mouth, turn to the breast/bottle, or quiet in anticipation before the feed itself.","The anticipation IS the cognitive milestone: 'I predict what happens next'.","Keep the ritual short and identical across feeds."],"signs_it_is_working":"Baby anticipates the feed by opening mouth, turning toward breast/bottle, or quieting cries when the ritual begins.","signs_to_stop":"Subtle: no anticipation past 4 months. Potent: none — this develops naturally with repetition.","adult_role":"Keep the pre-feed sequence stable so the pattern is learnable.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Memory Do guide: repeat predictable routines so infants learn to anticipate what comes next.","sources":["SRC-005"]},{"id":"ACT-0404","title":"Safe mouth exploration of objects","targets":["CG-008"],"supports":["FM-005","SR-006"],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"daily","materials":["3-4 varied safe objects to mouth (wooden teether, cloth ring, silicone spoon, unbreakable mirror)"],"cost_tier":"free","india_sourcing_note":"Safe household mouthing items: a cool clean silver spoon, a soft cotton hanky knotted, a wooden ladoo-shape teether from a local toy shop.","how_to":["Offer one object at a time; place it in the baby hand and let them bring it to the mouth.","Mouthing is how babies learn about texture, temperature, and shape.","Rotate the objects so the baby experiences different surfaces.","Wash the objects daily; babies mouth them thoroughly."],"signs_it_is_working":"Baby brings objects to the mouth deliberately, explores with lips and tongue, and moves on to a new object when interest fades.","signs_to_stop":"Subtle: gagging on a specific object — that shape is too big. Potent: crying. Remove and try another.","adult_role":"Offer; do not stop mouthing. Mouthing at this age is exploration, not misbehaviour.","safety":"Objects too large to swallow, no small parts, no strings. Never leave the baby alone with mouthed items.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6 mo): baby puts things in her mouth to explore them; give safe things to chew.","sources":["SRC-002"]},{"id":"ACT-0405","title":"Read the fullness cue during a feed","targets":["CG-009"],"supports":["AD-022","SE-008"],"type":"routine","age_window":{"from_months":2,"to_months":6},"duration_minutes":15,"frequency":"daily","materials":["a feed"],"cost_tier":"free","how_to":["During a feed, watch the baby signals: closing the lips, turning the head away, arching back, batting the bottle/breast.","Take these as 'I am full' — stop the feed at the first clear cue, do not push another spoon or ounce.","The baby is doing the cognitive-signalling milestone; your job is to honour it.","Trust the baby signals over any target quantity."],"signs_it_is_working":"Baby signals fullness consistently by turning head or closing mouth; you stop feeding on the cue and the baby settles.","signs_to_stop":"Subtle: baby signals with subtle cues that go unnoticed. Potent: fussing or spit-up because the feed continued. Slow down and watch more.","adult_role":"Watch and honour the cue. Do not chase target quantities.","safety":"Never force-feed. Never propped-bottle-feed (choking and fullness-cue risk).","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, and Nutrition Do guide: notice and honour infant fullness cues during feeds.","sources":["SRC-005"]},{"id":"ACT-0406","title":"Regard-a-small-object play","targets":["CG-006"],"supports":["CG-010","FM-008"],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":3,"frequency":"daily","materials":["a small non-edible object (a raisin-sized bead safely mounted on a card, or a small piece of cotton on a plate)"],"cost_tier":"free","india_sourcing_note":"A small piece of dry moong dal on a plate at safe distance from mouth; the baby regards, does not eat.","how_to":["Sit the baby in a supported position facing a plate or contrasting surface.","Place a raisin-sized object on the surface in their line of sight.","Wait; the baby will notice and stare at the small object.","The visual detection of a small object is the milestone; do not hand it to them (choking size)."],"signs_it_is_working":"Baby fixes attention on the small object, may point their finger or reach.","signs_to_stop":"Subtle: no attention to the small object. Potent: baby grabs and mouths — remove immediately.","adult_role":"Set up, watch, remove.","safety":"Choking-size objects only as visual targets, never within reach. Never leave the baby alone with them.","derivation":"adapted","evidence_note":"Denver FM6 (regard coffee bean, p50 4.5); framed as a supervised visual observation only.","sources":["SRC-018"]},{"id":"ACT-0407","title":"Work-for-the-toy game","targets":["CG-010"],"supports":["CG-014","GM-001"],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"daily","materials":["a small motivating toy or a light bright object"],"cost_tier":"free","how_to":["Put the toy in the baby line of sight but just outside reach.","Wait for the baby to work for it: shift weight, extend the arm further, roll toward it.","Do not slide the toy closer; the effort is the game.","Hand it over as the reward once the reach or roll succeeds."],"signs_it_is_working":"Baby works to obtain the toy — reaches, twists, and eventually grasps it after visible effort.","signs_to_stop":"Subtle: gives up quickly and looks away. Potent: cry that does not resolve when the toy is brought closer. Bring toy in; comfort.","adult_role":"Set the distance; do not close the gap.","safety":"Firm surface with clear space around the baby.","derivation":"adopted","evidence_note":"Denver PS5 (work for toy, p50 4.5).","sources":["SRC-018"]},{"id":"ACT-0408","title":"Watch-the-dropped-object game","targets":["CG-011"],"supports":["CG-012","CG-013"],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":3,"frequency":"daily","materials":["a soft cloth ball or small toy that makes a small sound when it lands"],"cost_tier":"free","how_to":["Sit the baby in a supported position (high-chair with cloth, or on your lap).","Hold a toy in the baby line of sight and drop it deliberately onto the floor or tray.","Wait for the baby eyes to follow it down.","Pick it up, show, drop again. Two or three cycles is a round."],"signs_it_is_working":"Baby eyes follow the falling object all the way to the landing surface.","signs_to_stop":"Subtle: baby stops tracking. Potent: baby fusses if the toy vanishes fully. Change to a slower drop or a shorter drop.","adult_role":"Drop slowly and predictably. Do not distract during the fall.","safety":"Soft toy only; no glass.","derivation":"adapted","evidence_note":"Standard Piagetian precursor to visible displacement; noted in Pathways.org early-cognition guidance.","sources":["SRC-018"]},{"id":"ACT-0409","title":"Search for a partially hidden object","targets":["CG-012"],"supports":["CG-013","FM-005"],"type":"play","age_window":{"from_months":4,"to_months":9},"duration_minutes":5,"frequency":"daily","materials":["a small toy and a light cloth or a small container"],"cost_tier":"free","how_to":["Show the baby the toy; let them touch or grasp it briefly.","Cover PART of the toy with the cloth so an edge sticks out.","Wait for the baby to pull the cloth and retrieve the toy.","Progress to a bigger visible edge if the baby needs help getting started."],"signs_it_is_working":"Baby reaches for the visible part of the toy and pulls the cloth away to complete the retrieval.","signs_to_stop":"Subtle: baby loses interest. Potent: crying. Show the toy fully and try again another day.","adult_role":"Cover partly, wait, celebrate the retrieval.","safety":"Light cloth only; not over the face.","derivation":"adapted","evidence_note":"Denver FM8 (look for yarn, p50 5.4); Piagetian partial-hiding stage of object permanence.","sources":["SRC-018"]},{"id":"ACT-0410","title":"Hide-and-find with a cloth","targets":["CG-013"],"supports":["CG-012","RC-008","SE-029"],"type":"play","age_window":{"from_months":7,"to_months":15},"duration_minutes":5,"frequency":"daily","materials":["a small favourite toy and a cloth (dupatta or handkerchief)"],"cost_tier":"free","how_to":["Show the baby the toy; let them touch it.","Slowly cover the toy fully with the cloth while the baby watches (visible displacement).","Wait; the baby now finds the toy by lifting the cloth.","Later, hide the toy under one of two cloths and switch them once (see if the baby follows the switch)."],"signs_it_is_working":"Baby lifts the cloth to retrieve the toy they saw hidden; recognises that an out-of-sight object still exists.","signs_to_stop":"Subtle: baby loses interest after 2-3 rounds. Potent: crying if the toy stays hidden too long. Uncover it and try again another day.","adult_role":"Move slowly, hide in full view, wait.","safety":"Light cloth only; not near baby face for long.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): baby looks for objects when hidden — like a toy under a blanket.","sources":["SRC-002"]},{"id":"ACT-0411","title":"Cause-and-effect toy exploration","targets":["CG-014"],"supports":["CG-017","CG-022"],"type":"play","age_window":{"from_months":7,"to_months":15},"duration_minutes":10,"frequency":"daily","materials":["one or two simple cause-effect toys (a pop-up-when-pressed toy, a musical instrument with buttons, a rattle) or household equivalents"],"cost_tier":"under_500_inr","india_sourcing_note":"Household equivalents: a light switch the baby can flip on and off (with supervision), a metal katori and spoon for banging, a plastic container with dry pulses for shaking.","how_to":["Model the action once: press the button, the toy pops up.","Hand the toy to the baby.","Wait; the baby will explore and eventually repeat the cause action deliberately.","Any 'I did that on purpose' cause-effect action counts — banging a pot to make sound, dropping a toy to see it fall."],"signs_it_is_working":"Baby intentionally causes the effect — presses the button, bangs the pot, shakes the rattle — and looks pleased at the result.","signs_to_stop":"Subtle: baby only mouths the toy. Potent: throws the toy. Try a different cause-effect object or wait a few weeks.","adult_role":"Model once, then let discovery drive.","safety":"Household electrical items only under close supervision.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): baby plays games with you like pat-a-cake and repeats actions that make something happen.","sources":["SRC-002"]},{"id":"ACT-0412","title":"Clapping and gesture games","targets":["CG-015"],"supports":["RC-008","SE-029","EC-026"],"type":"play","age_window":{"from_months":6,"to_months":15},"duration_minutes":5,"frequency":"daily","materials":["your hands and a small repertoire of clapping and finger-play songs"],"cost_tier":"free","india_sourcing_note":"Hindi finger-play songs: chapa chapa charkha chale, aloo kachaloo, machli jal ki rani hai. English: pat-a-cake, itsy bitsy spider, if you're happy and you know it.","how_to":["Sing a familiar song and do the clapping or hand-motion pattern that goes with it.","Take the baby hands and help them clap along the first few times.","Then wait for the baby to do the motion themselves.","Repeat the same songs across days so the pattern becomes familiar."],"signs_it_is_working":"Baby claps or does the finger motion in time with the song, and eventually starts the motion before you do (initiating the routine).","signs_to_stop":"Subtle: baby looks away. Potent: fussing. Move on to a different song or activity.","adult_role":"Sing, clap, wait for the baby to join.","safety":"Gentle hand-holding; do not force motion.","derivation":"adopted","evidence_note":"Denver PS7 (play clapping game, p50 8.1); CDC 12 mo tips also cite pat-a-cake.","sources":["SRC-002"]},{"id":"ACT-0413","title":"Imitate simple adult actions","targets":["CG-016"],"supports":["AD-021","CG-019"],"type":"play","age_window":{"from_months":8,"to_months":16},"duration_minutes":8,"frequency":"daily","materials":["everyday objects the baby sees adults use (broom, dust cloth, spoon, phone, keys)"],"cost_tier":"free","india_sourcing_note":"A small jhaadu from a broom cut short, a dry cotton wipe, a wooden spoon — all safe imitation props.","how_to":["Model everyday activities within the baby view: sweeping a bit of floor with a jhaadu, wiping a table, stirring a pot.","Hand a safe version of the tool to the baby.","Wait; the baby will imitate the action — the imitation is more important than the correctness.","Celebrate the try, not the result."],"signs_it_is_working":"Baby copies the action they saw you do — sweeping motion, wiping motion, stirring motion — with the tool you gave them.","signs_to_stop":"Subtle: baby loses interest quickly. Potent: baby uses the tool inappropriately (throws, hits). Take the tool away calmly and try later.","adult_role":"Model within eye-line; hand a safe version; do not correct the imitation.","safety":"No hot pots, no sharp cutlery, no glass, no electrical items.","derivation":"adopted","evidence_note":"CDC Milestone Moments (12 mo): baby copies your gestures like waving or clapping; imitates actions like sweeping.","sources":["SRC-002"]},{"id":"ACT-0414","title":"Uses common objects the right way","targets":["CG-017"],"supports":["CG-016","CG-020"],"type":"play","age_window":{"from_months":11,"to_months":20},"duration_minutes":8,"frequency":"daily","materials":["everyday small objects with clear function (spoon, cup, comb, phone, brush)"],"cost_tier":"free","how_to":["Lay 3-4 familiar objects in front of the child.","Watch; the child picks one up and uses it functionally: puts the spoon to mouth, the cup to lips, the comb to hair, the phone to ear.","Celebrate the functional use without correction if slightly off.","Rotate the objects across days."],"signs_it_is_working":"Child uses each common object for its actual purpose — spoon to mouth, cup to lips, comb to hair, phone to ear.","signs_to_stop":"Subtle: child mouths everything. Potent: throws objects. Reduce to two objects.","adult_role":"Observe; do not demonstrate every object every time.","safety":"Choking-safe versions of everything; toy phone, not a real phone.","derivation":"adopted","evidence_note":"CDC Milestone Moments (15 mo): baby tries to use things the right way — a cup, a book, a brush.","sources":["SRC-002"]},{"id":"ACT-0415","title":"Roll-the-ball give-and-take","targets":["CG-018"],"supports":["GM-001","SE-028","RC-005"],"type":"play","age_window":{"from_months":9,"to_months":18},"duration_minutes":8,"frequency":"daily","materials":["one soft ball 15-20 cm across"],"cost_tier":"under_500_inr","how_to":["Sit on the floor facing the child; legs open in a V.","Roll the ball slowly toward the child.","Wait for the child to catch and roll it back.","The turn-taking IS the cognitive milestone — the ball is the excuse."],"signs_it_is_working":"Child catches the ball, waits, and intentionally sends it back; the cycle repeats for several turns.","signs_to_stop":"Subtle: child keeps the ball. Potent: throws it away. Return to modelling with two adults for a while.","adult_role":"Slow the pace; wait for their turn.","safety":"Soft ball only.","derivation":"adopted","evidence_note":"Denver PS10 (play ball with examiner, p50 12.2). Cross-referenced with GM ball-rolling ACT-0016 (primary target GM-001) and SE ACT-0428 (primary target SE-028).","sources":["SRC-002"]},{"id":"ACT-0416","title":"Pretend feed the doll","targets":["CG-019"],"supports":["CG-020","CG-021","AD-007"],"type":"play","age_window":{"from_months":15,"to_months":28},"duration_minutes":10,"frequency":"daily","materials":["one soft doll or stuffed animal with a face","a small spoon and a small bowl"],"cost_tier":"under_500_inr","india_sourcing_note":"A cloth doll, an old teddy, or even a wooden peg-doll works; the child provides the pretend feeding, not the doll.","how_to":["Sit with the child, doll and spoon and bowl between you.","Model once: 'the doll is hungry — let us feed her'; put the spoon to the doll's mouth.","Hand the spoon to the child; wait.","Extend the game: 'she is thirsty — give her some water', 'she is sleepy — put her to bed'."],"signs_it_is_working":"Child pretends to feed the doll with the spoon, and later extends the pretend to other doll-care actions.","signs_to_stop":"Subtle: child bangs the spoon rather than pretending. Potent: throws the doll. Model once more; if still nothing, try again next week.","adult_role":"Model once; then let the pretend unfold on its own.","safety":"No small doll parts; no strings.","derivation":"adopted","evidence_note":"Denver PS16 (feed doll, p50 19.5). CDC 15-18 mo also cites pretend feeding.","sources":["SRC-002"]},{"id":"ACT-0417","title":"Object-substitution pretend","targets":["CG-020"],"supports":["CG-019","CG-021"],"type":"play","age_window":{"from_months":16,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["everyday objects the child can re-purpose (a wooden block used as a phone, a banana used as a car, a stick used as a spoon)"],"cost_tier":"free","how_to":["Model an object substitution: hold a wooden block to your ear as if it were a phone; 'hello!'.","Hand the block to the child; wait.","The child may extend the pretend — use a banana as a comb, a stick as a spoon.","Do not correct; the substitution IS the milestone."],"signs_it_is_working":"Child uses one object to stand for another in pretend play — a block for a phone, a stick for a spoon.","signs_to_stop":"Subtle: child insists on using only the correct object for each action. Continue modelling; substitution comes with practice.","adult_role":"Model, then step back.","safety":"Choking-safe objects only.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Imitation and Symbolic Representation Do guide: model and encourage using one object to stand for another in pretend play.","sources":["SRC-005"]},{"id":"ACT-0418","title":"Switches, knobs, and dials","targets":["CG-022"],"supports":["CG-014","FM-018","FM-027"],"type":"play","age_window":{"from_months":15,"to_months":30},"duration_minutes":8,"frequency":"daily","materials":["a toy or safe household object with switches, buttons, or dials (a busy board, an old TV remote with batteries removed, a light switch with supervision)"],"cost_tier":"under_2000_inr","india_sourcing_note":"Homemade busy board: mount a light switch, a doorbell button, a bicycle bell, a wooden knob on a plank of wood. Free with used household hardware.","how_to":["Show the child once: press the button — the light comes on. Twist the knob — the sound changes.","Let them experiment.","Add a new element each week so the challenge grows.","Trial-and-error is the point; do not correct sequence."],"signs_it_is_working":"Child figures out how to make different elements work — pressing, twisting, flipping — and remembers the sequence.","signs_to_stop":"Subtle: child mouths the elements. Potent: forces or breaks pieces. Simplify to fewer elements.","adult_role":"Supervise only; hands off unless safety.","safety":"Real electrical switches only under adult supervision. No small parts.","derivation":"adopted","evidence_note":"CDC Milestone Moments (24 mo): tries to use things the right way, like a switch or a knob.","sources":["SRC-002"]},{"id":"ACT-0419","title":"Combining-toys play","targets":["CG-023"],"supports":["CG-019","CG-020","FM-018"],"type":"play","age_window":{"from_months":18,"to_months":30},"duration_minutes":10,"frequency":"daily","materials":["assorted small toys (blocks, cars, dolls, plastic animals) mixed on a play mat"],"cost_tier":"under_500_inr","how_to":["Scatter several kinds of toys on the mat.","Model a combination: 'the doll is riding in the car', 'the animals are on top of the block wall'.","Let the child combine on their own.","Ask 'what is happening' to prompt narration."],"signs_it_is_working":"Child combines two or more toys into one play scenario — the doll rides in the car, the animals climb the block tower.","signs_to_stop":"Subtle: child plays with each toy in isolation. Continue modelling combinations without pressure.","adult_role":"Model, ask, listen.","safety":"Small-parts safe.","derivation":"adopted","evidence_note":"CDC Milestone Moments (24 mo): plays with more than one toy at the same time — like putting toy food on a plate.","sources":["SRC-002"]},{"id":"ACT-0420","title":"Multi-step pretend sequence","targets":["CG-021"],"supports":["CG-019","CG-020","CG-024"],"type":"play","age_window":{"from_months":24,"to_months":40},"duration_minutes":15,"frequency":"daily","materials":["doll or figure","props for a familiar scenario (small cup, spoon, cloth for bed)"],"cost_tier":"under_500_inr","how_to":["Set up a scenario: 'the doll is hungry, then she is sleepy, then she wakes up'.","Model the sequence: feed doll — put doll to bed — wake doll up.","Wait for the child to run the sequence themselves.","Extend across days with new scenarios (bath the doll, take the doll to the market, put the doll in a car)."],"signs_it_is_working":"Child runs a 3-4-step pretend sequence in order: feeds doll, then puts to bed, then wakes and dresses.","signs_to_stop":"Subtle: child does one step and moves on. Reduce to 2 steps.","adult_role":"Model the sequence; then step back and narrate what the child is doing.","safety":"No small doll accessories.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Play Do guide: model and support multi-step pretend sequences by 24-36 months.","sources":["SRC-005"]},{"id":"ACT-0421","title":"Anticipate the next step in a routine","targets":["CG-024"],"supports":["CG-007","SE-022","SR-011"],"type":"routine","age_window":{"from_months":24,"to_months":40},"duration_minutes":1,"frequency":"a few times a day","materials":["your family daily routines (bath, bedtime, mealtime)"],"cost_tier":"free","how_to":["In a familiar sequence (bath → pyjamas → story → bed), pause between steps and ask 'what happens next'.","Wait; the child fills in the next step, either with words or by moving to it (walking to the storybook, getting into bed).","Do this in several routines: morning wake-up, mealtime, going out.","Predictable routines make this a lot easier."],"signs_it_is_working":"Child predicts and moves to the next step in a familiar multi-step routine without being told.","signs_to_stop":"Subtle: child seems lost. Restore predictable order for a few weeks before pausing to test.","adult_role":"Keep routines predictable; pause and let the child fill in.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Memory Do guide: use predictable routines and pauses to build anticipation of familiar sequences.","sources":["SRC-005"]},{"id":"ACT-0422","title":"Counting two or three objects","targets":["CG-026"],"supports":["CG-025","CG-023"],"type":"play","age_window":{"from_months":24,"to_months":40},"duration_minutes":5,"frequency":"daily","materials":["small identical objects to count (blocks, bindis, chana, pebbles)"],"cost_tier":"free","india_sourcing_note":"Roasted chana, small pebbles from the garden, wooden blocks — anything identical and countable.","how_to":["Line up 2-3 objects on a plate.","Point to each in turn and count aloud: 'one, two, three'.","Ask the child to count with you.","Increase to 4-5 objects only when 2-3 is reliable; do not push beyond what stays fun."],"signs_it_is_working":"Child counts along and, later, points to and counts 2-3 objects on their own with the correct number words.","signs_to_stop":"Subtle: child says numbers out of order or misses objects. Continue modelling; sequence comes with time.","adult_role":"Count aloud yourself. Do not correct wrong counts mid-count; recount together after.","safety":"Choking-safe items only.","derivation":"adopted","evidence_note":"CDC Milestone Moments (36 mo): counts to at least 2. Head Start ELOF Cognition Counting Do guide.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0423","title":"Sort by one characteristic","targets":["CG-027"],"supports":["CG-023","RC-020"],"type":"play","age_window":{"from_months":24,"to_months":40},"duration_minutes":8,"frequency":"daily","materials":["small objects that vary on one clear dimension (red vs blue blocks; big vs small stones; forks vs spoons)"],"cost_tier":"free","how_to":["Set up two small bowls.","Show the child: 'the red ones go here, the blue ones go here'.","Model 2-3 placements; then hand the rest to the child.","Rotate the sorting dimension across days: colour, size, shape, kind."],"signs_it_is_working":"Child sorts the objects into the two groups by the named characteristic with only a few errors.","signs_to_stop":"Subtle: child mixes deliberately (that is play, not failure). Potent: throws pieces. Save for later.","adult_role":"Model, hand pieces, celebrate.","safety":"Small-parts safe.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Reasoning and Problem-Solving Do guide: model sorting objects by an attribute.","sources":["SRC-005"]},{"id":"ACT-0424","title":"Simple two-to-three-piece puzzle","targets":["CG-028"],"supports":["FM-018","CG-023"],"type":"toy","age_window":{"from_months":22,"to_months":36},"duration_minutes":8,"frequency":"daily","materials":["a wooden or thick-card puzzle with 2-3 large pieces (each shape drops into a matching cutout)"],"cost_tier":"under_500_inr","india_sourcing_note":"Indian brands (Skillofun, Little Genius) sell shape-cutout wooden puzzles in the INR 200-500 range. Homemade version: cut a matching hole in a shoebox lid and use the cutout piece.","how_to":["Show the empty puzzle board and the loose pieces.","Model one placement: 'the circle goes here'.","Hand the child the next piece; wait for them to try.","Rotate the pieces so they have to figure out which fits which — trial and error is the point."],"signs_it_is_working":"Child figures out which piece fits which slot, rotates pieces to fit, and completes the puzzle unaided.","signs_to_stop":"Subtle: forces the wrong piece. Potent: throws pieces. Reduce to a single-piece puzzle.","adult_role":"Model once; then let trial-and-error work.","safety":"Large pieces, no small removable knobs.","derivation":"adapted","evidence_note":"Head Start ELOF Cognition Reasoning and Problem-Solving Do guide: puzzles that require trial-and-error and shape-fitting build cognitive problem-solving.","sources":["SRC-005","SRC-018"]},{"id":"ACT-0425","title":"Function of two common objects","targets":["CG-025"],"supports":["CG-017","EC-023"],"type":"play","age_window":{"from_months":28,"to_months":42},"duration_minutes":5,"frequency":"daily","materials":["everyday household items (spoon, cup, comb, phone, key)"],"cost_tier":"free","how_to":["Show two objects; ask 'what do we do with this'.","Wait; the child answers (in words or gesture) — spoon → eating, cup → drinking.","If they do not know, model the use and say the answer.","Rotate objects across days."],"signs_it_is_working":"Child names or demonstrates the correct use of two common objects when asked.","signs_to_stop":"Subtle: child names the object but not the use. Model the use paired with the name.","adult_role":"Ask, wait, model if needed.