Developmental Stages – Four Months
Social and Emotional
May smile on social approach
Emergence of personality traits, i.e. dislike of certain routine or position
Language
Repeats sound chains 4-5 syllables (ba-ba-ba)
Laughs out loud
Comfort sighs
Babbles
Cry changes with bodily state
Begins to vocalize socially
Fine Motor
Grasp reflex waning
Placing reaction in upper limbs
Grasps toy if toy touches hand
Reaches toy when dropped within reach
Brings hands together to midline and plays with fingers
Holds fists open
Sensory
Visual
Searches for sound with eyes
Fixiates on sound with eyes
Looks at hand
Active inspection of environment and objects
Shifts regard from object to hand and back to object
Complete horizontal regard
Auditory
Turns head to sound
Attends to human voice
Recognizes mother’s voice
Possible recognition of strange vs. familiar sounds
Tactile
Mouths objects
Body awareness
Localization of sensation
Moves body at sight of toy if dangled
Gross Motor
Midline syndrome is gone
Free rotation of head, arms move freely
Pulls to sit when hands held
Kicks when supine or prone
Head holds position in supine
Neck righting
Moro gone
Asymmetric al A-tonic (ATN) neck reflex
Swimming in prone
Prone bilateral upward extension of legs; back arches
Rolls both ways
Pushes whole chest off bed
Waves arms
Symmetrical postures predominate
Slight head lage with gross sitting
Holds head 90 degrees prone on abdomen
Falls sideways – arms flexed, spine extends, arch of body and toes
