The Complete Guide To Pediatric Occupational Therapy Milestones

3-5 MONTHS

Fine Motor, Self-Help, and Visual Motor Milestones:
• Lying on back, brings hands to mouth and midline of body
• Sustains grasp on toys with involuntary release
• Looks at hands
• Can pick up and shake a rattle
• Transfers toy between both hands
• Brings both hands to the midline of body while lying on back
Gross Motor Milestones:
• Bears weight on forearms while on stomach looking at toy
• When on back, brings both feet to mouth
• Holds head aligned when visually tracking toy or when body is tilted from side to side
• Develops unsupported sitting pattern

6-8 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Sitting while unsupported and brings both hands together at midline to grasp toy
• Uses extended arms to reach for toys
• Picks up and maintain grip on 2 blocks
• Uses a lateral prehension grasp (using thumb
and side of index finger) while self-feeding
• Holds bottle with both hands
• Grasps and pulls string using a fisted grasp to obtain toy
Gross Motor Milestones:
• When on stomach can independently reach for toy with one hand
• Bears weight through palms when on stomach
• Reaches for toy while in side-lying position on from right or left sides
• Rolls independently from back to stomach
• Maintains dynamic sitting balance while moving to manipulate toy
• Pulls to sit from back to unsupported sitting position while grasping on adult’s fingers for support
• Sits unsupported while reaching for and obtaining toys

9-11 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Bangs 2 blocks together at midline
• Claps hands together independently after demonstration
• Releases toy into adults hand when verbally prompted
• Takes off both socks independently
• Uses a neat pincer grasp (thumb and index finger)
on small puffs or pieces of food to finger feed
• Puts in 3 toys/blocks in large bin when prompted
• Activates cause and effect toys
Gross Motor Milestones:
• Bears weight on hands and knees and can rock back
and forth in quadruped position
• Crawls 5 feet on hands and knees with alternating arms and legs
• Uses hands and legs to move forward while maintaining a seated position
• Pulls to stand using stable object for support
• Transitions from standing to sitting independently
• Maintains standing position for 5 seconds without support
• Maintains dynamic (moving) sit balance
• Pulls up to sit from lying position
• Transitions from prone (on stomach) to sit position independently

12-14 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Turns page in a book (a few at a time)
• Empties a container
• Places items in container with prompting
• Independently places 3 pegs into large pegboard
• Places 1 shape correctly on simple inset puzzle
• Scribbles on paper
• Grasps 2 blocks using one hand
• Takes off socks
Gross Motor Milestones:
• Independently takes 5 steps forward
• Bends to pick up toy from standing and takes 3 steps
• Can maintain kneeling balance without assistance
• Independently propels a medium-sized ball forward using arms or hands
• Throws a small ball on own

15-18 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Stacks 2-5 blocks independently
• Turns knobs by self
• Inserts 2 shapes correctly into simple inset puzzle
• Independently isolates index finger to point
• Attempts to bring spoon to mouth
• Holds marker in a fisted grasp while scribbling on paper
Gross Motor Milestones:
• Attempts to kick medium-sized ball forward

19-24 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Turns pages of book x3
• Inserts 3 shapes correctly into simple inset puzzle
• Stacks 4-6 blocks
• Stacks rings on tower
• Draws a vertical line
• Drinks from open cup
Gross Motor Milestones:
• Jumps 2 inches on both feet together
• Unsupported walking up 4 consecutive stairs
• Uses one foot to kicks ball 3 feet
• Uses one hand to throw ball 3 feet

25-30 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
•Unscrews cap while rotating their wrist
• Makes a tower of 8-10 blocks
• Snips paper with scissors
• Draws a vertical and horizontal line
• Independently creases paper after a demonstration
• Threads large beads through string independently
Gross Motor Milestones:
• Attempts to catch medium-sized ball using arms for support
• Throws small ball overhand or underhand up to 7 feet
• Uses one foot to kick ball 6 feet

31-36 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Draws vertical, horizontal lines and circle
• Hand preference emerging
• Assembles ‘wall’ by stacking 4 blocks
• Unzips zippers
• Independently feeds self
• Turns pages one at a time
• Squeezes and manipulates playdoh
Gross Motor Milestones:
• Jumps 2 feet forward on both feet
• Jumps off 1 ½’ high surface
• Stands on one foot for 3 seconds

37-42 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Cuts on a line within ½ inch of boundaries
• Emerging coordination to cut out circle
• Draws vertical and horizontal lines, circle, and cross
• Builds a 9 block tower
• Grasps marker with thumb and pad of index finger, middle and ring finger, rests on 5th finger. Moves entire arm while coloring/writing.
• Unbuttons large buttons
Gross Motor Milestones:
• Stands on 1 foot for 5 seconds
• Throws small ball overhand up to 10 feet

43-48 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Buttons & unbuttons medium to large buttons on clothing
• Colors shape within general boundaries
• Independently puts on shirt and pants may need assistance with small fasteners
Gross Motor Milestones:
• Jumps 6 inches forward independently on 1 foot
• Jumps 3 inches off the ground independently

49-54 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Draws vertical and horizontal lines, circle, cross and square
• Cuts out circle and square independently
• Draws straight line to connect dots
• Writes numbers 1-5
• Copies letters of alphabet
• Grasps marker with pads of thumb and index finger, resting on third. May still move entire arm while coloring/writing.
• Alternates touching each finger to thumb after demonstration
Gross Motor Milestones:
• Catches small ball (using hands) from 5 feet
• Completes linear rolling forward

55-60 MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Folds paper in half once matching long edges
Gross Motor Milestones:
• Imitates motor planning arm movements from visual demonstration
• Lying on back completes 3 sit ups independently with active core movement

61-72+ MONTHS
Fine Motor, Self-Help, and Visual Motor Milestones:
• Folds paper in half twice matching long edges
• Able to draw 6 body parts on person
• Writes name and alphabet independently
• Keeps letters on the line when writing
• Draws vertical and horizontal lines, circle, cross, square, triangle and diamond
• Ties his/her own shoes
• Uses glue appropriately during craft projects
Gross Motor Milestones:
• Lying on back completes 5 sit ups with active core movement
• Completes 8 push-ups on bilateral upper extremities
• Catches a small ball after bouncing from floor

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