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver LA28 (use of 2 objects) with the 25th percentile at 30.4mo. Framing our own.","sources":["SRC-002"]},{"id":"ACT-0426","title":"Kitchen pretend play","targets":["CG-019"],"supports":["CG-020","CG-021","AD-021","EC-022"],"type":"play","age_window":{"from_months":18,"to_months":42},"duration_minutes":15,"frequency":"daily","materials":["a small set of pretend kitchen items (empty containers, wooden spoon, plastic plates)"],"cost_tier":"under_500_inr","india_sourcing_note":"Empty dabbas, a wooden belan cut short, plastic plates, empty spice jars — the pretend kitchen builds itself from what is already there.","how_to":["Set up a small 'kitchen' corner with the pretend items.","Model one action: 'cooking dal — stir, stir'.","Let the child cook, serve, feed dolls, wash dishes — the play unfolds.","Enter the play as a customer or guest: 'can I have some roti please'."],"signs_it_is_working":"Child engages in multi-step kitchen pretend, invites others in, uses objects for their pretend function, and talks about what they are doing.","signs_to_stop":"Subtle: child bangs pots without pretending. That is fine; add pretend by joining them briefly.","adult_role":"Set up the space; step in as a customer briefly; step out.","safety":"No hot items, no real knives, no small parts.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Play Do guide and CDC 24-30 mo tips both cite kitchen pretend play as a rich cognitive/imitation activity.","sources":["SRC-002","SRC-005"]},{"id":"ACT-0427","title":"Numbers-in-daily-life narration","targets":["CG-026"],"supports":["EC-016","RC-024"],"type":"language","age_window":{"from_months":18,"to_months":40},"duration_minutes":15,"frequency":"ambient","materials":["everyday moments"],"cost_tier":"free","how_to":["Count objects out loud in daily life: 'two shoes, one, two'; 'three chapatis for you, one, two, three'.","Give the child small counting jobs: 'bring me two forks'.","Count steps as you climb stairs; count spoons of rice in the pot.","Numbers before four are enough at first."],"signs_it_is_working":"Child begins to count spontaneously in daily life, says 'one, two, three' with pointing.","signs_to_stop":"Subtle: child recites numbers in the wrong order. Continue modelling; sequence emerges.","adult_role":"Count aloud everywhere. Do not test.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Cognition Counting Do guide: model counting during daily routines.","sources":["SRC-005"]},{"id":"ACT-0440","title":"Face time at 25 centimetres","targets":["CG-001","CG-029"],"supports":["SE-001"],"type":"play","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is alert, hold him so your face is about 25 cm from his.","Stay still and let him study your face; talk softly.","Then hold a bright toy at the same distance and let him look at it."],"signs_it_is_working":"He looks at your face and at the toy for several seconds.","signs_to_stop":"Looking away repeatedly, hiccoughs or a yawn. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Hold still and be interesting; do not wave the toy about.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tips on looking at pictures together and holding the baby close (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0441","title":"Contrast corner","targets":["CG-029"],"supports":[],"type":"environment","age_window":{"from_months":0,"to_months":4},"duration_minutes":0,"frequency":"ambient","materials":["white card and a black marker"],"cost_tier":"free","how_to":["Draw bold black-and-white shapes (stripes, a bullseye, a simple face) on white card.","Stand one card beside where he lies awake, about 25 cm from his eyes.","Change the card every few days."],"signs_it_is_working":"He stares at the card for several seconds and looks back at it.","signs_to_stop":"Turning his head away from the card and staying away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set it up and let him look; take it away when he is tired.","safety":"Card fixed so it cannot fall on him.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0442","title":"Slow-track the toy","targets":["CG-002","CG-003","CG-004"],"supports":[],"type":"play","age_window":{"from_months":0,"to_months":6},"duration_minutes":2,"frequency":"daily","materials":["a bright rattle or toy"],"cost_tier":"free","how_to":["Hold a bright toy or your face about 25 cm from his eyes until he looks at it.","Move it very slowly to one side, then across to the other.","As he manages, take it further round, from one side all the way to the other."],"signs_it_is_working":"His eyes and head follow the toy to the middle, then past it, then all the way across.","signs_to_stop":"Eyes losing the toy and looking away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Move slowly enough that he keeps up.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 4-month tip 'Use bright toys and slow movements to encourage visual tracking' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0443","title":"Hands free to watch","targets":["CG-005"],"supports":[],"type":"environment","age_window":{"from_months":1,"to_months":5},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["When he lies awake on his back, leave his hands uncovered.","A bright hair band or soft scrunchie on his wrist can draw his eyes to his hand.","Let him watch his hands without adding toys."],"signs_it_is_working":"He watches his own hands, turning them in front of his face.","signs_to_stop":"Pulling at the wrist band; take it off. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give him quiet time with nothing to look at but his hands.","safety":"Loose band only while you are watching; remove it before sleep.","derivation":"original","evidence_note":"Common practice, no formal evidence; ELOF IT-SE 10 describes learning about self by exploring hands. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0444","title":"Small dot on a plain card","targets":["CG-006"],"supports":[],"type":"play","age_window":{"from_months":3,"to_months":7},"duration_minutes":1,"frequency":"daily","materials":["a white card","one small sticker or bindi"],"cost_tier":"free","how_to":["Put a single small sticker or bindi on a plain white card.","Hold it in front of him at about 25 cm while he sits supported.","Watch whether he notices and looks at the small dot."],"signs_it_is_working":"He notices and looks at small details like the dot.","signs_to_stop":"Reaching to mouth the card; take the sticker off afterwards. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show and watch; nothing more is needed.","safety":"Adult holds the card; the sticker never goes near his mouth.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-008"]},{"id":"ACT-0445","title":"Feed-time rhythm","targets":["CG-007","CG-009"],"supports":[],"type":"routine","age_window":{"from_months":1,"to_months":8},"duration_minutes":0,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Keep the same small ritual before feeds: the same chair, the same words ('milk time').","Watch for his signs of expecting the feed — opening his mouth, turning.","Stop the feed when he closes his lips or turns away."],"signs_it_is_working":"He opens his mouth or gets excited as feeding starts, and turns away or closes his lips when full.","signs_to_stop":"Subtle: slowing down, looking around, playing with the nipple or spoon. Potent: turning the head away, closing the lips, pushing the spoon or bottle away, arching. End the feed at these signs; do not coax more.","adult_role":"Keep the routine steady and read his signals. Do not push the last bit of milk or food.","safety":"Standard feeding safety; hold him upright.","derivation":"adapted","evidence_note":"Adapted from the CDC 2- and 6-month tips on feeding cues and consistent routines (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0446","title":"Safe mouthing basket","targets":["CG-008"],"supports":[],"type":"environment","age_window":{"from_months":3,"to_months":10},"duration_minutes":10,"frequency":"daily","materials":["a basket","4-6 safe household objects"],"cost_tier":"free","how_to":["Fill a small basket with clean, safe things to mouth: a steel spoon, a teether, a clean cloth, a wooden ring.","Let him pick them up and mouth them.","Wash them daily and swap a couple each week."],"signs_it_is_working":"He brings things to his mouth and explores them in different ways.","signs_to_stop":"Gagging on an object; take it away and check its size. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Choose safe things and let him explore. Do not stop him mouthing safe objects.","safety":"Every object bigger than a film canister, no small parts, no batteries, washed.","derivation":"adapted","evidence_note":"Adapted from the CDC 4-month tip 'Allow your baby to put safe things in his mouth to explore them.' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0447","title":"Drop it, find it","targets":["CG-011","CG-030"],"supports":[],"type":"play","age_window":{"from_months":4,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["When he drops a toy from his lap or high chair, say 'uh-oh, where did it go?'.","Wait for him to look for it; then pick it up and give it back.","Let the drop-and-return game run a few rounds."],"signs_it_is_working":"He looks down for the dropped toy and starts dropping things on purpose to make you fetch them.","signs_to_stop":"You are tired of it: end the game kindly with 'last one'. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Play along a few times; the repetition is the learning.","safety":"Nothing breakable.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month tip on retrieving dropped toys and the 9-month tip on turning dropping into a game (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0448","title":"Toy on the far side","targets":["CG-010"],"supports":[],"type":"play","age_window":{"from_months":3,"to_months":8},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["During floor play, put a toy just beyond his reach.","Let him stretch, roll or wriggle to get it.","If he tries hard for a while, move it a little closer."],"signs_it_is_working":"He works at getting the toy — stretching, rolling, shifting.","signs_to_stop":"Giving up and crying at once; move it closer. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Just out of reach, not too far. Do not hand it over at the first try.","safety":"Floor play with supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month tip 'Place toys out of reach to encourage rolling and reaching' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0449","title":"Under the cloth","targets":["CG-012","CG-013"],"supports":[],"type":"play","age_window":{"from_months":5,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["a small cloth or napkin","a toy"],"cost_tier":"free","how_to":["While he watches, cover part of a toy with a cloth and ask 'where is it?'.","When he finds that easily, cover it completely.","Later hide it under one of two cloths while he watches."],"signs_it_is_working":"He pulls the cloth off a half-hidden toy, then finds a toy hidden completely while he watched.","signs_to_stop":"Losing interest when the toy disappears; go back to half-hiding. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Hide it while he watches; let him find it.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on hiding toys under blankets (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0450","title":"Make it go again","targets":["CG-014","CG-030"],"supports":[],"type":"play","age_window":{"from_months":6,"to_months":14},"duration_minutes":5,"frequency":"daily","materials":["pots, pans, a steel plate, a sealed water bottle"],"cost_tier":"free","how_to":["Give him things that do something when he acts: a steel plate to bang, a ball that rolls, a bottle of water that sloshes.","When he makes it happen, react: 'you made it bang!'.","Wait to see if he does it again on purpose."],"signs_it_is_working":"He repeats the action to get the effect, and uses simple cause-and-effect toys on purpose.","signs_to_stop":"Throwing the object aside; offer a different one. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"React, then wait. Do not do it for him.","safety":"Sealed bottles; nothing heavy.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Give your baby pots and pans or a small musical instrument' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0451","title":"Clap-and-sing games","targets":["CG-015"],"supports":["RC-008"],"type":"play","age_window":{"from_months":5,"to_months":12},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Play pat-a-cake, 'Tai tai tai' or other clapping rhymes with him on your lap.","Take his hands gently at first, then pause and let him clap.","Repeat the same few games so he learns them."],"signs_it_is_working":"He claps and makes the game's gestures with you.","signs_to_stop":"Pulling his hands away; do the actions yourself. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model the game; let him join when ready.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year milestone 'Plays games with you, like pat-a-cake' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0452","title":"Little helper chores","targets":["CG-016","CG-033"],"supports":["AD-021"],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["a small cloth","a small broom or brush"],"cost_tier":"free","how_to":["Give him a small cloth when you wipe the table, or a little broom when you sweep.","Let him copy you side by side.","Later notice if he does the chore on his own at another time, and thank him."],"signs_it_is_working":"He copies chores as you do them, and later does them on his own.","signs_to_stop":"Wandering off; that's fine — invite him next time. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Do the chore where he can see and give him his own tool. Do not correct how he does it.","safety":"Nothing sharp or chemical; child-safe tools.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month milestone 'Copies you doing chores, like sweeping' and the 15-month tip on showing how objects work (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0453","title":"Real things, real uses","targets":["CG-017"],"supports":[],"type":"play","age_window":{"from_months":9,"to_months":16},"duration_minutes":5,"frequency":"daily","materials":["comb, cup, spoon, old phone without battery"],"cost_tier":"free","how_to":["Give him safe real objects: a comb, a cup, a spoon, an old phone with the battery out.","Show what each is for once — comb your hair, drink from the cup.","Watch him try to use them the right way."],"signs_it_is_working":"He uses everyday objects for their purpose.","signs_to_stop":"Chewing or throwing every object; let him explore and try again later. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show once, then let him try.","safety":"Old phones with batteries removed; nothing small.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month milestone 'Tries to use things the right way, like a phone, cup, or book' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0454","title":"Roll it back","targets":["CG-018"],"supports":[],"type":"play","age_window":{"from_months":9,"to_months":18},"duration_minutes":5,"frequency":"daily","materials":["a soft ball"],"cost_tier":"free","how_to":["Sit facing him with legs apart to make a 'goal'.","Roll a ball gently to him and hold out your hands for it.","Take turns: 'my turn, your turn'."],"signs_it_is_working":"He rolls or pushes the ball back and waits for his turn.","signs_to_stop":"Keeping the ball and crawling off. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep turns short and cheerful.","safety":"Soft ball.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Play with your child by rolling balls back and forth' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0455","title":"Pretend kitchen with stand-ins","targets":["CG-020","CG-023"],"supports":[],"type":"play","age_window":{"from_months":15,"to_months":28},"duration_minutes":10,"frequency":"daily","materials":["steel plate, katoris, spoon, blocks"],"cost_tier":"free","how_to":["Give him a steel plate, katoris, a spoon and a few blocks.","Pretend a block is a roti and 'eat' it; offer him one.","Let him combine things: blocks in the katori, the katori on the plate."],"signs_it_is_working":"He uses one thing to stand for another and puts toys together in play.","signs_to_stop":"Throwing the things; end and try another day. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Join his pretend; do not direct the story.","safety":"Nothing small enough to swallow.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip on toys that encourage pretend play and the 2-year milestone 'putting toy food on a toy plate' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"kitchen steel is the best pretend-play kit"},{"id":"ACT-0456","title":"Switch and knob board","targets":["CG-022"],"supports":[],"type":"toy","age_window":{"from_months":15,"to_months":30},"duration_minutes":10,"frequency":"daily","materials":["an old switch, latch and lids fixed to a board"],"cost_tier":"under_500_inr","how_to":["Collect safe things that click and turn: an old light switch on a board, a bottle lid, a latch on a box.","Show him one, then let him explore.","Name what happens: 'click — on!'."],"signs_it_is_working":"He works switches, knobs and lids to make things happen.","signs_to_stop":"Pulling at the board angrily; show one part again. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him explore; help only if asked.","safety":"Nothing connected to electricity; screws covered; small parts fixed firmly.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip on cause-and-effect toys and milestone 'Tries to use switches, knobs, or buttons on a toy' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0457","title":"Pour and fill","targets":["CG-031"],"supports":["FM-013","FM-014"],"type":"play","age_window":{"from_months":12,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["katoris, a bowl, dry rice or chana"],"cost_tier":"free","how_to":["Give him a few katoris and a larger bowl with dry rice or chana.","Let him fill, pour and tip out, over and over.","Sweep up together at the end."],"signs_it_is_working":"He fills and empties containers again and again.","signs_to_stop":"Throwing handfuls; move to water play outside instead. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Supervise and let him repeat as long as he likes.","safety":"Close supervision with dry grains; stop if he mouths them.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on block dumping and the 2-year tip on sensory play with containers (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0458","title":"Water and sand containers","targets":["CG-031","CG-034"],"supports":[],"type":"play","age_window":{"from_months":14,"to_months":30},"duration_minutes":15,"frequency":"daily","materials":["cups, a colander, a funnel, water or sand"],"cost_tier":"free","how_to":["Outside or at bath time, give him cups, a colander and a funnel with water (or sand).","Let him discover how each one fills and empties.","If he tries to fill the colander, let him find out — then see what he tries next."],"signs_it_is_working":"He fills and empties repeatedly and tries different containers when one does not work.","signs_to_stop":"Splashing at people; end the game. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him experiment; resist fixing the problem for him.","safety":"Never leave him alone near water, even a bucket.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip 'Provide sensory play with sand, water, and containers' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0459","title":"'More' and 'all gone' at meals","targets":["CG-032"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":0,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["At meals, when he wants more, say and sign 'more' (fingertips together).","When the plate is empty, say 'all gone!' with open hands.","Wait a moment for him to sign or say it before giving more."],"signs_it_is_working":"He uses a word or sign for 'more' or 'all gone'.","signs_to_stop":"Frustrated crying when you pause; give food straight away. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model the words in real moments; never hold back food.","safety":"Standard feeding safety.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month and 15-month tips on simple signs and gestures (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0460","title":"Copy-me later","targets":["CG-033"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":24},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Do a simple new action with him watching: put a hat on teddy, knock on a door.","Put the things away without asking him to copy.","Next day, leave them out and see if he does the action himself."],"signs_it_is_working":"He repeats actions he saw earlier, without being shown again.","signs_to_stop":"No interest in the things; try a different action. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Show and then leave it; the delay is the point.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0461","title":"Problem boxes","targets":["CG-034"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Put a toy in a box with the lid on loosely, or under a cushion.","Let him work out how to get it; wait before helping.","If he is stuck, give the smallest hint (tilt the lid) rather than solving it."],"signs_it_is_working":"He tries different ways to get the toy when the first way does not work.","signs_to_stop":"Crying and handing the box over; help with one small step. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Wait before helping; offer hints, not solutions.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip on problem-solving toys (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0462","title":"Getting-ready jobs","targets":["CG-035"],"supports":["AD-015"],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":1,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Before going out, say 'time to go — where are your shoes?' and let him fetch them.","Before bath, ask him to bring the towel.","Keep these things in the same place every day."],"signs_it_is_working":"He starts fetching the right thing, or going to the right place, as soon as a routine begins.","signs_to_stop":"Refusing; get the thing together. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep things in fixed places and give him a job each time.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip 'Let her get her shoes to go outside' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0463","title":"Mealtime set-up helper","targets":["CG-035","CG-032"],"supports":["AD-021"],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Before meals, give him his plate or spoon to carry to his place.","Say 'it's khana time' and let him go to his seat.","At the end, 'all gone!' and he carries the plate to the kitchen with you."],"signs_it_is_working":"He heads to the table when he hears it's mealtime and uses 'all gone' at the end.","signs_to_stop":"Running off with the plate; carry it together. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give him the job; accept spills.","safety":"Unbreakable plates only.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip on carrying items to the table (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0500","title":"Familiar-face and warm-caregiving time","targets":["SE-001","SE-005"],"supports":["RC-002","SR-002"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":5,"frequency":"a few times a day","materials":["your face and voice"],"cost_tier":"free","how_to":["During calm alert moments, hold the baby facing you at close range (20-30 cm).","Say their name softly; be still and warm.","The baby studies your face; give them time to look and take you in.","Do this consistently — the recognition of a familiar face grows from repetition."],"signs_it_is_working":"Baby settles when they see or hear you, looks longer at your face than at unfamiliar faces, quiets to your voice.","signs_to_stop":"Subtle: gaze aversion. Potent: cry that does not settle. Try again when they are less overstimulated.","adult_role":"Be present, warm, and predictable. Familiarity is built by repetition, not by novelty.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional IT-SE 1/2 (attachment) Do guide: warm predictable caregiver presence is the foundation of secure attachment.","sources":["SRC-005"]},{"id":"ACT-0501","title":"Smile-back conversation","targets":["SE-002","SE-003"],"supports":["RC-004","EC-002"],"type":"play","age_window":{"from_months":0,"to_months":5},"duration_minutes":3,"frequency":"a few times a day","materials":["your face"],"cost_tier":"free","how_to":["Face the baby closely.","Smile at them.","Wait; the responsive smile appears from around 6 weeks.","Once smiling back is familiar, wait for the baby to smile first sometimes; smile back in reply."],"signs_it_is_working":"Baby smiles back at your smile (responsive) and later smiles at you first (spontaneous), often paired with cooing.","signs_to_stop":"Subtle: baby averts gaze. Potent: no responsive smile by 3 months. Consult the paediatrician; this is a screening-worthy observation.","adult_role":"Smile warmly; wait. Do not force it.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (2 mo): begins to smile at people. Persistent absence past 3 mo is a Phase 6 red-flag threshold.","sources":["SRC-002"]},{"id":"ACT-0502","title":"Sustained eye-contact play","targets":["SE-004"],"supports":["SE-002","EC-007"],"type":"play","age_window":{"from_months":1,"to_months":5},"duration_minutes":3,"frequency":"a few times a day","materials":["your eyes"],"cost_tier":"free","how_to":["Hold the baby facing you closely.","Look into their eyes with a soft warm expression.","Talk quietly; sing; hum.","Let the baby hold your gaze; some minutes some days, only seconds on others."],"signs_it_is_working":"Baby holds your gaze longer than a few seconds, smiles or vocalises during eye contact, and returns to your eyes after brief looks away.","signs_to_stop":"Subtle: gaze aversion, dulled look. Potent: fussing. Bring them to your shoulder for a break.","adult_role":"Do not stare intensely or unbroken; the game is warm and mutual.