It can often be challenging to determine whether or not your child is delayed. Some children may not exhibit difficulties in all areas, or the signs may be subtle. Common signs of a gross motor delay include but are not limited to: difficulty using both sides symmetrically, inability to sit independently between 6 and 9 months, and inability to independently walk between 12 and 18 months. However, not all signs of delay are as apparent as others.
Other signs that your child may have a physical delay, particularly with school aged children, is their ability to keep up with their peers. These children may appear clumsy on the playground, or stay away from obstacles that are difficult, such as climbing walls and monkey bars, or parents may receive reports their child is having difficulty with activities in P.E. class. Also, the child may be less motivated, or outright refuse, to be an active participant in extracurricular sports.
What should a parent or caregiver do if they think a child is delayed?
Schedule an evaluation.
Pediatric physical therapists utilize standardized assessments to accurately determine if a child is developmentally delayed. These assessments include all aspects of gross motor development including strength, balance, and gross motor skills. The resultant score of the assessments is able to provide the parent with information including the percent of delay and the age equivalent. This allows for the parents, child, and therapist to determine an appropriate, individualized plan of care and direction for treatment. The standardized assessments are also a way to show improvement following an episode of care.
If you have any questions or are unsure if your child is delayed, use available resources to help.
Make the First Five Count is Easter Seals FREE online child development screening tool to help measure and keep track of your child’s growth and development.
Take the ASQ-3 to look at key developmental areas: communication, gross motor, fine motor, problem solving and personal social skills. You will be asked to answer questions about things your child can and cannot do.
Take the ASQ SE-2 for a more in depth look at a child’s social and emotional skills. This survey includes questions about your child’s ability to calm down, take direction, follow rules, follow daily routine, demonstrate feelings and interact with others.
Also the CDC offers a developmental checklist that takes you through 2-months-old to 5-years-old. This checklists offers an easy to read guide if parents are concern that their child is delayed. They also offer a Milestone Tracker Mobile App for Apple and Android phones.
By detecting developmental delays early, you have the power to change lives and educational outcomes for children! If delays are identified, Easter Seals DuPage & Fox Valley can offer the support needed to be school-ready and build a foundation for a lifetime of learning. Learn more at eastersealsdfvr.org.
If you’re a parent, you know how busy your child’s hands are 24/7. Kids are constantly using their hands to pinch, squish, pull, draw, and manipulate toys and objects in their environment; all thanks to fine motor skills that they have developed over months of play and exploration. But what are fine motor skills exactly, and why do they matter?
Fine motor skills typically refer to the ability of the hands (through development of the small muscles of the hand and experiential learning) to manipulate objects in order to accomplish specific tasks. Without fine motor skills, your child would have trouble zipping up their coat, buttoning their jeans, tying their shoes, pinching finger foods during dinner, writing with a pencil, scribbling with crayons, opening containers to get a snack, pushing LEGO® together, or turning pages in their favorite bedtime story.
How do fine motor skills typically develop? While every child develops fine motor skills at different rates, children typically develop fine motor skills in this general developmental sequence:
Babies: Learning to reach, grab, and pinch!
1-2 months old:
Bat arms inaccurately toward a toy placed by them and will occasionally struggle to grasp onto toys in an intentional manner.
Babies at this stage (from birth to approximately 4-6 months old) have a reflexive grasp, meaning that if an object is placed in their palm, they will automatically grasp around the object.
Grasp onto objects in the palm of their hands without their thumb helping them hold onto the object.
Reach and grasp onto objects placed by them with greater accuracy.
Begin to use the thumb more in grasping with their palm of their hand around 4-5 months. This is called a “palmar grasp”
Reach accurately to items they want.
Start using their first 3 fingers (thumb, index, and middle fingers) to hold items in the palm of their hands. OT’s refer to this type of grasp as a “radial palmar grasp”
Start to primarily use their fingers to hold onto objects. For example, they may hold a block between their thumb, index and middle fingers around their knuckles and not with the very tips of their fingers. OT’s refer to this kind of grasp as a “radial digital grasp”
Develop an “inferior pincer grasp” in which they can use the pads of their thumb and index fingers to “pinch” onto objects
Become interested in dropping objects into containers for play
Starts scribbling on paper while coloring
Toddlers: Learning to manipulate, grasp, and cut with scissors
Develop a “superior” or “fine pincer grasp” in which they can use the very tips of their thumb and index finger to pinch onto smaller objects. Think about how you would pick up a tiny bead with your thumb and index finger; that’s the superior pincer grasp!
Move small items in one hand from their fingertips to the palms of their hand. This is referred to as “finger-to-palm translation.” A good example of finger to palm translation is the action of picking up multiple coins, one-at-a-time, with the fingers and moving them into the palm of your hands.
Color using their whole hand to grip onto markers and crayons with their palms facing up, known as a “palmar-supinate grasp.
Kids are able to stack 2 cubes on top of each other
Kids are able to put large puzzle pieces into a puzzle
Develop the ability to move small objects from their palm to their fingers, also known as “palm-to-finger translation.”
Start motion of twisting caps on bottles with their fingers tips, called “simple rotation.”
When drawing, copies an adult in making horizontal, vertical, and circular marks
Color using a “digital-pronate grasp” where the palm faces down and whole fist is wrapped around the marker or crayon, with one or two fingers “pointing” on the utensil.
Start to use scissors to make small little cuts into paper.
At 3, kids can copy a pre-drawn vertical and horizontal line and circle
Thread medium sized beads onto string
Color/write using a “static tripod grasp”, which means that kids use their thumb, index, and middle finger to hold onto a pencil with the tips of their fingers and use their wrist to move the utensil.
Uses scissors to cut straight lines and simple shapes like squares and triangles. At this point, cutting out circles is pretty tricky.
Around 4 ½ years, kids may begin using a “dynamic tripod grasp” which involves the thumb, index, and middle finger to hold a utensil with the tips of their fingers and use the motion of their fingers to draw
Around 4-5 years old, a child is able to write some letters and numbers and may be able to write their own name
Can copy a cross when drawing
Further development of the dynamic tripod grasp occurs from 4 ½ -6 years old
Cuts out complex shapes with scissors and is able to more neatly cut out circles
Able to copy a triangle
Copy most uppercase and lower case letters
Print their name
Of course, this is not an exhaustive list of the fine motor skills that kids display at different ages. But, this list will definitely give you an idea of what skills you should see in your little one in time.
If you have any questions about your child’s fine motor development or any concerns get connected with an occupational therapist. The Occupational Therapy team at Easter Seals DuPage & Fox Valley offer a depth of knowledge and range of certifications to assist children with autism or physical challenges at any level of involvement. Because each child’s needs are different, we create an individualized treatment plan based on parent concerns and the most current treatment approaches. Click here to learn more.
 Case-Smith and O’Brien (2015). Occupational Therapy for Children and Adolescents (7th ed.). Saint Louis, MO: Elsevier
 Rita P. Fleming-Castaldy (2014). National Occupational Therapy Certification Exam Review & Study Guide. Scranton, PA: TherapyEd.