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    Motor Development

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    Jesus Sanabria
    This document provides an overview of typical motor development milestones from birth to 12 months. It describes the major motor skills that develop each month, including rolling, sitting, crawling, and walking. Potential indicators of atypical development are also outlined for each month. The progression generally follows a head-to-toe and proximal-to-distal pattern, with foundational skills like head control developing before more complex skills like independent walking.

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    Motor Development

    Uploaded by

    Jesus Sanabria
    304 views38 pages
    This document provides an overview of typical motor development milestones from birth to 12 months. It describes the major motor skills that develop each month, including rolling, sitting, crawling, and walking. Potential indicators of atypical development are also outlined for each month. The progression generally follows a head-to-toe and proximal-to-distal pattern, with foundational skills like head control developing before more complex skills like independent walking.

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    This document provides an overview of typical motor development milestones from birth to 12 months. It describes the major motor skills that develop each month, including rolling, sitting, crawling, and walking. Potential indicators of atypical development are also outlined for each month. The progression generally follows a head-to-toe and proximal-to-distal pattern, with foundational skills like head control developing before more complex skills like independent walking.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    304 views38 pages

    Motor Development

    Uploaded by

    Jesus Sanabria
    This document provides an overview of typical motor development milestones from birth to 12 months. It describes the major motor skills that develop each month, including rolling, sitting, crawling, and walking. Potential indicators of atypical development are also outlined for each month. The progression generally follows a head-to-toe and proximal-to-distal pattern, with foundational skills like head control developing before more complex skills like independent walking.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 38

    Motor Development from Birth to Twelve Months

    Amy S. OMalley, PT, MPT


    Good Beginnings Falls Church, VA, USA Firefly, Inc.

    This presentation is made possible, in part, by the support of the American people through the United States Agency for International Development (USAID). The content of this presentation is the sole responsibility of the author(s) and does not necessarily reflect the views of USAID or the United States Government. The opinions and views expressed by the authors in this document do not necessarily reflect the views and opinions of KPMG.

    A month to month overview-why?


    The first year of life is a wonderful compilation of sequential activities. Each one purposefully builds on the previous to allow for the development of:
    Independent locomotion (gross motor) Independent use of bilateral upper extremities (fine motor) Independent verbal and nonverbal skills (communication)

    If one component skill is unattained, further development becomes difficult.

    Month to Month (cont.)


    Understanding the basic components and when milestones are expected to be achieved is ESSENTIAL to designing intervention Skills must be acquired in a relatively sequential order to be successful (i.e. you cannot run before you walk, walk before you sit, etc.) General principles
    Cephalo-caudal (head to foot) Proximal-distal (from the core to the extremities) Gross motor-fine motor (large movements before small, refined movements)

    Birth to One Month (Neonatal Period)


    Typical gestation is 38-42 weeks Purpose: learn to tolerate extrauterine environment Sensory input Feeding Sleeping Physiologic flexion dominates Pull to sit is completely passive Unable to contract UE/abd/LE muscles to assist Neck muscles may contract, but head is too heavy for lifting

    Neonate (cont.)
    Reflexes and gravity dominate
    Moro reflex: Sudden backwards movement of the head causes UE abd/ext. followed by add/flex. Rooting reflex: Tactile stimulation to the mouth in supine causes head rotation

    Can clear head to the cheek to either side while prone (prevents suffocation)

    Potential Indicators of Atypical Motor Development-Perinatal


    Profound Medical History
    Prematurity Intraventricular Hemmohage (Grade III/IV) Bronchopulmonary Dysplasia (BPD) Very low birth weight (under 1500 grams) Perinatal aspyhxia

    Neurological insults will either result in a very stiff (hypertonic or spastic) or floppy (hypotonic) muscle pattern

    First Month (4-8 weeks)


    Purpose: eat, sleep, emotionally bond with caregivers, visual exploration Supine
    Random extremity movements Head rotation Head lifting and turning (requires maximum effort) Emerging tracking in horizontal plane of a high contrast, black and white object/picture

    Prone

    Visual

    Pull to sit is still passive, but infant tries to assist

    Second Month (8-12 weeks)


    ATNR (asymmetric tonic neck reflex) dominates
    Head rotation causes extension of face side arm and flexion of skull side arm

    Vision
    Brief fixation at midline Tracking side to midline/midline to side

    Second month (8-12 weeks) (cont.)


    Prone
    Brief lifting of head to 45

    Pull to sit
    Head lag continues despite attempts to assist UE produce some active elbow flexion

    Third Month (12-16 weeks)


    Symmetry returns ATNR starting to integrate, but not fully Can hold head in midline Can hold a rattle placed in the hand Can play with the hands together

    Third month (1216 weeks) (cont.)


    Prone
    VERY important to have a lot of tummy time Able to lift head between 45-90 Can track horizontally 180

    Pull to sit
    Head lag persists until nearly upright, then some flexion occurs

    Potential Indicators of Atypical Motor Development-3 months


    Inability to keep head in midline Inability to lift head while prone Inability to bear weight on the UE while prone Inability to focus visual gaze

    Fourth Month (16-20 weeks)


    The beginnings of movements that are:
    Controlled and purposeful Alternating and coordinated

    Symmetry extends down through the head and trunk ATNR should be rarely seen

    Fourth month (16 to 20 weeks) (cont.)


