occupational therapy

Fine Motor
Visual Motor

5 to 7 months

  • Tolerates various textures when putting objects in mouth
  • Hitting or shaking actions during feeding
  • Plays with caregiver during feeding
  • Eats cereal when presented on a spoon

6 to 9 months

  • Attempts to hold a bottle
  • Anticipates a spoon or a bottle
  • Consumes soft foods
  • Bangs spoon on the table
  • Sucks on a spoon
  • Starts to use a cup without a lid

9 to 13 months

  • Finger feeds soft table food
  • Begins to grasp various objects of different sizes

12 to 14 months

  • Brings a loaded spoon to the mouth
  • Releases objects, such as a Cheerio
  • Begins to recognize objects and their functions, like a spoon
  • Holds a cup with two hands

15 to 18 months

  • Scoops food with a spoon
  • Begins to use a fork at 18 months
  • Begins precise movements for self-feeding

24 to 30 months

  • Uses a fork and spoon with decreased mess during mealtime
  • Tolerates various textures of food in the mouth
  • Expresses wants and imitates movements

0 to 2 months

  • Closes finger in a tight grasp
  • Holds a rattle for 30 seconds
  • Sporadically drops a rattle

3 to 5 months

  • Moves a rattle 15 degrees
  • Picks up a rattle
  • Grasps and pulls a string
  • Secures paper
  • Grasps and holds a cube

6 to 8 months

  • Moves a rattle in a 90-degree arc
  • Grasps a cube with first and second fingers
  • Uses a raking motion to secure two small objects at once
  • Crumples paper with one or two hands

9 to 11 months

  • Grasps a small object with the thumb and index finger
  • Reaches for objects from the top

12 to 14 months

  • Picks up two cubes with one hand and holds them
  • Uses a fisted grasp on a writing utensil

24 to 36 months

  • Grasps a writing utensil from the top with the index finger pointed down, using a digital pronate grasp

37 to 48 months

  • Grasps a writing utensil with the thumb and index finger, using a tripod grasp

12 months

  • Cooperates with dressing
  • Removes socks
  • Exhibits discomfort with soiling
  • Imitates household work

18 months

  • Sits on the toilet for a short time

24 months

  • Removes fastened coat
  • Removes shoes if untied
  • Pulls down pants
  • Finds arm holes
  • Begins to put away toys
  • Copies domestic activities

30 months

  • Pulls down pants
  • Assists with putting socks on
  • Puts t-shirt on
  • Unbuttons large buttons
  • Demonstrates regular toileting, with few daytime accidents, when given reminders to go

36 months

  • Puts on pull-over shirt
  • Puts shoes on (wrong feet) but does not complete fasteners
  • Zips and unzips a jacket
  • Buttons large buttons
  • Is independent to go to the bathroom, with some assistance for wiping and fasteners
  • Puts toys away

42 months

  • Finds the front of clothing
  • Completes three to four buttons, snaps, hooks, or fasteners
  • Unzips a jacket and is able to separate a zipper

48 months

  • Removes clothing independently
  • Zips a jacket
  • Puts on socks correctly
  • Puts on shoes with assistance for laces
  • Identifies the front and back of clothing
  • Is independent with dressing and shoe tying by 60 months

0 to 3 months

  • Turns his/her head from side to side
  • Bears weight on forearm
  • Is held in sitting
  • Voluntarily releases objects (1 to 4 months)

4 to 6 months

  • Shifts weight on forearms
  • Brings feet and hands to the mouth
  • Rolls from stomach to back (starts as accidental)
  • Sits alone at six months

7 to 9 months

  • Begins to dislike being placed on stomach
  • Begins to develop protective responses, such as reaching out to catch self when falling
  • Begins to sit well without support
  • Begins to pull to standing
  • Begins cruising along furniture
  • Crawls on belly

10 to 12 months

  • Continues to develop protective reflexes, such as catching self when falling backwards
  • Exhibits improved trunk control
  • Creeps on hands and feet
  • Continues cruising along furniture

12 months and onward

  • 15 months: walking

18 months

  • Seldom falls

0 to 2 months

  • Tracks object on both sides of his/her body
  • Places an open hand on a table
  • Looks at hands for at least three seconds
  • When lying on back, turns head to the side and tracks an object

3 to 5 months

  • Extends arms straight towards rattle
  • Moves hands to reach for a toy

6 to 8 months

  • Sits up and brings hands together
  • Extends one arm to reach for a toy while the other arm is stationary
  • Picks up and retains two cubes
  • Transfers a cube from one hand to the opposite hand

9 to 11 months

  • Brings two cubes together
  • Claps
  • Removes three pegs from a pegboard
  • Releases a cube
  • Places three to seven small objects in a cup

12 to 14 months

  • Opens a book
  • Stirs a spoon in a cup
  • Turns a cup over and dumps out objects
  • Places three pegs in a pegboard
  • Places one shape into a shape puzzle correctly
  • Makes one scribble

