Motor Milestones

Elite Therapy Center’s occupational and physical therapy is provided through Elite Therapy Services. Pediatric occupational therapy provides skilled treatment for infants and children who need special  help developing or regaining functional skills such as self-care and activity of daily living (ADL) skills, feeding and oral-motor difficulties, play and social skills. We offer encouragement and celebrate in each client’s success. Remember: Early detection and intervention are key. If you have any concerns, please contact us.

Speech Milestones

Gross & Fine Motor Milestones

  • Birth – Physiological Flexion, Full head lag with pull to sit, clears nose from the bed on stomach, Pelvis high with legs flexed, head sags forward in supported sitting, hands fisted yet easily opened
  • 1 month – Moves both arms and legs while on stomach, alternately kicks legs while on back, able to briefly align head with trunk in supported sitting
  • 2 months – Arms more extended and alternately kicking legs while on back, continued head lag with pull to sit, lifts head to 45 degrees, legs “frogged while on stomach but pelvis lower to surface, in supported sitting head bobs erect yet still unable to control trunk
  • 3 months – Elbows inline with shoulders for forearm support while on stomach, Rolls stomach to back with lateral weight shifting, hand to foot play, minimal head lag with pull to sit, midline head alignment in most positions, reach and grasp of rattle emerging
  • 4 months – No head lag with pull to sit, symmetrical posture on back, head in midline in all positions, lifts and holds head at 90 degrees while on stomach, props on elbows with elbows in line with shoulders, legs together in prone, rolls back to side, sit supported with head steady, sitting with support with upper back more extended, takes weight on feet while supported at under arms.
  • 5 months – Weight shifting on stomach to reach with one arm, Brings feet to mouth while on back, gross grasp of toys at midline, briefly able to static ring sit after placed in sitting, pivots on stomach, begins to push back up onto hands and knees
  • 6 months – Plays with feet while on back, Tucks chin and pulls to sit, reaches with bilateral arms, pushes up on extended arms while on stomach, sits independently with hands propped forward, stands with support at hands, sidelying props
  • 7 months – Rocks on hands and knees, transitions from all fours to sitting, rapid rolling, quick sit up with external support, able to static sit and play with a toy, crawls on belly
  • 8 months –  Refuses to lie on back, head leads with pull to sit, assumes all fours easily and rocks readily, Sits independently with hands free for play, assumes sitting from stomach, side props in sitting, stands holding on with wide base of support, creeps on hands and knees, controlled release of objects and passes objects hand to hand, begins to pull to stand
  • 9 months – Kneels at a support, creeps rapidly on hands and knees, pulls to stand on objects, drops abruptly to return to sit.
  • 10 months – Creeps very quickly, rotates to reach toys in sitting easily with no loss of balance, side sits, cruises at furniture, lowers to sit on the floor, walks with two hands held, quick transitions in and out of sitting
  • 11 months – Pulls to stand by ½ kneel, bounces in standing,
  • 12 months – Stands alone, Takes first steps with arms held high and a wide base of support, walks with one hand held, smooth descent from standing, rolls a ball away, picks up raisin between thumb and fore finger, transitions floor to stand through ½ kneel without support.
  • 13–14 months – Sustained standing without external support, squats to pick up objects and regains standing, holds two cubes and takes a third, builds two cube tower, independent walking, climbs into adult chairs, says 2-3 words plays patty cake, points at desired object
  • 15-16 months – Mid to low arm position during walking, creeps up steps, walks up small steps with support with one foot on each step, builds a tower with 3 cubes, flings ball, takes shoes off, pulls at socks, self feeding with fingers, drinks from cup, indicates if pants are soiled, walks backwards a few steps, stoops and recovers easily, standing from floor, carries objects while walking.
  • 18 months – Carries or pulls an object while walking, creeps down steps, walks up stairs with the rail, turns book pages, scribbles, builds tower with 3-4 cubes, takes off socks, dry for several hours during the day, decreased base of support width of pelvis, 20 word vocabulary
  • 20 months – Walks up steps with step to pattern with one hand support, down stairs with step to pattern with assistance and external support, builds tower of 5-6 cubes, places pellet in bottle, separates pop beads, identifies some body parts, pulls adults to point out objects, begins to consent to sit on potty, running, tries to jump down
  • 24 months – Ascends stairs alone with one foot on each step, Attempts foot over foot with adult support, kicks a small ball, throws a ball overhand five feet, jumps off a low step, builds a tower of 6-7 cubes, turns pages of a book individually, puts on shoes and socks, pulls pants up & down, uses a spoon or fork with little spillage, combines words to phrases, identifies 6 body parts, often wakes dry from naps.
  • 2 ½ years – Jumps off step with 1 foot leading, jumps off floor with two feet, climbs on tricycle, imitates tip toe walking, builds an 8 cube tower, imitates pen strokes, identifies all major body parts, climbs onto toilet, independent with removing and replacing clothing, up stairs reciprocally, down stairs reciprocally with help, jumps off objects after climbing.
  • 3 years – Jumps off step and lands on two feet, rides tricycle, stands on one foot briefly, attempts to use scissors, 9 cube tower, block bridge, practices counting, independent dressing except shoes and buttons, independent with toileting except wiping, not always dry over night, running well, jumps over small 1-2 inch objects, descends steps without support, understands turn taking.
  • 4 years – Balances on 1 foot 4-5 seconds, hopping begins, tracing lines, hand preference indicated, negotiates roles and responsibilities, majority toilets independently without accidents at night, running fluid with arm swing
  • 5 years-  Jumps forward and sideways, jumps over object 6-8 inches off floor, throws ball to hit target, drawing simple shapes, letters and numbers, vocabulary adequate to communicate well with adults and children in familiar situations, complex play with friends and siblings of same age, can learn to ride two wheel bike and roller skate, tripod grip.

The occupational therapist addresses the treatment and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases and provides individualized assessment and often early detection of physical challenges. Treatments are play-based and are unique to the developmental level of each child.

Occupational therapy provides skilled treatment for infants and children who need special  help developing or regaining functional skills such as self-care and activity of daily living (ADL) skills, feeding and oral-motor difficulties, play and social skills. Occupational therapy is also indicated for children having difficulties with upper extremity orthopedic / neurological injury, splinting and positioning needs, home accessibility evaluations, motor planning / visual motor control, sensory integration dysfunction, school functional assessments including handwriting.

As with most problems in life, the sooner they are detected and addressed, the higher the success rate. This is especially true for children with special needs. We can help you address a functional difficulty before it causes a reduction in functional abilities, low self-esteem, poor school performance, or strained peer and family relationships.


More information about Sensory Processing Disorder

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into responses. For those with Sensory Processing Disorder, sensory information goes into the brain but does not get organized into appropriate responses. Those with SPD perceive and/or respond to sensory information differently than most other people. Unlike people who have impaired sight or hearing, those with Sensory Processing Disorder do detect the sensory information; however, the sensory information gets “mixed up” in their brain and therefore the responses are inappropriate in the context in which they find themselves.

Sensory Processing Disorder or SPD (originally called Sensory Integration Dysfunction) is a neurological disorder in which the sensory information that the individual perceives results in abnormal responses.  A more formal definition is: SPD is a neurophysiologic condition in which sensory input either from the environment or from one’s body is poorly detected, modulated, or interpreted and/or to which atypical responses are observed. Pioneering occupational therapist, psychologist, and neuroscientist A. Jean Ayres, Ph.D., likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. Information from: