Gross and Fine Motor Development

Neonate (GM)

Prone: Head elevates to clear face and reposition it. Flexor bias of trunk (physiological flexion)

Supine: Head rotates fully in either direction but can come to midline with arousal.

Sitting: Head may bob while in kyphotic (slumped) supported sitting position. Head position is typically flexed forward.

Standing: Reflex standing/stepping

1m (GM)

Prone: Head rotates when placed face down; lifts head momentarily. Still physiological flexion, but less. Head drops when suspended, momentarily lifts to plane of body.

Supine: Asymmetrical postures predominates with all limbs flexed (not as much as birth); more random movements of limbs; hands fisted; reciprocal kicking alternates with symmetric kicking.

Sitting: Forward flexion trunk, can hold head in line with trunk for short intervals.

Standing: Reflex standing and stepping

2-3m (GM)

Prone: Elbows in line with shoulders for forearm support; lift head 45* sustained, 90* shortly; posture with pelvis flat on floor

Supine: Symmetrical posture with mid-position of head, but may still prefer head to one side; legs kicky reciprocally.

Sitting: Head upright but still bobbing in supported sitting; needs full support to sit; variable head lag in pull to sitting position

Standing: Supported standing with poor weight bearing with hips in flexion, behind shoulders

4-5m (GM)

Prone: Props on forearms, one arm extended (forearm support position); weight shifting to free arm and reach with one hand; props on hands with extended arms (assume hand support position); pivot prone

Supine: Alternates feet to mouth and bridging; attempts roll to side with leg or arm leading

Sitting: Prop sit with assistance; Static ring sit shows no head lag

Standing: Supported standing with some weight bearing.

6-7m (GM)

Prone: Elevates trunk with elbow extension; may rock on hands and knees; belly crawling; rolls to supine

Supine: Brings feet to chin or mouth; rolls to prone; attempts to raise self to sit

Sitting: Unsustained sitting with high guard. Static sitting while manipulating a toy (sitting independently with high guards); weight-shifting with lateral and anterior arm support

Standing: Supported standing with better weight bearing; take large fraction of weight; bounces actively in supported standing

8-9m (GM)

Prone: Transition in and out of sitting to quadruped or prone; pulls to stand with support; Creeping

Supine: Raise self to sit; not interested in supine

Sitting: Manipulate toy in sitting position; anterior, lateral protective reactions.

Standing: Bears full weight holding on to rail; stands at furniture

10-11m (GM)

Prone: Pull to stand by rolling up over feet; pulls to stand through half kneeling.

Supine: Transitions to sitting and quadruped.

Sitting: Rotates or pivots while sitting to reach; transitions to prone or supine easily.

Standing: Lowering to sitting position from supported standing; stepping in standing when both or one hand are/is held; cruises with external support.

12m (GM)

Prone: Stands up through quadruped.

Supine: Moves rapidly into sitting or quadruped to standing.

Sitting: Wide variety of sitting positions includes side-sitting.

Standing: Independent walking with high guars arms and wide space; lower self with control from standing.

0-3m (FM)

Eye-to-Eye contact; Fixes eyes on light; eyes follow object to midline (1month), to past midline (2 months), over 180* (3 months),down, then up eye movement. Hands opening from closed posture,

3-5m (FM)

“Grasp with the eyes” (can lock onto object with eyes, and even use this staring to assist bringing the arm/hand to object) *also corals objects to study them

Hand regard: studies hands, bring them to midline, clutches and unclutches hand (think symmetry)

Visual exploration of environment

Clutches clothes, touches body, mouth face

Grasps object placed in hand, adducted thumb, palmar grasp

5-7m (FM)

Reach all directions; needs trunk support when standing

Bilateral and unilateral reach; excessive MP/finger extension

Maintains grip on stationary object

Ulnar grasp changing to radial palmar grasp; flexed wrist becomes straight around 7 months

Mirror movements of grasp in the other hand

Move head/eyes independent of each other; eyes converge and focus on pellet at 10 feet; smaller pellets seen by 9 months

