Parent Guide: Motor Milestones

As a parent of an infant or toddler, it is often difficult to know whether to be concerned about your child’s growth and development. There are many examples of children developing at their own pace and catching up to their peers over time. When should you wait and see how your child develops? When should you speak with your child’s doctor? When should you insist on more testing and referrals?

Motor Milestone Guide
Children should meet their motor milestones by certain ages. The information below is about motor delays. Motor delays can have different causes, but delays may be clues that a child might be weak in his or her muscles. Parents can use this information to figure out when to ask for referral to early intervention, physical therapy, and a specialist.

Infants
Skill: Pull up to seated position without head lag
If you lay a young infant on her back, hold onto her hands, and pull her to sitting, you’ll probably notice that her head lags behind. By 5 months old, however, most infants are able to hold their heads upright (that is, their heads should no longer lag behind) when a parent pulls them from lying on their back to a seated position.
Expert advice: If your baby’s head still lags back at 5 months of age when you pull her into a sitting position: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

6 Months and older
Skill: Sitting without help
Most babies can sit by themselves (not propped up) between five and seven months of age. By nine months, children should be able to get into a seated position all by themselves.
Expert advice: If your baby can’t sit without being propped up by seven months, or if he can’t get into a sitting position by himself by nine months: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

12 Months and Older

Skill: Walking
Most children can walk all alone by 14 months old.
Expert advice: If your child does not walk well by herself when she is 18 months old, or if she starts to get worse at walking or stops walking: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

Skill: Standing up from the floor
Once a child is able to walk alone, he or she should also be able to get off of the floor and stand up without having to hold onto anything or pull up. Children should not need to push off of their knees or legs to stand up.
Expert advice: If your child can’t get up off the floor by himself when he is 18 months old, or if he starts to get worse at getting up off the floor: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

Skill: Running
Most children can run well by the time they are 18 or 19 months old. Some children who are struggling to run do an exaggerated walk instead; they move their arms and upper body a lot and often have a “funny” gait.
Expert advice: If your child can’t run well when she is 24 months old, or if she starts to get worse at running: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

Skill: Climbing stairs
By 3 years old, most children can easily walk up and down stairs, using alternating feet on each step. Children who have weakness in their muscles have a hard time going up and down stairs. They often pull themselves up the stairs using the railing, crawl up stairs, or stop to rest.
Expert advice: If your child can’t easily walk up and down stairs when he is 3 and 1/2 years old, or if he starts to get worse at climbing stairs: talk to your child’s doctor about referrals for early intervention, therapy, and to a specialist for an evaluation.

Resources for Families

Child Motor Development

Centers for Disease Control and Prevention’s Guide for parents of children’s milestones by age

http://www.cdc.gov/ncbddd/actearly/milestones/index.html

Baby Development News Guide to Child’s Motor Development http://www.babydevelopmentnews.com/infantmotordevelopment.html

Centers for Disease Control and Prevention’s Guide for parents concerned about their child’s developmental progress

http://www.cdc.gov/ncbddd/actearly/concerned.html

Parent-completed record of contacts and next steps in pursuing a child’s diagnosis

http://nichcy.org/wp-content/uploads/docs/recordkeeping.pdf

Centers for Disease Control and Prevention’s Guide for parents about the Developmental Screen process (English and Spanish versions available)http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/DevelopmentalScreening.pdf

Early Intervention Support.com

http://www.earlyinterventionsupport.com/development/default.aspx

Early Intervention

National Dissemination Resource Center for Children with Disabilities Early Intervention Early Intervention Guide http://nichcy.org/babies/overview

Wrights Law Early Intervention Resources

http://www.wrightslaw.com/info/ei.index.htm

Information and Support Organizations (if a neuromuscular diagnosis is suspected or confirmed)

Cure CMD: for Congenital Muscular Dystrophies

http://curecmd.org

Families of SMA: for Spinal Muscular Atrophies

http://www.fsma.org

Muscular Dystrophy Association: for pediatric and adult neuromuscular disorders

http://www.mdausa.org

Parent Project Muscular Dystrophy: for on Duchenne and Becker muscular dystrophies http://www.parentprojectmd.org

SMA Foundation: for Spinal Muscular Atrophies

http://www.smafoundation.org