Wee Kids Therapy - Helping You Achieve Your Goals

While every child learns skills at an individual rate, developmental delays may cause concern and hardship. Use the guide below to see what milestones your child should be reaching at each of the following ages.  

Fine Motor Skills / Visual Motor Skills

First Year

• Brings hands to mouth for exploration
• Grasps rattle if placed in hand
• Reaches forward and touches toy
• Hits at dangling objects with hands
• Beginning to follow toys or parents with eyes

4-5 Months 

• Bring hands together when lying on back
• Grasp rattle when placed in hand
• Reaches toward and touches toy
• Hits at dangling objects with hands
• Holds small object with palm and fingers, but not thumb (“palmar” grasp)
• Tracks fast moving objects with eyes

6 Months 

• Puts fingers in mouth
• Reaches for a toy when playing on belly
• Holds a toy and shakes it
• Holds hands open at least ½ of the time
• Starting to explore and figure out how to activate toys
• Moves head to track fast moving objects or people with eyes, while on back and on belly 

7 Months 

• Bangs a toy on the floor
• Passes a small object from one hand to the other
• Holds a toy in each hand and bangs together
• Learns to clap
• Inferior pincer grasp and lateral pincer grasp (can pick up a small item such as a cheerio using the side of the thumb and side of the finger)

8 Months 

• Grasps two toys in one hand
• Inferior pincer grasp and lateral pincer grasp (can pick up a small item such as a cheerio using the side of the thumb and side of the finger)
• Turns head to visually track objects while sitting

9 Months 

• Begins to help with dressing by reaching/lifting arm or leg
• Enjoys stacking toys or put 1 toy in another like stacking cups
• Releases objects intentionally
• Pulls on a string to get a toy
• Picks up, pushes, or shoves fairly large objects
• Bangs a toy on the floor
• Passes a small object between hands
• Picks up small objects between fingertips and thumb, with a space between the object and palm (pincer grasp)
• Turns head to visually track objects while sitting

10 Months 

• Picks up small object with improved pincer grasp
• Grasps with thumb and first 2 fingers (3 jaw chuck)
• Begins turning page in cardboard book
• Removes things form containers, picking out or dumping them
• Pays attention to where you are looking and pointing

11 Months 

• Tears paper
• Pokes into holes with index finger
• Can open and close drawers/doors or uses switches to turn on and off
• Throws things just to see what happens
• Pays attention to where you are looking and pointing

12 Months 

• Builds 2 block tower
• Can place small objects in a bottle
• Grasp thick crayon or pencil in fist, but may not mark on paper
• Turns page of cardboard book
• Puts objects into container
• Pays attention to where you are looking and pointing

Fine Motor Skills / Visual Motor Skills

 Second Year

• Turns pages of regular book when page is lifted
• Imitates scribbling with crayon
• Pushes a toy car
• Brings a filled spoon/fork to mouth

14 Months  

• Makes a stack of 2 blocks
• Points at objects with index finger, keeping other fingers toward palm
• Rolls a ball to you

15 Months 

• Marks on paper with crayon or pencil without help
• Puts things in and out of containers
• Turns a bottle of small objects over
• Places round object in round opening
• Removes socks with some help

16-18 Months 

• Turns a small knob
• Puts large round pegs into pegboard
• Helps dress and undress self
• Copies housework or activities you do (i.e. brushing hair)
• Builds a 3-block tower
• Removes socks without help

19-20 Months 

• Gets a spoon
• Drinks from a cup independently
• Turns one or more regular book pages without help
• Stacks a 4-block tower
• Zips and unzips easy zippers
• Uses grasp with thumb towards paper
• Sits on a toilet with assistance
• Still needs help to brush teeth

21-22 Months 

• Uses play doh, paint, and paper
• Washes and dries hands with help
• Scribbling remains on the paper
• Builds 6 block tower
• Hand preference may be emerging (from 18 months), but not established
• Strings some large beads
• Sits on a toilet with less assistance
• May be helpful around the house
• Washes and dries hands with help

22-24 Months 

• Grasps a pencil in palm
• Grasps a thick crayon with thumb and fingers
• Uses only fingers to manipulate objects
• Imitates drawing a vertical line
• Draws dots and circular shapes spontaneously
• Cylindrical grasp
• Continues to establish hand dominance
• Sits on a toilet with less help than before
• Begins to control toileting during the daytime
• Strings 3 1-inch beads on a long-tipped lace

 Areas of Concerns for Development by the End of the Second Year 

• Not meeting developmental milestones
• Walking on toes the majority of the time
• Complains of pain or fatigue on a regular basis for no apparent reason
• Generally clumsier than same-aged peers
• Once acquired skills now seem to be regressing
• No words by 16 months
• Doesn't seem to know how to play with toys or excessively lines up toys or other objects
• Is attached to one particular toy or object
• Occasionally seems not to hear you or environmental sounds
• Avoids eye contact and wants to be alone
• Avoids or resists physical contact
• Is not comforted by others when upset
• Gives unrelated answers to questions
• Gets upset by minor changes
• Has obsessive interests
• Has unusual reactions to various sensations
• Has flat facial expressions
• Has a loss of speech or babbling or social skills
• Cannot use thumb and pointer finger alone (pincer grasp) to pick up small objects
• Does not point with pointer finger
• Does not respond consistently to name
• Does not respond to familiar sounds
• Does not look at or point to objects and pictures when named
• Does not show or give objects without prompting
• Does not initiate a turn taking game
• Not able to put things into containers
• Cannot imitate drawing a line from the top of the paper to the bottom
• Still putting a lot of objects in mouth
• Not able to put a simple, large puzzle piece into a wooden puzzle
• Not able to put a simple shape into a shape sorter
• Unable to feed self with spoon
• Cannot to stack 2-3 blocks

Please contact our office if you have concerns about you child's development and feel your child would benefit from occupational therapy services.  We would be happy to speak with you. 

 Call our office at 828-816-0433 or email shela@weekidstherapy.com

Fine Motor Skills / Visual Motor Skills

 Third Year

• Begins to establish hand preference
• Grasping a cup with one hand without spilling
• Grasping spoon and turning hand to bring to mouth
• Turning pages 1 at a time
• Building a tower using 8 cubes
• Folding paper in half
• Cutting on line
• Turning door knobs and jar lids
• Stringing half inch beads
• Recognizing outline of familiar pictures

30-36 Months  

• Completing simple 3-piece puzzle
• Matching identical pictures
• Copying drawing circles
• Pouring liquid from one container directly into another
• Holding a fork with a fist
• Building a 9-block tower
• Making continuous cuts with child-safe scissors

Please see our Preschool Readiness Section for ages four and five.