Baby Milestones- Should I be Worried?

Baby Milestones provide a helpful guide to measure your child's development.

Unfortunately, they are often an additional source of stress and concern too. More so, when your child appears to be behind schedule. Read on as we seek to address some of these concerns.

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What Is Expected?

0 - 6 Months

Gross Motor

• Head and trunk control

  • Hold head against gravity in various positions

• Sits with arms propped

• Maintains balance in sitting with head turns

Fine Motor

• Hands to midline

• Reaches to toys

• Grasps and holds rattle

6 - 12 Months

Gross Motor

• Rolls and sits up independently from lying

• Pushes into 4 point position independently

• Crawl

• Pulls to stand with arm support

• Cruises and takes steps with hand support

Fine Motor

• Grasps toys in each hand and brings together

• Transfers toys from one hand to the other

• Claps hands

• Progression from palmar to radial palmar grasp to radial digital grasp

• Development of gross pincer grip

12 - 18 Months

Gross Motor

• Stands from floor independently

• Squats to pick up toys and stand

• Creeps up steps

• Climbs stairs with hand held

• Walk backwards

Fine Motor

• Opens book

• Stack a tower of 2-3 blocks

• Finger isolation and pointing

• Refinement of gross to fine pincer grip

• Palmar grasp for writing or colouring

18 - 24 Months

Gross Motor

• Runs forwards

• Walk up steps without help, commonly two feet to one step

• Walk down steps holding adult’s finger, commonly two feet to one step

• Walks sideways and backwards

Fine Motor

• Turn pages of book, one page at a time

• Stack a tower of 5 or more blocks

• Draw vertical lines

• Place shapes into correct holes in formboard

From the ages of 2, it is worth nothing that there is variability between children and skills may develop at different rates. Some of this may be attributed to their interest, the presence of elder siblings, as well as exposure.

2 - 3 Years

Gross Motor

• Kick and throw a ball

• Attempt to catch ball (catches with arms > hands)

• Tiptoe and takes steps with hand held

• Climbs steps using reciprocal steps, may use rail

• Attempts to jump

• Jump upwards or off low step

Fine Motor

• Attempt new Actions:

  • Combing hair

  • Brushing teeth

• Progression to pronated grasp:

• Transition from palmar grasp

  • Fingers active and involved

  • Movement still dominantly from elbow

• Draw vertical lines

• Cut paper in place

3 - 4 Years

Gross Motor

• Run, hop, stand on one leg

• Catch ball with arms extended

• Goes up and down stairs with reciprocal steps

• Jump forwards or off higher steps

• Pedal and steer a tricycle of bicycle

Fine Motor

• Stack a tower of 6 or more blocks

• Progression to 5-finger or static quadrupod grasp

  • Hand dominance solidifies by ~4 years

  • Able to draw a circle

  • Able to trace horizontal line

  • Neutral wrist in writing position

  • Start to display dissociation of fingers

4 - 5 Years

Gross Motor

• Throw, bounce and catch ball

• Skip

• Jump over objects, jump and land in opposite direction

• Climb playground ladder

• Climb up and down stairs using reciprocal steps with minimal effort

Fine Motor

• Progression from static to dynamic tripod grasp

• Connect dots

• Doing and undoing button

• Use scissors to cut paper and simple shapes

• Lace 2 to 3 holes

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What Can I Do To Help?

Increase Stimulus

• Tummy time

• Songs, books

• Talk and engagement

Learning and Exposure through Play

• Use of toys as motivation

• Sensory exposure- leaves, sand, grass

Gross Motor Skills

• Setting up furniture to encourage standing or steps

• Encourage walking as much as possible (once able)

• Playground- ladder, swing, slide

• Rolling and somersaults

• Encourage finger and self-feeding

  • Practise utensils as much as possible

• Engage in household and every day tasks

• Reinforcement, encouragement and reassurance

Fine Motor Skills

• Picking and transferring small items

  • Use of small bowl or ice cube tray

  • Beans, small toys, beads

  • Progression to use of tweezers

  • Pegs

• Threading practice

  • Shoelace and big beads

  • Progression to shoelaces and yarn

• Peeling and pasting stickers

• Using broken crayons for colouring

• Writing or colouring against a vertical surface

• Use of moldable clay or plasticine

  • Rolling into sticks

  • Cutting and using fork

• Pre-writing Skills

  • Lines

  • Shapes

  • Dot-to-dot

  • “Bubble” letters

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When Should I Seek Help?

< 12 months

• Advised to seek professional advice if lacking milestones within 3 month “expected”

12 - 18 months

• Advised to seek professional advice if lacking milestones within 3 month “expected”

• Not walking by 18 months

> 24 months

• Advised to seek professional advice if lacking milestones within 6 month “expected”

Key Points of Consideration:

• Certain skills develop faster than others

• Variability between children

• Consider entire child:

  • Physical- Gross and Fine Motor Skills

  • Speech and Language

  • Cognition

  • Socio-emotional

• Advised to seek professional advice if more than one domain is delayed

• Not meeting milestones along the way and seems to be lacking progression of skills