What Are Developmental Milestones: Gross and Fine Motor

Occupational Therapy
Written By Kimberley Arnett-DeSimone

The early years of a child's life are a time of remarkable growth and development. From the moment they are born, children begin a journey of learning and discovery, reaching important developmental milestones along the way. These milestones are key indicators of a child's progress in various areas of development, including physical, cognitive, social, and emotional. Understanding these milestones can help parents and caregivers ensure that a child is on track and provide the necessary support to foster healthy development. The following is meant to be a guideline. Infants and children develop at varying rates; however, if you are concerned that your child may have a significant delay, speak with your pediatrician and explore options for a formal developmental assessment by a professional.

Physical Development 

Physical development in the first four years of life is rapid and dramatic. It includes the growth of muscles, bones, and the development of gross and fine motor skills.

0-3 months: 

  • Exhibit primitive reflexes (Moro reflex, ATNR, Babinksi)

  • Lift head for 1-2 seconds while lying on their stomach

  • Lift legs up in air when lying on back

  • Bring both hands to midline when lying on back

  • Stretch legs pushing feet against objects/kick with feet

  • Grasp objects placed in palm (Palmar Grasp)

4-6 months: 

  • Holds bottle or breast with hands

  • Uses raking motion with fingers to get objects

  • Uses radial palmar grasp (thumb, pointer, and palm)

  • Roll over from stomach to back

  • Press up onto forearms when lying on stomach

  • Hold head steady when supported in sitting

  • Sit with support

  • Press up onto hands (maybe fisted) from the stomach position

  • Brings feet to the mouth when lying on back

  • Rolls from back to side

  • Rolls from back to stomach

  • Leans on hands in propped sitting

  • Can pull to sitting from lying on back, holding adult’s fingers

  • Grasp objects with more control

  • Transfers objects hand-to-hand

7-8 months:

  • Begin belly crawling

  • Momentarily pushes up onto hands and knees

  • Lifts head off the surface when lying on back

  • Sits without propping and hands free for a short time

  • Independently transitions into sitting

  • Holds small objects in both hands 

9-10 months:

  • Grasps cubes with thumb and fingertips, leaving a space between object and palm

  • Releases toys or objects intentionally

  • Creeps on hands and knees well

  • Sits with good trunk control and hands-free to play

  • Can rotate trunk while sitting

  • Pulls up to stand

  • Cruises along furniture without leaning into furniture

  • Take their first steps with hands held

  • Can lower to the ground without falling or plopping

11-12 months:

  • Stands briefly without support

  • Walks with hands held and a wide base of support

  • Can squat in play

  • Pokes index finger into holes

  • Refined Pincer Grasp - Can finger feed Cheerios

  • Tears paper

  • Beats a drum

  • Turns thick pages in a cardboard book

1-2 years:

  • Hands toys to others 

  • Points with index finger

  • Can set down a cup with minimal spilling

  • Can turn a container to dump out the contents

  • Stacks cubes

  • Turns knobs

  • Begins Finger Plays

  • Washes and dries hands with help

  • Can bring spoon to mouth correctly

  • Uses fork

  • Operates light switches

  • Turns pages of book singly

  • Scribbles with crayon

  • Walks well and can carry a toy

  • Push a toy while walking

  • Runs 

  • Jumps with two feet simultaneously

  • Can ascend and descend steps, placing both feet on every step

  • Can propel a ride-on toy

  • Can briefly stand on one foot and on tip-toes

  • Pulls apart playdough

  • Inserts peg into pegboard

  • Completes knob puzzles

  • Turns doorknobs

  • Independently removes clothing

  • Imitates crayon or marker strokes

3-4 years: 

  • Toilet Trained

  • Can run easily, stopping without crashing

  • Can pedal a tricycle

  • Dances to music

  • Ascends and descends steps without support and alternates feet

  • Hops on one foot

  • Climbs on play equipment

  • Pumps a swing

  • Jumps forward

  • Completes easy jigsaw puzzles

  • Can isolate fingers to show age

  • Strings beads

  • Rolls and flattens dough

  • Uses a static three-finger grip (tripod)

  • Unbuttons and buttons large (¾ inch) buttons

  • Can identify common objects held in the palm without using vision

  • Can serially touch thumb to each fingertip of same hand 

  • Puts a key in the lock

  • Establishes Hand Preference

  • Copies circle and cross

  • Copies diagonal lines, X and square

  • Cuts with scissors

  • Independent with buttons

These developmental milestones provide a framework for understanding a child's progress and helping them reach their full potential. It's important to remember that every child is unique, and development can vary from one individual to another. If a child seems significantly behind in achieving these milestones or experiences regression, it is advisable to consult with a healthcare professional or a developmental specialist for further guidance. Early intervention and appropriate support can make a significant difference in a child's development and future success. Parents and caregivers play a crucial role in fostering these milestones, providing a nurturing and stimulating environment for children to grow and thrive during their formative years.

Kimberley Arnett-DeSimone, a career pediatric occupational therapist in Huntersville, North Carolina, authored this post.

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