Physical development is the most readily visible of the child development domains. Parents notice height and weight as well as the development of both fine motor and gross (large) motor skills. It’s important to remember that what we can see physically corresponds to what we can’t see which is brain development. In all developmental domains, the brain is promoting exploration and movement but when exploration and movement occur it also stimulates brain development including both neurogenesis (growth of new brain cells) and synaptogenesis (forming new connections between brain cells). In fact at various times during the first few years of life, a baby’s brain produces so many connections that they end up with more than in an adult brain. Later through a process called pruning, synaptic connections that are not used by the child are eliminated.
Parents play an important role in all of the developmental domains and physical development is equally important. Parent’s bonding with their child develops a sense of feeling safe to explore and positive feedback encourages a child to reach out more and push harder. Parents also provide guidance and support through a process known as “scaffolding”. Providing objects to encourage a baby to reach and grasp, holding the hands of a toddler while they take a few steps, teaching potty training, help a child with buttoning and zipping clothing, helping them learn to ride a bike and playing catch are just a few examples of how parents provide scaffolding to help children develop physical abilities.
In addition to encouraging and teaching specific skills, parents should promote a healthy lifestyle for their children. This includes helping them to get adequate sleep, eat a well-balanced diet and stay active physically. In this endeavor, the best approach for parents to take is to model the behavior as well as teach and encourage these very important health habits. Teaching safety and maintaining a safe home environment (especially in the early years) is also very important. Keeping up with regular check-ups and keeping immunizations up to date is important as well.
If you are concerned about possible delays in your child’s physical development we suggest you use the American Academy of Pediatrics: Motor Delay Tool and then discuss any concerns you have with your pediatrician.
Physical Developmental Milestones
Birth to Six Months
Gross (Large) Motor Skills
- Lifts head and chest when on the stomach.
- Rolls from back to side or side to back.
- Rolls completely over from back or stomach.
- Sits with support.
- Holds head erect.
- Can raise him/herself up on forearms (while on tummy) and hold head up
- Rolls from back to tummy (by 4-6 months)
Fine (Small) Motor Skills
- Reaches for objects.
- Holds objects for short periods of time before dropping them.
- Touches and pats bottle.
- Usually responds to objects or faces as they move
- Plays with fingers, hands, and toes
- Holds and manipulates objects; sucks on everything!
Six to 12 Months
Gross (Large) Motor Skills
- Progresses from sitting steady when supported to sitting without support.
- Crawls on hands and knees.
- Pulls to standing position.
- Walks with help.
- Stands alone.
- Learns to crawl, stand up and walk
- Sits without support (by 8 months)
- Begins to cruise and eventually walk
- Develops eye-hand coordination
Fine (Small) Motor Skills
- Reaches for small objects.
- Places objects in a container.
- Picks up medium and large objects.
- Changes objects from one hand to another.
- Plays with two toys; one in each hand.
- Points with fingers.
- Transfers toys from hand to hand
- Sees almost everything with good vision
- Develops eye-hand coordination
12 to 18 Months
Gross (Large) Motor Skills
- Stands alone.
- Walks without support; starting and stopping with control.
- Walks backward with a pull toy.
- Runs stiffly.
- Squats down to pick up an object and stands up.
- Climbs up stairs; creeps down backward one at a time.
- Climbs out of the crib and playpen.
- Can throw a ball
- Walks well
- Can walk while holding an object
Fine (Small) Motor Skills
- Turns several pages of a book at one time.
- Scribbles on paper with crayon.
- Releases ball with slight thrust.
- Picks up small objects between thumb and forefinger.
- Can open a small box.
- Holds a spoon with a fist.
- Feeds self with fingers.
- Holds and drinks from a cup.
- Picks up small objects with pointer finger and thumb
- Can build a tower of cubes
- Turns pages in a book
18 To 24 Months
Gross (Large) Motor Skills
- Runs stiffly.
- Jumps off the ground with both feet.
- Bends at the waist to pick up an object.
- Walks up and down steps, one step at a time.
- Throws objects overhead.
- Kicks a large ball.
- Climbs onto low objects.
- Kicks backward and forward
- Stands on a balance beam
- Walks up stairs with help
- Runs well
- Enjoys riding small wheeled riding toys
Fine (Small) Motor Skills
- Manages spoon.
- Makes vertical marks and circles with crayon (pencil).
- Turns doorknobs.
- Pulls down zippers.
- Shows hand preference, but switches hands often.
- Assists in dressing and undressing self.
- Can draw scribbles
- Drinks from a straw
Two to Three Years
Gross (Large) Motor Skills
- Is constantly in motion.
- Jumps off low objects.
- Pushes self on wheeled toys.
