Helping Hands Children’s Therapy Services, Inc. — New Lenox, Illinois
Milestones
0–1 Month
Gross and Fine Motor
- Makes jerky arm movements; both sides of the body
- Follows moving object briefly with both eyes
- Moves head from side to side while on tummy
- Head flops backward if it is unsupported
- Brings hands within range of eyes and mouth
- Is able to keep hands in tight fists
- Momentary regard for objects
- Arm thrust
- Brief grasp response to touch
- Hand to mouth coordination
- Visual response to own hand
- Visual response to object in own hand
Language/Oral Motor
- Makes sounds
- Suckle/swallow reflex
- Tongue, jaw, lips, work as one unit
- Tongue movement — in/out pattern
- Tongue is cupped to provider channel for backward movement of liquid
- Rooting reflex
- Phasic bite reflex
- Gag reflex
Personal and Social
- Prefers to look at human faces more than objects
Visual
- Has limited ability to focus on someone’s face or an object
- Sees light and form
- Horizontal and vertical eye movements
Other Characteristics
- Focuses on things 8–12 inches away
- Eyes tend to wander and occasionally cross
- Is startled by loud sounds
- Prefers black and white or high contrast patterns
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2–3 Months
Gross and Fine Motor
- Raises head and chest when lying on tummy
- Supports upper body and arms when lying on tummy
- Waves, kicks, and squirms when lying on back or tummy
- Opens and shuts hands
- Pushes down on legs when feet are placed on a firm surface
- Brings hands to mouth
- Swipes at dangling objects with hands
- Grasps toys or other objects when put in hand and shapes them
- Sustained grasp response
- Midline hand play
- Object manipulation
- Head lag on pull to sit
- Thumb in palm, fingers flexed (bent)
- Reflex hand/flaring open
Language/Oral Motor
- Smiles at sound of familiar voices or sight of familiar faces
- Begins to babble
- Startles to loud sounds
- Says “ooh” and “ahah”
- Laughs and possibly squeals
- Suck/swallow reflex
- Tongue, jaw, and lips work as one unit
- Tongue movement in/out pattern
- Tongue is cupped to provide channel for backward movement of liquid
- Rooting reflex
- Phasic bite reflex
- Gag reflex
Personal and Social
- Begins to smile in response to someone else’s smile
- Enjoys playing with others and may cry when people stop or leave
- Becomes more communicative and expressive with face and body
- Imitates some movements and facial expressions
- Appears fussy at times, often at end of the day
Visual
- Watches mother’s face
- Begins eye focus and follow horizontally at 6″–10″ side to midline
- Has longer periods of focus; follows objects; learns to use eyes together
- Circular eye movement
- Visual response to environment and sound
Other Characteristics
- Watches faces intently
- Responds to loud sounds by becoming quiet and still, or with general body movements
- Follows moving objects
- Recognizes familiar objects and people at a distance
- Looks at own hands and stares with hands and eyes in coordination
- Stares at things a lot
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4–7 Months
Gross and Fine Motor
- Rolls from tummy to back and back to tummy
- Sits with, and then without support with support of hands
- Props self up on arms when on stomach
- Can support whole body weight on legs
- Reaches for objects with hands
- Head in midline, turns from side to side
- Fully extended hips and trunk while on tummy
- Rakes at small objects (reaches for object with fingers bent)
- Ulnar palmar grasp
- Hand-mouth coordination
- Bilateral reach grasp
- Grasp and thumb in partial opposition
- Visual attention to scribbling
- Transfers objects from hand to hand (5–6 months)
- Wrist rotation (5–6 months)
- Radial palmar grasp (5–6 months)
- Beginning pincer (5–6 months)
- Reaching across midline
Language/Oral Motor
- Turns to sounds and voices
- Responds to own name
- Distinguishes emotions by tone of voice
- Begins to respond to “no”
- Responds to sounds by making sounds and may imitate sounds
- Uses voice to express joy and displeasure
- Babbles chains and consonants
- Suckles in anticipation
- Munch chew pattern (5–6 months)
- Tongue jaw and move as one unit
- Poor coordination of suck, swallow, breathing
- Rooting decreases by 5 months
- Phasic bit reflex decreases by 5 months
- Gag reflex
Personal and Social
- Finds partially hidden objects
- Explores things with hands and by putting items in mouth
- Works to get objects that are out of reach
- Enjoys social play
- Notices small things, such as pieces of cereal in front of them
