Developmental Milestones

Developmental milestones are skills that children acquire within certain time frames.

During the first few years of your child’s life they will grow at a phenomenal speed. One day you will be bringing your baby home from the hospital and before you know it, they will be rolling over, crawling and even walking! These are called developmental milestones.

As a parent, it is important to understand how your child is progressing and how they should continue to progress. Children will develop from one milestone to another in a sequential fashion. For example, they typically learn how to crawl and put themselves in a standing position before being able to walk. Children grow and develop very quickly and the more you can understand their progress, the better prepared you will be to recognize if there are any reasons for concern in the progress of their development.

Occupational therapists focus on the fine motor skills. Fine motor skills are small movements of the hands, wrists, fingers, feet, toes, lips and tongue. Below, you will find an easy to understand chart that we have developed for you to use to monitor your child’s fine motor developmental milestones.

Please review these and contact us with any questions or concerns that you may have with regard to your child’s development.

Birth to 3 months

  • Hands are in a fist, thumbs are tucked in
  • Arms move randomly in asymmetric patterns
  • Watches movements of their hands and places fist in mouth
  • Swings at a target using her entire arm
  • Follows a moving person with their eyes
  • Brings hands to midline while lying on back

3 to 6 months

  • Picks up objects with one hand
  • Reaches out and grasp object near body
  • Transfers objects from one hand to another
  • Looks at objects a few feet away
  • Holds hands or clasps them together
  • Drops objects
  • Reaches for a toy using both arms and holds it briefly

6 to 9 months

  • Rakes tiny objects with fingers
  • Uses thumb and fingertips to grasp objects
  • Holds 2 objects, one in each hand, at the same time
  • Uses 2 hands to pick up large objects
  • Bangs two objects together or on table
  • Bites and chews toys

9 to 12 months

  • Puts small objects in cup or other container
  • Releases object voluntarily
  • Turns pages of a book a few at a time
  • Hold bottle independently
  • Attempts to imitate new gestures
  • Pokes and points at things using index finger
  • Grabs crayons in fist
  • Uses both hands and begins to show preference for one

12 to 18 months

  • Builds tower of 2-3 blocks
  • Marks or scribbles spontaneously with crayon
  • Starts to scribble imitatively
  • Takes objects such as blocks out of a containers
  • Grasps and releases objects easily
  • Can hold an object with one hand and manipulate it with the other hand

18 to 24 months

  • Starts using fingers and thumb to grasp crayons
  • Can imitate vertical and circular scribbles after watching adult draw them
  • Turns pages of a book one at a time
  • Strings 1-3 inch beads
  • Snips paper using scissors
  • Builds tower of 3-5 blocks

2 to 3 years

  • Builds a tower of 6-9 blocks
  • Can imitate a cross, horizontal and vertical line after watching an adult draw them
  • Can copy a circle when given a picture of a circle
  • String large beads
  • Snips with scissors
  • Takes off shoes
  • Turns doorknob to open door
  • Moves fingers independently

3 to 4 years

  • Cuts across small pieces of paper
  • Can imitate a circle, square, and cross after watching an adult draw them
  • Builds tower of 9 blocks or more
  • Places small pegs in boards
  • Pulls pants up and down
  • Puts shoes on correct feet
  • Puts on sock and shoes
  • Unbuttons clothing
  • Unzips and unsnaps clothing

4 to 5 years

  • Tract first name (four letters)
  • Draws a recognizable picture
  • Draws a person, about 7 body parts (head, legs, ears, eyes, arms, etc)
  • Cuts across paper following a straight or curved line
  • Beginning to cut out simple shapes
  • Folds paper in half
  • Washes and rinses body areas
  • Buttons and zips up front-opening clothing

5 to 6 years

  • Prints first name
  • Copies most lowercase and uppercase letters given a model
  • Ties shoes
  • Starts writing left to right
  • Brushes teeth
  • Combs/brushes hair
  • Folds paper diagonally and creases it


Contact us and learn more about how we can partner with you and your child to enhance their potential for growth, development and independence.

We work with families throughout the Raleigh, Durham and Chapel Hill NC areas.

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