Table 2.

Motor Development

MOS. GROSS MOTOR SKILLS FINE MOTOR SKILLS RED FLAGS
1 Head up in proneHands tightly fisted
2 Chest up in prone positionRetains rattle (briefly) if placed in handRolling prior to 3 months may indicate hypertonia
Head bobs erect if held sittingHands unfisted half of time
3 Partial head lagHands unfisted half of time Embedded Image
Rests on forearms in proneBats at objects
4 Up on hands in proneObtains/retains rattle
Rolls front to backReaches/engages hands in supine
No head lagClutches at objects
5 Rolls back to frontTransfers objects hand-mouth-hand Embedded Image Poor head control
Lifts head when pull to sitPalmar grasp of dowel, thumb adducted
Sits with pelvic support
Anterior protection
6 Sits-props on handsTransfers objects hand-hand Embedded Image
Immature rake of pellet
7 Sits without supportRadial-palmar grasp of cube Embedded Image W-sitting and bunny hopping, may indicate adductor spasticity or hypotonia
Supports weight and bounce while standingPulls round peg out
Commando crawls
Feet to mouth
Lateral protectionInferior scissors grasp of pellet; rakes object into palm Embedded Image
8 Gets into sitting positionScissors grasp of pellet held between thumb and side of curled index finger Embedded Image
Reaches with one hand while 4-point kneelingTakes second block; holds 1 block in each hand
9 Pulls to standRadial-digital grasp of cube held with thumb and finger tips Embedded Image Persistence of primitive reflexes may indicate neuromotor disorder
Creeps on hands and knees
Inferior pincer grasp of pellet held between ventral surfaces of thum band index finger Embedded Image
10 Cruises around furnitureIsolates index finger and pokes Embedded Image
Walks with 2 hands heldClumsy release of cube into box; hand rests on edge
Pincer grasp, held between distal pads of thumb and index finger Embedded Image
11 Stands alone
Walks with 1 hand held
12 Independent stepsFine pincer grasp of pellet between finger tips Embedded Image Failure to develop protective reactions may indicate neuromotor disorder
Posterior protectionsMarks with crayon
Attempts tower of 2 cubes
Precise release of cube
Attempts release of pellet into bottle
14 Walks well independentlyTower of 2 cubes
Attains third cubes
16 Creeps up stairsPrecise release of pellet into small container Embedded Image
Runs stiff-leggedTower of 3 cubes
Climbs on furniture
Walks backwards
Stoops and recovers
Imitates scribble Embedded Image
18 Push/pulls large objectTower of 4 cubes Embedded Image Hand dominance prior to 18 months may indicate contralateral weakness
Throws ball while standingCrudely imitates single stroke
Seats self in small chairScribbles spontaneously
20 Walks up stairs with hand heldCompletes square pegboard
22 Walks up stairs with rail, marking timeTower of 6 cubes
Squats in play
24 Jumps in placeTrain of cubes without stack Embedded Image Inability to walk up and down stairs may be the result of lack of opportunity
Kicks ballImitates vertical stroke
Walks down stairs with rail, marking time
Throws overhand