Complete a Milestone Checklist (5 Years) Please enable JavaScript in your browser to complete this form. - Step 1 of 5Social/EmotionalWants to please friends *YesNot YetNot SureWants to be like friends *YesNot YetNot SureMore likely to agree with rules *YesNot YetNot SureLikes to sing, dance, and act *YesNot YetNot SureIs aware of gender *YesNot YetNot SureCan tell what's real and what's make-believe *YesNot YetNot SureShows more independence (for example, may visit a next-door neighbor by himself [adult supervision is still needed]) *YesNot YetNot SureIs sometimes demanding and sometimes very cooperative *YesNot YetNot SureNextLanguage/CommunicationSpeaks very clearly *YesNot YetNot SureTells a simple story using full sentences *YesNot YetNot SureUses future tense; for example, "Grandma will be here." *YesNot YetNot SureSays name and address *YesNot YetNot SurePreviousNextCognitive (Learning, Thinking, Problem-Solving)Counts 10 or more things *YesNot YetNot SureCan draw a person with at least 6 body parts *YesNot YetNot SureCan print some letters or numbers *YesNot YetNot SureCopies a triangle and other geometric shapes *YesNot YetNot SureKnows about things used every day, like money and food *YesNot YetNot SurePreviousNextMovement/Physical DevelopmentStands on one foot for 10 seconds or longer *YesNot YetNot SureHops; may be able to skip *YesNot YetNot SureCan do a somersault *YesNot YetNot SureUses a fork and spoon and sometimes a table knife *YesNot YetNot SureCan use the toilet on her own *YesNot YetNot SureSwings and climbs *YesNot YetNot SurePreviousNextTo have Help Me Grow follow-up about your child's results, please select the county the child lives in:Select County...BayBrevardCalhounClayDuvalFlaglerFranklinGadsdenGladesGulfHendryHillsboroughHolmesIndian RiverJacksonJeffersonLakeLeeLeonLibertyMadisonMarionMartinMiami-DadeNassauOkeechobeeOrangeOsceolaPalm BeachPinellasPutnamSeminoleSt. LucieTaylorVolusiaWakullaWashingtonOtherHelp Me Grow Florida is currently not available in your area. Please call 2-1-1 to find other resources in your county. Click the "Email" or "Print" button below for a summary of your child's milestones to share with your child's doctor and other care providers. If you have noted any concerns or selected "not yet" or "not sure" for any milestones, talk with your child's doctor, share the summary, ask for developmental screening, and go to cdc.gov/findEl to learn more about services that can help. For more information, visit cdc.gov/Concerned. PrintChild Name *Parent Name *Phone NumberEmail Address *Send Copy to my Email AddressYesBy clicking “Submit”, you are authorizing the information you provided to be released to your local Help Me Grow. I agree to allow Help Me Grow Florida to contact and follow-up with me on the results of this checklist and provide me with other relevant resources.PreviousNameSubmit