Neonatal neurodevelopmental follow-up recommendations: 12 month visit

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This page provides recommendations to encourage development in babies aged 12 months who have spent time in the NICU or CCCU, or who require care a neonatal follow-up clinic.

Key points

  • Babies who have been in the NICU or CCCU may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth.
  • Recommendations at 12 months focus on encouraging standing, developing more intricate fine motor skills, and further encouraging verbal communication.
  • Parents and caregivers should follow these recommendations to encourage neurodevelopment.

Talking and playing with babies are two of the most important things parents and caregivers can do to help them develop. There are many ways to encourage development. The recommendations provided are general and not all inclusive. The recommendations provide strategies to help promote gross motor skills, fine motor skills, early language development, and socialization.

  • Gross motor skills include big movements such as rolling, crawling, standing or walking.
  • Fine motor skills include hand movements such as reach and grasp.
  • Early language development includes cooing, babbling, and a baby’s first words.

What is the Neonatal Follow-Up Clinic?

The Neonatal Developmental Follow-Up Program is a specialized clinic for children who had medical complications related to, or immediately after, their birth. This clinic assesses gross-motor, fine-motor, social development, language and learning ability at specific ages to determine if the child is developing normally.

Babies who have been admitted to the Neonatal Intensive Care Unit (NICU) or Cardiac Critical Care Unit (CCCU) may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth. However, not all babies followed in the Neonatal Developmental Follow-Up Clinic have been in the NICU or CCCU. These recommendations can be used to encourage development in babies who have not spent time in the NICU or CCCU. Talk to your child’s doctor to see if you should be following these guidelines with your baby.

Babies and toddlers are assessed at specific ages in the clinic and given recommendations that parents and caregivers can refer to at home to help their baby achieve their maximum potential. These recommendations are for corrected age, as most of the babies followed in the clinic were premature at birth.

If you are concerned about your baby’s development, speak with your primary health-care provider.

Neonatal neurodevelopmental recommendations at 12 months

Gross motor:

  • Practice standing at a stable surface (e.g. couch) to play. Encourage flat feet when baby is standing. Check to make sure the surface is low enough to promote flat feet.
  • Hold your child low on their body (pelvis, thighs, or lower) when practicing standing to help activate stomach muscles.
  • Encourage cruising on the floor using furniture as a support by putting toys at one end of the couch and your child at the other. Do this so that your child moves in both directions along the floor.
  • Your child benefits more by practicing cruising and early stepping without hand-holding. If you are holding hands, hold hands at or below shoulder level. You can also hold low on the body (pelvis or lower) when practicing stepping.
  • Practice gross motor skills, including coordination, on riding toys. In playgrounds practice coordination and climbing over small things on the small climbers and slides.
  • Practice ball games such as kicking and throwing. Do not expect catching yet.

Fine motor:

  • The high chair is an excellent place to finger feed or practice pincer grasp. Build it into your daily routine. You can sit opposite your child (face-to-face) and enjoy this time together. As you play, verbally label toys to encourage development of early language skills.
  • Provide opportunities for container play and introduce shape sorters and simple puzzles for play.
  • Practice stacking for refinement of release skills (e.g., nesting cups, rings on pole, small blocks).
  • Continue with cause and effect toys that have to be pushed, pulled or turned (e.g., pop-up toy).
  • Introduce thick crayons and encourage scribbling. Introduce connecting toys, blocks (e.g., “Duplo”) and a variety of objects with different textures, shapes, sizes for exploration with hands.
  • Handedness (left/right) – encourage use of non-dominant hand by presenting toys and objects to non-dominant side.


  • Be face to face with your baby. Use short phrases and lots of gestures to communicate. Repeat what you say and do.
  • Watch what your child is doing, wait, listen and respond. Imitate actions and keep the interaction going.
  • Play vocal turn-taking games.
  • Make sure there are reasons to communicate; avoid anticipating all of their needs.
  • Use simple picture books with real life photos, and books that have “patterns”. Try to read to your baby every day.


  • Functional play – introduce playing with toys/objects as they were intended to be used.
  • Encourage pretend play (e.g. feeding a doll or farm animals).
  • Provide opportunities for interaction with peers (e.g., Ontario Early-Years Drop-In Centres, library programs or community groups) for greater socialization and early language development.
  • Electronic media use by children younger than two years old is not recommended. This includes phones, television, computers, and tablet devices.


  • Continue regular visits to your family doctor/paediatrician to monitor growth.
  • Transition to homogenized milk at 12 months corrected age. Avoid juice.
  • Present a variety of cubed or chopped foods for finger feeding and introduce own spoon at mealtime.


  • Establish a regular sleep schedule and bedtime routine. Consider reading to your child as part of routine.
  • Practice safe sleep habits; back to sleep, on a separate, firm surface.

For more information on neonatal neurodevelopmental recommendations at different ages, please see the links below:

Parental mental health and well-being

All caregivers are encouraged to have ongoing discussions about their mental health and well-being with their family doctor. There are free community services available to promote coping and resilience for caregivers. Consider learning more about the following supports and interventions.

Last updated: March 30th 2021