- Responds to other people’s expressions of emotion
- Squeals and make other high-pitched sounds when happy
- Smiles when looking at self in mirror
- Shows frustration when trying new skills such turning over
Visual
- Explores environment, reaches for objects (3–5 months)
- Has improved distance vision
- Has improved ability to track moving objects
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8–12 Months
Gross Motor
- Gets to sitting position without assistance
- Gets to hands-and-knees position independently
- Crawls
- Stands holding on
- Pulls self to stand
- Walks holding onto furniture
- Stands momentarily without support
- Possibly walks 2 or 3 steps without support
Fine Motor
- Uses pincer grasp
- Puts objects into container
- Takes objects out of container
- Let’s go of objects voluntarily
- Pokes at things with index finger
- Independent wrist and finger movements
- Left or right hand preference observed
- Turns pages/pushes a car/stacks rings
Language/Oral Motor
- Pays increasing attention to spoken words of others
- Talks or “jabbers” all the time, usually with nonsensical sounds
- Responds to simple verbal requests
- Stops doing something if told “no”, but only momentarily
- Says “dada” and “mama”
- Uses exclamations such as “uh-oh”
- Tries to imitate words/indicates wants
- Cup drinking unstable jaw/tongue protrusion on swallow
- Some jaw separation from tongue and lip during bite
- Improved coordination to suck, swallow, breathing (10–12 months)
Personal and Social
- Explores objects in different ways (shaking, banging, throwing, dropping)
- Finds hidden objects easily
- Looks at correct picture when the image is named
- Begins to use objects correctly (drinking from cup, brushing hair, holding phone to ear)
- Imitates gestures
- Is shy or anxious with strangers
- Cries when mom or dad leaves
- Enjoys imitating people
- Shows specific preferences for certain people and toys
- Tests parental responses to behaviors
- May be fearful in some situations
- Prefers primary caregiver over others
- Repeats sounds or gestures for attention
- Feeds self with fingers
- Extends arm or leg to help when being dressed
Visual
- Improved eye hand coordination; shifts focus (5–8 months)
- Looks for hidden objects; imitates faces (8–15 months)
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1–2 Years
Gross Motor
- Walks independently
- Pulls toys while walking
- Carries large toy or several toys while walking
- Stoops to pick item up and stands again without holding onto anything
- Can walk backwards
- Kicks a ball
- Walks up and down stairs
Fine Motor
- Scribbles spontaneously
- Turns over containers to put out contents
- Builds tower of 3–4 blocks (15–17 months) 6–8 blocks (18–23 months)
- Possibly uses one hand more frequently than other
- Functional supination
- Nests cups
- Releases and places an object in horizontal opening (17-18 months)
- Strings one bead (17–18 months); 3 beads (18–24 months)
- Imitates vertical stroke (17–18 months)
- Places 3 shapes into form board (18–23 months)
Language/Oral Motor
- Turns and looks when name is called
- Points to object or picture when it is named
- Waves “bye-bye” when someone is leaving, and says “bye-bye”
- Recognizes names of familiar people, objects, and body parts
- Says several single words like up and out
- Uses two word phrases such as “want drink”
- Follows simple instructions
- Repeats words overheard in conversation
- Uses objects, body gestures, and simple words to communicate
- Lip closure during chewing
- Reduced tongue extension during swallowing (16–18 months)
- Controlled bite without associated head movement (16–18 months)
- Uses tongue to clean lips (19–24 months)
- Straw drinking with lips (19–24 months)
- Chews meat completely (19–24 months)
- Transfers across midline (19–24 months)
Personal and Social
- Finds object even when hidden under two or three covers
- Can perform simple tasks or chores around the house
- Can pull off of some clothing
- Begins to play make-believe
- Imitates behavior of others, especially adults and children
- Is more aware of self as separate from others; recognizes self in photos
- Is increasingly enthusiastic about the company of other children
Other Characteristics
- Demonstrates increased independence
- Strives to leave caretakers to explore, but fears separation
- Begins to show defiant behavior
- Displays separation anxiety which increases towards 1½ years and fades as 2nd birthday approaches
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2–3 Years
