Children's Developmental Milestones: Gross and Fine Motor Skills
You might be wondering if your child is reaching certain developmental milestones in an appropriate time frame. While each child is different and will develop their motor skills at different times, there are some guidelines that pediatricians and pediatric physical and occupational therapists follow.
What are motor skills?
Motor skills are the different ways in which the body uses muscles to perform specific tasks. Crawling, sitting up, and walking are all motor skills. So are picking up a toy or grabbing onto the railing of a crib. Motor skills are grouped into two types: fine motor skills and gross motor skills.
Fine Motor Skills
These motor skills use smaller muscles, specifically those in the hand and wrist. These include grasping skills as well as eye-hand coordination.
Gross Motor Skills
These motor skills use larger muscles and muscle groups. They include rolling, crawling, and walking.
What are fine and gross motor milestones?
Milestones are behaviors that indicate typical stages of growth and development. Milestones occur at every age. Many of our gross and fine motor milestones occur within a range of time, so this list may be used as a guideline. Each child develops at their own pace and if you are concerned for developmental delay, bring these concerns to your pediatrician.
Newborn to two months developmental milestones
By two months, children should start lifting the head during tummy time and pushing up onto forearms. They can close their fingers in a tight grasp, and hold onto a rattle with one hand briefly. They also start to bring their hands to their mouths.
Three to five months developmental milestones
At three months, children are able to lift their head further while on their tummies, and push up higher on forearms. For fine motor skills, children are able to grasp a string and pull it, hold on to a block, and reach their arms up toward a toy while lying on their backs.
At four months, children’s gross motor skills allow them to sit with their hands placed on the floor in front and pull up to sitting with their chin tucked. They can also bring their hands to their midline for play time.
At five months, children begin rolling from belly to back and shift their weight to reach while on their tummies. They are also able to bring their hands to their feet while on their backs. They also begin to exhibit the fine motor skill of grasping a block with pinky and ring fingers.
Six to eight months developmental milestones
In this age range, children typically begin to be more mobile. Six-month-old gross motor skill milestones include rolling from the back to the belly, pushing up onto hands from the tummy, and sitting independently. At seven months, children begin crawling on their bellies and can maintain a quadruped position (on their hands and knees). And at eight months they really take off, crawling on hands and knees, transitioning from sitting to a quadruped position, and pulling to stand up with support.
During this time, children also develop the fine motor skills of moving a rattle in 90° arcs, grasping toys with their whole hands, and using a raking motion with their hands palm facing down to grasp small toys.
Nine to eleven months developmental milestones
At nine months, children start walking along surfaces and furniture. By ten months, they are standing independently for a few seconds. And by eleven months, they’re standing longer and starting to take steps.
During this time, they also develop the fine motor skills of clapping their hands together and grasping and pulling, often demonstrated by removing both socks.
Twelve to fourteen months developmental milestones
By this age, children are able to creep with hands and feet on the ground in a bear crawl, transition from sitting to standing, walking independently, and creeping upstairs. They’re also able to open a board book and place pegs onto pegboards and shaped toys into their correct holes on a shape board. They are also better able to hold smaller objects using a pincer grasp (forefinger and thumb), start to hold markers in their fist, and also begin to try using spoons to feed themselves.
Developmental milestones for 15-18 months
Between 15 and 18 months, children begin creeping downstairs as well as walking up and down stairs with assistance, either from an adult or using the wall. They will also be able to walk backwards. During this time, they are able to stack 2-3 cubes, place two shapes correctly in a shape board, and hold a marker in an “overhand” way.
Developmental milestones for 19-24 months
Children begin to run at this age, and can ascend stairs with a step-to pattern. They also are able to turn 3 pages, one at a time, in a board book, stack 4-6 cubes, and draw vertical lines.
Developmental milestones for 2-3 years
At this age, children should be able to balance on one leg for a few seconds, ascend stairs with an alternating step pattern, and descend the stairs in the step-to pattern. They can stack 8-10 cubes, draw a horizontal line, string 2-4 beads on a line, draw a circle, and are proficient in using a spoon and start to show interest in using forks. They are also able to hold an object with one hand while using the other to perform an action, such as stabilizing a piece of paper while drawing. They can unbutton large buttons and hold and snip with safety scissors.
Developmental milestones for 3-4 years
During this time, children become better at balancing and are able to stand on one leg for 3-4 seconds. They also can kick a ball, run, and jump. They can also lace three holes, draw a cross of horizontal and vertical lines, button and unbutton large buttons, and grasp a marker in a tripod grip. They can also manipulate small buttons and use scissors to cut a straight line.
Developmental milestones for 4-5 years
As they reach school age, children are able to hop on one foot, balance on one leg longer, and skip. They can also draw squares, cut out simple shapes on paper, and have established if they prefer using their right or left hand most frequently.
What are developmental delays?
Developmental delays occur when a child does not display expected milestones for his or her age. Developmental delays may occur at any time from infancy to school-age. They can occur in:
- Fine motor skills
- Gross motor skills
- Communication skills
- Adaptive skills
- Speech and language skills
- Cognitive skills
What to do if you notice a developmental delay in your child?
Talk to your child’s pediatrician. A pediatrician can perform simple tests with your child and refer you to specialists as needed. Specialists may include physical therapists, occupational therapists, speech therapists, neurologists, psychologists, and developmental behavioral pediatricians.
Lifespan’s Children’s Rehabilitation Services uses a child- and family-centered approach to help children gain the skills they need to participate in daily life and in the community. We are here for children and families at every stage of life. Learn more about our services on our FAQ page.
About the Author:
Paula Cava, OTD, OTR/L, Taylor Coffey, DPT, and Nicole Perno, DPT
Paula Cava, OTD, OTR/L, is an occupational therapist with Children's Rehabilitation Services at Hasbro Children's Hospital. Taylor Coffey, DPT, and Nicole Perno, DPT, are physical therapists with Children's Rehabilitation Services.
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