Rakes pellet with flexing-adducting thumb

Mouths everything, hand to mouth with object, mouth used for exploration

7-9m (FM)

Transfers object from hand to hand

Unilateral reach and grasp; wrist extends

Radial digital grasp;, beginning use of fingertips with opposed thumb

Holds one block while given another-start using fingers

Offers cube, but cannot release it; drops objects

Release cube by pressing it against a hard surface

Bangs objects together, compares them

Pats, bangs, strokes, clutches, rakes, scratches - pats mother’s face, pats image of face in mirror, thumb abducted or opposed

9-12m (FM)

Can point,. have other fingers flex, and poke objects

Grasps between finger and thumb, then one finger and thumb (crude to pincer grasp, and later fine pincer grasp)

Pick up and place in and out of large containers; place lids

Reach and grasp possible all directions, with supination and other improved arm control

Release with gross opening of hand then more precise until places small objects in jar, peg in hole, for appropriate anticipatory release

Looks for fallen toy (permeance of objects); casts toys

13-18m

Independent walking (9-17m)

Climbs stairs on hands, knees, and feet (8-14m)

Walking up stairs while holding on (15-16)

Creeps backwards down stairs (15-23m)

Walking down stairs while holding on (17-18m)

Stoops to pick up objects and regains standing (can squat up and down)

Crayon is held in the fist with thumb up (12-18) (palmar-supinate grasp)

Precise, controlled release into smaller container with wrist extended

Imitative Scrabble

18-24m

Run stiff, eyes on ground (18-20m) seldom falls, and is okay if they do

Climbs stairs using railing (both feet on steps)

Creeps backwards down stairs (15-23m)

Spontaneous scribble

24-36m

Walks backwards 10 feet (18-20m)

Walks three steps on a taped line (27-28m)

Runs 30 feet in 6 seconds (29-30m)

Walks up and down stairs without support (24-30 months)

Walks up stairs, alternating feet (30-36 months)

Jumps down from step (2years)

Stand on one foot for 1-2 seconds (31-32 months)

Jumps on one foot, few steps (2.5 years)

Begins to ride tricycle

Kicks small ball

Crayon is head with fingers, hands on top of tool, forearm turned so thumb is directed downward (digital pronate) (2 years)

Imitates vertical then horizontal stroke

3-4y

Jumps off floor with both feet (3 years)

Jumps over objects, hops on one foot (3-5 years)

Gallops, leading with one foot and transferring weight smoothly and evenly (3-4 years)

Walks down stairs, alternating feet (36-42 months)

Runs with arms moving back and forth, balls of feet used to push forward, high knee and heel lift and trunk leans forward (41-42m)

Stands on tiptoes (43-52m)

Copies circles (3-3.5y)

Traces diamonds with angles rounded (3.5-4y)

4-5y

Stands on one foot for 10 seconds without swaying more than 20* (53-60 months)

Catches ball if prepared

Jumps 2-3 inches

Lean forward when jumping from a height

4-4.5 years:

Cuts straight line with scissors

Copies cross

Use static tripod grasp of pencil

May begin to hold writing tool in finger grip

Can button small buttons

Copies Square

5-6y

Can stop and change directions quickly when running

Can hop 8-10 steps on one foot

Throw ball and hits target at 10 ft

Roller Skates

Rides bike

Use dynamic grasp of pencil

Copies triangle

6y

Can skip

Can connect a zipper

May tie shoes

Moves writing tool with finger while side of hand rests on table

Copies diamond

7y

Makes small controlled marks with pencils due to more refined finger dexterity

8y

Jump ropes skillfully

Throws and bats better

Plays game requiring lots of fine motor skill and good reaction time

9y

Enjoys hobbies with high levels of fine-motor skills (sewing, model building (Legos))

10y

Jumping distance continues to increase

Fine motor development reached adult skill levels around 9-10 years of age

11y

Running speed stabilizes for girls

12y

Plays ball more skillfully due to improved reaction time

Adolescence

13y: males continue to increase run speed and jump distance

14y:Standing long jump distance continues to increase for males, but stabilizes for females

15y: may reach fastest reaction time

16y: may reach peak performance levels in sports