    Prone
    90 on elbows Head in midline

    Pull to sit
    Head righting strong/chin tuck Stabilized in midline with shoulders

    Rolling begins via reflexive action


    Supine to side Prone to side

    Sitting begins with support


    Brief periods of maintaining position without support (a few seconds)

    Potential Indicators of Atypical Motor Development-4 months


    Continued asymmetry
    Overuse of ATNR reflex Inability to keep head in midline in either prone or supine Inability to visually track objects Lack of UE muscle contraction during pull to sit Inability to achieve a sitting position with support

    Fifth Month (20-24 weeks)


    Characterized by movement that is:
    Voluntary Asymmetrical Dissociated Reciprocal

    Head control and righting are present in all positions Hands to feet emerges

    Fifth month (20-24 weeks) continued


    Prone on extended elbows Rolling
    Active from supine to side Accidental from prone to supine

    Pull to sit
    Flexes and lifts head when holding hands Abdominal begin to contract

    Sitting
    Independent briefly but through positional stability LEs are in ring position Prop sitting with UEs

    Play involves grabbing, mouthing, banging, shaking a small toy in hand

    Potential Indicators of Atypical Motor Development-5 months


    Lack of flexion control (unable to reach hands to knees/feet)
    Weak abdominals/lack of kicking LEs Lack of choice between asymmetry and symmetrical use of UEs Unable to stabilize head in supported sitting Unable to attempt to straighten back in supported sitting

    Weak use of spinal extensors


    Inability to achieve weight bearing on ischial tuberosities in supported sitting

    Sixth Month (24-28 weeks)


    Head control fully developed for prone, supine, and sidelie Feet to mouth Pulls to sit holding hands Sits independently
    No propping No external support

    Bears full weight on LEs in supported standing

    Sixth month (24-28 weeks) continued


    Prone
    Functional and mobile Prone on extended arms (POEE) Weight shift on extended arms Pivot prone in a circle Reach to front and side for toys

    Rolling
    Active supine to prone Head righting is present during the movement

    Potential Indicators of Atypical Motor Development-6 months


    Inability to sit Inability to be active in prone Inability to roll Inability to correct head position

    Seventh Month (28-32 weeks)


    Very rarely in supine Active play in sidelye Sit independently
    Back and pelvis straight Can manipulate toys while in base of support (BOS) Frequent falls backwards Uses protective extension when falling forward

    Seventh month (28-32 weeks) continued


    Prone
    Pushes up into quadruped Rocking in quadruped

    Creeping
    Sometimes called belly or commando crawling

    Can be supported in standing at trunk or hands

    Potential Indicators of Atypical Motor Development-7 months


    Preference for supine over prone Inability to roll Inability to sit Lack of motivation to move Compensations to accomplish ageappropriate tasks
    Head/neck hyperextension while sitting Extra wide BOS during sitting

    Eighth Month (32-36 weeks)

    MOVEMENT!
    Multiple LE positions in sitting
    Ring sitting when focused on UE play ring long sit Long sit Side sit

    Transitions in/out of quadruped


    Pre-vaulting over hip Controlled back to floor

    Eighth Month (32-36 weeks) continued


    Crawling emerges
    Hands and knees Reciprocal extremity movement

    Pull to stand with UEs


    Kneeling Standing at a surface or holding onto fingers

    Potential Indicators of Atypical Motor Development-8 months


    Inability to sit
    Inability to vary sitting positions

    Lack of transitions between floor, sitting, and quadruped


    Standing on tiptoes

    Ninth Month (36-40 months)


    FLOOR MOBILITY

    Combining gross and fine motor skills


    Crawling
    Varied speeds
    Quickly changes directions

    Climbing
    Stairs, furniture
    Can climb up but not down

    Ninth Month (36-40 months) (cont.)


    Standing
    Squat to floor with hand on surface Moving to floor not always controlled

    Cruising
    Along the furniture Lateral (side to side) is the first pattern

    Potential Indicators of Atypical Motor Development-9 months


    Sitting only in ring sit or w-sit
    Inability to transition between positions Bunny hopping during crawling

    Tenth Month (40-44 weeks)


    Actively exploring environment
    Concepts of in and out/container play Crawling and climbing are primary, rarely sitting
    Can crawl over objects Starting to motor plan going down

    Tenth Month (40-44 weeks) continued

    Kneeling and half kneeling


    LEs contribute to pull to stand Standing with hands manipulating objects Cruising
    Lateral Around furniture

    Supported walking

    Eleventh Month (44-48 weeks)


    Independent standing
    Can pull to stand at furniture, on a person, along the wall

    Squatting

    Cruise around and over furniture


    Must be taught to descend backwards

    Walking
    With one hand held May attempt to take independent steps

    Twelfth Month (48-52 weeks)


    Basic motor skills are all present
    All transitions are independent
    Moving floor to stand with out a surface is new

    Stand independently without support Independent walking may begin but is not obligatory

    Potential Indicators of Atypical Motor Development10-12 months


    Inability to perform any of the ageexpected tasks

    Poor quality of movement during ageappropriate tasks


    Poor velocity of movement during ageappropriate tasks

    References
    Bly, Lois, M.A., PT Motor Skills Acquisition in the First Year. Therapy Skill Builders, San Antonio, Texas, 1994.

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