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Do guide (adult-as-resource): sustained eye contact during warm interactions builds the earliest social attachment.","sources":["SRC-005"]},{"id":"ACT-0503","title":"Facial-expression play","targets":["SE-008"],"supports":["SE-006","EC-005"],"type":"play","age_window":{"from_months":1,"to_months":6},"duration_minutes":5,"frequency":"daily","materials":["your face"],"cost_tier":"free","how_to":["Face the baby; show one clear expression at a time — a big smile, a surprised open mouth, a soft calm face.","Hold each expression for a moment so the baby can study it.","Wait for the baby to match with their own face; imitation happens over weeks.","Rotate the expressions across sessions."],"signs_it_is_working":"Baby shows a range of facial expressions of their own — smile, wide eyes, brow furrow, soft resting face — often paired with sound.","signs_to_stop":"Subtle: baby covers their face with hands. Potent: crying. Return to a calm face and soft voice.","adult_role":"Model clearly; wait. Do not push a specific expression from the baby.","safety":"No sudden loud sounds or startling faces.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Emotional Expression Do guide: adults model varied clear facial expressions so infants build a repertoire.","sources":["SRC-005"]},{"id":"ACT-0504","title":"Chuckling face-and-tickle play","targets":["SE-006"],"supports":["SE-007","EC-003"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":3,"frequency":"daily","materials":["your face, voice, and gentle tickle hands"],"cost_tier":"free","how_to":["Hold or seat the baby facing you.","Do a slow build-up ('here comes the tickle...') then a gentle tickle on the belly or toes.","The pause-and-arrival is what earns the chuckle.","Stop before the chuckle stops sounding like delight."],"signs_it_is_working":"Baby chuckles or shows clear delight; anticipates the tickle with a brightening face before it arrives.","signs_to_stop":"Subtle: laughter becoming high-pitched, gaze aversion. Potent: crying after a laugh. Hold quietly for 30-60 seconds.","adult_role":"Read the delight and stop before it flips to overload.","safety":"No shaking. No tossing.","derivation":"adopted","evidence_note":"CDC Milestone Moments (4 mo): laughs and shows delight when you play together.","sources":["SRC-002"]},{"id":"ACT-0505","title":"Follow-the-baby's-lead engagement","targets":["SE-007"],"supports":["EC-006","SE-002"],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":5,"frequency":"daily","materials":["your presence and attention"],"cost_tier":"free","how_to":["When the baby coos, kicks, or grins to get your attention, respond in kind — coo back, mirror the kick with your own hand, smile.","The baby learns that their sounds and movements bring you close.","Do not initiate every exchange; let some come from the baby.","Answer within a few seconds so the cause-effect is clear."],"signs_it_is_working":"Baby uses sounds, kicks, or facial expressions to draw you in; the exchanges lengthen across weeks.","signs_to_stop":"Subtle: baby stops trying to get your attention. That is often a fatigue signal, not a lasting change. Hold and rest.","adult_role":"Answer their initiations. This is the earliest 'I have agency' lesson.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Adult as Resource Do guide: respond to infant social bids to build early confidence and communicative intent.","sources":["SRC-005"]},{"id":"ACT-0506","title":"Familiar-people attachment support","targets":["SE-009"],"supports":["SE-005","SE-010"],"type":"routine","age_window":{"from_months":5,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["family time"],"cost_tier":"free","how_to":["Give the baby daily face-time with a small stable set of familiar caregivers (parents, grandparents, primary nanny).","Do not force the baby onto unfamiliar arms; let the transition be gradual, at the baby's pace.","The clear preference for familiar people is a healthy attachment milestone, not a problem to fix.","Handoffs within the familiar circle can feel routine, not tense."],"signs_it_is_working":"Baby settles more quickly with familiar adults, protests briefly when handed to less familiar ones, seeks the familiar face when scared.","signs_to_stop":"Subtle: none. Potent: none. Preference for familiar people is normative through 12 months; do not treat it as anxiety to overcome.","adult_role":"Honour the preference. Time introductions to unfamiliar adults with the baby leading.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Attachment Do guide: preference for familiar people is a healthy attachment milestone from around 6 months.","sources":["SRC-005"]},{"id":"ACT-0507","title":"Predictable brief-separation routine","targets":["SE-010"],"supports":["SE-011","SE-026"],"type":"routine","age_window":{"from_months":5,"to_months":15},"duration_minutes":5,"frequency":"daily","materials":["your daily comings and goings"],"cost_tier":"free","how_to":["When you leave the room briefly (bathroom, kitchen), say a consistent short phrase: 'mummy's coming back'.","Come back within the promised time.","When you return, greet warmly.","Never sneak out to avoid a scene; predictability is more soothing than avoidance."],"signs_it_is_working":"Baby may fuss briefly, then settles knowing you will return; over months, the fuss shortens and the trust grows.","signs_to_stop":"Subtle: baby watches the door anxiously; that is age-typical. Potent: prolonged crying after every leave-take. Slow the pace of departures for a while; reassure more.","adult_role":"Be predictable. Do not vanish. Do not make a big drama of the leave-take.","safety":"Never leave a baby alone; ensure another adult or safe space.","derivation":"adopted","evidence_note":"Head Start ELOF Attachment Do guide: brief, predictable separations with reliable returns support secure attachment; separation reactions are normative through toddlerhood.","sources":["SRC-005"]},{"id":"ACT-0508","title":"Respond to the arms-up signal","targets":["SE-012"],"supports":["EC-027","SE-005"],"type":"routine","age_window":{"from_months":5,"to_months":12},"duration_minutes":1,"frequency":"a few times a day","materials":["your arms"],"cost_tier":"free","how_to":["When the baby raises their arms toward you (asking to be picked up), respond.","Say 'up' or 'come here' as you lift them.","The gesture is an early communicative bid; honouring it builds the connection.","Do not test the gesture by ignoring it to see if it strengthens."],"signs_it_is_working":"Baby raises arms toward familiar adults consistently to signal 'pick me up'; the gesture becomes part of the daily social vocabulary.","signs_to_stop":"Subtle: baby stops signalling and only cries. Ensure quick warm responses to arms-up so the gesture stays functional.","adult_role":"Notice and answer. Do not delay to teach patience at this age.","safety":"Support the baby fully as you lift; do not swing.","derivation":"adopted","evidence_note":"CDC Milestone Moments (9 mo): raises arms up to be picked up (originally in EC pool per G-032; landed in SE per phase2_se.md).","sources":["SRC-002"]},{"id":"ACT-0509","title":"Offer-and-give play with a peer or sibling","targets":["SE-028"],"supports":["CG-018","SE-013"],"type":"play","age_window":{"from_months":7,"to_months":18},"duration_minutes":8,"frequency":"daily","materials":["one or two toys; another child, sibling, or a doll acting as receiver"],"cost_tier":"free","how_to":["Sit with the baby and another child (or, if none available, use a doll and yourself in turn).","Model giving a toy to the other child: 'here, for you'.","Wait for the baby to imitate: hold out a toy toward the other child.","Praise the offering itself; do not force the other child to accept if not ready."],"signs_it_is_working":"Baby offers a toy to another child by extending it, sometimes with a smile or vocalisation.","signs_to_stop":"Subtle: baby offers only to you, not other children. That is common until 12+ months. Continue modelling.","adult_role":"Model the offer; do not require the exchange.","safety":"Age-appropriate toys, no small parts.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Peer Interest Do guide: model and reinforce early sharing gestures. Cross-referenced with CG-018 give-and-take (ACT-0415 primary).","sources":["SRC-005"]},{"id":"ACT-0510","title":"Initiate a familiar game","targets":["SE-029"],"supports":["RC-008","CG-015"],"type":"play","age_window":{"from_months":7,"to_months":15},"duration_minutes":5,"frequency":"daily","materials":["your familiar game repertoire (peek-a-boo, pat-a-cake, itsy-bitsy spider)"],"cost_tier":"free","how_to":["Once the baby knows a game well (from ACT-0205, ACT-0412), pause and wait for them to start it.","The baby may cover their own face to invite peek-a-boo, or offer their hands for pat-a-cake, or start clapping the tune.","Respond warmly when they initiate: 'oh! peek-a-boo!'.","The initiation IS the social milestone — it says 'I remember and I want more of this with you'."],"signs_it_is_working":"Baby starts a familiar game with a signature action (covers face, offers hands, starts clapping) without prompting.","signs_to_stop":"Subtle: baby does not initiate by 15 months. Play the games more first; initiation follows familiarity.","adult_role":"Wait for them. Answer warmly when they start.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Peer/Adult Interest Do guide: reciprocal game initiation is a social-emotional milestone by 12-15 months. Third of the game-routine trio (RC-008, CG-015, SE-029).","sources":["SRC-005"]},{"id":"ACT-0511","title":"Slow, respectful introductions to unfamiliar adults","targets":["SE-011"],"supports":["SE-009","SR-012"],"type":"routine","age_window":{"from_months":8,"to_months":18},"duration_minutes":5,"frequency":"weekly","materials":["situations where unfamiliar people are present"],"cost_tier":"free","how_to":["When a new adult approaches (visiting relative, stranger at the shop), keep the baby in your arms or on your lap.","Let the baby watch from safety; do not hand them over.","Ask the other adult not to press with intense eye contact or immediate hands.","Warm-up may take minutes or many visits — that is common."],"signs_it_is_working":"Baby watches strangers with quiet wariness, may hide the face in your shoulder, and warms up over minutes or repeated visits.","signs_to_stop":"Subtle: none. Potent: none. Wariness of strangers is a healthy attachment milestone from about 9-12 months; do not force interaction.","adult_role":"Hold the baby; brief the other adult on slow approach.","safety":"Do not hand a fearful baby to an unfamiliar adult 'to get over it'. That teaches distrust, not comfort.","derivation":"adopted","evidence_note":"Head Start ELOF Attachment Do guide: stranger wariness peaks 9-15 months and is a healthy attachment sign; slow introductions honour it.","sources":["SRC-005"]},{"id":"ACT-0512","title":"Share-what-you-see routine","targets":["SE-013"],"supports":["EC-028","RC-007"],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":3,"frequency":"a few times a day","materials":["walks, window-time, playtime"],"cost_tier":"free","how_to":["When the child notices something interesting, come close and share the look.","When YOU notice something, point it out and check that the child sees.","Take turns bringing each other's attention to interesting things.","This is the foundation of joint attention and social sharing."],"signs_it_is_working":"Child holds up or gives you an object they want to share, points at things across a room to draw you in, checks your face for shared reaction.","signs_to_stop":"Subtle: no sharing behaviour by 15 months. Persistent absence past 18 months is a screening-worthy observation.","adult_role":"Notice, share, name.","safety":"None specific.","derivation":"adopted","evidence_note":"CDC Milestone Moments (15 mo): shows you an object she likes (originally in EC pool per G-032; landed in SE per phase2_se.md).","sources":["SRC-002"]},{"id":"ACT-0513","title":"Copy-another-child playdate","targets":["SE-014"],"supports":["SE-019","CG-016"],"type":"play","age_window":{"from_months":10,"to_months":22},"duration_minutes":15,"frequency":"weekly","materials":["one other child of similar age, and a set of duplicate toys if possible"],"cost_tier":"free","how_to":["Arrange a playdate with a same-age child (or with a sibling or cousin close in age).","Provide duplicate toys where possible so 'copying' does not have to become 'taking'.","Let the children play near each other without directing an interaction; the copying happens naturally.","Adults sit nearby but do not choreograph the play."],"signs_it_is_working":"Child watches another child, tries to do what they are doing, may laugh together at a shared moment.","signs_to_stop":"Subtle: child avoids the other. Do not force interaction; parallel presence is enough at first.","adult_role":"Sit nearby, do not direct.","safety":"No small parts. Adults present to intervene in disputes.","derivation":"adopted","evidence_note":"CDC Milestone Moments (15 mo): copies other children (like taking toys out of a container when they do).","sources":["SRC-002"]},{"id":"ACT-0514","title":"Comfort-object introduction","targets":["SE-015"],"supports":["SR-003","SR-013"],"type":"routine","age_window":{"from_months":8,"to_months":24},"duration_minutes":3,"frequency":"daily","materials":["one soft item the child may adopt as a comfort object (a small blanket, a soft toy, a clean handkerchief)"],"cost_tier":"under_500_inr","india_sourcing_note":"A cotton dohar, a soft cloth doll, or a small stuffed animal. The child chooses which becomes theirs — you cannot force the choice.","how_to":["Offer the same soft object at nap time, bedtime, and moments of distress.","Let the child hold it, sleep with it, drag it around.","Do not remove it because it looks dirty; wash it periodically and return it.","The choice of comfort object is the child's, not yours. Some children never adopt one; that is also common."],"signs_it_is_working":"Child reaches for the comfort object at bedtime and during upset; uses it to self-soothe.","signs_to_stop":"Subtle: child does not adopt the object. That is fine; not every child uses a comfort object. Do not force it.","adult_role":"Offer; honour the choice; do not remove.","safety":"Comfort object small enough not to smother; nothing with buttons, string, or removable parts for the crib.","derivation":"adopted","evidence_note":"Head Start ELOF Self-Regulation Do guide: comfort objects support the transition to independent self-soothing.","sources":["SRC-005"]},{"id":"ACT-0515","title":"Weather-the-tantrum co-regulation","targets":["SE-016"],"supports":["SR-013","SE-020"],"type":"routine","age_window":{"from_months":12,"to_months":36},"duration_minutes":10,"frequency":"weekly","materials":["your calm presence"],"cost_tier":"free","how_to":["When a tantrum starts, ensure the child is safe (nothing to hit their head on, no hazards).","Stay nearby, calm and quiet. Do not lecture, bargain, or shout.","Name the feeling once: 'you are angry that we cannot buy the toy'.","Wait it out. Offer a hug when they can accept one. Do not solve the problem during the tantrum."],"signs_it_is_working":"Tantrums pass within minutes and end with the child accepting comfort; over months, the frequency and intensity drop as language grows.","signs_to_stop":"Subtle: tantrums increase in a specific context (bath, meals). Look for a trigger, adjust the setup. Tantrums are developmentally EXPECTED between 12 and 36 months; they are not misbehaviour.","adult_role":"Present, calm, quiet. Model the regulation the child is learning.","safety":"Move the child away from hazards; do not restrain forcefully unless preventing an injury.","derivation":"adopted","evidence_note":"Head Start ELOF Self-Regulation Do guide: co-regulate through calm presence, safety, and naming the emotion. Tantrums are a normative 12-36 month developmental behaviour.","sources":["SRC-005"]},{"id":"ACT-0516","title":"Social-referencing prompts","targets":["SE-017"],"supports":["RC-007","CG-024"],"type":"routine","age_window":{"from_months":15,"to_months":30},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday new situations"],"cost_tier":"free","how_to":["In an unfamiliar or ambiguous situation (a loud dog barking, a new food, a stranger smiling), the child will look at your face to check for a cue.","Give them a clear face: calm and confident for safe things, alert for genuine hazards.","Do not mask fear about non-hazards — the child reads authentic cues better than performed ones.","Say a short phrase to match: 'the dog is friendly; we can watch from here'."],"signs_it_is_working":"Child looks at your face before approaching or backing away from something new, and takes their cue from what they see.","signs_to_stop":"Subtle: child never checks with you in new situations. Deliberately pause in ambiguous moments so the check has time to happen.","adult_role":"Be honest; match your face to the reality.","safety":"Model realistic caution around real hazards.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Emotional Recognition Do guide: children look to trusted adults for emotional cues in ambiguous situations from ~15 months.","sources":["SRC-005"]},{"id":"ACT-0517","title":"Naming feelings and noticing others","targets":["SE-018"],"supports":["SE-008","EC-016"],"type":"routine","age_window":{"from_months":18,"to_months":36},"duration_minutes":3,"frequency":"a few times a day","materials":["everyday moments involving feelings"],"cost_tier":"free","how_to":["When someone in the family is sad, tired, hurt, or excited, name it out loud: 'papa is tired'; 'didi is upset because her toy broke'.","When the child notices — a look, a pat — acknowledge: 'you saw that she was sad'.","Talk about characters in books the same way: 'the boy looks sad; what could help him'.","Do not require empathy on demand; it grows from noticing being named."],"signs_it_is_working":"Child pauses when someone is hurt or crying, may pat or offer comfort; emotional vocabulary grows.","signs_to_stop":"Subtle: child does not notice. Continue naming; noticing follows exposure. Persistent absence past 30 months is a screening-worthy observation.","adult_role":"Name emotions in daily life. Do not perform emotions to teach; name real ones.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Empathy Do guide: name emotions in the child and others; empathy grows from exposure to named emotional cues.","sources":["SRC-005"]},{"id":"ACT-0518","title":"Assertive-words modelling","targets":["SE-020"],"supports":["EC-014","SE-016"],"type":"routine","age_window":{"from_months":15,"to_months":30},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments of the child protesting"],"cost_tier":"free","how_to":["When the child protests (grabs, cries, hits) to keep something or say no, model the word for the feeling: 'you want to say no'.","Give them the words: 'you can say NO' or 'MINE'.","Do not scold the assertion itself; the milestone is the child claiming a self through language.","Draw the line at the action (no hitting), not the feeling (yes to the no)."],"signs_it_is_working":"Child uses 'no' and 'mine' verbally instead of only hitting or grabbing.","signs_to_stop":"Subtle: child hits without saying anything. Continue modelling the word paired with the action.","adult_role":"Give words to the feeling; set limits on the action, not the assertion.","safety":"Prevent hitting/biting others; separate briefly if needed.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Emotion Expression Do guide: model verbal assertiveness to give the child language for boundary-setting.","sources":["SRC-005"]},{"id":"ACT-0519","title":"Parallel play at a shared table","targets":["SE-019"],"supports":["SE-014","SE-024"],"type":"play","age_window":{"from_months":20,"to_months":32},"duration_minutes":20,"frequency":"weekly","materials":["a shared surface (a low table, a picnic mat) and duplicate sets of a play material (crayons, blocks, playdough)"],"cost_tier":"under_500_inr","how_to":["Set up two children with their own set of the same materials at a shared table.","Let them play alongside each other without directing interaction.","Occasionally comment on what each is doing: 'you are drawing a big line; she is stacking blocks'.","Do not force sharing or turn-taking — parallel play is the milestone here."],"signs_it_is_working":"Children play near each other for several minutes, watching each other's work; occasional glance and copy; no forced cooperation.","signs_to_stop":"Subtle: one child leaves. That is fine; the exposure was the practice.","adult_role":"Set up; sit near; comment lightly.","safety":"Age-appropriate materials.","derivation":"adopted","evidence_note":"CDC Milestone Moments (30 mo): plays next to other children and sometimes plays with them.","sources":["SRC-002"]},{"id":"ACT-0520","title":"Show-and-tell moment for new skills","targets":["SE-021"],"supports":["SE-013","EC-018"],"type":"routine","age_window":{"from_months":22,"to_months":36},"duration_minutes":2,"frequency":"a few times a day","materials":["your attention"],"cost_tier":"free","how_to":["When the child does something new (stacks a taller tower, says a new word, jumps for the first time), notice with warm words: 'you did it — I see you'.","Let them show you again if they want.","The child comes to expect that you notice their achievements; this is the foundation of secure confidence.","Do not overpraise every routine action; save warmth for real firsts."],"signs_it_is_working":"Child seeks out familiar adults after doing something new, waits for the recognition, sometimes says 'look'.","signs_to_stop":"Subtle: child stops showing. Check whether attention is being reliably given.","adult_role":"Notice, name, share. Do not manufacture praise.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Confidence Do guide: warm reliable acknowledgement of the child's efforts builds self-confidence and secure attachment.","sources":["SRC-005"]},{"id":"ACT-0521","title":"Cooperate-with-routine games","targets":["SE-022"],"supports":["SE-027","AD-015"],"type":"routine","age_window":{"from_months":22,"to_months":36},"duration_minutes":5,"frequency":"a few times a day","materials":["everyday routines (mealtime, tidy-up, bath, going out)"],"cost_tier":"free","how_to":["During tidy-up, mealtime setup, or getting-ready-to-go-out routines, give the child a small role: put the plates on the table, drop toys in the basket, bring your own shoes.","Ask, wait, help if needed; praise participation.","Sing a tidy-up song or a routine phrase to signal the change.","Cooperation is easier when the request is small, specific, and paired with a routine."],"signs_it_is_working":"Child cooperates with simple routine requests; over weeks, the initiative grows — the child anticipates and helps.","signs_to_stop":"Subtle: child ignores the request in a specific context. Adjust the ask (smaller, more specific); do not make it a battle.","adult_role":"Ask small; help; celebrate.","safety":"Age-appropriate tasks.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Self-Regulation Do guide: small routine cooperation tasks build self-regulation and belonging.","sources":["SRC-005"]},{"id":"ACT-0522","title":"Naming the preferred playmate","targets":["SE-023"],"supports":["SE-019","EC-022"],"type":"routine","age_window":{"from_months":24,"to_months":40},"duration_minutes":1,"frequency":"weekly","materials":["regular contact with the same one or two other children"],"cost_tier":"free","how_to":["Keep a small stable set of playmates (cousins, neighbours, creche friends).","Talk about them by name across days: 'shall we go to Aarav's house today'; 'you and Meera played with the blocks'.","The naming grows out of familiarity, not from being drilled on names.","Later, ask 'who do you want to play with' and let the child name."],"signs_it_is_working":"Child names a preferred playmate spontaneously; asks about them by name across days.","signs_to_stop":"Subtle: no named preference by 30-33 months. That is fine if the child has few regular peer interactions; increase the frequency if possible.","adult_role":"Use names in ambient conversation.","safety":"None specific.","derivation":"adopted","evidence_note":"Denver PS20 (name playmate, p50 28.3).","sources":["SRC-002"]},{"id":"ACT-0523","title":"Simple cooperative play with another child","targets":["SE-024"],"supports":["SE-019","SE-023","CG-023"],"type":"play","age_window":{"from_months":28,"to_months":42},"duration_minutes":15,"frequency":"weekly","materials":["shared play props that require two (a see-saw, a big block set, a doll one child feeds while another dresses)"],"cost_tier":"free","how_to":["Once the child is comfortable in parallel play, offer materials that reward cooperation: a see-saw needs two; a large block tower needs two hands to hold.","Model the cooperation once: 'we build together — you put here, I put there'.","Step back; let the children negotiate the play.","Intervene only for safety or a clear meltdown."],"signs_it_is_working":"Children take turns, hand each other pieces, and share a goal for a few minutes at a time.","signs_to_stop":"Subtle: children revert to parallel play with occasional conflict. That is common at 24-36 months; cooperation is a growing skill.","adult_role":"Model, step back, intervene minimally.","safety":"Adults present.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Peer Interaction Do guide: model and support early cooperative play by 30-36 months.","sources":["SRC-005"]},{"id":"ACT-0524","title":"Mirror-and-photo self-recognition play","targets":["SE-025"],"supports":["EC-021","CG-016"],"type":"play","age_window":{"from_months":15,"to_months":36},"duration_minutes":5,"frequency":"daily","materials":["a mirror at child height, and photos of the child at different ages"],"cost_tier":"free","how_to":["Sit with the child in front of a mirror.","Point to yourself in the mirror and say 'me'. Point to the child and say their name.","Show photos: 'this is you when you were a baby'.","Over months the child recognises themselves in mirror and photo, using their name or 'me'."],"signs_it_is_working":"Child points to themselves in the mirror or a photo and names themselves.","signs_to_stop":"Subtle: child treats the mirror image as another child. That is common until around 18 months; keep playing.","adult_role":"Name; wait.","safety":"Unbreakable mirror at floor level.