A 4-year-old child is assessed for fine motor development. The child can copy a circle and a cross but cannot yet copy a square. According to standard developmental milestones, by what age should a child normally be able to copy a square?
- A By 3 years
- B By 4 years
- C By 4.5 to 5 years ✓
- D By 6 years
Correct answer: C. By 4.5 to 5 years
Explanation
Copying a square is a fine motor milestone achieved by 4.5 to 5 years of age. A circle is copied by 3 years, a cross by 4 years, and a triangle by 5 years. A diamond is copied by 6 to 7 years. These drawing milestones assess visuomotor coordination and are useful screening tools for school readiness. The sequence is circle, cross, square, triangle, then diamond. Delay in these milestones may indicate fine motor coordination disorder or intellectual disability.
Reference: Nelson Textbook of Pediatrics, 21st ed.
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