Physical Development in Children and Adolescents

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 synaptogenisis (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 life style 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 are 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.

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Physical Developmental Milestones

Infant (0 to 18 m)Toddler (18 m - 3y)Preschooler (3y - 5y)School Age (6y - 12y)Teens (13-18)

Birth to Six Months

Gross (Large) Motor Skills

  • Lifts head and chest when on 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 pull toy.
  • Runs stiffly.
  • Squats down to pick up object and stands up.
  • Climbs up stairs; creeps down backwards one at a time.
  • Climbs out of crib and play pen.
  • Can throw a ball
  • Walks well
  • Can walk while holding an object

Fine (Small) Motor Skills

  • Turns several pages of book at one time.
  • Scribbles on paper with crayon.
  • Releases ball with slight thrust.
  • Picks up small objects between thumb and forefinger.
  • Can open small box.
  • Holds spoon with fist.
  • Feeds self with fingers.
  • Holds and drinks from 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 ground with both feet.
  • Bends at waist to pickup object.
  • Walks up and down steps, one step at a time.
  • Throws objects overhead.
  • Kicks 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 backwards
  • Can balance on one foot (by 3 years)
  • Walks up and down stairs independently

Fine (Small) Motor Skills

  • Turns individual pages of 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 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 ball and catches ball with elbows in front of 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 ball and catches ball with elbows in front of 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 sleep each night.
  • Needs frequent rest.
  • Establishes preference for one side of 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, 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