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Self-Awareness Do guide: mirror and photo self-recognition emerges 18-24 months and consolidates by 36.","sources":["SRC-005"]},{"id":"ACT-0525","title":"Gradual separation for creche or drop-off","targets":["SE-026"],"supports":["SE-010","SR-013"],"type":"routine","age_window":{"from_months":22,"to_months":42},"duration_minutes":15,"frequency":"daily","materials":["your drop-off routine"],"cost_tier":"free","how_to":["At creche or grandparent drop-offs, establish a short predictable goodbye ritual: hug, say bye, hand over the comfort object, walk out without lingering.","Do not extend or shorten the ritual based on how upset the child is — predictability soothes.","The child usually settles within minutes after the parent has left.","Reunions are consistent and warm."],"signs_it_is_working":"Child settles within minutes of drop-off, resumes engagement with the caregiver or activity; over weeks the initial protest shortens.","signs_to_stop":"Subtle: protracted distress lasting most of the day. Talk to the receiving adult about what settles the child; consider adjusting the transition (later start, shorter days).","adult_role":"Predictable brief goodbye. Do not sneak out.","safety":"Only leave the child with a caregiver you trust and have vetted.","derivation":"adopted","evidence_note":"Head Start ELOF Attachment Do guide: predictable separation and reunion rituals build the child's confidence in the caregiver's return.","sources":["SRC-005"]},{"id":"ACT-0526","title":"Simple-rule play (colours, red-light-green-light)","targets":["SE-027"],"supports":["SE-022","RC-020"],"type":"play","age_window":{"from_months":26,"to_months":42},"duration_minutes":10,"frequency":"daily","materials":["your instruction and a small clear rule"],"cost_tier":"free","how_to":["Play a simple-rule game: 'when I say red, we stop; when I say green, we go'.","Start with one rule; add a second only when the first is reliable.","Follow-the-leader style with 2-3 clear actions works well.","The child learns to hold a rule in mind and act on it, which is the milestone."],"signs_it_is_working":"Child follows the rule for several rounds, corrects themselves when they slip, and understands and mostly follows simple household rules across the day.","signs_to_stop":"Subtle: child cannot hold the rule for a full round. Reduce to one action; slower pace.","adult_role":"Play; keep rules simple.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Social and Emotional Self-Regulation Do guide: simple-rule games (freeze, follow-the-leader) build early rule-holding.","sources":["SRC-005"]},{"id":"ACT-0527","title":"Daily emotion-word narration","targets":["SE-008"],"supports":["SE-017","SE-018","EC-016"],"type":"language","age_window":{"from_months":6,"to_months":42},"duration_minutes":15,"frequency":"ambient","materials":["everyday life"],"cost_tier":"free","how_to":["Name emotions as they happen in the family: 'you are happy that nana came'; 'I am tired after work'; 'she is excited about her birthday'.","Emotions include happy, sad, tired, angry, scared, excited, surprised, calm.","The child hears these words attached to real states across many months.","Over time, the child uses the words themselves and reads them in others."],"signs_it_is_working":"Child uses emotion words to describe themselves and others; range of facial expressions grows and matches situations.","signs_to_stop":"Subtle: child shows only 1-2 expressions. Increase modelling of clear varied expressions in yourself.","adult_role":"Name in daily life. Do not perform emotions to teach; name real ones.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Emotional Expression Do guide: rich emotion-word exposure builds emotional literacy across infancy and toddlerhood.","sources":["SRC-005"]},{"id":"ACT-0540","title":"Hello face when you arrive","targets":["SE-030","SE-005","SE-001"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":5},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Each time you come to him, come into his view first and greet him by name with a smile.","Pause and let him react before picking him up.","Ask other family members to do the same."],"signs_it_is_working":"He brightens, wriggles or quiets when a familiar person approaches, and watches their face.","signs_to_stop":"Startling at an approach; approach more slowly and speak first. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Greet before you lift; give him a moment to respond.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip 'Respond positively to your baby. Act excited, smile, and talk to him' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0541","title":"Face-first pick-ups","targets":["SE-030"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":5},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Before picking him up from sleep or the floor, lean over so he sees your face.","Say 'I'm here, I'm going to pick you up'.","Lift him slowly, keeping your face close."],"signs_it_is_working":"He shows pleasure at seeing you before being lifted.","signs_to_stop":"Startle reflex on lifting; slow down. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him see and hear you first.","safety":"Support head and neck when lifting.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0542","title":"Smile conversations","targets":["SE-002","SE-003","SE-004"],"supports":[],"type":"play","age_window":{"from_months":0,"to_months":5},"duration_minutes":3,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is calm and alert, hold his gaze and smile slowly.","When he smiles, smile back bigger and say something warm.","Keep going while he holds your eye; let him look away to rest."],"signs_it_is_working":"He smiles back at you, smiles on his own, and holds eye contact longer.","signs_to_stop":"Looking away; wait until he looks back. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Match his pace; his look-aways are rests, not rejections.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month milestone 'Smiles when you talk to or smile at her' and its tips (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0543","title":"Delight games","targets":["SE-006","SE-007"],"supports":[],"type":"play","age_window":{"from_months":2,"to_months":6},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Play a simple surprise game: a funny face, a 'boo', a gentle tummy nuzzle.","Pause and wait for him to kick, smile or make a sound to ask for more.","Answer his signal by doing it again."],"signs_it_is_working":"He chuckles and uses sounds and movements to keep you playing.","signs_to_stop":"Stiffening or turning his face away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Pause for his signal; it teaches him he can keep you engaged.","safety":"Gentle play only.","derivation":"adapted","evidence_note":"Adapted from the CDC 4-month milestones and tips on peek-a-boo and responding to the baby (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0544","title":"Low mirror","targets":["SE-031"],"supports":[],"type":"environment","age_window":{"from_months":2,"to_months":12},"duration_minutes":0,"frequency":"ambient","materials":["an unbreakable mirror"],"cost_tier":"under_500_inr","how_to":["Fix an unbreakable mirror low on the wall, or stand one beside his floor mat.","During tummy time and floor play, let him look into it.","Sometimes sit at his back so he sees you both."],"signs_it_is_working":"He looks at his reflection with interest, smiles or pats it.","signs_to_stop":"No interest; that's fine — it is there when he wants it. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Set it up; no need to point it out every time.","safety":"Unbreakable mirror only, fixed firmly.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip on a baby-safe mirror (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0545","title":"Mirror peek and name","targets":["SE-031"],"supports":[],"type":"play","age_window":{"from_months":4,"to_months":12},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Hold him in front of a mirror and say 'who's that? It's ...!' with his name.","Touch his nose and say 'nose' while he watches in the mirror.","Move out of view and back in: 'here's Mama!'."],"signs_it_is_working":"He smiles, pats or talks to his reflection.","signs_to_stop":"Turning away from the mirror. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep it light and short.","safety":"Hold him securely.","derivation":"adapted","evidence_note":"Adapted from the CDC 6-month milestone 'Likes to look at self in a mirror' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0546","title":"Warm-up for new people","targets":["SE-009","SE-011"],"supports":[],"type":"routine","age_window":{"from_months":5,"to_months":15},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When someone new visits, hold him on your lap and talk with the visitor first.","Let the visitor offer a toy from a little distance rather than picking him up.","Let him decide when to go closer."],"signs_it_is_working":"He shows he prefers familiar people and is wary of strangers, then warms up in his own time.","signs_to_stop":"Clinging and crying; keep him with you and ask the visitor to wait. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be his safe base; do not hand him over before he is ready.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'Give your baby time to get to know a new caregiver.' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0547","title":"Cheerful goodbyes","targets":["SE-010"],"supports":[],"type":"routine","age_window":{"from_months":6,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When you leave the room or the house, say a short cheerful goodbye instead of slipping away.","Tell him you will come back, and greet him when you do.","Keep the goodbye the same each time."],"signs_it_is_working":"He reacts when you leave (looks, reaches, cries) and settles faster over time because goodbyes are predictable.","signs_to_stop":"Long distress after you leave; make goodbyes shorter, not sneakier. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Say goodbye and go; do not linger or sneak out.","safety":"Leave him with a known adult.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on cheerful goodbyes (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0548","title":"Arms-up lift","targets":["SE-012"],"supports":[],"type":"routine","age_window":{"from_months":4,"to_months":12},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Before picking him up, hold your arms out and say 'up?'.","Wait a moment for him to lift his arms toward you.","Lift him as soon as he does (or after a short pause if he doesn't)."],"signs_it_is_working":"He raises his arms to ask to be picked up.","signs_to_stop":"Fussing during the pause; lift him straight away. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer the gesture and a short pause; never leave him waiting when distressed.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month milestone 'Lifts arms up to be picked up' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0549","title":"Show and tell back","targets":["SE-013"],"supports":["EC-028"],"type":"play","age_window":{"from_months":9,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he holds something up to show you, stop and respond warmly: 'Oh, you found a spoon!'.","Look at it with him before handing it back.","Show him things too: 'look what I found'."],"signs_it_is_working":"He shows or brings you things more often to share them.","signs_to_stop":"Showing with no response over days; make sure someone answers. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Answer every show. Do not take the object away unless it is unsafe.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month milestone 'Shows you an object she likes' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0550","title":"Side-by-side playdates","targets":["SE-014","SE-028"],"supports":[],"type":"outing","age_window":{"from_months":9,"to_months":24},"duration_minutes":30,"frequency":"weekly","materials":["nothing extra"],"cost_tier":"free","how_to":["Meet another young child regularly — a cousin, a neighbour's child.","Give them similar toys and sit nearby.","Notice and name kind moments: 'you gave him the ball!'."],"signs_it_is_working":"He watches and copies the other child and sometimes offers them a toy.","signs_to_stop":"Grabbing and crying; give each child their own toy and a little space. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Stay close; do not force sharing at this age.","safety":"Supervise closely; toddlers push and pull.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip on monitoring playdates, as toddlers play alongside each other (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0551","title":"Comfort object at sleep","targets":["SE-015"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":24},"duration_minutes":0,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["If he has a favourite soft cloth or toy, include it in the bedtime routine.","Offer it when he is upset, along with your comfort.","Keep a spare if it is very important to him."],"signs_it_is_working":"He reaches for his comfort object when tired or upset and calms with it.","signs_to_stop":"Not interested; some children do not use a comfort object, and that is fine. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer, never force. It adds to your comfort, it does not replace it.","safety":"For babies under 12 months, keep soft toys out of the cot during sleep.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip on supporting self-soothing (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0552","title":"Riding out a tantrum","targets":["SE-016"],"supports":[],"type":"routine","age_window":{"from_months":12,"to_months":36},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When a tantrum starts, stay close and calm; keep him safe.","Say little: 'you're very angry. I'm here.'","When it passes, offer a hug and move on without a lecture."],"signs_it_is_working":"Tantrums happen, then get shorter over the months as he gets words for his feelings.","signs_to_stop":"Hurting himself or others; move him gently to a safe spot and hold him if he accepts it. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Stay calm and present; do not give in to the demand or punish the feeling.","safety":"Move hard or sharp things away.","derivation":"adapted","evidence_note":"Adapted from the CDC 15- and 18-month tips 'Expect tantrums' and 'Create a spot in your home for your child to go to when he's upset' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0553","title":"New place, check my face","targets":["SE-017","SE-035"],"supports":[],"type":"outing","age_window":{"from_months":12,"to_months":26},"duration_minutes":20,"frequency":"weekly","materials":["nothing extra"],"cost_tier":"free","how_to":["In a new place (a park, a relative's house), let him move away to explore while you stay put.","When he looks back at you, smile and nod: 'go on, it's fine'.","Stay where he can find you easily."],"signs_it_is_working":"He explores and checks your face for how to react, then carries on.","signs_to_stop":"Clinging; let him stay on your lap until ready. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be the steady base; your face tells him it's safe. Do not follow him everywhere.","safety":"Safe, enclosed space; keep him in sight.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month milestone 'Moves away from you, but looks to make sure you are close by' and the 2-year 'Looks at your face to see how to react' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0554","title":"Park explorer","targets":["SE-035"],"supports":[],"type":"outing","age_window":{"from_months":12,"to_months":24},"duration_minutes":20,"frequency":"weekly","materials":["nothing extra"],"cost_tier":"free","how_to":["Take him to a park or open courtyard and sit on a bench or mat.","Let him wander off and come back as he likes.","Welcome him each time he returns."],"signs_it_is_working":"He goes a little further each time and comes back or checks in.","signs_to_stop":"Staying glued to you; that is fine — try again another day. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Stay still and welcoming; the returning is as important as the exploring.","safety":"Enclosed area away from roads and water.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0555","title":"Naming others' feelings","targets":["SE-018"],"supports":[],"type":"language","age_window":{"from_months":15,"to_months":30},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When another child cries, say: 'she's sad, she fell down'.","In books, name the characters' feelings.","Show him a kind response: 'shall we give her the ball?'."],"signs_it_is_working":"He notices when someone is upset — pauses, looks sad, or offers something.","signs_to_stop":"Upset himself by the crying; move away and comfort him. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name the feeling and model kindness; do not force an apology or a hug.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Help your child learn about others' feelings and about positive ways to react' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0556","title":"Two-choice offers","targets":["SE-020"],"supports":[],"type":"routine","age_window":{"from_months":15,"to_months":30},"duration_minutes":0,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Offer two acceptable choices: 'red cup or blue cup?'.","Accept 'no', 'mine' and 'this one' as real answers.","Keep the choices small and real."],"signs_it_is_working":"He says what he wants, including 'no' and 'mine'.","signs_to_stop":"Refusing both; pick one calmly yourself. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give real, limited choices. Do not offer a choice you cannot honour.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Give simple choices. Let your child choose between two things' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0557","title":"His turn to start","targets":["SE-029"],"supports":[],"type":"play","age_window":{"from_months":7,"to_months":15},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Play a game he knows (peek-a-boo, clapping), then stop and wait.","Watch for him to start it: covering his face, clapping.","Join in as soon as he does."],"signs_it_is_working":"He starts familiar games himself.","signs_to_stop":"Wandering off; start the game again yourself. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Wait, and follow his start.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Play simple games where both of you have a part to play' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0558","title":"Clap for joy","targets":["SE-032"],"supports":[],"type":"play","age_window":{"from_months":9,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When something good happens (he stacks a block, Papa comes home), clap and cheer.","Say 'yay!' with a big smile.","Notice and answer when he claps on his own."],"signs_it_is_working":"He claps spontaneously when excited or pleased.","signs_to_stop":"Covering his ears at loud cheering; clap more softly. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model the joy; do not ask him to clap.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month milestone 'Claps when excited' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0559","title":"Music and dance","targets":["SE-032"],"supports":["GM-028"],"type":"play","age_window":{"from_months":9,"to_months":24},"duration_minutes":10,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Put on music he likes and dance with him in your arms or holding his hands.","Clap to the beat and stop when the music stops.","Let him choose songs by pointing or bouncing."],"signs_it_is_working":"He bounces, claps and shows excitement to music.","signs_to_stop":"Covering his ears or turning away; lower the volume. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Enjoy it together; no need to teach steps.","safety":"Keep volume moderate.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip on playing music and dancing together (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0560","title":"Caring for a soft toy","targets":["SE-033"],"supports":[],"type":"play","age_window":{"from_months":10,"to_months":20},"duration_minutes":5,"frequency":"daily","materials":["a soft toy or cloth doll"],"cost_tier":"free","how_to":["Give him a soft toy and hug it yourself: 'teddy needs a hug'.","Let him hug, carry and pat it.","Include the toy in routines: teddy has a bath, teddy sleeps."],"signs_it_is_working":"He hugs and cares for the soft toy.","signs_to_stop":"Throwing the toy; that's fine — try another toy another day. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model care; do not insist.","safety":"Soft toy without loose eyes or buttons.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip 'Practice pretend play with stuffed animals' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0561","title":"Tuck teddy in","targets":["SE-033","SE-034"],"supports":[],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["At bedtime, let him put his soft toy to bed with a hug and a pat.","Say goodnight to teddy, then to him with a hug and a kiss.","Let him give goodnight hugs to family members if he wants to."],"signs_it_is_working":"He hugs his toy and offers hugs and kisses to family.","signs_to_stop":"Refusing hugs; never force affection. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model affection; let him choose whether to give it.","safety":"Soft toy out of the cot if he is under 12 months.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-002"]},{"id":"ACT-0562","title":"Hugs on his terms","targets":["SE-034"],"supports":[],"type":"play","age_window":{"from_months":9,"to_months":20},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["Offer hugs and cuddles often, with open arms, and let him come to you.","When he offers a hug or kiss, respond warmly.","Name it: 'thank you for the hug'."],"signs_it_is_working":"He offers hugs, cuddles or kisses on his own.","signs_to_stop":"Pulling away; respect it and offer again later. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer; never demand affection.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month milestone 'Shows you affection (hugs, cuddles, or kisses you)' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0563","title":"Show me what you want","targets":["SE-036"],"supports":["EC-027"],"type":"play","age_window":{"from_months":10,"to_months":20},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he fusses for something you cannot see, say 'show me'.","Hold out your hand and let him lead you.","Name what he wanted when you get there."],"signs_it_is_working":"He takes your hand and leads you to what he wants.","signs_to_stop":"Crying harder; try guessing aloud. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Follow his lead; name it for him.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from ELOF IT-SE 3 (8-18 months) on taking the adult's hand to lead them to something wanted. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0564","title":"Wait for the lead","targets":["SE-036"],"supports":[],"type":"play","age_window":{"from_months":12,"to_months":20},"duration_minutes":3,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Put a favourite toy where he can see it but not reach it (on a shelf).","Sit nearby and wait instead of offering help.","When he comes to get you, go with him and get it down together."],"signs_it_is_working":"He comes to get you and leads you to what he wants.","signs_to_stop":"Crying without trying to get you; go to him and ask 'what do you want?'. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Wait a little before helping so he can come to you.","safety":"Nothing heavy on the shelf.