About early child development

A child's early years are very important for healthy development. This is a time when a child's brain and body develop at a rapid pace. Healthy babies and toddlers are more likely to stay healthy through their childhood, teen and adult years.

Ontario offers early child development programs to support children in their growth and development before birth to the time they enter school.

The programs provide services based on your child's needs.

You do not need a referral from a doctor.

Programs and services to support your child’s growth and development

Healthy Babies Healthy Children

Learn about the support you can get during pregnancy, after your baby is born and as your child grows.

Preschool Speech and Language

Find out about your child's speech and language development, and the help that's available.

Infant Hearing Program

Learn what hearing services and supports are available in your community.

Blind-Low Vision Early Intervention Program

Learn about support that's available for children who have a visual impairment.

18-Month Well-Baby Visit

Learn what to expect at your baby's Enhanced 18-Month Well-Baby Visit, including your child's 18-month vaccination.

Support your child's health

Child care and school

Monitor your child's developmental milestones

These developmental milestones have been provided to show some of the skills that mark the progress of young children as they learn to communicate. You may use these milestones to help monitor your child's development.

By 6 months

Most children can:

  • turn to source of sounds
  • startle in response to sudden, loud noises
  • make different cries for different needs (for example, I'm hungry, I'm tired)
  • watch your face as you talk
  • smile and laugh in response to your smiles and laughs
  • imitate coughs or other sounds (for example, ah, eh, buh)

By 9 months

Most children can:

  • respond to their name
  • respond to the telephone ringing or a knock at the door
  • understand being told "no"
  • get what they want through sounds and gestures (for example, reaching to be picked up)
  • play social games with you (for example, peek-a-boo)
  • enjoys being around people
  • babbles and repeats sounds (for example, babababa, duhduhduh)

By 12 months

Most children can:

  • follow simple one-step directions (for example, "sit down")
  • look across the room to something you point to
  • use three or more words
  • use gestures to communicate (for example, waves "bye bye", shakes head "no")
  • get your attention using sounds, gestures and pointing while looking at your eyes
  • bring you toys to show you
  • "perform" for attention and praise
  • combine lots of sounds as though talking (for example, abada baduh abee)
  • show interest in simple picture books

By 18 months

Most children can:

  • understand the concepts of "in and out", and "off and on"
  • point to several body parts when asked
  • use at least 20 words
  • respond with words or gestures to simple questions (for example, "where's teddy?", "what's that?")
  • demonstrate some pretend play with toys (for example, gives teddy a drink)
  • make at least four different consonant sounds (for example, b, n, d, g, w, h)
  • enjoy being read to and looking at simple books with you
  • point to pictures using one finger

By 24 months

Most children can:

  • follow two-step directions (for example, "go find your teddy bear and show it to Grandma")
  • use 100 or more words
  • use at least two pronouns (for example, "you", "me", "mine")
  • consistently combine two or more words in short phrases (for example, "daddy hat", "truck go down")
  • enjoy being with other children
  • begin to offer toys to peers and imitate other children's actions and words
  • be understood by people 50% to 60% of the time
  • form words and sounds easily and effortlessly
  • hold books the right way up and turn pages
  • "read" to stuffed animals or toys
  • scribble with crayons

By 30 months

Most children can:

  • understand the concepts of size (big and little) and quantity (a little, a lot, more)
  • use some adult grammar (for example, "two cookies", "bird flying", "I jumped")
  • use more than 350 words
  • use action words (for example, run, spill, fall)
  • begin taking turns with other children, using both toys and words
  • show concern when another child is hurt or sad
  • combine several actions in play (for example, feed a doll then put it to sleep, put blocks in train then drive train and drop blocks off)
  • include sounds at the beginning of most words (for example, say "cat" rather than "at")
  • produce words with two or more syllables or beats (for example, "ba-na-na", "com-pu-ter", "a-pple")
  • recognize familiar logos and signs, for example stop sign
  • remember and understand familiar stories

By age 3

Most children can:

  • understand "who", "what", "where" and "why" questions
  • create long sentences using 5 or more words and talk about past events (for example, trip to grandparents' house, day at childcare)
  • tell simple stories
  • show affection for favourite playmates
  • engage in multi-step pretend play (for example, cooking a meal, repairing a car)
  • be understood by most people outside of the family, most of the time
  • be aware of the function of print (for example, in menus, lists, signs)
  • have a beginning interest in, and awareness of, rhyming

By age 4

Most children can:

  • follow directions involving three or more steps (for example, "first get some paper, then draw a picture, last give it to mom")
  • use adult-type grammar
  • tell stories with a clear beginning, middle and end
  • talk to try to solve problems with adults and other children
  • demonstrate increasingly complex imaginative play
  • be understood by strangers most of the time
  • be able to generate simple rhymes (for example, cat and bat)
  • match some letters with their sounds (for example, the letter T says 'tuh')

By age 5

Most children can:

  • follow group directions (for example, "all the children get a toy")
  • understand directions involving "if...then" (for example, "if you're wearing runners, then line up for gym")
  • describe past, present and future events in detail
  • seek to please their friends
  • show increasing independence in friendships (for example, may visit a neighbour by themselves)
  • use almost all of the sounds of their language with few to no errors
  • know all the letters of the alphabet
  • identify the sounds at the beginning of some words (for example, "pop starts with the 'puh' sound")

Information for professionals

Healthy Child Development - Integrated Services for Children Information System (HCD-ISCIS)

The Healthy Child Development - Integrated Services for Children Information System (HCD-ISCIS) is a provincial database that stores personal information of families who receive services from the five early childhood development programs.

Service providers must get consent from families before they enter their information in the provincial database.

Service providers are:

  • public health units
  • hospitals
  • children's treatment centres
  • other community-based organizations funded by the Province of Ontario

Information protection and privacy

The Province of Ontario provides the HCD-ISCIS database to participant service providers in its role as a "health information network provider" under the Personal Health Information Protection Act, 2004.

Ontario protects personal health information stored in the HCD-ISCIS application. All employees that oversee the HCD-ISCIS application must attend privacy training and sign appropriate confidentiality agreements. Any individual or third party engaged by the Ministry of Children, Community and Social Services (MCCSS) to support HCD-ISCIS is bound by the same privacy requirements. Ontario employs technical safeguards for information systems where personal information may be accessed, including:

  • passwords
  • audit logging
  • encryption
  • role-based access controls