15 to 18 months

  • Stacks two to three cubes
  • Places two shapes into a shape puzzle correctly

19 to 24 months

  • Turns three pages in a book, one at a time
  • Places three shapes into shape puzzle correctly
  • Draws vertical lines

25 to 30 months

  • Removes screw-on lid from a bottle
  • Stacks eight to 10 cubes
  • Cuts paper in one place
  • Draws horizontal lines
  • Bends paper producing crease
  • Strings two to four beads

31 to 36 months

  • Builds a bridge of three blocks
  • Draws a circle
  • Builds a wall of four blocks

37 to 48 months

  • Cuts paper into two pieces
  • Cuts paper within 1/2-inch of a line
  • Laces three holes
  • Draws a cross
  • Puts 10 small pellet-sized objects in a bottle
  • Traces a horizontal line

49 to 54 months

  • Draws a square
  • Cuts out a circle on paper
  • Builds a set of steps with six blocks
  • Connects dots by drawing a straight line
  • Builds a pyramid of six blocks

55 to 60 months

  • Colors in-between two vertical lines

The above developmental milestones were derived from the Peabody Motor Scales as well as the TherapyEd textbook. If you think your child’s occupational skills are not progressing to an age-appropriate level, please contact us to set up an evaluation. 

physical therapy

Birth to 2 months

·       Lifts head while lying on his/her stomach
·       Rolls from side to back from both the left and right sides

3 months

·       Pushes up through forearms and holds head steady on his/her stomach
·       Brings hands to mouth
·       Sits supported with belly off the legs for five seconds

4 months

·       Rolls from back to side on both the left and right sides
·       May begin rolling from tummy to back
·       Lifts arms and legs off the ground during tummy time

5 months

·       Sits, propping with arms in front for support
·       Brings feet to hands/mouth

6 months

·       Rolls from back to belly
·       Reaches for toys and pivots during tummy time
·       Bounces and bears weight through legs in supported standing

7 months

·       Sits without external support
·       Reaches and grabs for toys without falling over
·       Comes from lying down to sitting up independently

8 months

·       Army crawls
·       Maintains a hands-and-knees position while reaching for toys
·       Moves from hands and knees to a sitting position and back

9 months

·       Consistently crawls with good motor control
·       Pulls to stand on support surface
·       Is able to consistently catch self with loss of balance in sitting

10 months

·       Pulls to stand and lowers to sit with control
·       Walks/steps with two hands held
·       Cruises, holding onto furniture

11 months

·       Stands without holding onto support surface
·       Squats to pick up a toy and returns to standing with hand held

12 months

·       Begins to step and walk independently
·       Plays in a variety of positions (standing, tall kneeling, half kneeling)

15 months

·       Walks independently as the primary form of mobility
·       Creeps up/down stairs on hands and knees
·       Is able to squat to pick up a toy and return to standing without falls

18 months

·       Walks backwards a few steps
·       Walks up and down the stairs with hands held
·       Attempts to kick, throw, and catch a ball

24 months

·       Runs short distances
·       Jumps forward, up or down

30 months

·       Stands on one foot for three seconds
·       Walks up on tiptoes
·       Throws a ball to a target
·       Kicks a ball forward to intended target

36 months

·       Walks up the stairs, alternating feet without support
·       Runs with increased speed and distance
·       Catches a ball with hands only
·       Throws overhand and underhand

The above developmental milestones were derived from the Peabody Motor Development Chart. If you think your child’s movement is not progressing to an age-appropriate level, please contact us to set up an evaluation.

speech-language therapy

Birth to 3 months
  • Begins to recognize your voice
  • Makes cooing sounds
  • Smiles when you talk or when they see you
  • Startles at loud sounds
4 to 6 months
  • Coos and babbles by making sounds like pa, ba, and mi
  • Expresses happiness or sadness through sounds
  • Giggles and laughs
  • Pays attention to music and sounds from toys
  • Responds to sounds with eye movements
7 to 12 months
  • Responds to sounds by turning and looking in the direction of the sounds
  • Visually follows hand gestures
  • Understands common items and people (e.g., mom, dad, cup, toy, water)
  • Begins to respond to simple words
  • Continues babbling for longer moments (e.g., mimi, upup, bababababa)
  • Expresses desire to get and maintain attention through sounds
  • Gestures to objects and people by pointing, waving, reaching
  • Imitates sounds
  • Says one to two simple words; voice quality may not be clear
12 to 24 months
  • Points to objects when prompted
  • Begins to name objects
  • Follows one-step instructions
  • Responds to simple questions like “Who’s that?”
  • Asks questions like “What’s that?”
  • Uses a lot of new words (p, b, m, h, and w used in words)
  • Puts two words together like “More water.”
24 to 36 months
  • Understands opposites
  • Follows two-step instructions
  • Quickly comprehends new words
  • Talks about things not physically present
  • Uses two and three words to talk
  • Uses words including k, g, f, t, d, and n
  • Asks “Why?”
  • Sometimes repeats words and sounds when talking

The above developmental milestones were derived from the American Speech-Language-Hearing Association. If you think your child’s speech and language skills are not progressing to an age-appropriate level, please contact us to set up an evaluation.