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0600","title":"Bringing food to the mouth by self","targets":["AD-001"],"supports":["FM-005","CG-008"],"type":"routine","age_window":{"from_months":4,"to_months":10},"duration_minutes":15,"frequency":"daily","materials":["a soft finger food (soft banana slice, boiled soft matar, cooked pasta)","a wipeable seat"],"cost_tier":"free","india_sourcing_note":"Boiled soft moong dal, banana bits, and small paneer cubes are classic Indian starter finger foods.","how_to":["Once the baby can sit with support (around 5-6 months), sit them in a high chair or on your lap during your meal.","Place a soft safe piece on the tray in front of them.","Let them grasp and bring it to the mouth themselves. The messy exploration is the point.","Do not pop pieces into their mouth; the self-hand-to-mouth is the milestone."],"signs_it_is_working":"Baby picks up food with the hand, brings it to the mouth, and mouths it deliberately.","signs_to_stop":"Subtle: baby loses interest quickly. Potent: gagging, coughing. Remove the food and take a break; check the size and softness.","adult_role":"Provide safe pieces; do not feed for them.","safety":"Sit-up-and-supervised only. No round hard foods (whole grape, whole nut, chunk of raw carrot). Never propped bottle-feeding.","derivation":"adopted","evidence_note":"CDC Milestone Moments (6 mo): brings things to the mouth. Denver PS6 (feed self, p50 5.9).","sources":["SRC-002"]},{"id":"ACT-0601","title":"Self-hold-the-bottle routine","targets":["AD-003"],"supports":["FM-005","FM-007"],"type":"routine","age_window":{"from_months":6,"to_months":13},"duration_minutes":10,"frequency":"daily","materials":["the baby's usual bottle"],"cost_tier":"free","how_to":["During an ordinary bottle feed, once the baby is sitting up in your lap or a high chair, offer the bottle at the right height.","Guide their hands to the bottle sides; let them hold while you support underneath.","Over weeks, ease your support so the baby holds the bottle themselves.","Do not use the bottle-hold as a chance to walk away — the baby still needs your presence."],"signs_it_is_working":"Baby holds their own bottle steadily for most of a feed; by 12 months, holds it independently start to finish.","signs_to_stop":"Subtle: baby drops the bottle repeatedly. Continue guiding; strength builds.","adult_role":"Guide, then release, but stay present.","safety":"Never prop-bottle-feed (choking, ear infection, dental risk). Never leave the baby alone with a bottle.","derivation":"adopted","evidence_note":"Dosman self-care 12 mo limit-age marker for bottle-hold. Sitting position guidance from ELOF Health, Safety, Nutrition Do guide.","sources":["SRC-004","SRC-005"]},{"id":"ACT-0602","title":"Cup held by an adult during meals","targets":["AD-004"],"supports":["AD-005","CG-009"],"type":"routine","age_window":{"from_months":6,"to_months":12},"duration_minutes":5,"frequency":"daily","materials":["a small open cup (a stainless-steel katori works well) and a small amount of water or milk"],"cost_tier":"free","india_sourcing_note":"A small steel katori tilted slowly toward the baby lips is the traditional Indian first-cup approach, simpler than a sippy cup and skips a transition.","how_to":["Sit the baby upright.","Hold the small cup to the baby lips; tip slowly so a tiny amount of liquid touches the lip.","Let the baby sip; the mouth learns the cup shape.","Small amounts, many meals. Spilling is expected."],"signs_it_is_working":"Baby opens mouth for the cup, sips, and swallows most of what enters.","signs_to_stop":"Subtle: baby turns head away. Potent: coughing, spitting up. Slow the tilt or wait a few days.","adult_role":"Hold the cup; you set the pace.","safety":"No forcing liquid into the mouth. Watch for cough and pause.","derivation":"adopted","evidence_note":"Denver PS12 (drink from cup or glass, p50 11.8). Direct-to-cup skipping the sippy stage is common Indian practice.","sources":["SRC-002"]},{"id":"ACT-0603","title":"Open cup with spills allowed","targets":["AD-005"],"supports":["AD-004","AD-006","FM-005"],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":8,"frequency":"daily","materials":["a small open cup (steel katori or a small plastic cup) with a small amount of water"],"cost_tier":"free","india_sourcing_note":"A shot-glass-sized steel katori or a small chai cup works well for early self-cup drinking.","how_to":["Sit the baby with a bib in a spillable spot.","Fill the cup a third full with water.","Hand it to the baby with both hands guided to the cup.","Let them drink; expect spills. Refill and repeat rather than restricting drinks."],"signs_it_is_working":"Baby holds the cup with both hands, tips it to the mouth, and gets most of the water down.","signs_to_stop":"Subtle: throwing the cup after a sip. Potent: crying. Return to adult-held cup for another few weeks.","adult_role":"Fill; hand over; refill. Do not steady the cup for them.","safety":"Water only for early practice. Small volumes so a spill is not a mess crisis.","derivation":"adopted","evidence_note":"Denver PS12 (drink from cup) — the 25th percentile at 9.7 mo means many children hold and drink from a cup by their first birthday.","sources":["SRC-002"]},{"id":"ACT-0604","title":"Well-controlled cup drinking","targets":["AD-006"],"supports":["AD-005","FM-005"],"type":"routine","age_window":{"from_months":24,"to_months":40},"duration_minutes":5,"frequency":"daily","materials":["a small open cup with any beverage (water, milk, dal ka pani)"],"cost_tier":"free","how_to":["By 3 years, most children manage a small open cup with minimal spills.","Offer an ordinary small cup at meals (no sippy or straw).","Do not fill to the top; a third-full cup is safer to control.","Refill often rather than fill fully."],"signs_it_is_working":"Child drinks from an open cup with almost no spilling; sets the cup down carefully.","signs_to_stop":"Subtle: still frequent spills at 30-36 months. Continue practice; some spilling is expected until 3 years.","adult_role":"Hand over full-child cup, no lid.","safety":"No glass at the table with a toddler.","derivation":"adopted","evidence_note":"Dosman self-care 36 mo limit-age marker for well-controlled cup drinking (Level A).","sources":["SRC-004"]},{"id":"ACT-0605","title":"Reliable finger-food self-feeding","targets":["AD-002"],"supports":["FM-010","FM-012","AD-001"],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":20,"frequency":"daily","materials":["a plate of small soft food pieces the child can pincer-pick (small paneer cubes, matar, small pasta, small roti pieces)"],"cost_tier":"free","india_sourcing_note":"A small thali with 4-5 soft finger foods (paneer, matar, boiled aloo, cheela pieces, cooked chawal) is a full self-feeding meal.","how_to":["Serve a small variety of soft pieces on the child's plate.","Sit alongside and eat your own meal.","Let the child pick and eat at their own pace.","If the child stops eating, take the plate away without pressure."],"signs_it_is_working":"Child reliably self-feeds most of a small meal with pincer grasp; gets most of the food to the mouth.","signs_to_stop":"Subtle: throwing food after a period of eating means the meal is done. Potent: gagging warrants smaller pieces.","adult_role":"Serve; sit with; do not spoon-feed as a shortcut. Ownership of eating is the milestone.","safety":"Sit-up-and-supervised. Choking-safe sizes.","derivation":"adopted","evidence_note":"CDC Milestone Moments (18 mo): tries to use a spoon; self-feeds finger foods. Dosman 18 mo self-care limit-age marker for reliable self-feeding (Level A).","sources":["SRC-002","SRC-004"]},{"id":"ACT-0606","title":"Spoon-trying introduction","targets":["AD-007"],"supports":["AD-008","FM-005","FM-013"],"type":"routine","age_window":{"from_months":12,"to_months":22},"duration_minutes":15,"frequency":"daily","materials":["a small child-sized spoon and a thicker food (dahi, dal, khichdi, mashed sabzi)"],"cost_tier":"under_500_inr","india_sourcing_note":"A small steel spoon (baby-sized) and a bowl of thick dahi or khichdi lets a child practice — thick foods stay on the spoon better than thin ones.","how_to":["Sit the child at their meal with a small bowl of thick food and a spoon.","Load the spoon for them the first few times; hand it over.","Let them try; the spoon will tip, food will fall, that is the practice.","Alternate: they scoop themselves, or you load and hand over."],"signs_it_is_working":"Child holds the spoon, scoops or gets loaded food to the mouth, and looks proud of the achievement.","signs_to_stop":"Subtle: throws the spoon. Potent: refuses spoon and demands hands. Try a stickier food or wait a few weeks.","adult_role":"Model, load, hand over. Do not spoon-feed them all the time or spoon competence is delayed.","safety":"No sharp-edge cutlery. Sit-up-and-supervised.","derivation":"adopted","evidence_note":"CDC Milestone Moments (18 mo): tries to use a spoon.","sources":["SRC-002"]},{"id":"ACT-0607","title":"Spoon mostly independent","targets":["AD-008"],"supports":["AD-007","AD-009","FM-012"],"type":"routine","age_window":{"from_months":13,"to_months":26},"duration_minutes":20,"frequency":"daily","materials":["the child's own small spoon and their usual meal"],"cost_tier":"free","how_to":["At each meal, hand the child their spoon and their bowl or plate.","Sit alongside eating your own meal.","Do not spoon-feed unless they specifically ask, or for very thin foods (soup).","Praise the effort more than the neatness."],"signs_it_is_working":"Child eats most of a meal with the spoon; still some mess, but the eating is theirs.","signs_to_stop":"Subtle: reverting to hands for a specific food. That is fine; hands are always allowed.","adult_role":"Hand over the tool; step back.","safety":"No sharp-edge cutlery; supervised sitting.","derivation":"adopted","evidence_note":"Denver PS14 (eats using spoon/fork/fingers, p50 14.5). Dosman 24 mo limit-age marker for reliable spoon use.","sources":["SRC-002","SRC-004"]},{"id":"ACT-0608","title":"Spoon-and-fork mastery","targets":["AD-009"],"supports":["AD-008","FM-012"],"type":"routine","age_window":{"from_months":24,"to_months":40},"duration_minutes":20,"frequency":"daily","materials":["a small spoon and a small child-sized fork (blunt tines)"],"cost_tier":"under_500_inr","india_sourcing_note":"Small child-sized cutlery sets (Fisher-Price, IKEA, several Indian brands) at INR 200-500. Or use a small salad fork with blunt tines from the family cutlery.","how_to":["By 30-36 months, offer both a spoon and a fork at meals.","Model when each is easier: fork for pasta, roti pieces; spoon for rice, dal, dahi.","Let the child choose which tool to use.","Do not correct the tool choice; the mastery is the flexibility, not the etiquette."],"signs_it_is_working":"Child uses spoon and fork appropriately by 3 years; eats most of a meal with minimal spill and adult help.","signs_to_stop":"Subtle: only-fingers preference persisting. That is culturally fine for some foods; do not force a tool.","adult_role":"Offer both tools; model use; do not correct choice.","safety":"Blunt-tine forks at this age.","derivation":"adopted","evidence_note":"Dosman self-care 36 mo limit-age marker for spoon-and-fork mastery (Level A).","sources":["SRC-004"]},{"id":"ACT-0609","title":"Cooperate-with-dressing scaffolding","targets":["AD-013"],"supports":["AD-015","SE-022"],"type":"routine","age_window":{"from_months":8,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["the child's usual clothes"],"cost_tier":"free","how_to":["During everyday dressing, invite the child to help: 'give me your arm'; 'lift your foot'; 'push through'.","Wait for them to do the small part before you do the rest.","Sing the same dressing song each time — predictability makes cooperation easier.","Praise the specific participation: 'you pushed your arm through'."],"signs_it_is_working":"Child anticipates and does small dressing steps: extends arms, lifts feet, pushes head through.","signs_to_stop":"Subtle: child stiffens when dressing time comes. Potent: crying, refusing. Check for a shirt that pulls too tight over the head; offer choice ('red shirt or blue shirt today').","adult_role":"Wait, invite, praise. Do not do it all at speed and skip their part.","safety":"No tight collars over the face.","derivation":"adopted","evidence_note":"Dosman 24 mo limit-age marker for cooperation with dressing (Level A).","sources":["SRC-004"]},{"id":"ACT-0610","title":"Remove hat and socks first","targets":["AD-010"],"supports":["AD-011","FM-005"],"type":"routine","age_window":{"from_months":12,"to_months":26},"duration_minutes":3,"frequency":"daily","materials":["the child's socks or a soft cap"],"cost_tier":"free","how_to":["After a walk or when coming home, sit with the child and invite them to pull off their own hat or socks.","Get the sock started around the heel; let the child pull it off.","Praise the removal; hand them the hat for the next round.","Undressing before dressing — removal is easier and comes first."],"signs_it_is_working":"Child pulls off a hat or a loose sock independently.","signs_to_stop":"Subtle: child needs the sock started every time. That is fine at first; the starting-help fades.","adult_role":"Start the sock; let them finish.","safety":"No socks over strings or ties around the ankle.","derivation":"adopted","evidence_note":"Denver PS15 (remove garment, p50 20.4). CDC 15-18 mo tips also cite this.","sources":["SRC-002"]},{"id":"ACT-0611","title":"Undressing loose clothing","targets":["AD-011"],"supports":["AD-010","AD-012"],"type":"routine","age_window":{"from_months":20,"to_months":34},"duration_minutes":5,"frequency":"daily","materials":["the child's loose clothing (pyjama pants with elastic, loose t-shirt, drawstring shorts)"],"cost_tier":"free","how_to":["At bedtime or bath time, invite the child to take off their own loose clothes.","Start with pants (elastic waist, straight pull-down); shirt comes later.","Give them time; do not rush the undressing.","Praise the completion; help with the head-tricky moment on a shirt if needed."],"signs_it_is_working":"Child takes off pants and later t-shirt without help; sometimes struggles with heads and sleeves.","signs_to_stop":"Subtle: child gives up mid-undress. Help just the stuck bit; do not take over.","adult_role":"Invite, wait, help the stuck bit.","safety":"Loose clothing only for early practice.","derivation":"adopted","evidence_note":"CDC Milestone Moments (30 mo): takes off some clothes by themselves.","sources":["SRC-002"]},{"id":"ACT-0612","title":"Undresses fully","targets":["AD-012"],"supports":["AD-011"],"type":"routine","age_window":{"from_months":28,"to_months":40},"duration_minutes":5,"frequency":"daily","materials":["the child's own clothes"],"cost_tier":"free","how_to":["By 36 months, most children manage a full undressing session — shoes off, socks off, pants off, shirt off.","Give them the time; a full undress can take several minutes.","Do not do parts as a shortcut; the sequence-mastery is the point.","Put out a small basket for the removed clothes to go into."],"signs_it_is_working":"Child undresses fully — shoes, socks, pants, shirt — on their own within reasonable time.","signs_to_stop":"Subtle: consistently gets stuck on one item (shoes with straps, tight shirt). Change to easier versions of that item.","adult_role":"Wait, do not step in.","safety":"No small shoe parts (small buckles the child could pull off); no ribbons.","derivation":"adopted","evidence_note":"Dosman self-care 36 mo limit-age marker for full undressing (Level A).","sources":["SRC-004"]},{"id":"ACT-0613","title":"Put-on-clothing early attempts","targets":["AD-014"],"supports":["AD-013","AD-012"],"type":"routine","age_window":{"from_months":22,"to_months":40},"duration_minutes":10,"frequency":"daily","materials":["easy-to-put-on items (elastic-waist pants, hat, loose slip-on shoes, pull-on cardigan)"],"cost_tier":"free","how_to":["Offer easier items first: pull-on hat, wide-mouth cap, slip-on shoes on the correct feet.","Let the child try; help with the tricky-first-arm on a jacket if needed.","Praise the completion, not the correctness (shirt backwards is fine).","Choose clothes with big openings and no small buttons for practice."],"signs_it_is_working":"Child puts on a hat, coat, or shoes; sequence gets better across months.","signs_to_stop":"Subtle: child gives up. Simplify to one item at a time.","adult_role":"Offer easy items; wait; help the stuck bit only.","safety":"No small choking buttons; correctly-sized shoes.","derivation":"adopted","evidence_note":"Denver PS17 (put on clothing, p50 31.8; p90 lost to schema cap per G-072). CDC 30 mo tips cite this too.","sources":["SRC-002"]},{"id":"ACT-0614","title":"Cooperates in daily care routines","targets":["AD-015"],"supports":["AD-013","SE-022","SR-018"],"type":"routine","age_window":{"from_months":10,"to_months":26},"duration_minutes":5,"frequency":"a few times a day","materials":["the day's usual routines"],"cost_tier":"free","how_to":["During bath, diaper change, or dressing, ask the child to help: 'hold this'; 'lift'; 'open your mouth'.","Wait for their part before you do the next step.","Sing a routine song for each recurring event so the child anticipates and cooperates.","Praise the specific cooperation."],"signs_it_is_working":"Child cooperates with routines: holds still for wipe, lifts arm for shirt, opens mouth for toothbrush.","signs_to_stop":"Subtle: cooperation drops in one specific routine. Simplify or offer choice.","adult_role":"Ask small; wait; praise.","safety":"None specific beyond routine safety.","derivation":"adopted","evidence_note":"Head Start ELOF Perceptual, Motor, and Physical Development Do guide (Healthy Behaviors): scaffold self-help routines through active child cooperation.","sources":["SRC-005"]},{"id":"ACT-0615","title":"Holds toothbrush during brushing","targets":["AD-017"],"supports":["AD-018","FM-005"],"type":"routine","age_window":{"from_months":10,"to_months":22},"duration_minutes":3,"frequency":"daily","materials":["a small child-sized toothbrush"],"cost_tier":"under_500_inr","india_sourcing_note":"Colgate, Pigeon, Chicco all sell child toothbrushes with small heads for INR 60-200.","how_to":["At tooth-brushing time, hand the child their toothbrush and let them hold it.","You can guide their hand or brush their teeth with a second brush.","Sing a two-minute brushing song so the routine has a clear duration.","The holding IS the milestone; brushing well comes later."],"signs_it_is_working":"Child holds the toothbrush during brushing, sometimes brushes their own teeth in a rough way.","signs_to_stop":"Subtle: child chews the brush. That is fine; they still hold it. Give a second brush for brushing.","adult_role":"Hand over their brush; sing the timing song; brush their teeth with another brush.","safety":"No fluoride toothpaste until dentist-recommended age (usually with the first tooth or 12 mo). Small pea-size amount from 3 years.","derivation":"adopted","evidence_note":"Head Start ELOF Health Do guide: give infants and toddlers their own toothbrush to hold during brushing.","sources":["SRC-005"]},{"id":"ACT-0616","title":"Brushes teeth with adult supervision","targets":["AD-018"],"supports":["AD-017"],"type":"routine","age_window":{"from_months":22,"to_months":42},"duration_minutes":3,"frequency":"daily","materials":["small toothbrush, small pea of child-safe toothpaste"],"cost_tier":"under_500_inr","how_to":["Twice a day (morning and night), the child brushes their own teeth while you supervise.","Adult then does a follow-up brush of all surfaces the child missed — this is standard practice until at least 7 years.","Sing the two-minute song so the child knows the duration.","Make it a routine, not a battle."],"signs_it_is_working":"Child brushes their teeth twice a day, using the brush on most surfaces; accepts the adult follow-up.","signs_to_stop":"Subtle: child refuses one brushing. Try a favourite flavour; a different brush colour. Not doing all of it is fine at this age with the adult follow-up.","adult_role":"Supervise, then finish. The adult finish is the hygiene milestone; the child's brushing is the self-care one.","safety":"Pea-size fluoride toothpaste from 3 years (per AAP/CDC). Adult follow-up until at least 7 years.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide (IT-PMP 9-10). Standard AAP guidance for early tooth brushing.","sources":["SRC-005"]},{"id":"ACT-0617","title":"Handwashing routine before meals and after toilet","targets":["AD-016"],"supports":["AD-015","SE-022"],"type":"routine","age_window":{"from_months":14,"to_months":36},"duration_minutes":2,"frequency":"a few times a day","materials":["soap and running water; a stool for reach"],"cost_tier":"under_500_inr","india_sourcing_note":"A small folding wooden stool from any Indian household shop (INR 200-400) lets the child reach the tap.","how_to":["Before every meal and after every diaper change, wash the child's hands together.","Model the sequence: wet — soap — rub for 20 seconds — rinse — dry.","Sing a 20-second song so the rubbing has a duration.","Over months, the child takes over more of the sequence."],"signs_it_is_working":"Child comes to the sink for handwashing without a full reminder; does most of the wet-soap-rub-rinse sequence with adult support.","signs_to_stop":"Subtle: child refuses handwashing. Try a different soap smell or a fun song. Water temperature comfortable.","adult_role":"Model, sing, supervise. Never leave alone at the tap.","safety":"Comfortable warm water. Never leave a child alone with a running tap or in a bathroom.","derivation":"adopted","evidence_note":"Denver PS19 (wash and dry hands, p50 27.4). CDC and AAP handwashing guidance is core public-health content.","sources":["SRC-002"]},{"id":"ACT-0618","title":"Wipe-mouth-after-eating routine","targets":["AD-020"],"supports":["AD-015"],"type":"routine","age_window":{"from_months":15,"to_months":30},"duration_minutes":1,"frequency":"a few times a day","materials":["a napkin or a soft cloth after every meal"],"cost_tier":"free","how_to":["After every meal, hand the child a napkin or a soft wet cloth.","Say 'wipe your mouth'.","Wait for the child to try; help finish if needed.","Over months, the child wipes without prompt."],"signs_it_is_working":"Child accepts the mouth-wipe or wipes their own mouth after a meal; the routine consolidates by 24-28 months.","signs_to_stop":"Subtle: refuses the wipe. Offer a favourite napkin, or wipe your own mouth in a big performance first.","adult_role":"Hand the cloth; wait; finish.","safety":"Clean cloth; no rough wiping.","derivation":"adopted","evidence_note":"Denver PS18 (wash mouth with help, p50 24.8).","sources":["SRC-002"]},{"id":"ACT-0619","title":"Blow-nose-with-help routine","targets":["AD-019"],"supports":["AD-015"],"type":"routine","age_window":{"from_months":15,"to_months":36},"duration_minutes":1,"frequency":"a few times a day","materials":["soft tissues"],"cost_tier":"free","how_to":["When the child's nose is running or blocked, offer a tissue.","Show the blow: 'like this — puff out through your nose'.","Hold the tissue for them the first many times; the child learns the puff-out action first, the tissue-holding later.","Wash hands after."],"signs_it_is_working":"Child accepts the tissue, tries the nose blow, and eventually blows the nose with the tissue held for them.","signs_to_stop":"Subtle: child refuses tissue. Try a soft cotton hanky; be brief; do not force.","adult_role":"Model, hold, wash after.","safety":"Never force a tissue up the nose. Do not blow both nostrils at once at this age.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide (IT-PMP 9): early hygiene routines including nose-care.","sources":["SRC-005"]},{"id":"ACT-0620","title":"Help-with-household participation","targets":["AD-021"],"supports":["CG-016","SE-022"],"type":"routine","age_window":{"from_months":12,"to_months":36},"duration_minutes":5,"frequency":"daily","materials":["the day's household tasks"],"cost_tier":"free","how_to":["Give the child a small real role in a household task: put the diaper in the bin, wipe a spot on the floor, carry your own plate to the sink, help fold a small napkin.","The task is small AND real; not a made-up performance.","Praise the participation; do not redo their work in front of them.","Include the child in the household routine, not aside from it."],"signs_it_is_working":"Child looks for tasks to do, imitates household actions, and takes pride in participating.","signs_to_stop":"Subtle: child loses interest quickly. That is typical at this age; keep the ask small.","adult_role":"Include them. Do not exclude them for speed.","safety":"Age-appropriate tasks only. No sharp knives, no hot pans, no chemicals.","derivation":"adopted","evidence_note":"Denver PS13 (help in house, p50 15.9). CDC 15-18 mo tips: your child copies things you do like household chores.","sources":["SRC-002"]},{"id":"ACT-0621","title":"Food preferences and mealtime conversation","targets":["AD-022"],"supports":["AD-023","EC-016","CG-009"],"type":"routine","age_window":{"from_months":20,"to_months":40},"duration_minutes":10,"frequency":"daily","materials":["your usual meals"],"cost_tier":"free","how_to":["At meals, ask the child what they want more or less of on their plate.","Honour their food preferences within a sensible range — do not force-feed one item, but do not skip nutritious food groups entirely because of one refusal.","Talk about the food during the meal: 'this dal is yellow; how does it taste'.","Do not label the child as picky — food preferences at 2-3 years are normative."],"signs_it_is_working":"Child asks for or refuses specific foods with words, participates in the mealtime conversation.","signs_to_stop":"Subtle: child refuses a whole food group for many days. Consult the paediatrician if any food group is refused for weeks.","adult_role":"Ask, listen, honour reasonable preferences.","safety":"Watch for choking-size foods regardless of preference.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide: honour toddler food preferences within a healthy variety; picky-eating phases are normative.","sources":["SRC-005"]},{"id":"ACT-0622","title":"Communicate hunger, thirst, or fullness","targets":["AD-023"],"supports":["AD-022","EC-018"],"type":"routine","age_window":{"from_months":24,"to_months":40},"duration_minutes":1,"frequency":"a few times a day","materials":["daily meals and drinks"],"cost_tier":"free","how_to":["Model the words in your own speech: 'I am hungry; let us eat'; 'I am thirsty; I need water'; 'I am full; that is enough'.","Ask the child before offering: 'are you hungry' or 'are you full'.","Wait for the answer; honour the answer even if it means less eaten.","Do not test hunger by withholding food; test fullness by not pushing."],"signs_it_is_working":"Child uses words to say they are hungry, thirsty, or full at appropriate moments.","signs_to_stop":"Subtle: child never signals fullness. Honour cues you see (turning head, closing mouth) as fullness; the words follow the honoured cue.","adult_role":"Model the words; ask; honour the answer.","safety":"Access to water throughout the day; do not withhold.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide (IT-PMP 11): support toddlers in noticing and communicating their own hunger and fullness cues.","sources":["SRC-005"]},{"id":"ACT-0623","title":"Awareness of some unsafe situations","targets":["AD-025"],"supports":["AD-024","SR-015"],"type":"routine","age_window":{"from_months":22,"to_months":40},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday situations"],"cost_tier":"free","how_to":["Name specific hazards in a calm even voice: 'that is hot — we do not touch'; 'the road is dangerous — we hold hands'; 'stove is very hot — we stay away'.","Use the same short phrases across every occurrence so the child recognises them.","Model the safe behaviour: you walk around the stove, you hold hands near the road.","Do not overuse warnings — save them for real hazards so the word 'careful' still matters."],"signs_it_is_working":"Child spontaneously points out familiar hazards ('road, careful', 'hot, no touch') and shows awareness in unfamiliar situations.","signs_to_stop":"Subtle: child ignores warnings that used to work. Reduce overuse; save for real hazards.","adult_role":"Name specifically; model the safe action.","safety":"Warnings do not substitute for barriers. Never rely on a toddler's awareness alone for a real hazard.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide (IT-PMP 10): scaffold safety awareness through specific naming and modelling.","sources":["SRC-005"]},{"id":"ACT-0624","title":"Accepts adult guidance in unsafe situations","targets":["AD-024"],"supports":["AD-025","SE-022"],"type":"routine","age_window":{"from_months":24,"to_months":42},"duration_minutes":1,"frequency":"a few times a day","materials":["everyday moments"],"cost_tier":"free","how_to":["In genuine safety moments (near traffic, on stairs, at a stove), give a firm short instruction: 'hand on the wall'; 'stop — car'; 'back'.","Wait for compliance; help physically if the child does not stop in time.","Praise the compliance briefly ('thank you for stopping'), then move on.","Do not shout unless the danger is immediate."],"signs_it_is_working":"Child stops, comes back, or moves as instructed in safety moments — most of the time.","signs_to_stop":"Subtle: child ignores commands in play. Match to context; toddlers are testing, not defiant.","adult_role":"Short, firm, calm; physical assist if needed.","safety":"Never rely on child compliance for an immediate hazard; always physically manage.","derivation":"adopted","evidence_note":"Head Start ELOF Health, Safety, Nutrition Do guide (IT-PMP 10).","sources":["SRC-005"]},{"id":"ACT-0625","title":"Indicates when they have voided","targets":["AD-026"],"supports":["AD-013","SR-018"],"type":"routine","age_window":{"from_months":18,"to_months":42},"duration_minutes":1,"frequency":"a few times a day","materials":["clean diapers or underwear; a small potty if using"],"cost_tier":"under_2000_inr","india_sourcing_note":"A small plastic potty from any children's shop (INR 300-800). Or use a small chowki (low stool) with a hole cut in the middle, over a container, if potty-training in the traditional Indian setup.","how_to":["Every diaper change, name what happened: 'you did a susu / potty'.","As the child becomes aware (usually 18-30 months), ask 'do you need to go'.","Praise indicating without pressure to actually use the potty at first.","Toilet training itself follows readiness cues; this activity is only the awareness milestone."],"signs_it_is_working":"Child indicates when they have voided (touches diaper, says 'susu', comes to you); may indicate BEFORE voiding, which is the toilet-training readiness cue.","signs_to_stop":"Subtle: child ignores voiding. That is developmentally fine before 24-30 months.","adult_role":"Name; ask; do not push toileting before readiness.","safety":"Never scold accidents; toilet training thrives on positive framing.","derivation":"adopted","evidence_note":"Dosman self-care 36 mo limit-age marker for voiding indication (Level A). Head Start ELOF Health Do guide supports gradual toileting readiness.","sources":["SRC-004","SRC-005"]},{"id":"ACT-0640","title":"Finger foods on the tray","targets":["AD-001","AD-002"],"supports":[],"type":"routine","age_window":{"from_months":6,"to_months":18},"duration_minutes":15,"frequency":"a few times a day","materials":["soft pieces of family food"],"cost_tier":"free","how_to":["Once solids have started, put a few soft pieces from the family meal on his plate or tray.","Let him pick them up and bring them to his mouth himself, alongside spoon-feeding.","Expect mess; wipe up at the end, not during."],"signs_it_is_working":"He brings food to his mouth himself, then feeds himself a good part of the meal with his fingers.","signs_to_stop":"Gagging or coughing, or throwing food and turning away. