Motor Delay
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.
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