- Runs but has difficulty stopping.
- Seats self in small chairs.
- Alternates feet going upstairs, but not downstairs.
- Kicks ball.
- Throws ball overhand; no aim.
- Catches objects with arms extended and elbows stiff.
- Walks backward
- Can balance on one foot (by 3 years)
- Walks up and down stairs independently
Fine (Small) Motor Skills
- Turns individual pages of a book.
- Screws lids on and off.
- Builds crude towers of six or more blocks.
- Scribbles circles and horizontal and vertical lines.
- Takes simple objects apart and puts back together.
- Uses spoon; spills a lot.
- Strings large beads
- Holds scissors correctly
- Zips and snaps
Three to Four Years
Gross (Large) Motor Skills
- Hops, skips, jumps, and runs.
- Makes sudden stops and starts.
- Walks on tiptoes.
- Hops on one foot.
- Marches to a rhythm.
- Alternates steps when climbing stairs; comes down one step at a time.
- Throws ball by thrusting with arm and shoulder; catches with arms held out straight.
- Swings on a swing.
- Walks a low balance beam.
- Rides tricycle.
Fine (Small) Motor Skills
- Builds block towers of about 9 or 10 blocks.
- Holds pencils and crayons with control.
- Draws straight lines and copies circles.
- Draws three-part person.
- Cuts with scissors.
- Unbuttons clothes.
- Pulls up large zippers.
- Uses spoon and fork.
Four to Five Years
Gross (Large) Motor Skills
- Whirls around turns somersaults and hangs on bars.
- Hops several times in a row.
- Climbs large play equipment.
- Jumps forward using a forward arm action.
- Jumps up and down.
- Throws ball overhead with less body movement.
- Bounces a ball and catches the ball with elbows in front of his body.
- Can hop on one foot, skip and jump
- Can catch a ball with both hands
- Can catch a beanbag
Fine (Small) Motor Skills
- Builds straight block towers.
- Draws a house and person.
- Prints name.
- Forms crude shapes with clay.
- Cuts on lines with scissors.
- Brushes teeth, combs hair and washes hands.
- Dresses self except for tying shoes.
- Develops hand preference.
- Dresses and undresses him/herself
- Can copy a simple design
- Uses scissors to cut a straight line
Five to Six Years
Gross (Large) Motor Skills
- Whirls around, turns, somersaults and hangs on bars.
- Hops several times in a row.
- Climbs large play equipment.
- Jumps forward using a forward arm action.
- Jumps up and down.
- Throws ball overhead with less body movement.
- Bounces a ball and catches the ball with elbows in front of her body.
Fine (Small) Motor Skills
- Builds straight block towers.
- Draws a house and person.
- Prints name.
- Forms crude shapes with clay.
- Cuts on lines with scissors.
- Brushes teeth, combs hair and washes hands.
- Dresses self except for tying shoes.
- Develops hand preference.
Six to Nine Years
- Growth rate slows.
- Requires around eleven hours of sleep each night.
- Needs frequent rest.
- Establishes preference for one side of the body over the other.
- Has established which hand to use.
- Girls mature faster than boys.
- Coordination not fully developed.
- Runs, jumps, climbs, slides, and dances.
- Plays ball, tag, and catch.
- Improves writing skills.
- Engages in art activities.
- Plays musical instruments.
- Dresses and undresses self completely.
Nine to 12 Years
- Develops more adult-like proportions.
- Develops harder, larger bones.
- Is sick less often.
- Extremely active.
- Starts developing secondary sex characteristics.
- May begin growth spurt.
- Develops interest in more specific motor skills such as skating, bicycling, running and gymnastics.
- Engages in organized sports such as tennis, baseball, football, swimming, and golf.
- Has well developed small muscles.
- Refines writing.
- Develops special interests in activities such as model building, shop work, art classes, music and crafts.
- Tries new foods; has favorites.
- Eats neatly.
12 – 15 years of age
- Puberty: Rapid growth period
- Secondary sexual characteristics appear: grow body hair, increase perspiration and oil production in hair and skin
- Girls – breast and hip development, the onset of menstruation
- Boys – growth in testicles and penis, wet dreams, deepening of voice Tremendous physical growth: gain height and weight
- Body Image
- Preoccupation with physical changes and critical of appearance
- Anxieties about secondary sexual characteristic changes
- Peers used as a standard for normal appearance (comparison of self to peers)
15 – 18 years of age
- Secondary sexual characteristics advanced
- 95% of adult height reached
- Puberty is completed
- Physical growth slows for girls, continues for boys
- Body Image
- Less concern about physical changes but increased interest in personal attractiveness
- Excessive physical activity alternating with lethargy