2017 Stethoscopes & Little Folks

Motor Delay

November 13, 2017

 

Motor delay is when a child does not reach the expected gross &/or fine motor skill milestones for their age. Motor delays are common and vary in severity. Some children with motor delays will eventually achieve their milestones at a later age, others may need therapy to reach their milestones, and some children may have a permanent disability.

 

Developmental coordination disorder (DCD) or dyspraxia is a disorder where children have difficulty with coordinated motor skills. Children with DCD are often seen as clumsy. They have difficulty with a combination of fine motor skills (eg. handwriting, tying shoelaces) and gross motor skills (eg. walking, jumping). As a result, these children may struggle with day-to-day activities at home and at school. It is estimated that 10% of children entering primary school are affected by DCD.

 

Cerebral palsy is a permanent physical disability that affects muscles and movement. It is caused by damage to the developing brain either during pregnancy or shortly after birth. 2 in 1000 babies are affected by cerebral palsy.

 

Genetic disorders can also cause motor delay. These are often associated with other problems like poor growth and delays in speech, language, and cognition. Most genetic disorders are present from birth and are quite rare, affecting one in several thousand or million. They may be inherited from the parents’ genes or may be from a new gene mutation.

 

 

Gross Motor Milestones

 

4 months

  • Rolls over front to back

  • Can do a mini push-up

6 months

  • Rolls over back to front

  • Sits without support

9 months

  • Pulls self to stand

  • Comes to sit from lying

  • Crawls

1 year

  • Walks independently

  • Stands

18 months

  • Walks backward

  • Runs

  • Walks up steps with hand held

 

2 years

  • Rides on toy without pedals

  • Jumps up

 

2.5 years

  • Begins to walk up steps alternating feet

3 years

  • Pedals

  • Climbs on and off furniture

4 years

  • Climbs stairs without support

  • Skips on 1 foot

 

 

Fine Motor Milestones

 

4 months

  • Hands unfisted

  • Plays with fingers in midline

  • Grasps object

6 months

  • Reaches for objects and transfers

  • Rakes small object with 4 fingers

9 months

  • Picks up small object with 3 fingers

1 year

  • Puts 1 block in a cup

  • Bangs 2 objects together

  • Picks up small object with pincer grasp

18 months

  • Scribbles

  • Self-feeds with minimal assistance

  • Dumps small object from bottle

  • Builds tower of 2 blocks

  • Puts blocks in a cup

2 y

  • Builds tower with 3 blocks

2.5 years

  • Imitates horizontal and vertical line

  • Builds a train with a chimney with 4 blocks

3 years

  • Copies a circle drawing

  • Draws a person with head and one other body part

  • Builds a bridge with 3 blocks

4 years

  • Draw a person with 6 parts, simple cross

  • Able to do up medium-sized buttons

 

 

When to seek help

 

Be concerned if:

  • at 5 months or older your baby’s head still lags back when you pull him/her into a sitting position

  • by 7 months your baby can’t sit without help or roll in both directions

  • by 9 months your baby can’t get into a sitting position by himself, or is not using both hands to grasp objects

  • by 18 months your child does not walk well by himself, can’t get up off the floor by himself, or not able to pick up small objects

  • by 2 years your child can’t run well, it is hard for your child to run, or if she moves her arms and upper body a lot and has a 'funny' way of running

  • by 3.5 years your child can’t easily walk up and down stairs or needs to rest a lot when walking up and down stairs

  • your child loses gross or fine motor skills they once had

 

 

NOTE: The gross and fine motor milestones listed here are taken from an American Academy of Paediatrics publication aimed at healthcare professionals. If you have any concerns about your child's motor development, or any other aspect of their development, please speak with your doctor.

Useful Links

 

ChildMuscleWeakness.org

 

Cerebral Palsy Alliance

 

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