Gross Motor
- Climbs well
- Runs and jumps well
- Walks up and down stairs, alternating feet
- Kicks ball forward
- Throws ball overhand
- Can balance on one foot for one to two seconds
- Pedals tricycle or Big Wheel
- Bends over easily without falling
Fine Motor
- Turns pages of a book one at a time
- Holds pencil in writing position
- Screws and unscrews jar lids
- Turns rotating handles
- Sorts objects by shape and color
- Completes 3–4 piece puzzles
- Makes mechanical toys work
- Cuts with scissors
- Imitate horizontal stroke (24–29 months)
- Copies circle (30–35 months)
- Traces a cross
- Builds tower of 9 blocks
- Traces square
- Catches large ball
- Uses a hammer
- Moves individual fingers
- Preferential use of one hand
Language/Oral Motor
- Follows a 2–3 part command (get doll and bring it to me)
- Ask questions/uses pronouns (me, you) and some plurals
- Recognizes and identifies many common objects and pictures
- Matches an object in hand or room to picture in book
- Knows major body parts, can say name, age, and sex (boy or girl)
- Uses 4–5 word sentences
- Appropriate jaw grading for bite
- Total disassociation of head movement for bite
- Smooth transfer of food from side to side
- Gradual refinement of tongue movements
- Tongue-lip elevation for swallowing/internal jaw stabilization
Personal and Social
- Plays make-believe with dolls, animals, and people
- Understands concept of two
- Can wash and dry hands
- Imitates adults and peers
- Spontaneously shows affection for familiar playmates
- Can take turns in games
- Understands concept of “mine”, “his” or “hers”
Other Characteristics
- Expresses affection openly, objects to major changes in routine
- Possibly puts on some clothes that are easy to get on
- Expresses wide range of emotions
- Separates easily from parents by age 3
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3–4 Years
Gross Motor
- Hops on one foot and can balance on one foot for 3–4 seconds
- Goes upstairs and downstairs without holding on
- Catches bounced ball most of the time
- Moves forward and backward with agility
Fine Motor
- Draws a person with 2–4 body parts
- Uses scissors and cuts on a line
- Copies a cross (36–41 months)
- Copies a square (42–47 months)
- Prints some letters
- Colors with direction
- Builds a tower of 10 blocks
- Cuts a straight line
- Cuts out a circle (42–47 months)
- Ties a knot
Language
- Understands the concepts of “same” and “different”
- Correctly names some colors
- Understands the concept for counting and possibly knows a few numbers
- Recalls some details from a story
- Speaks in sentences of five words
- Speaks clearly enough for strangers to understand
- Tells stories
Personal and Social
- Begins to have clearer sense of time
- Engages in imaginative play
- Is interested in new experiences
- Cooperates with other children
- Plays Mom or Dad (acts out family roles in play)
- Dresses and undresses self/negotiates solutions to conflicts
Other Characteristics
- Imagines that many unfamiliar images may be “monsters”
- Views self as whole person involving body, mind, and feelings
- Possibly has trouble distinguishing between fantasy and reality
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4–5 Years
Gross Motor
- Balances on one foot for five seconds or longer
- Jumps forward with feet together
- Performs a somersault (forward roll)
- Swings and climbs
- Possibly skips
Fine Motor
- Draws a person with body parts (about 7 parts)
- Dresses and undresses without assistance
- Uses a fork, a spoon, and sometimes a table knife
- Usually cares for own toilet needs
- Snaps fingers
- Copies diagonal strokes
- Colors within the lines
- Dynamic tripod improved and used consistently
- Builds gate as demonstrated with blocks
Language
- Speaks sentences of more than 5 words
- Uses future tense
- Tells longer stories
- Says address
- Names at least four colors
- Says what to do when a person is tired, hungry, or cold
Personal and Social
- Asks a lot of questions
- Can count five or more objects
- Better understands the concept of time
- Knows about things used every day in the home
- Plays board games and card games
- Wants to please friends and be similar to friends
- Is more likely to agree to the rules
- Likes to sing, dance, and act
- Shows more independence
Other Characteristics and Behaviors to Expect
- Is aware of gender differences — knows boy from girl
- Is able to distinguish fantasy from reality
- Is sometimes stubborn, demanding and very cooperative
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