| *All children develop differently. Please consult your pediatrician if you are concerned about your child's development. |
| | Self Care | Fine Motor | Sensorimotor | Social/Play Skills |
| 0-2 months | | Will close hand when object is placed in palm(grasp reflex) | By 6 weeks of age, a child has developed consistent sleep/wake cycles | Primarily engage in exploratory and sensorimotor play-such as grasping, mouthing hands and by listening and watching people |
| | | Moves arms in random motions | Demonstrates little to no negative reactions in response to being moved | Children are bonding with and forming attachment through caregiver interactions |
| | | Holds hands fisted majority of the time | Parents able to determine child's likes or preferences, such as favorite songs, finger games | Can only engage in play for 10-15 minutes |
| 2-3 months | | When the back of the hand is rubbed, he/she will open his/her hand | | |
| | | Randomly swipes at objects, but unable to grasp | | |
| | | Child often bring hands to mouth and to the middle of the body | | |
| 3-4 months | | Demonstrates sustained grasp on toys, but involuntary releases objects | | Demonstrates interest in things around him or her |
| | | Able to spontaneously open and close their hands | | |
| | | Attempts to reach for items, but with a bent arm | | |
| | | Brings hands to mouth and watches hands | | |
| 4-6 months | At 5 1/2 months a child is able to independently hold bottle | Swipes for items with both arms with poor control | | Engage in sensorimotor and exploratory play by touching, grasping, transferring and mouthing toys |
| | | Plays with hands when positioned in middle of body | | Enjoys playing with simple cause and effect toys |
| | | When lying on stomach, child is able to reach for toys by shifting weight | | Displays stranger anxiety |
| | | Grasps items with fingers and thumb but does not wrap thumb around item | | Becomes happy when a they see a familiar person |
| | | Transfers toys from hand to hand | | |
| 6-8 months | | Able to reach for items with straight arms | At 6 months, able to tolerate various textured food | Primarily engage in play with caregivers. Begin to notice other children but do not directly engage with them |
| | | Attempt to pick up small items off play surface using finger raking motion | Able to simultaneously attend to various stimuli in environment | |
| | | Grasps toys with thumb opposed to index and middle finger | | |
| | | Unable to voluntarily release objects without placing against a surface to assist | | |
| 8-9 months | Engages in finger feeding | Grasps small items with thumb against side of pointed finger | | Able to show what they want by reaching/pointing or reaching out to be picked up |
| | | Demonstrates playing with toys | | Responds to people talking to them by making noises or reaching |
| | | Release of medium sized toy into large container clumsily | | |
| 9-12 months | Holds a spoon | Able to accurately release medium sized objects into larger container and starts to scribble | | Begins to play with toys according to their functional purpose and interact with others |
| | | Attempts to reach into container to remove objects | | Enjoys playing with simple shape sorters, dolls, activity centers |
| 12-18 months | Notifies parent that diapers are soiled | Demonstrates turning arms towards the ceiling when playing | Able to play with various textured toys with little or no negative reactions | Engage in simple pretend play |
| | "Cooperates" with dressing | Able to imitate and scribble with fisted grasp | Able to tolerate various clothing textures | Enjoys gross motor play but has little safety awareness |
| | Engages in bath time by helping to wash a few body parts | Able to stack between 2 and 5 blocks | Child demonstrates little or no negative reactions to loud noises | Enjoys simple fine motor/manipulative play (puzzles, stacking, picture books) |
| | Removes socks | | Actively explores all aspects of a toy | Begin to participate in play along side children |
| | | | Able to make eye contact, listen, and follow simple directions | Should be able to imitate your sounds, gestures, or words. |
| 18-24 months | Able to hold and drink from cup with minimal spilling | Grasps small items between tips of thumb and index finger | | Continue to engage in functional play and simple pretend play |
| | Able to load spoon and bring to mouth with moderate spilling | Able to play with shape sorters, puzzles, scribble, and turn pages of book | | Engage in parallel play and small group play and begin learning how to take turns |
| | Gives up bottle | Imitates vertical then horizontal strokes | | Continues to enjoy gross motor play |
| 2-3 years | Has few accidents during the day and can indicate when they need to go to the bathroom | Snips with scissors | Able to modify his/her play to the environment | Able to imitate familiar pretend actions such as hugging a doll |
| | Able to take off pants, coat, socks and shoes without fasteners. Able to unzip and unbutton large buttons | Imitates drawing a cross | Can tolerate changes in routine or trying new things | Able to meet basic needs with one or few words such as juice and open |
| | Able to feed self with little to no spilling | Matches circle, triangle or square | Able to maintain focus on play/activity even with moderate levels of different stimuli | Can follow one step directions from a caregiver |
| | Requires assistance to manage pullover clothing | Inserts pegs into a round hole and can screw and unscrew lids | Engages in group activities and is able to follow group rules | Able to engage in interactive play |
| 3-4 years | Independent with toilet control and notification. | Able to copy a circle at 3 years | | Can engage in pretend play with other children where the story makes sense |
| | Able to dress self independently, but may need help with fasteners | Able to thread a medium sized bead at 3 years old | | Able to begin to explain wishes or needs |
| | Able to bathe self with the exception of washing own hair | Colors mostly within the lines. Able to cut out a circle | | Able to make a logical conversation with three or more give and take sequences. |
| 5-6 years | Independent with all toileting care | Able to cut out a square | | |
| | Independent with all dressing tasks; including tying shoes | Draws a person with 6 or more parts | | |
| | Supervision for all grooming and bathing cares to ensure safety and quality of performance | Can copy a triangle and write alphabet and name | | |
| 7-9 years | Independent with all dressing tasks including the selections of appropriate clothing | Can write full sentences | | |
| Information adapted from: | | | |
| Beery, Keith E, PhD., Beery, Natasha A, MA. Beery VMI. Minneapolis, MN: NCS Pearson. |
| Erhardt, R.P (1982). Erhardt Developmental Prehension Assessment. Laurel, MD: Ramsco Publishing Co. |
| Exner, C.E. (2001). Development of hand skills. In J. Case-Smith (Ed.), Occupational therapy for children(4th ed., pp. 289-328). St. Louis, MO: Mosby. |
| Mulligan, S. (2003). Occupational therapy evaluation for children: A pocket guide. Philadelphia, PA: Lippincott Williams & Wilkins. |
| Greenspan, S. (1999). Building Healthy Minds. New York, NY: Da Capo Press. | |
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