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Offer and let him do it. Do not put the pieces into his mouth for him.","safety":"Soft pieces only, sitting upright, adult watching the whole meal. No whole nuts, whole grapes or hard raw pieces.","derivation":"adapted","evidence_note":"Adapted from the CDC 9-month tip on self-feeding with varied textures (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"],"india_sourcing_note":"soft idli, well-cooked sabzi, banana, soft roti pieces"},{"id":"ACT-0641","title":"Small open cup sips","targets":["AD-004","AD-005"],"supports":[],"type":"routine","age_window":{"from_months":6,"to_months":18},"duration_minutes":2,"frequency":"a few times a day","materials":["a small open steel glass or cup"],"cost_tier":"free","how_to":["Put a little water in a small open steel glass or cup.","Hold it to his lips and tip gently; let him put his hands on it.","As he gets steadier, let him hold it himself with a small amount inside."],"signs_it_is_working":"He drinks from a cup you hold, then from an open cup himself with some spilling.","signs_to_stop":"Coughing or spluttering; use less water and tip more slowly. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Keep the amount small so spills don't matter. Do not switch to a spouted cup to avoid mess.","safety":"Only water or milk; sitting upright.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year milestone 'Drinks from a cup without a lid, as you hold it' and 18-month tip 'Let your child use a cup without a lid' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0642","title":"Two spoons at meals","targets":["AD-007","AD-008"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":20},"duration_minutes":15,"frequency":"daily","materials":["a small spoon"],"cost_tier":"free","how_to":["Give him his own spoon while you feed him with another.","Put thick foods (dal-rice, khichdi, curd) in his bowl so they stick to the spoon.","Let him try; help load the spoon if he asks."],"signs_it_is_working":"He tries the spoon, then gets more food into his mouth with it by himself.","signs_to_stop":"Banging the spoon and turning away; let him finish with fingers. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him try without correction. Mess is part of it.","safety":"Upright seating; adult present.","derivation":"adapted","evidence_note":"Adapted from the CDC 15-month tip on practising self-feeding with cups and spoons (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0643","title":"Sock-off game","targets":["AD-010"],"supports":[],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":1,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["At bath or bed time, pull a sock half off his toes and say 'pull!'.","Let him finish pulling it off; cheer.","Do the same with a loose hat."],"signs_it_is_working":"He pulls off his socks and hat himself.","signs_to_stop":"Losing interest; just take them off. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Start the job, let him finish it.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0644","title":"Wash-hands song","targets":["AD-015"],"supports":[],"type":"routine","age_window":{"from_months":9,"to_months":20},"duration_minutes":1,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Before meals, sing 'this is the way we wash our hands' while you wash his hands.","Let him hold his hands out and rub them together with you.","Hand him the towel to help dry."],"signs_it_is_working":"He holds out his hands and joins in the washing and drying.","signs_to_stop":"Pulling away from the water; make it quicker and warmer. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Sing and let him do parts of it.","safety":"Check water temperature; step stool held steady.","derivation":"adapted","evidence_note":"Adapted from the CDC 1-year tip 'sing, 'This is the way we wash our hands'' and 18-month milestone 'Puts hands out for you to wash them' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0645","title":"Two toothbrushes","targets":["AD-017"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":24},"duration_minutes":2,"frequency":"daily","materials":["2 soft baby toothbrushes"],"cost_tier":"under_500_inr","how_to":["Give him his own soft baby toothbrush to hold while you brush with another.","Brush your own teeth beside him so he can copy.","Finish his teeth yourself with a smear of toothpaste."],"signs_it_is_working":"He holds the toothbrush and moves it in his mouth.","signs_to_stop":"Clamping his mouth shut; keep it short and try again at the next brush. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him hold one; you do the real cleaning.","safety":"Supervise; no walking around with the brush in his mouth.","derivation":"adapted","evidence_note":"Adapted from ELOF IT-PMP 9 (8-18 months) 'holding a toothbrush with assistance from adults'. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0646","title":"Nose-wipe routine","targets":["AD-019"],"supports":[],"type":"routine","age_window":{"from_months":10,"to_months":24},"duration_minutes":1,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When his nose runs, show him the tissue and say 'blow!' while you blow your own nose.","Hold the tissue to his nose and let him try to blow.","Let him throw the tissue in the bin."],"signs_it_is_working":"He tolerates the wipe and tries to blow with help.","signs_to_stop":"Pulling away; wipe gently and quickly. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Model and keep it quick. Do not chase him with the tissue.","safety":"Soft tissue; gentle wiping.","derivation":"adapted","evidence_note":"Adapted from ELOF IT-PMP 9 (8-18 months) 'blowing nose... with assistance from adults'. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0647","title":"Carry it to the table","targets":["AD-021"],"supports":["CG-016"],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":2,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Give him small jobs: carry the spoons to the table, put his clothes in the basket.","Thank him for helping.","Keep the jobs easy and safe."],"signs_it_is_working":"He helps with simple household jobs and asks to help.","signs_to_stop":"Refusing; that's fine — invite him next time. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give a job; accept how he does it.","safety":"Nothing breakable, hot or sharp.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-year tip on having the child carry items to the table and thanking them (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0700","title":"Support suck-swallow-breathe coordination at feeds","targets":["SR-001"],"supports":["AD-001","SE-005"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":15,"frequency":"a few times a day","materials":["your usual feeding setup (breast, bottle, or spoon)"],"cost_tier":"free","how_to":["Hold the baby upright-enough that gravity helps swallowing (~30-45 degrees) during every feed.","Watch the rhythm: suck, swallow, brief pause to breathe, then suck again.","Pause the flow if the baby coughs, sputters, or turns away — do not push through.","Slow feeds (paced bottle-feeding, breast pausing) build the coordination that the baby is learning."],"signs_it_is_working":"Baby feeds smoothly with a steady rhythm; no coughing, gagging, or milk running out of the mouth.","signs_to_stop":"Subtle: baby breathing sounds fast or wheezy. Potent: coughing, choking, milk coming out of the nose. Sit them upright, pat gently, and pause the feed. Slow feeds always; if persistent, consult a paediatrician.","adult_role":"Position and pace. The coordination itself is neurological — the caregiver only sets it up for success.","safety":"Never propped bottle-feeding. Never lay the baby flat during a feed. Persistent poor feeding coordination beyond newborn period warrants a paediatric review.","derivation":"adopted","evidence_note":"Rourke 1-week visit item on suck-swallow-breathe coordination. Standard paced-feeding guidance across paediatric sources.","sources":["SRC-006"]},{"id":"ACT-0701","title":"Rocking, holding, and swaddling for calming","targets":["SR-002"],"supports":["SR-014","SE-001"],"type":"routine","age_window":{"from_months":0,"to_months":5},"duration_minutes":10,"frequency":"a few times a day","materials":["your arms; a soft cotton dohar or muslin cloth for swaddling"],"cost_tier":"free","india_sourcing_note":"A soft cotton dohar or a large muslin cloth (available at any children's shop for INR 200-500) is the traditional Indian swaddle.","how_to":["When the baby fusses, try rocking (gentle bounce or side-to-side sway), holding upright against your chest, or swaddling with a light muslin.","Note what works for your baby — different babies have different vestibular / pressure / warmth preferences.","The calming response IS the milestone — the baby learns their nervous system can be soothed.","Stop swaddling once the baby is rolling (usually 3-4 months); swaddling then becomes unsafe."],"signs_it_is_working":"Baby quiets within minutes of rocking, holding, or swaddling; the calming input works predictably.","signs_to_stop":"Subtle: the baby remains alert or fussy despite gentle input. Potent: crying that intensifies with rocking. Try a different input (upright hold instead of rocking, unswaddled). If persistent, check for hunger, discomfort, or illness.","adult_role":"Offer soothing input; observe what works; do not force one approach.","safety":"Swaddle only in a cotton cloth, arms straight down, hips loose (hip-safe swaddle). Stop swaddling once the baby rolls.","derivation":"adopted","evidence_note":"Rourke 1-month visit: baby quiets when rocked, held, or swaddled. Standard newborn regulation content.","sources":["SRC-006"]},{"id":"ACT-0702","title":"Allow hand-to-mouth self-calming","targets":["SR-003"],"supports":["SE-015","FM-004"],"type":"routine","age_window":{"from_months":1,"to_months":18},"duration_minutes":5,"frequency":"ambient","materials":["nothing — the baby's own hands"],"cost_tier":"free","how_to":["Give the baby awake alert time with unrestricted arms (no mittens, no swaddled arms during wake time).","Let them bring hands to the mouth on their own; do not offer a pacifier that pre-empts it.","When they suck on fingers to soothe themselves, allow it — this is self-regulation, not misbehaviour.","Some children never adopt hand-to-mouth self-calm; that is also common (per phase2_sr.md G-055 skippable flag)."],"signs_it_is_working":"Baby brings hand or fingers to the mouth during fussy moments and settles briefly.","signs_to_stop":"Subtle: none — this is a self-directed behaviour. Potent: none. Do not train the baby out of this at this age.","adult_role":"Allow. Do not remove the hand.","safety":"Clean hands. No rings, no long nails scratching mouth.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Emotional/Behavioral Self-Regulation Do guide: allow and support early self-soothing behaviours.","sources":["SRC-005"]},{"id":"ACT-0703","title":"Notice orienting to new stimuli","targets":["SR-004"],"supports":["RC-003","CG-011"],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":2,"frequency":"a few times a day","materials":["everyday sounds and sights"],"cost_tier":"free","how_to":["In daily life, notice how the baby responds when a new sound, sight, or event happens: a door closing, a light changing, a person entering the room.","Watch for the head or eye turn toward the source — that IS the orienting milestone.","Do not deliberately startle the baby to test — the orienting comes naturally as life happens around them.","Log what you notice — this is a data-gathering routine more than a play activity."],"signs_it_is_working":"Baby turns head or eyes toward a new sound or movement within a few seconds; the response is consistent.","signs_to_stop":"Subtle: consistent lack of orienting response to everyday stimuli past 3 months. Potent: no orienting after 3 months. Consult the paediatrician for hearing and vision screening.","adult_role":"Observe; do not create artificial stimuli. Real life provides enough.","safety":"No loud noises to test the response.","derivation":"adopted","evidence_note":"Rourke 1-month visit item on orienting response.","sources":["SRC-006"]},{"id":"ACT-0704","title":"Filter-background-stimulation setup for focus","targets":["SR-005"],"supports":["SR-009","CG-010"],"type":"environment","age_window":{"from_months":3,"to_months":12},"duration_minutes":10,"frequency":"a few times a day","materials":["a quiet corner of the room"],"cost_tier":"free","how_to":["Set up play in a room with minimal background noise (TV off, no music, phone away).","Offer one focus target (a rattle, a face, a mobile) at a time.","Watch the baby settle into looking at or engaging with the target while ignoring low background hum.","Rich background stimulation (a busy market, loud TV, many voices at once) is common in Indian family homes; the baby learns to filter over months — provide the quiet corner as a contrast."],"signs_it_is_working":"Baby stays focused on a single target for progressively longer periods; less distraction from background sound.","signs_to_stop":"Subtle: baby overloads easily even in a calm room. Simplify the environment further and shorten sessions.","adult_role":"Set the environment; provide one target at a time.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide: reduce competing stimuli when supporting infant attention and focus.","sources":["SRC-005"]},{"id":"ACT-0705","title":"Texture exploration play","targets":["SR-006"],"supports":["SR-007","CG-008","FM-005"],"type":"play","age_window":{"from_months":4,"to_months":18},"duration_minutes":8,"frequency":"daily","materials":["small containers with different safe textures (soft cotton cloth, rough gunny cloth, cool metal katori, wooden block, smooth silk scarf, warm dohar)"],"cost_tier":"free","india_sourcing_note":"Different textures already in every Indian home: dhoti fabric, cotton dupatta, jute matting, wooden puja items, steel katori, silk saree scrap. A small basket of textures beats any bought sensory toy.","how_to":["Offer one texture at a time; let the baby feel with hands and mouth.","Name the texture as they explore: 'soft', 'cool', 'rough', 'smooth'.","Rotate through the basket across days.","Do not force a texture the baby dislikes; note preferences and offer variety."],"signs_it_is_working":"Baby explores textures with hands, mouth, and eyes; shows preferences and interest across different materials.","signs_to_stop":"Subtle: baby recoils from a specific texture. Honour the preference; try again later. Potent: crying at all textures — the environment is too stimulating; take a break.","adult_role":"Present textures; name them; do not push disliked ones.","safety":"Nothing small enough to swallow. No sharp edges. No dyes that run.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide (IT-PMP 1): offer varied textures and materials for sensory exploration.","sources":["SRC-005"]},{"id":"ACT-0706","title":"Messy-play with fragile, sticky, or wet materials","targets":["SR-007"],"supports":["SR-006","FM-005","CG-014"],"type":"play","age_window":{"from_months":18,"to_months":42},"duration_minutes":20,"frequency":"weekly","materials":["messy play materials (atta dough, mashed banana, soap foam, dry rice grains, water)"],"cost_tier":"free","india_sourcing_note":"Atta dough, mashed banana, and dry pulses in a tray are classic Indian messy-play staples — no purchase needed.","how_to":["Set up a tray on the floor with an old sheet underneath and easily-washed clothes on the child.","Offer one messy material at a time to start (dough, then mashed banana, then rice grains).","Let the child touch, squeeze, pour, and spread.","Over sessions the child learns to handle fragile items gently, sticky items without overload, wet items without freaking out."],"signs_it_is_working":"Child engages with the material without extreme reactions; adjusts touch for fragile items; tolerates sticky and wet input.","signs_to_stop":"Subtle: child refuses one texture. Do not force; that specific texture may need building up to across weeks. Potent: crying, meltdown. Wipe hands, cuddle, move on.","adult_role":"Model the touch; do not hold the child's hand into a texture they refuse.","safety":"Non-toxic materials only. Supervise so nothing choking-size goes in the mouth.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide (IT-PMP 1/2): offer graduated sensory experiences to build tolerance and preference.","sources":["SRC-005"]},{"id":"ACT-0707","title":"Surface-adaptation walking practice (SR framing)","targets":["SR-008"],"supports":["GM-006","SR-015","SR-016"],"type":"outing","age_window":{"from_months":15,"to_months":36},"duration_minutes":20,"frequency":"weekly","materials":["access to varied surfaces (tile floor, rug, sand, grass, gravel, ramp)"],"cost_tier":"free","how_to":["Take the child on a walk that crosses several surface types; slow at each boundary.","Let the child adjust gait and step length between surfaces — this IS the sensory-regulation milestone.","Do not carry across boundaries the child is capable of navigating; the adjustment IS the practice.","Barefoot on safe surfaces builds the sensory feedback loop faster; shoes back on for gravel or hot ground."],"signs_it_is_working":"Child adjusts step and pace between surfaces, keeps balance on soft or uneven ground, slows deliberately at boundaries.","signs_to_stop":"Subtle: child freezes at a boundary. Potent: fall or refusal. Carry across; try shorter surface transitions.","adult_role":"Slow the pace; hold a hand at boundaries.","safety":"Check surfaces for glass, hot ground, or sharp gravel before barefoot walking. Never near traffic without a firm hand-hold.","derivation":"original","evidence_note":"Constructed from the SR-008 hard-prerequisite edge from GM-006 in edges.json. Cross-references GM ACT-0018 (walking on varied surfaces) which has GM-006 as primary target; this SR version has SR-008 as primary target and frames the milestone as sensory adaptation rather than motor competence.","sources":["SRC-005","SRC-018"]},{"id":"ACT-0708","title":"Sustained attention on a simple task","targets":["SR-009"],"supports":["SR-005","CG-023","CG-028"],"type":"routine","age_window":{"from_months":22,"to_months":42},"duration_minutes":10,"frequency":"daily","materials":["a task the child chooses (puzzle, stacking blocks, drawing, tearing paper)"],"cost_tier":"free","how_to":["Offer a task the child is already interested in — do not manufacture engagement.","Sit nearby quietly; do not interrupt or coach unless asked.","Let the child stay with the task as long as they want — even 3-5 minutes is a real milestone at 2 years.","Praise the sticking with it, briefly, once, at the end."],"signs_it_is_working":"Child stays with a simple task for 5-15 minutes by 3 years; over months, sustained-attention duration grows.","signs_to_stop":"Subtle: child jumps between tasks constantly at 3 years. Reduce environmental distractions; try a very high-interest task.","adult_role":"Sit nearby; do not interrupt. Attention grows in silence.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Cognitive Self-Regulation Do guide (IT-ATL 3): offer engaging tasks and protect attention from interruption.","sources":["SRC-005"]},{"id":"ACT-0709","title":"Attention-shifting play","targets":["SR-010"],"supports":["SR-011","CG-024"],"type":"play","age_window":{"from_months":10,"to_months":30},"duration_minutes":5,"frequency":"daily","materials":["two familiar activities set up in view"],"cost_tier":"free","how_to":["Set up two familiar activities the child likes: a stack of blocks and a book, say.","Play with one for a few minutes; then say 'now let us do the book'.","Wait for the child to shift attention to the second activity.","This is the reverse of sustained attention — the flexibility to move on when needed."],"signs_it_is_working":"Child shifts attention from one activity to another when the shift is called for; may resist briefly but does move.","signs_to_stop":"Subtle: child ignores the shift call. Try naming what comes next: 'first blocks, then book'. Potent: tantrum at shift. Slow the transition; give a longer warning next time.","adult_role":"Give a clear cue for the shift; allow a moment.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Cognitive Self-Regulation Do guide (IT-ATL 5): scaffold attention-shifting through predictable transitions.","sources":["SRC-005"]},{"id":"ACT-0710","title":"Routine-change warnings and previews","targets":["SR-011"],"supports":["CG-024","SE-022"],"type":"routine","age_window":{"from_months":20,"to_months":42},"duration_minutes":1,"frequency":"a few times a day","materials":["your day's schedule"],"cost_tier":"free","how_to":["Before a routine change, tell the child what is coming: 'in a few minutes we will go home'; 'after this book we brush teeth'.","Use a timer or a song end as the actual transition marker.","For big changes (creche start, holiday), preview in the days before with photos or by walking past the place.","Predictability + preview reduces regulation demand."],"signs_it_is_working":"Child accepts routine changes with fewer meltdowns when previewed; anticipates the next step in a familiar sequence.","signs_to_stop":"Subtle: child resists a specific transition consistently. Look for what makes it hard (leaving a fun activity, going to a place they dislike). Give more warning; increase the preview.","adult_role":"Warn ahead; do not spring transitions.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Emotional/Behavioral Self-Regulation Do guide (IT-ATL 1): use verbal and visual previews to support transitions.","sources":["SRC-005"]},{"id":"ACT-0711","title":"Come-to-me-for-comfort attachment routine","targets":["SR-012"],"supports":["SR-013","SE-009","SE-010"],"type":"routine","age_window":{"from_months":12,"to_months":36},"duration_minutes":3,"frequency":"a few times a day","materials":["your consistent warm presence"],"cost_tier":"free","how_to":["When the child is upset (fall, fright, tiredness), be present and welcoming.","Do not require the child to explain first — comfort first, talk later.","Hold, rub back, speak softly. Do not immediately try to fix the problem.","Once the child is regulated, then help problem-solve if needed."],"signs_it_is_working":"Child comes to a familiar adult when upset — that is the milestone. Over time, the visits shorten as the child develops independent strategies too.","signs_to_stop":"Subtle: child stops seeking comfort even when clearly upset. Rebuild by initiating warm proximity yourself; a child who stops seeking has learned it is not offered.","adult_role":"Be reliably available. Comfort first, teach later.","safety":"Never punish a child for seeking comfort; comfort-seeking is a health milestone.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Emotional/Behavioral Self-Regulation Do guide (IT-ATL 1): the caregiver as reliable regulation partner supports the child's own developing regulation.","sources":["SRC-005"]},{"id":"ACT-0712","title":"Simple independent coping strategies","targets":["SR-013"],"supports":["SR-012","SE-016","SE-020"],"type":"routine","age_window":{"from_months":24,"to_months":42},"duration_minutes":2,"frequency":"a few times a day","materials":["the strategies themselves"],"cost_tier":"free","how_to":["Introduce simple strategies for big feelings: three deep breaths, count to five, hug the comfort object, sit on the calming cushion.","Model them yourself: 'I am frustrated; let me take three deep breaths'.","Coach in the moment: 'you look sad — do you want to take three breaths with me'.","Do not require independent regulation; scaffold with the adult until the child owns the strategy."],"signs_it_is_working":"Child uses a simple strategy (breath, count, comfort object) sometimes on their own when frustrated or upset.","signs_to_stop":"Subtle: child rejects the strategy in the moment. Do not push; regulation is co-built. Try again a different day.","adult_role":"Model, coach, do not require.","safety":"None specific.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Emotional/Behavioral Self-Regulation Do guide (IT-ATL 2): introduce simple positively-worded self-regulation strategies (e.g. take three deep breaths).","sources":["SRC-005"]},{"id":"ACT-0713","title":"Support the child's soothable baseline","targets":["SR-014"],"supports":["SR-002","SR-012","SE-005"],"type":"routine","age_window":{"from_months":6,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["your consistent responsive caregiving"],"cost_tier":"free","how_to":["Respond consistently to distress; keep basic needs met (sleep, food, comfort) on a predictable schedule.","Note what specifically soothes your child — every temperament is a little different.","Do not compare with other children's baseline temperaments; a slow-to-warm-up child is not less soothable, just different.","The goal is not a low-fuss child; the goal is a child whose distress you can meet reliably."],"signs_it_is_working":"Child is usually calm-able within reasonable time; everyday behaviour is manageable (age-appropriate — tantrums and stranger wariness still happen).","signs_to_stop":"Subtle: escalating fussiness across weeks with no clear trigger. Consider sleep, feeds, teething, illness. Potent: inconsolable crying over hours, or sudden temperament change. Consult a paediatrician.","adult_role":"Consistent, warm, responsive. Basic needs first.","safety":"Persistent inconsolable crying warrants medical review — do not attribute to temperament alone.","derivation":"adopted","evidence_note":"Rourke 18-month temperament item (merged with 'behaviour is usually manageable' per phase2_sr.md G-056). Standard temperament / soothability content.","sources":["SRC-006"]},{"id":"ACT-0714","title":"Hazard-awareness while moving","targets":["SR-015"],"supports":["GM-006","AD-025"],"type":"routine","age_window":{"from_months":12,"to_months":30},"duration_minutes":3,"frequency":"a few times a day","materials":["everyday environments with drop-offs (stairs, low walls, uneven ground)"],"cost_tier":"free","how_to":["When you approach a drop-off (stair edge, high mattress, low wall), name it: 'edge — careful'.","Slow the child; let them look over.","Do not lift them past every edge; the awareness is built by encountering edges with adult support.","Over months the child slows independently at edges."],"signs_it_is_working":"Child slows or stops at a drop-off, sometimes looks back at you before proceeding.","signs_to_stop":"Subtle: child charges edges without pause. Slow the pace; hold a hand at every edge for another few weeks.","adult_role":"Name the edge; hold hand; do not carry past.","safety":"Never rely on child awareness alone at real drops; adult always within grabbing distance.