CHANG MIDTERM DEV MILESTONEs

Gross motor developmental sequence

Head/trunk control → sitting → mobility → walking → running → jumping → hopping/skipping → improved coordination and endurance.

Object grasp developmental sequence

Reflexive palmar grasp → voluntary whole-hand grasp → increased thumb use → pincer grasp → precision release → functional manipulation.

Pencil grasp developmental sequence

Palmar-supinate → digital-pronate → static tripod/quadrupod → dynamic tripod/quadrupod.

Bilateral coordination developmental sequence

Hands at midline → transferring objects → using both hands together → one hand stabilizes → complementary hand roles.

Scissor developmental sequence

Opening/closing → isolated snipping → repeated snips → cutting lines/circles → cutting complex shapes.

Prewriting developmental sequence

Scribbling → vertical/horizontal lines → circle/cross → diagonals/square → X/triangle → name/letters.

Play developmental sequence

Sensorimotor → functional → symbolic/pretend → increasing cooperative play → games with rules.

Self-care developmental sequence

Participation → partial sequencing → increasing independence → responsibility for routines.

Feeding developmental sequence

Finger feeding → spoon/fork use → improving open-cup control → increasingly independent meals.

Reaching developmental sequence

Exploratory swiping → reaching toward midline → reaching and grasping → directional/adaptive reaching.

Birth–6 months: Gross motor

Develops head/trunk control, rolling, and supported standing play.

Birth–6 months: Fine motor

Midline hand play, early reaching, palmar grasp, and mouthing objects.

Birth–6 months: Play

Sensorimotor exploration, repeated pleasurable actions, hands/mouth exploration; coos, smiles, laughs, responds to caregiver voice, repeats pleasurable actions

Birth–6 months: Social

Coos, smiles, laughs, and communicates early emotional signals.

6–12 months: Gross motor

Sits independently, crawls, creeps, and stands with support, cruises; hand-held walking may emerge around 12 months.

6–12 months: Fine motor

Transfers objects between hands, bangs objects, points, develops fingertip grasp, and releases objects into containers.

6–12 months: Feeding

Holds bottle with both hands, uses a cup with help, and begins exploring spoon; finger feeding.

6–12 months: Play/social

Purposeful toy use, give-and-take, cause-and-effect play, response to name, and emerging stranger awareness.

12–18 months: Gross motor

Walks, squats, climbs, begins early running, and negotiates stairs with help.

12–18 months: Fine motor

Refines pincer grasp, scribbles, stacks objects, inserts pieces, and opens containers.

12–18 months: Feeding

Holds cup with both hands, takes a few sips, explores straw use, and scoops with a spoon with spilling.

12–18 months: Play

Functional object use and emerging symbolic play using real props.

18–24 months: Gross motor

Runs, climbs, kicks and throws a ball, and jumps in place.

18–24 months: Fine motor

Completes simple puzzles, stacks 4-6 blocks, turns pages, manipulates beads, and uses simple tools; scribbles purposefully

18–24 months: Feeding

Spoon and fork use improve; increasing independence with self-feeding.

18–24 months: Play

Links pretend-play actions, uses objects symbolically, and emerging parallel play.

2–3 years: Gross motor

Tricycle skills emerge, catches a ball against the chest, jumps down, and begins early one-foot hopping.

2–3 years: Fine motor

Snips with scissors, colors broadly, traces a cross, and begins producing circles.

2–3 years: Pencil grasp

Digital-pronate grasp is common; more refined grasp patterns are developing.

2–3 years: Dressing

Removes simple clothing and begins participating with buttons.

2–3 years: Toileting

Sits upright for toileting and may indicate wet or soiled clothing.

2–3 years: IADLs

Helps pick up toys and participates in simple household routines.

2–3 years: Play

Combines pretend actions into scripts, sorts/matches objects, and develops peer interest and early turn-taking; parallel play; pretend play;

3–4 years: Gross motor

Runs and climbs; emerging hopping and skipping, and alternating feet on stairs continue emerging; rides tricyle

3–4 years: Fine motor

Develops tripod-like grasp, copies shapes, practices cutting, and demonstrates emerging in-hand manipulation.

3–4 years: Dressing

Puts on and removes clothing without complex fasteners.

3–4 years: Grooming

Washes hands, spits toothpaste, and enters the bath with support.

3–4 years: Toileting

Daytime control and sequencing of clothing/toileting routines emerge.

3–4 years: IADLs

Picks up belongings and retrieves familiar items.

3–4 years: Play

Uses imaginary objects, engages in role play, categorizes objects, and participates increasingly in group play.

4–5 years: Gross motor

Jumps forward/down, throws toward targets, develops longer hopping/skipping sequences, and uses reciprocal stairs.

4–5 years: Fine motor

Dynamic grasp emerges; copies simple shapes and increasingly stabilizes paper with the helper hand.

4–5 years: Dressing and grooming

Simple fasteners progress; gathers grooming supplies and assists with grooming setup.

4–5 years: IADLs

Obtains simple snacks with appropriate support.

4–5 years: Play

Understands game rules, engages in cooperative role play, and participates in goal-oriented small-group play; sharing and turn taking; imaginary role play

5–6 years: Gross motor

Sustained hopping, balanced skipping, catching with both hands, accurate kicking, and brief single-leg stance.

5–6 years: Fine motor

Copies name and triangle, manipulates small objects, and develops sustained pencil control.

5–6 years: ADLs

Increasing independence with face washing, brushing teeth, bathing, and managing dressing fasteners.

5–6 years: IADLs

Helps set/clear the table and learns emergency actions, stranger awareness, and safety rules.

5–6 years: Play

Complex pretend scripts, organized games, friendships, simple problem solving, and perspective-taking.

6–7 years: ADLs

Increasing independence with dressing, toileting hygiene, and grooming routines.

6–7 years: IADLs

Prepares simple snacks, manages school belongings, and learns locks, road safety, and family safety plans.

6–10 years: Handwriting

Greater emphasis on legibility, spacing, alignment, speed, endurance, and efficient written output.

6–10 years: Play

Games involving rules, strategy, planning, problem solving, and peer participation.

1.5–2.5 years: Scissors

Explores opening and closing scissors; isolated snipping may occur.

2.5–3.5 years: Scissors

Repeated snips progress across paper.

3.5–4 years: Scissors

Cuts lines and simple circles using the helper hand.

4.5–6 years: Scissors

Cuts simple and increasingly complex shapes near a guideline.

12–18 months: Grasp

Refined pincer grasp and precision release support manipulation of small objects; stack 2-3 blocks, scribbles.

3–4 years: Pencil grasp

Tripod-like grasp develops; movement may still rely on wrist/forearm control.

4–5 years: Pencil grasp

Dynamic grasp begins emerging, with increasingly refined finger movement.

12–18 months: IADLs

Gives requested items and helps search for familiar objects within routines.

18–24 months: Play type

emergin parallel play, pretend play, imitates household chores, linked play steps

2–3 years: Open cup

Drinks from an open cup with reduced spilling.

3–5 years: Feeding

Increasing independence during familiar meals.

Preschool handwriting progression

Circle/cross → diagonals/square → X/triangle → name/letters.

School-age handwriting concerns

Consider legibility, speed, endurance, comfort, and actual classroom participation rather than grasp appearance alone.

Developmental delay interpretation

Compare age, expected sequence, actual performance, opportunity, performance quality, and occupational impact before identifying a concern.