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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"After almost 2 years our son’s time at CST Academy has come to an end. The preschool program has done wonders for him. Ms Jaclyn is such a warm, kind and patient teacher. She and my son’s OT (Ms. Nikki) and ST (Ms. Erika) worked together to ensure he was meeting all of his goals. The level of collaboration between all therapies shows how dedicated they are to helping your child reach their full potential. They have all made such an impact on him, it’s amazing to see the changes since he started there. He has blossomed into a strong, confident boy who is more than prepared to start his new school in a few weeks. We will always fondly remember our time at CST Academy. Can’t recommend them enough!"
"I worked with CST Academy over a period of about 10 months. They are absolutely incredible! I also referred a friend to their program and the progress his child made just blew him away! Usually, I don’t write reviews unless I feel strongly compelled one way or the other, and in this case I do! You cannot go wrong here. I would not trust my children to anyone else. Call them and see for yourself. I have seen other programs and there is just no comparison."