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide (IT-PMP 2): support depth awareness through supervised encounter with edges.","sources":["SRC-005"]},{"id":"ACT-0715","title":"Balance-while-focused activities","targets":["SR-016"],"supports":["GM-001","GM-035","CG-023"],"type":"play","age_window":{"from_months":24,"to_months":42},"duration_minutes":8,"frequency":"daily","materials":["a task requiring both balance and focus (stacking blocks while sitting cross-legged, drawing while standing at a low table, throwing while balancing on one foot)"],"cost_tier":"free","how_to":["Set up a task that requires holding a body position while focusing on a hand-task.","Simple version: sit cross-legged and stack a small tower.","Harder version: stand at a low table and draw; balance on one foot briefly while catching a soft ball.","The dual demand (balance + focus) IS the milestone."],"signs_it_is_working":"Child holds a body position (sit, stand, one-foot) while completing a small hand-task without falling over.","signs_to_stop":"Subtle: child abandons one demand (drops the block, breaks the position). That is fine at first; both improve.","adult_role":"Set up the dual demand; step back.","safety":"Soft flooring under a one-foot balance task.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide (IT-PMP 2): scaffold body-in-space awareness through dual-task play.","sources":["SRC-005"]},{"id":"ACT-0716","title":"Body-awareness through openings and spaces","targets":["SR-017"],"supports":["GM-006","CG-023"],"type":"play","age_window":{"from_months":24,"to_months":42},"duration_minutes":10,"frequency":"weekly","materials":["household objects that make small spaces (a tunnel of cushions, an under-table space, a doorway curtain, an empty cardboard box)"],"cost_tier":"free","india_sourcing_note":"Under the takht, behind the almirah, inside an empty carton — Indian homes have many child-sized nooks that make natural body-awareness play spaces.","how_to":["Set up a small space the child has to figure out how to get through: crawl under a table, squeeze through a cushion tunnel, duck under a curtain.","Let the child figure out the body position and adjust.","Sometimes the child overshoots or bumps — that is the feedback that builds the awareness.","Do not lift them through; the fitting IS the practice."],"signs_it_is_working":"Child adjusts their body position to fit through openings, ducks appropriately, crawls when needed, remembers what worked last time.","signs_to_stop":"Subtle: child gives up mid-attempt. Simplify the opening. Potent: child gets stuck in a real way. Help out calmly.","adult_role":"Set up the space; watch; do not lift through.","safety":"No trapping small spaces where the child cannot back out. No spaces near hazards.","derivation":"adopted","evidence_note":"Head Start ELOF Perception Do guide (IT-PMP 2/5): scaffold body-in-space awareness through spatial-fit play.","sources":["SRC-005"]},{"id":"ACT-0717","title":"Cooperate during care with sensory-comfort adjustments","targets":["SR-018"],"supports":["AD-013","AD-015","SE-022"],"type":"routine","age_window":{"from_months":10,"to_months":26},"duration_minutes":5,"frequency":"a few times a day","materials":["your daily-care routine (bath, diaper, dressing)"],"cost_tier":"free","how_to":["Notice what the child finds sensory-uncomfortable during care: cold wipe, cold water, tag inside shirt, waistband too tight.","Adjust: warm the wipe, warm the bath water, cut off scratchy tags, choose soft clothes.","Explain briefly what is happening: 'wiping now, it is warm'.","Care becomes easier when the sensory experience is comfortable — this is regulation support, not spoiling."],"signs_it_is_working":"Child cooperates through routine care with adult support; less arching, crying, or resistance over weeks.","signs_to_stop":"Subtle: child resists a specific step consistently. Adjust that step (temperature, texture). Potent: any real distress warrants pausing the routine and trying differently.","adult_role":"Adjust the sensory input; explain the step.","safety":"Water temperature always warm not hot. Never leave a child in the bath.","derivation":"adopted","evidence_note":"Rourke 18-month cooperation item. Head Start ELOF Approaches to Learning Do guide (IT-ATL 1): support cooperation through sensory-comfort adjustments.","sources":["SRC-005","SRC-006"]},{"id":"ACT-0718","title":"Short-delay tolerance with adult support","targets":["SR-019"],"supports":["SR-013","SE-022","EC-016"],"type":"routine","age_window":{"from_months":24,"to_months":42},"duration_minutes":2,"frequency":"a few times a day","materials":["a small delay in an everyday moment"],"cost_tier":"free","how_to":["In moments when the child wants something now, introduce a small explicit delay: 'first the water, then we go outside'; 'after I finish this call, I will come'.","Name the wait time roughly: 'two minutes' or 'when the timer beeps'.","Stay warm during the wait; do not use the wait as a lesson in self-control alone.","Praise the waiting after: 'thank you for waiting'."],"signs_it_is_working":"Child manages a short delay (30 seconds to 2 minutes) with adult support; the wait gets easier over months.","signs_to_stop":"Subtle: child cannot manage the delay you set. Reduce the wait; do not force patience beyond capacity. Potent: tantrum from a wait. Wait alongside them; do not lecture during the meltdown.","adult_role":"Name the wait; stay warm; keep the delay short.","safety":"Do not delay physical safety needs (hunger, thirst, pain) as a lesson.","derivation":"adopted","evidence_note":"Head Start ELOF Approaches to Learning Emotional/Behavioral Self-Regulation Do guide (IT-ATL 1): scaffold short-delay tolerance with adult presence.","sources":["SRC-005"]},{"id":"ACT-0719","title":"Learn to read your child's cues","targets":["SR-014"],"supports":["SR-001","SR-002","SE-005"],"type":"routine","age_window":{"from_months":0,"to_months":42},"duration_minutes":5,"frequency":"ambient","materials":["your attention"],"cost_tier":"free","how_to":["In every play, feed, and interaction, watch the child's face and body for engagement cues (bright face, alert quiet state, reaching, smiling) and overload cues (gaze aversion, yawning, hand-to-ear, colour change, arching).","Slow or stop input when the overload cues appear, before the child gets to a full cry.","The subtle-cue-then-potent-cue pattern is universal across ages; the specific cues change with age.","Every activity in this app has a signs_to_stop field for the age band — treat those as guides."],"signs_it_is_working":"Adult reads the child's cues quickly and adjusts input before overload; child spends more time in the alert engaged state.","signs_to_stop":"Subtle: you keep missing cues. Slow down; watch the face more; talk less. Overload happens fastest when adults are performing rather than observing.","adult_role":"Watch. Adjust. Do not perform.","safety":"None specific.","derivation":"adopted","evidence_note":"Consolidates the phase1_reading_the_child.md cue framework (NCAST / Als synactive theory / RCH COCOON / NHS Ready to Relate) into a single ambient routine that supports every SR item.","sources":["SRC-005"]},{"id":"ACT-0740","title":"Paced, upright feeds","targets":["SR-001"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":4},"duration_minutes":0,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Hold him fairly upright for feeds, with his head in line with his body.","If bottle-feeding, keep the bottle more level and pause every few minutes so he can breathe and rest.","Watch his breathing and colour during the feed."],"signs_it_is_working":"Feeds are calmer, with fewer splutters and less gulping.","signs_to_stop":"Subtle: pulling off, milk leaking from the mouth, wide eyes, hiccoughs. Potent: coughing, choking, colour change, arching. Stop, sit him up and let him recover before continuing.","adult_role":"Let him set the pace; pause often.","safety":"If feeds regularly involve choking, colour change or breathing pauses, see the doctor promptly.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-006"]},{"id":"ACT-0741","title":"Rock and hush","targets":["SR-002"],"supports":[],"type":"routine","age_window":{"from_months":0,"to_months":6},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he is upset, hold him close against your chest.","Rock slowly and rhythmically and make a steady 'shhh' sound near his ear.","Keep the room dim and quiet while he settles."],"signs_it_is_working":"He quiets more quickly when held and rocked.","signs_to_stop":"Crying that climbs with more movement; slow down and just hold him. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Stay calm; slow and steady beats fast and bouncy.","safety":"Never shake a baby. If crying feels overwhelming, put him down safely and take a short break.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tips 'Stay calm when your infant is distressed' and 'Never shake your baby' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0742","title":"Let him find his fingers","targets":["SR-003"],"supports":[],"type":"routine","age_window":{"from_months":2,"to_months":18},"duration_minutes":0,"frequency":"ambient","materials":["nothing extra"],"cost_tier":"free","how_to":["When he brings his hand or fingers to his mouth to calm down, let him.","Wait a moment before stepping in so he can try settling himself.","Come in with comfort if it doesn't work."],"signs_it_is_working":"He uses his hand or fingers to calm himself sometimes.","signs_to_stop":"Crying escalating while you wait; step in straight away. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Give him a moment; he is learning a skill. Do not pull his hand away.","safety":"Short nails; clean hands.","derivation":"adapted","evidence_note":"Adapted from the CDC 2-month tip on supporting self-soothing through finger-sucking (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0743","title":"One thing at a time","targets":["SR-004","SR-005"],"supports":[],"type":"environment","age_window":{"from_months":0,"to_months":9},"duration_minutes":10,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["During play, turn off the TV and quieten background noise.","Offer one sound or one toy at a time and let him turn to it.","Watch for him to focus on your face or the toy."],"signs_it_is_working":"He turns toward new sounds and sights and holds his focus on you or a toy in a quiet room.","signs_to_stop":"Looking everywhere and nowhere, or fussing in a busy room; move somewhere quieter. Subtle: looking away, hiccoughs, a yawn burst, fingers splaying. Potent: arching, colour change (red, pale, mottled), crying. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make the room quiet; offer one thing at a time.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC tips to limit screens and use slow, bright toys (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0744","title":"Texture basket","targets":["SR-006"],"supports":[],"type":"environment","age_window":{"from_months":4,"to_months":12},"duration_minutes":10,"frequency":"daily","materials":["a basket","5-6 household objects of different textures"],"cost_tier":"free","how_to":["Fill a basket with safe things that feel different: a steel spoon, a wooden spoon, a soft cloth, a sponge, a coconut-fibre brush.","Let him touch and hold each one; name the feel: 'cold', 'soft', 'rough'.","Swap items each week."],"signs_it_is_working":"He explores the objects differently — patting, rubbing, mouthing — and shows preferences.","signs_to_stop":"Pulling his hand away from a texture; take that one out. Subtle: looking away and staying away, jerky flailing instead of smooth movement, going quiet. Potent: fussing, pushing away, arching. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Let him explore at his pace; do not press textures he dislikes.","safety":"Nothing small, sharp or breakable; check for loose bristles.","derivation":"adapted","evidence_note":"Adapted from ELOF IT-PMP 1 (birth-9 months) on recognising differences in texture. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0745","title":"Warning song before change","targets":["SR-010"],"supports":[],"type":"routine","age_window":{"from_months":12,"to_months":24},"duration_minutes":0,"frequency":"a few times a day","materials":["nothing extra"],"cost_tier":"free","how_to":["Before changing activity, give a warning: 'two more turns, then bath'.","Use the same short song every time you move to the next thing.","Help him put the toy down or bring it with him."],"signs_it_is_working":"He moves from one activity to the next with less protest.","signs_to_stop":"Meltdown at every change; give warnings earlier and offer to carry the toy along. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Warn, then follow through calmly.","safety":"Standard supervision.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0746","title":"Calm corner and lap","targets":["SR-012"],"supports":[],"type":"environment","age_window":{"from_months":12,"to_months":24},"duration_minutes":0,"frequency":"ambient","materials":["a cushion","his comfort toy or cloth"],"cost_tier":"free","how_to":["Set up a quiet corner with a cushion and his comfort things.","When he is upset, go there with him and hold him on your lap.","Stay until he settles; name the feeling."],"signs_it_is_working":"He comes to you or the corner for comfort when upset, and settles faster.","signs_to_stop":"Pushing you away; stay nearby without touching until he reaches for you. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Be available; comfort first, talk later.","safety":"Standard supervision.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month tip 'Create a spot in your home for your child to go to when he's upset' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]},{"id":"ACT-0747","title":"Edge walks with you","targets":["SR-015"],"supports":[],"type":"outing","age_window":{"from_months":12,"to_months":24},"duration_minutes":5,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["On walks, hold his hand near a kerb, step or ledge and say 'careful, step down'.","Stop at edges and let him look before stepping.","Praise when he slows down at an edge himself."],"signs_it_is_working":"He slows down or stops at drops and edges.","signs_to_stop":"Pulling away toward the edge; pick him up and move on. Subtle: wandering off, throwing the thing, shaking the head. Potent: saying 'no' or 'down', flopping to the floor, crying that does not settle with a change of activity. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Name the danger calmly and let him look; hold his hand.","safety":"Always hold hands near roads, water and heights.","derivation":"original","evidence_note":"Common practice, no formal evidence; written to cover a skill the harvested sources had no activity for. (phase9a)","sources":["SRC-005"]},{"id":"ACT-0748","title":"Dressing as a game","targets":["SR-018"],"supports":[],"type":"routine","age_window":{"from_months":9,"to_months":20},"duration_minutes":0,"frequency":"daily","materials":["nothing extra"],"cost_tier":"free","how_to":["Make dressing a game: 'where's your hand? Here it is!' as it comes through the sleeve.","Ask him to push his arm through or lift his foot.","Keep it quick and cheerful."],"signs_it_is_working":"He helps with dressing, bathing and nappy changes instead of resisting.","signs_to_stop":"Arching and crying; finish quickly and try the game next time. Subtle: dropping or pushing the thing away, turning the body away, no longer taking turns. Potent: crawling off, a protest cry with a reach back to you. Pause for 30-60 seconds of quiet contact; offer again only when he looks back or reaches.","adult_role":"Make it a game and let him do a small part.","safety":"Changing on the floor when he is wriggly.","derivation":"adapted","evidence_note":"Adapted from the CDC 18-month milestone 'Helps you dress him by pushing arm through sleeve or lifting up foot' (raw/phase9a_cdc_tips.md). (phase9a)","sources":["SRC-002"]}],"redflags":[{"id":"RF-001","age_months":4,"domain":"GM","description":"By 4 months, the head still drops back when the child is pulled from lying to sitting, or the head is not held steady when held upright. Head control has not appeared as expected — worth a paediatric review.","instrument":"Dosman limit-age","basis":"Head-holding is a Rourke 4-month expert marker and a Dosman 90th-percentile outer age. Absence past 4mo is a persistent-absence flag.","related_items":["GM-009","GM-010"],"urgency":"next_well_visit","action":"Raise at the next well-child visit for a hypotonia screen and to consider a paediatric neurology referral.","sources":["SRC-004","SRC-006"]},{"id":"RF-002","age_months":9,"domain":"GM","description":"By 9 months, the child cannot yet sit on the floor without hands or an adult propping. Sitting without support has not appeared as expected — worth a paediatric review.","instrument":"Dosman limit-age","basis":"Independent sitting: WHO median 5.9mo, p99 9.2mo (GM-001); Dosman's AIMS 90th percentile for 'sits well' is 8mo. Not sitting by the 9-month visit is past both.","related_items":["GM-001"],"urgency":"next_well_visit","action":"Raise at the next well-child visit and consider a motor evaluation.","sources":["SRC-004","SRC-006"]},{"id":"RF-003","age_months":18,"domain":"GM","description":"By 18 months, the child is not yet taking several steps independently without holding on. Independent walking has not appeared as expected — worth a paediatric review. This flag does not apply to a child who is a confirmed bottom-shuffler (an alternative motor path).","instrument":"Dosman limit-age","basis":"Independent walking: WHO median 12.0mo, p99 17.6mo (GM-006). Dosman places walking in the 18-month row of its chart (PDMS-2 50th-percentile range 11.5-14.5mo). Not walking by 18 months is past the WHO outer window.","related_items":["GM-006"],"urgency":"next_well_visit","action":"Raise at the next well-child visit and consider a paediatric physiotherapy referral.","sources":["SRC-001","SRC-004","SRC-006"]},{"id":"RF-010","age_months":18,"domain":"FM","description":"A strong one-hand preference — using one hand almost exclusively and neglecting or fisting the other — that appears clearly before 18 months. Typical handedness sorts out closer to 2-3 years, so a very early strong preference is a marker worth reviewing.","instrument":"Rourke visit marker","basis":"Rourke lists 'No hand preference' at 6 months, 'Uses both hands/no hand preference' at 9 months and 'Uses both hands equally' at 12-13 months, and its rule is that the absence of any milestone merits further assessment. A strong one-hand preference before 18 months can reflect weakness on the other side. Related items are two-handed milestones.","related_items":["FM-007","FM-009","FM-011"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a neuromotor examination of the non-preferred side.","sources":["SRC-006"]},{"id":"RF-011","age_months":0,"domain":"FM","description":"In a newborn, the hand does not close on an adult finger placed in the palm. The palmar grasp reflex is absent.","instrument":"Dosman limit-age","basis":"Palmar grasp is a primitive reflex present at birth (FM-001 median 3mo for a voluntary hold; the reflex itself is expected from day one).","related_items":["FM-001"],"urgency":"same_week","action":"Discuss with the birthing team or paediatrician within the first week for a neonatal neurology assessment.","sources":["SRC-004","SRC-006"]},{"id":"RF-020","age_months":3,"domain":"RC","description":"By 3 months, the child does not startle, blink, or otherwise react to sudden loud sounds — a clap, a slammed door, a shout. Response to loud sound has not appeared as expected.","instrument":"Rourke / CDC milestone","basis":"Rourke 1-month 'Startles to loud noise' and 2-month 'Turns head towards sounds'; CDC 2-month 'Reacts to loud sounds' (75% or more); Dosman newborn 'Orients to sound'. No reaction to loud sound by 3 months is past all of these; hearing is time-sensitive.","related_items":["RC-001"],"urgency":"same_week","action":"Ring the paediatrician; ask for an audiology (BERA/OAE) referral. Hearing loss is time-sensitive for language development.","sources":["SRC-006","SRC-002","SRC-004"]},{"id":"RF-021","age_months":12,"domain":"RC","description":"By 12 months, the child does not turn, look up, or stop what they are doing when a familiar adult calls their name from nearby. Name response has not appeared as expected — this can be a hearing marker or an early autism marker.","instrument":"Dosman limit-age","basis":"Name response median 6.5mo (RC-005). Persistent absence past 12mo is on the Dosman limit list and is one of the M-CHAT-R critical items.","related_items":["RC-005"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for both audiology screening and a developmental evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-022","age_months":18,"domain":"RC","description":"By 18 months, the child does not follow an adult's look or point to notice an out-of-reach object, and does not look at the adult, at the object, and back to check attention is shared. Joint attention has not appeared as expected.","instrument":"M-CHAT-R/F screening","basis":"Joint attention (RC-007, median 10.5mo) is a core M-CHAT-R/F item and a widely cited early autism marker when persistently absent past 18mo.","related_items":["RC-007"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for an M-CHAT-R/F screen and a developmental evaluation.","sources":["SRC-013"]},{"id":"RF-030","age_months":12,"domain":"EC","description":"By 12 months, the child is not yet producing strings of consonant-vowel babble like 'mamama', 'bababa', or 'badago'. Babbling has not appeared as expected.","instrument":"Dosman limit-age","basis":"Reduplicated babble median 6.7mo (EC-010); variegated babble median 7.5mo (EC-011). Persistent absence of babble past 12mo is a Dosman outer marker.","related_items":["EC-010","EC-011","EC-012"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for audiology screening and a speech-language evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-031","age_months":24,"domain":"EC","description":"At any age, the child loses words, gestures, or phrases they were previously using regularly. Any loss of previously acquired language skills is a marker for developmental regression.","instrument":"M-CHAT-R/F screening","basis":"Regression of language between 15 and 30 months is a well-established autism spectrum marker; loss at any age is treated as a same-week concern.","related_items":["EC-013","EC-014","EC-015","EC-026","EC-027"],"urgency":"prompt_call","action":"Ring the paediatrician the same week; ask for a developmental evaluation and an autism screen.","sources":["SRC-004","SRC-013"]},{"id":"RF-032","age_months":18,"domain":"EC","description":"By 18 months, the child is using fewer than five different words meaningfully. Expressive vocabulary is not appearing as expected.","instrument":"Dosman limit-age","basis":"Five meaningful words median 12.5mo (EC-015). Dosman's 18-month marker is 15 words; this flag uses the more lenient 'fewer than five words at 18 months'.","related_items":["EC-015"],"urgency":"next_well_visit","action":"Raise at the next well-child visit; ask for audiology screening and a speech-language evaluation.","sources":["SRC-004"]},{"id":"RF-033","age_months":24,"domain":"EC","description":"By 24 months, the child is not yet putting two words together into a short phrase — 'more milk', 'daddy go', 'my ball'. Two-word combinations have not appeared as expected.","instrument":"Dosman limit-age","basis":"Two-word combinations median 21.3mo (EC-019). Persistent absence past 24mo is one of the most widely cited expressive-language red flags.","related_items":["EC-019"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a speech-language evaluation.","sources":["SRC-004"]},{"id":"RF-034","age_months":30,"domain":"EC","description":"By 30 months, the child is using fewer than fifty different words meaningfully across daily life. Expressive vocabulary is not appearing as expected.","instrument":"Dosman limit-age","basis":"Fifty-word vocabulary: Wordbank median about 17.8mo (EC-020); Dosman places 50 words in its 24-month row; CDC lists 'says about 50 words' at 30 months. Fewer than fifty words at 30 months is past all three.","related_items":["EC-020"],"urgency":"next_well_visit","action":"Raise at the next well-child visit; ask for a speech-language evaluation.","sources":["SRC-002","SRC-004"]},{"id":"RF-035","age_months":36,"domain":"EC","description":"By 36 months, the child is not yet producing sentences of three or more words to describe or request. Three-word sentences have not appeared as expected.","instrument":"Dosman limit-age","basis":"Three-word sentences median 33.5mo (EC-031). Persistent absence past 36mo is a Dosman outer marker for expressive delay.","related_items":["EC-031"],"urgency":"next_well_visit","action":"Raise at the next well-child visit; ask for a speech-language evaluation.","sources":["SRC-004"]},{"id":"RF-040","age_months":4,"domain":"CG","description":"By 4 months, the child does not look at familiar faces, does not visually track a moving object, and shows little interest in the surroundings. Visual interest has not appeared as expected.","instrument":"Rourke / CDC milestone","basis":"Face-looking is present from birth (CG-001); tracking past midline median 1.5mo (CG-003). CDC lists 'Looks at your face' and 'Watches you as you move' at 2 months (75% or more); Rourke lists 'Follows a moving toy or person with eyes past midline' at the 4-month visit, and Rourke's rule is that the absence of any milestone merits further assessment.","related_items":["CG-001","CG-003","CG-006"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a