Dr. Anne Zachry

occupational therapist & child development specialist

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Developmental Milestones

Use this infant developmental milestones chart as a general guide to see what skills and behaviors are common for each age level. 

Infant Developmental Milestones Chart:

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Newborn

  • Closes fingers around toy place in hand
  • Brings hands to mouth
  • Watches adult’s face when feeding

One to Two Months

  • Regards a toy in the line of her vision
  • Holds hands open for a 5 minute period
  • Shows awareness of hands
  • Visually follows a toy past midline
  • Focuses on toy for 5 seconds
  • Recognizes familiar person
  • Smiles or gurgles to a familiar person

Three to Four Months

  • Manipulates hands at midline
  • Reaches out for toy
  • Grasps toy crudely
  • Holds bottle for one minute
  • Laughs out loud when stimulated
  • Puts hand in mouth
  • Raises head and chest when lying on stomach

Five to Six Months

  • Reaches and attains toy
  • Bangs in play
  • Transfers toy hand-to-hand
  • Grasps tiny toy with palm and fingers

Seven to Eight Months

  • Shakes rattle in imitation
  • Grasps toy with thumb and fingers
  • Pokes at tiny toy with index finger
  • Picks up food to place in mouth
  • Responds to name
  • Shows shyness around strangers
  • Rolls from back to stomach and stomach to back

Nine to Ten Months

  • Grasps pellet with thumb and index finger
  • Holds a toy in one hand- reaches with the other
  • Points with index finger
  • Good release of objects is present
  • Responds to image in mirror
  • Responds to familiar words
  • Smiles selectively
  • Sits without support
  • Crawls

Eleven to Twelve Months

  • Removes lid from box with no assistance
  • Places one cube/block in a cup
  • Removes cover to attain hidden toy
  • Repeats a performance to draw laughs
  • Drops a toy deliberately
  • Brings spoon from bowl to mouth
  • Temporarily responds to “no” or “stop”
  • Walks with or without support

Thirteen to Eighteen Months

  • Pulls to stand
  • Walks with or without support
  • Squats down and picks up a toy
  • Eats with fingers
  • Turns pages of a board book
  • Drinks from a cup independently
  • Throws a ball underhand
  • Stacks 4 blocks
  • Removes basic clothing

Nineteen to Twenty-Four Months

  • Runs with stiff legs
  • Eats with spoon (some spillage)
  • Kicks a ball forward with one foot
  • Scribbles in circles
  • Jumps in place two times
  • Points to specifics in a book
  • Assists with some dressing
  • Stacks 6 blocks

Twenty-Five to Thirty Months

  • Begins to run
  • Jumps in place
  • Strings beads
  • Removes lid from jar
  • Sorts objects by shapes and color
  • Can follow simple instructions
  • Uses 2 to 3-word sentences
  • Drinks from open cup

Thirty to Thirty-Six Months

  • Pedals a tricycle
  • Kicks a ball
  • Walks backward
  • Knows first and last name
  • Turns pages of a book one at a time
  • Copies a cross and circle
  • Puts on loose clothing
  • Feeds self with child-size fork and spoon

Thirty-Seven to Forty-Two Months

  • Goes upstairs and downstairs without holding on
  • Catches bounced ball most of the time
  • Draws a person with 2–4 body parts
  • Uses scissors and cuts on a line
  • Pretends during play
  • Names a few colors
  • Holds crayon or pencil between fingers and thumb 
  • Draws a person with three or more body parts

Forty-Three to Forty-Eight Months

  • Walks up and down stairs using alternating feet 
  • Throws and catches a large ball
  • Bends over, without falling
  • Build a tower of nine to ten small blocks
  • Ask questions such as “what’s that”
  • Counts from 1 – 5
  • Understand categories and puts object in categories

Forty-Nine to Fifty-Four Months

  • Stand on one foot for more than 10 seconds
  • Solves an 8 – 10 piece puzzle
  • Colors within the lines
  • Walk up and downstairs easily and swiftly
  • Manages toilet needs during the day time
  • Draws a circle, triangle, square
  • Shares and ask to take turns

Fifty-Four to Sixty Months

  • Swings and climbs
  • Laces shoes
  • Cuts on thick curved line
  • Prints some capital letters
  • Refers to self in first person
  • Can count 10 or more objects
  • Aware of gender
  • Uses future tense

Other Types of Sensory Defensiveness

If your child has tactile defensiveness, it’s likely that there are some other issues going on as well. You might notice a resistance to eating certain textures of food, which is called oral defensiveness. If your child demonstrates oversensitivity to light and visual distractibility, it’s possible that there is some visual defensiveness going on. If certain sounds are particularly annoying or even painful to your child, this is called auditory defensiveness. One type of defensiveness that I didn’t mention in my earlier post is gravitational insecurity. This is an extreme sensitivity to heights, movement and/or a change in head position in space. When a child is experiencing defensiveness in more than one sensory system, it’s likely that this is impacting his or her quality of life. That means it’s time to seek therapy from an experienced therapist.

A common treatment for sensory defensiveness is the Wilbarger Deep Pressure Protocol. This involves deep touch pressure using a special brush along with joint compressions. The program is typically done in conjunction with a “sensory diet” of activities that include vestibular and proprioceptive input. For little ones with oral defensiveness, there are special techniques that a trained therapist will utilize to address this issue. With the Wilbarger Protocol, the therapist will provide hands-on training so that the parents and other adults who work with the child can administer the program. It is typically carried out approximately every 2 to 3 hours throughout the day. Your therapist will supply brushes or let you know where to order them.              

What is a sensory processing disorder…continued!

“What is a sensory processing disorder?”   It is a condition in which an individual has difficulty processing the information coming in from the various systems. With a sensory processing disorder, one, two, or all three of the following sensory systems might be involved (as well as any of the other senses), leading to sensory modulation problems.  Sensory modulation is the ability to regulate sensory input from the various sensory systems so that a person can orient, attention can be focused, and an alert and a relaxed state can be maintained during daily routines. To better understand sensory modulation, you need to know about the following sensory systems.

Tactile System: The tactile system is the sense of touch. This is the sensory system that helps us learn about our bodies and our environment. It is important in the development of a child’s body scheme (the internal map of our body and how we use our body to interact with the world around us). This system is composed of two subsystems: (1) discriminatory- allows us to know where we are being touched, (2) protective- lets us know if we are in contact with something dangerous. Tactile input is very important for the development of fine-motor skills, visual perception skills, and articulation of sounds.

The Vestibular System: The vestibular system is the sensory system that responds to accelerated and decelerated movement. It is through the vestibular system that we learn directions and are aware of our body position in space. This input helps us to form a basic reference for all sensory experiences. This system has interconnections with many parts of the body and influences many different functions, for example, muscle tone, postural control, balance, eye and neck muscles.

The Proprioceptive System: Proprioceptive information is sensations from muscles and joints. Proprioceptive input tells the brain when and how muscles are contracting and stretching and how joints are being compressed or stretched. It helps us to know where our bodies are in space and how they are moving. Proprioceptive input provides a calming effect. It works along with the vestibular system.

An experienced therapist can evaluate and determine which systems are involved, allowing for more specific treatment planning, which leads to more effective treatment! In my next entry, I’ll share a variety of sensory activities that are alerting, calming, etc.

 Photo by David Castillo Dominici @ freedigitalphotos.net

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