Healthy Growth and Development - Preschool

Developmental milestones

As children grow, they will learn new things for their age and stage of development - these are called developmental milestones.

The Nipissing District Developmental Screen (NDDS) is an easy-to-use checklist that can be used to track your child's development starting as early as one month of age.

By registering online at you will get:

  • The NDDS checklist (in your inbox) at key times to see how your child is developing
  • Email reminders to check your child's development as they grow
  • Tips and activities to help your child's development

Call Region of Waterloo Public Health at 519-575-4400 if you have any questions about your child's development or how you can get the NDDS.

Is your child 18 months old?

Now is an important time to book an appointment with a health care provider to check your child's development. Your health care provider will give your child a more detailed medical check-up and any immunizations needed. Most importantly they will talk to you about your child's development and answer any questions or concerns you may have.

If concerns are identified they will link you with community resources to get started on helping your child reach their full developmental potential.

Does your 18 month old:

  • Identify pictures in a book ("Show me the dog")?
  • Use gestures (waving, pushing, reaching up)?
  • Show affection towards people, pets, toys (hug, kiss)?
  • Say 20 or more words (in any language)?

For a complete list of what your 18 month old should be doing, visit

For information about your child's development go to Rourke Baby Record

Act now:

If you or someone around your child is concerned about their development at any age speak to your health care provider. Don't wait and see if they will "catch up" to other children their age.

The earlier a child gets support the more successful they will be in school. Key areas of developmental concern are listed below.

Speech and Language Development

Early in life children learn to know what you are saying and to make sounds of their own. Without help some children may struggle with listening, speaking, learning to read and playing with other children.

Learning to speak is very important to your child's success in school and life.


Hearing is an important part of language development and your child's learning. Delayed speech is one sign of hearing problems in children.

The earlier a hearing problem is found and treated, the better chance your child has for learning in school.


Children need to have their eyes examined at six months of age and then once a year.

Difficulty learning, behavioural problems and poor social skills can be the result of poor vision.

Eye exams are covered by OHIP for children 18 years of age and under. Visit to find an optometrist.

Programs and services for children 0-6 years

The Region of Waterloo Early Identification Service Pathway and Referral List     includes programs and services information, for families with children 0-6 years of age with concerns about their child's development including vision/hearing/speech difficulties, mental health or behavioural issues, and/or problems with their teeth or nutrition.

For additional programs and services available to parents and children check the New Parent Resource Guide

Physical growth

A child's growth depends on:

  • Family Traits (parents' heights and weights, cultural background)
  • Environment
  • Nutrition

Children need to eat a variety of healthy foods and to be physically active to grow properly.  For more information on nutrition for preschool children visit our Feeding Your Preschooler page.

One to two years

  • Lose up to 10 per cent of their birth weight in the first three to four days after birth.
  • Your child will grow taller, but may not gain a lot of weight (less body fat is deposited now).
  • Have growth spurts around three weeks and six weeks after birth.

How do I know if my child is growing normally?

  • Children grow at different rates.
  • You and/or your health care provider may keep track of your child's growth by taking the following measurements:
    • Head Circumference (until two years of age)
    • Height (length up to two or three years of age)
    • Weight
  • Growth measurements should be taken at 12 months, 18 months, 24 months of age, between four and six years of age and then once a year from then on.
  • Measurements should be plotted on a growth chart to see your child's growth pattern.
  • Your health care provider can help you decide if your child's growth pattern is normal for your child.

Growth over time is more important than a single measurement.

The resource Is my child growing well? - Questions and Answers for Parents is available in English, French, Spanish, Punjabi, Chinese and Vietnamese at the Dietitians of Canada website.  

Growth charts

If you have any questions about your child's growth, check the information on the Growth Charts page.

Resources and more information

"The Talk" from Tots to Teens

For more information  please call Region of Waterloo Public Health 519-575-4400.