vision assessment and a developmental evaluation.","sources":["SRC-006","SRC-002"]},{"id":"RF-041","age_months":36,"domain":"CG","description":"At any age, the child loses cognitive skills they were previously using — no longer imitates, no longer uses objects for their purpose, no longer explores. Any loss of previously acquired cognitive skills is a marker for developmental regression.","instrument":"M-CHAT-R/F screening","basis":"Loss of previously acquired skills in any area is a red flag at any age: Rourke's rule is that 'loss of attained milestones' merits further assessment; M-CHAT-R/F probes for regression between 16 and 30 months.","related_items":["CG-013","CG-014","CG-016","CG-017","CG-018"],"urgency":"prompt_call","action":"Ring the paediatrician the same week; ask for a developmental evaluation.","sources":["SRC-004","SRC-006","SRC-013"]},{"id":"RF-042","age_months":18,"domain":"CG","description":"By 18 months, the child does not copy simple adult actions — sweeping with a small broom, wiping with a cloth, stirring in a bowl. Imitation of everyday actions has not appeared as expected.","instrument":"Dosman limit-age","basis":"Imitation of adult actions median 11.6mo (CG-016). Persistent absence past 18mo is a Dosman outer marker and an autism-spectrum indicator.","related_items":["CG-016"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a developmental evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-043","age_months":24,"domain":"CG","description":"By 24 months, the child does not use objects in pretend ways — does not pretend-feed a doll, does not use a block as a phone, does not stir with a stick. Pretend play has not appeared as expected.","instrument":"M-CHAT-R/F screening","basis":"Pretend feeding and object-substitution median 19.5mo (CG-019, CG-020). Persistent absence past 24mo is a core M-CHAT-R item and a Dosman outer marker.","related_items":["CG-019","CG-020"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for an M-CHAT-R/F screen and a developmental evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-050","age_months":3,"domain":"SE","description":"By 3 months, the child does not smile in response to an adult smiling or talking to them. The responsive social smile has not appeared as expected.","instrument":"Dosman limit-age","basis":"Responsive smile median 1.1mo (SE-002); CDC 2-month milestone 'smiles when you talk to or smile at her'; Rourke 2-month visit marker. Dosman's chart places social smiling in its 6-month row.","related_items":["SE-002"],"urgency":"next_well_visit","action":"Raise at the next well-child visit; ask for a vision assessment and a developmental evaluation.","sources":["SRC-006","SRC-002"]},{"id":"RF-051","age_months":36,"domain":"SE","description":"At any age, the child stops smiling at familiar people, no longer seeks the caregiver, no longer plays social games, or otherwise loses social skills they previously had. Any loss of previously acquired social skills is a marker for developmental regression.","instrument":"M-CHAT-R/F screening","basis":"Social regression is a well-established autism spectrum marker; M-CHAT-R/F probes regression between 15 and 30 months.","related_items":["SE-002","SE-005","SE-009","SE-013"],"urgency":"prompt_call","action":"Ring the paediatrician the same week; ask for an M-CHAT-R/F screen and a developmental evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-052","age_months":18,"domain":"SE","description":"By 18 months, the child does not extend objects toward an adult to share interest — does not show a toy, does not bring items over to share the moment. Sharing of interest has not appeared as expected.","instrument":"M-CHAT-R/F screening","basis":"Showing/sharing of objects (SE-013, median 12.5mo) is a core M-CHAT-R item; persistent absence past 18mo is an autism marker.","related_items":["SE-013"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for an M-CHAT-R/F screen and a developmental evaluation.","sources":["SRC-004","SRC-013"]},{"id":"RF-053","age_months":24,"domain":"SE","description":"By 24 months, the child does not pause, look concerned, or seek out someone in distress. Noticing others' emotions has not appeared as expected.","instrument":"Dosman limit-age","basis":"Empathy noticing (SE-018) median 21.5mo. Persistent absence past 24mo is a Dosman outer marker for social-emotional development.","related_items":["SE-018"],"urgency":"next_well_visit","action":"Raise at the next well-child visit; ask for a developmental evaluation.","sources":["SRC-004"]},{"id":"RF-054","age_months":12,"domain":"SE","description":"By 12 months, the child shows few or no facial expressions of feeling — no visible happiness, sadness, anger or surprise across situations. A range of facial expressions has not appeared as expected.","instrument":"CDC milestone","basis":"Differentiated facial expressions (SE-008) median 1.5mo; CDC lists 'Shows several facial expressions, like happy, sad, angry, and surprised' at 9 months (75% or more). Few or no facial expressions of feeling by 12 months is past that.","related_items":["SE-008"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a developmental evaluation.","sources":["SRC-002"]},{"id":"RF-060","age_months":12,"domain":"AD","description":"By 12 months, the child is not yet accepting any solid or mashed foods and is entirely on liquid feeds. Solid-food acceptance has not appeared as expected.","instrument":"Dosman limit-age","basis":"Finger-food self-feeding (AD-001) median 5.9mo. Persistent refusal of solid foods past 12mo is a Dosman outer marker and a feeding-therapy indicator.","related_items":["AD-001"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a feeding assessment (paediatric OT or speech-language therapist).","sources":["SRC-004"]},{"id":"RF-061","age_months":0,"domain":"AD","description":"In a newborn, sucking, swallowing, and breathing during feeding do not coordinate into a rhythmic pattern; feeding is prolonged, weak, or interrupted by choking. Newborn feeding coordination has not appeared as expected.","instrument":"Rourke visit marker","basis":"Coordinated suck-swallow-breathe (SR-001) is present from birth. Failure to coordinate is a Rourke 1-week and 2-week visit red flag.","related_items":["SR-001","AD-001"],"urgency":"same_week","action":"Discuss with the birthing team or paediatrician within the first week for a feeding assessment and to rule out neurological or structural causes.","sources":["SRC-006"]},{"id":"RF-070","age_months":18,"domain":"SR","description":"By 18 months, the child is rarely soothed by familiar caregivers — not calmed by holding, a gentle voice, rocking or a comfort object, across weeks — and does not come to a familiar adult for comfort when upset. Being soothed by caregivers has not appeared as expected.","instrument":"Rourke visit marker","basis":"Rourke lists 'Usually easy to soothe' and 'Comes for comfort when distressed' at the 18-month visit and 'Can be comforted & calmed by touching/rocking' at 2 months; CDC 2-month 'Calms down when spoken to or picked up'. Rourke's rule is that the absence of any milestone merits further assessment.","related_items":["SR-002","SR-012","SR-014"],"urgency":"prompt_call","action":"Ring the paediatrician; ask for a developmental evaluation.","sources":["SRC-006","SRC-002"]},{"id":"RF-071","age_months":18,"domain":"SE","description":"A positive M-CHAT-R/F screen at any point between 16 and 30 months — the standard autism screening window — indicates the need for a diagnostic developmental evaluation. Ask the paediatrician for the M-CHAT-R/F at the 18-month and 24-month visits.","instrument":"M-CHAT-R/F screening","basis":"M-CHAT-R/F (SRC-013) is the standard autism screening between 16-30 months. Positive screen (score 3-7 with failed follow-up interview, or 8+) requires diagnostic evaluation.","related_items":["RC-005","RC-007","SE-013","CG-019","EC-011"],"urgency":"prompt_call","action":"Ring the paediatrician; request the M-CHAT-R/F at the 18-month and 24-month well-child visits and follow the tool's follow-up-interview logic.","sources":["SRC-013"]}],"sources":[{"id":"SRC-001","name":"WHO Motor Development Study — windows of achievement for six gross motor milestones","publisher":"WHO Multicentre Growth Reference Study Group","url":"https://cdn.who.int/media/docs/default-source/child-growth/child-growth-standards/indicators/motor-development-milestones/who-motor-development-study-windows-of-achievement-for-six-gross-motor-development-milestones.pdf","retrieved":"2026-08-28","tier":"A","access":"open","license_note":"Published by WHO in Acta Paediatr Suppl 450 (2006). Windows-of-achievement values reused as factual data with citation; full text of source not reproduced.","coverage":{"age_from":3,"age_to":18,"domains":["GM"]},"percentile_points":[1,50,99],"limit_ages":false,"sample":{"size":816,"countries":["Ghana","India","Norway","Oman","USA"],"year":2006},"notes":"Calibration standard. Bounds are 1st/99th percentiles for six gross motor milestones; monthly assessment in year 1. >15y old but remains the referenced standard.","superseded_check":"n_a"},{"id":"SRC-002","name":"CDC Learn the Signs. Act Early. — milestone checklists 2mo–5yr (English)","publisher":"US Centers for Disease Control and Prevention","url":"https://www.cdc.gov/act-early/media/pdfs/2025/10/cdc-milestone-checklists-ltsae-english-508.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"US federal government work; not copyright-protected under 17 U.S.C. § 105 (US-govt-works exception, per usa.gov/government-copyright). Third-party content, trademarks and logos are exceptions. The checklists themselves are authored by CDC employees and are reusable with attribution.","coverage":{"age_from":2,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[],"limit_ages":true,"sample":{"size":null,"countries":["USA"],"year":2022},"notes":"12 checklists: 2, 4, 6, 9, 12, 15, 18, 24, 30 months and 3, 4, 5 years. Uses the criterion 'these developmental milestones show what most children (75% or more) can do by each age' — treat threshold ages as p75 per Phase 3 rule. No warning-signs section in the current edition (per Zubler 2022 methodology, SRC-003); missed milestones are the action trigger. Phase 9b (2026-09-27): used as a SOFTER limit_age tier (tier='mention') — CDC pages say 'If your child is not meeting one or more milestones … act early. Talk with your child's doctor'. Never a red-flag source; never tier 'referral'.","quote":"These developmental milestones show what most children (75% or more) can do by each age.","superseded_check":"done"},{"id":"SRC-003","name":"Zubler et al. 2022 — Evidence-informed milestones for developmental surveillance tools","publisher":"Pediatrics (American Academy of Pediatrics)","url":"https://publications.aap.org/pediatrics/article/149/3/e2021052138/184748","retrieved":"2026-08-28","tier":"A","access":"open","license_note":"Journal article, open-access at Pediatrics. Cite as evidence for methodology; do not reproduce figures without permission. DOI 10.1542/peds.2021-052138.","coverage":{"age_from":2,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2022},"notes":"Underlying methodology for SRC-002 (CDC LTSAE 2022 revision). 159 final milestones: 79.9% retained/added on the basis of normative data, 20.1% on screening/evaluation tools, published clinical opinion and SME opinion. Inclusion criterion: milestones expected in ≥75% of children at the given age. Warning-signs category eliminated; each missed milestone now triggers screening consideration. Social-emotional and cognitive milestones had the least normative data.","quote":"Milestones should represent those that most (≥75%) children would be expected to demonstrate.","superseded_check":"done"},{"id":"SRC-004","name":"Dosman, Andrews & Goulden 2012 — Evidence-based milestone ages as a framework for developmental surveillance","publisher":"Paediatr Child Health 17(10):561–568 (Canadian Paediatric Society)","url":"https://papers.ucalgary.ca/paediatrics/assets/paedchildhealth_develop-milestones.pdf","retrieved":"2026-08-28","tier":"A","access":"open","license_note":"Open-access journal article. Cite; do not reproduce tables verbatim. This is the primary limit_age spine for the corpus.","coverage":{"age_from":0,"age_to":36,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[50,90],"limit_ages":true,"sample":{"size":null,"countries":["Canada","USA"],"year":2012},"notes":"Red-flag chart across intervals: newborn, 2, 4, 6, 9, 12, 18, 24, 36 months. Limit basis by sector — gross motor and self-care: 90th percentile; fine motor: 50th percentile; communication, cognitive, social-emotional: 'oldest age by which the skill has been typically mastered'. Evidence levels A–E in tables. >15y old but remains the referenced framework.","superseded_check":"n_a"},{"id":"SRC-005","name":"Head Start Early Learning Outcomes Framework (ELOF) — Ages Birth to Five","publisher":"US Department of Health and Human Services, Office of Head Start","url":"https://headstart.gov/sites/default/files/pdf/elof-ohs-framework.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"US federal government publication; not copyright-protected under 17 U.S.C. § 105. HHS 'Head Start' and 'Early Head Start' word marks and logos are registered HHS trademarks — do not reproduce those. Framework content itself is reusable with attribution.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2015},"notes":"Five domains: Approaches to Learning; Social and Emotional Development; Language and Literacy; Cognition; Perceptual/Motor/Physical Development. Three age bands: Infants, Toddlers, Preschoolers. Goals → developmental progressions → indicators. Strongest free structured spine for the item inventory in SE, CG and language.","superseded_check":"n_a"},{"id":"SRC-006","name":"Rourke Baby Record 2024 (National English edition)","publisher":"College of Family Physicians of Canada / Canadian Paediatric Society / Dietitians of Canada","url":"https://www.rourkebabyrecord.ca/pdf/2024/RBR%202024%20NAT-EN-1vpp-May%2018-BLACK-Feb%209.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"© 2026 Canadian Paediatric Society, all rights reserved. Free download from rourkebabyrecord.ca for clinical use. Cite; do not reproduce the record verbatim. Evidence-graded companion table at /pdf/2024/2024%20Rourke%20Baby%20Record%20Evidence%20Table%20for%20website%202025-07-31.pdf.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["Canada"],"year":2024},"notes":"Evidence-graded developmental surveillance items across well-child visits from 1 week to 5 years (Guides I–IV). Notes indicate 'improved clarity of the developmental surveillance section' as a 2024 revision.","superseded_check":"done"},{"id":"SRC-007","name":"Bright Futures / AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)","publisher":"American Academy of Pediatrics","url":"https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"© American Academy of Pediatrics. Free download from the AAP; permitted for clinical use. Cite; do not reproduce the schedule verbatim in a public app.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2024},"notes":"Page last updated 2025-02-06; references the 2024 Recommendations. Ages verified via Iowa EPSDT mirror (June 2024): well-visits birth, 2-5d, 1, 2, 4, 6, 9, 12, 15, 18, 24, 30 months. Standardised developmental screening at 9, 18 and 24 (or 30) months. Autism-specific screening at 18 and 24 months. This is the SCREENING SCHEDULE source, not a percentile source.","superseded_check":"done"},{"id":"SRC-008","name":"Denver II-Jimma — adaptation and standardisation of a Western tool for assessing child development in non-Western low-income context (Wondie et al. 2016)","publisher":"BMC Public Health 16:652","url":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3288-2","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"Open access under Creative Commons Attribution 4.0 International (CC BY 4.0). Data tables and figures may be reused with attribution. This is the cross-domain grade-B percentile spine for the corpus.","coverage":{"age_from":0,"age_to":71,"domains":["GM","FM","RC","EC","CG","SE"]},"percentile_points":[25,50,75,90],"limit_ages":false,"sample":{"size":1597,"countries":["Ethiopia"],"year":2016},"notes":"Table 3 gives age norms in months at 25/50/75/90 for Denver-II items across four domains (personal-social, fine motor-adaptive, language, gross motor). p90 is the outermost point — no p95/p99 — so items resting on this source cap at grade B. Not a limit-age source. Denver-II item bank itself is proprietary; only the age norms table from this open-access paper is reused.","superseded_check":"done"},{"id":"SRC-009","name":"Wordbank / MacArthur-Bates Communicative Development Inventories norms","publisher":"Stanford University Language and Cognition Lab (Frank, Braginsky, Yurovsky, Marchman)","url":"https://wordbank.stanford.edu/","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"Wordbank content is available under Creative Commons Attribution 4.0 International (CC BY 4.0). Data reuse permitted with attribution and citation of Frank, Braginsky, Yurovsky & Marchman (2017) 'Wordbank: an open repository for developmental vocabulary data', J Child Lang. Explicit disclaimer: not to be used as a normative standard for evaluating individual children — use here is descriptive (corpus reference table), not evaluative.","coverage":{"age_from":8,"age_to":30,"domains":["EC","RC"]},"percentile_points":[10,25,50,75,90],"limit_ages":false,"sample":{"size":92771,"countries":["USA","Multiple (42 languages)"],"year":2017},"notes":"Vocabulary production and comprehension percentile curves computable via the wordbankr R package. Covers 42 languages and 89 instruments including American English CDI:Words & Gestures (8-18mo) and CDI:Words & Sentences (16-30mo). Best cross-lingual percentile source for EC and word-comprehension parts of RC.","superseded_check":"done"},{"id":"SRC-010","name":"RBSK 2.0 Operational Guidelines 2026 — Rashtriya Bal Swasthya Karyakram","publisher":"National Health Mission, Ministry of Health and Family Welfare, Government of India","url":"https://nhm.gov.in/images/pdf/programmes/RBSK/RBSK%202.0_Operational_Guidelines_2026_English.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"Government of India public health guideline document, freely distributed. Cite; do not reproduce verbatim in a public app.","coverage":{"age_from":0,"age_to":216,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["India"],"year":2026},"notes":"Screens birth-18y under the 4 Ds (Defects at birth, Deficiencies, Diseases, Developmental delays including disabilities). 0-6y screened twice yearly via Anganwadi centres; 6-18y via schools. Does NOT publish a named national milestone chart — uses a generic 'age-appropriate developmental checklist' and Developmental Kit (bell, rattle, torch, one-inch cubes, small bottle with raisins, squeaky toys, coloured wool); states adapt tools locally. TDSC (SRC-011) is the Indian-validated instrument most commonly used. The 9 developmental-delay categories are: vision impairment, hearing impairment, neuro-motor impairment, motor delay, cognitive delay, language delay, behavioural disorders, neurodevelopmental disorders (ASD, SLD), global developmental delay.","superseded_check":"done"},{"id":"SRC-011","name":"Trivandrum Developmental Screening Chart TDSC (0-6) — Nair, Nair, Mini, Indulekha, Letha & Russell (2013)","publisher":"Indian Journal of Pediatrics 80(3):248-255","url":"https://link.springer.com/article/10.1007/s12098-013-1144-2","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"Journal article behind Springer paywall for full PDF; abstract and validation data cited from Springer/ResearchGate mirror. Cite; do not reproduce chart verbatim.","coverage":{"age_from":0,"age_to":72,"domains":["GM","FM","RC","EC","CG","SE"]},"percentile_points":[],"limit_ages":false,"sample":{"size":1183,"countries":["India"],"year":2013},"notes":"Indian-validated screening tool. Uses single reference ages (not percentiles) per milestone. Community sample in Trivandrum; sensitivity 84.62% (95% CI 71.92-93.12) and specificity 90.8% (95% CI 88.97-92.43) when one-item delay considered positive. Threshold-only source — Phase 3 constructs windows from these using the wide-rule.","superseded_check":"done"},{"id":"SRC-012","name":"IAP Consensus Guidelines on Diagnosis and Management of Global Development Delay (Juneja et al. 2022)","publisher":"Indian Pediatrics (Growth, Development and Behavioural Pediatrics, Neurology and Neurodevelopment Pediatrics Chapters, Indian Academy of Pediatrics)","url":"https://www.indianpediatrics.net/epub022022/RECOMM-00406.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"Open-access recommendation document from Indian Pediatrics. Cite; do not reproduce verbatim.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["India"],"year":2022},"notes":"Indian developmental surveillance schedule: developmental screening at 9-12 months, 18-24 months, and at school entry for all children (surveillance at every immunisation visit until 24 months). High-risk infants: 4-6mo, 9-12mo, 18-24mo, yearly until 5y. Complements SRC-007 with the Indian-context schedule.","superseded_check":"done"},{"id":"SRC-013","name":"M-CHAT-R/F — Modified Checklist for Autism in Toddlers, Revised, with Follow-up","publisher":"Robins, Fein & Barton","url":"https://www.mchatscreen.com/wp-content/uploads/2025/06/M-CHAT-R_F_March_2025.v2.pdf","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"© Diana Robins, Deborah Fein & Marianne Barton 2009 (March 2025 version). Free for pediatric primary-care clinicians (including their own EHR incorporation) and for non-profit teaching / research use. No modifications to title, items or instructions without permission. Commercial distribution of software (EHR, assessment packages, telehealth software, devices) requires a licence agreement. Referenced by our corpus only as the citation behind the autism-specific screen at 18mo and 24mo — instrument text itself is not reproduced.","coverage":{"age_from":16,"age_to":30,"domains":["SE","EC","RC"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2009},"notes":"Two-stage parent-report screen for autism likelihood, ages 16-30 months. Cited by the Bright Futures/AAP autism screening ages.","superseded_check":"done"},{"id":"SRC-014","name":"Raising Children Network — baby and toddler development milestones","publisher":"Raising Children Network (Australia) Limited","url":"https://raisingchildren.net.au/newborns/development/understanding-development/baby-development","retrieved":"2026-08-28","tier":"C","access":"open","license_note":"© 2006-2026 Raising Children Network (Australia) Limited, all rights reserved. Government-funded parenting portal. Cite; do not reproduce verbatim. Content is descriptive with ranges (e.g. 'usually between 4 and 10 months'), not published percentiles.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["Australia"],"year":2026},"notes":"Six domains: large body movements (GM), small body movements (FM), vision, hearing, speech and language, social behaviour. Funded by the Australian Government; member organisations include Parenting Research Centre, Murdoch Childrens Research Institute, RCH Centre for Community Child Health. Tier C item-inventory backup for SR (vision/hearing observables).","superseded_check":"done"},{"id":"SRC-015","name":"NHS Ready Steady Baby — baby development from 2 to 12 months","publisher":"NHS inform Scotland (Public Health Scotland)","url":"https://www.nhsinform.scot/ready-steady-baby/early-parenthood/your-baby-s-development-from-2-to-12-months/","retrieved":"2026-08-28","tier":"C","access":"open","license_note":"Crown copyright, NHS Scotland; available under the Open Government Licence v3.0 for public sector information. Attribution required for reuse.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD","SR"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["UK"],"year":2024},"notes":"Descriptive text, not percentile ages. Useful for parent-facing observable-behaviour phrasing.","superseded_check":"done"},{"id":"SRC-016","name":"UNICEF/WHO Care for Child Development (CCD) — counselling cards, participant manual, facilitator notes, clinical practice, framework, poster","publisher":"UNICEF / World Health Organization","url":"https://www.unicef.org/documents/care-child-development","retrieved":"2026-08-28","tier":"B","access":"open","license_note":"UNICEF/WHO publication (2012 update; original late 1990s). No explicit reuse licence on the landing page; UNICEF/WHO materials generally permit adaptation for non-commercial public-health purposes with attribution. Treat as `paraphrase_only: true` in Phase 5 until an explicit statement is located.","coverage":{"age_from":0,"age_to":36,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["Multiple (LMIC)"],"year":2012},"notes":"Counselling cards age bands: newborn–1wk, 1wk–6mo, 6–9mo, 9–12mo, 12mo–2y, 2y+. Play activities and communication activities per band. Designed for low-resource settings — closest fit for the Ujjain context. 7 downloadable components on the UNICEF page.","superseded_check":"done"},{"id":"SRC-017","name":"Vroom — brain-building activity tips","publisher":"Bezos Family Foundation","url":"https://www.vroom.org/","retrieved":"2026-08-28","tier":"C","access":"open","license_note":"© 2018-2026 Vroom (a program of the Bezos Family Foundation). No explicit reuse/reproduction licence on the site. Treat as `paraphrase_only: true` in Phase 5 — cite Vroom as the origin and rewrite each tip in the corpus's own words.","coverage":{"age_from":0,"age_to":60,"domains":["GM","FM","RC","EC","CG","SE","AD"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2026},"notes":"Ages 0-5. 1,000+ activities organised around the 'Five Brain Building Basics' (Look, Follow, Chat, Take Turns, Stretch). App and printable sets. Activity source only, never an age source.","superseded_check":"done"},{"id":"SRC-018","name":"Pathways.org — milestone guides and activity handouts","publisher":"Pathways.org (sister organisation of Shirley Ryan AbilityLab)","url":"https://pathways.org/","retrieved":"2026-08-28","tier":"C","access":"open","license_note":"© 2026 Pathways. Free download from pathways.org; no explicit reuse licence — 'materials are for informational purposes only'. Treat as `paraphrase_only: true` in Phase 5.","coverage":{"age_from":0,"age_to":72,"domains":["GM","FM","RC","EC","SE","SR","AD"]},"percentile_points":[],"limit_ages":false,"sample":{"size":null,"countries":["USA"],"year":2026},"notes":"Ages baby-on-the-way to 6+ years, incl. preemie/NICU sections. Motor-heavy activity handouts, milestone brochures by month, tummy-time tools. Refers to CDC and AAP for its milestone ages — not an independent norm source.","superseded_check":"done"}]}