A lot of times my friends and relatives ask me questions about their child’s gross motor development (especially if they are first time parents and have nothing to compare it to) and if they should be concerned so I decided to writie up a list of items that may be an area of concern for kiddos at 3 month intervals. This list doesn’t necessarily mean there is a problem but it doesn’t hurt to take a look and see if some of the things you are noticing continue to be a challenge. Many times I find that if there are some slight challenges with gross motor, the earlier the parents and the kiddo get tips on how to help develop the skills, the quicker the child catches up. I tried to take a slightly different approach than the typical look at gross motor milestones because there is such a range in milestone acquisition that often parents aren’t sure if their child is behind or not.
General Concerns:
- Very stiff or very floppy
- Torticollis/plagiocephaly (flat spot on the head)
- Prefers standing all the time
- Lack of opportunity for independent motor exploration (time spent out of equipment/carriers/bouncies/etc)
- Profound or significant birth/medical history
- Generally still (not moving) when awake
- Persistent ATNR
Three Months:
- Difficulty lifting head on belly or on back
- Stiff legs with little to no movement on belly or on back
- Pushes back with head
- Tends to keep hands fisted with little to no arm movement on back
- Challenges with bringing hands and/or head to midline on back
Six Months:
- Items listed previously
- Back is rounded or slumped
- Unable to lift head up in sitting, supported or unsupported
- Poor head control
- Arches back and stiffens legs
- Holds arms back and up (i.e. high guard)
- Has stiff legs
- Keeps legs in a frog leg position on belly or on back
- Doesn’t like to be on their stomach
- Thrusts into extension for movement (such as rolling or when sitting)
- Not able to roll
- Doesn’t bring feet to mouth or feet to hands on back
- Doesn’t weight bear on arms when on belly
- Doesn’t tolerate or like sitting
- Unable to sit supported
- Doesn’t kick legs
- Unable to lie on side
Nine Months:
- Items listed previously
- Uses one hand predominantly
- Poor use of arms in sitting
- Difficulty crawling
- Only uses one side of the body to move
- Inability to straighten back
- Can’t/won’t take weight through legs
- Prefers lying on back rather than on belly or exploring
- Doesn’t weight bear through upper extremities
- Uses bunny hopping or butt scooting as only means of mobility
- Uses w-sitting as primary method of sitting or a wide based ring sitting
- Inability to weight shift through legs or arms
- Inability to move legs separately from each other
- Difficulty getting onto hands and knees
Twelve Months:
- Items listed previously
- Difficulty getting to stand because of stiff legs and pointed toes
- Relies on arms rather than legs to get into standing
- Sits with weight to one side
- Strongly flexed or stiffly extended arms
- Needs hands to maintain sitting
- No desire or ability to climb onto objects
- Avoids standing
- Trouble transitioning between positions (i.e. sitting to hands and knees, lying down to sitting)
- Difficulty with cruising
- Not attempting to walk with support
Fifteen Months:
- Items listed previously
- Unable to take steps independently
- Trouble maintaining standing balance
- Walks on toes
This is just a guideline for some areas that may be cause for concern and for peace of mind may be worth having a pediatric physical therapist take a look at your kiddo.
- My Child Isn’t Walking Should I Be Concerned
- My Child Isn’t Rolling Should I Be Concerned
- My Child Hates Tummy Time Should I Be Concerned
Do you have a little one? This e-book can help you learn how to purposely play with them!
References:
Bly, L. (1994). Motor Skills Acquisition in the First Year. San Antonio, TX: Therapy Skill Builders.
https://pathways.org/awareness/parents/new-parents/monthly-milestones/