Podcast
Questions and Answers
During the first month, what type of movements would you expect to observe in a newborn?
During the first month, what type of movements would you expect to observe in a newborn?
- Random and total pattern movements (all flexion or all extension) (correct)
- Controlled and purposeful movements
- Isolated movements of individual joints
- Active movements with a full range of motion
When observing a 1-month-old infant in a prone position, which of the following is a typical gross motor characteristic?
When observing a 1-month-old infant in a prone position, which of the following is a typical gross motor characteristic?
- Symmetrical neck extension with the ability to lift the head to 90 degrees
- Ability to push up onto extended arms, bearing weight on palms
- Physiologic flexion dominates with the baby keeping their head turned to the side (correct)
- Consistent head control in midline with no head preference
A physical therapist is evaluating a one-month-old infant. Which of the following supine gross motor skills is expected at this age?
A physical therapist is evaluating a one-month-old infant. Which of the following supine gross motor skills is expected at this age?
- Rolling from supine to prone
- Consistent holding of the head in midline
- Reaching for toys with controlled arm movements
- Uses gross swiping motions of the upper extremities (correct)
When assessing a one-month-old infant's gross motor skills in sitting, what is a typical characteristic?
When assessing a one-month-old infant's gross motor skills in sitting, what is a typical characteristic?
During an evaluation, a physical therapist holds a one-month-old infant in an upright position. Which of the following gross motor responses is most likely to be observed?
During an evaluation, a physical therapist holds a one-month-old infant in an upright position. Which of the following gross motor responses is most likely to be observed?
Which of the following reflexes is typically integrated latest within the first year?
Which of the following reflexes is typically integrated latest within the first year?
A two-month-old infant is demonstrating increased extension and decreased flexion. In what position would this be MOST evident?
A two-month-old infant is demonstrating increased extension and decreased flexion. In what position would this be MOST evident?
What is a typical gross motor characteristic of a two-month-old infant in the prone position?
What is a typical gross motor characteristic of a two-month-old infant in the prone position?
A two-month-old infant is being assessed in supine. What upper extremity position would be expected?
A two-month-old infant is being assessed in supine. What upper extremity position would be expected?
A physical therapist is observing a two-month-old infant during a pull-to-sit maneuver. Which of the following is a typical observation at this age?
A physical therapist is observing a two-month-old infant during a pull-to-sit maneuver. Which of the following is a typical observation at this age?
When a two-month-old infant is held in an upright position, what is a primary characteristic of their gross motor control?
When a two-month-old infant is held in an upright position, what is a primary characteristic of their gross motor control?
A three-month-old infant is starting to demonstrate bilateral control of neck musculature. How might this be observed in supine?
A three-month-old infant is starting to demonstrate bilateral control of neck musculature. How might this be observed in supine?
A three-month-old infant is placed in the supine position. What gross motor skill is MOST likely to be observed?
A three-month-old infant is placed in the supine position. What gross motor skill is MOST likely to be observed?
A physical therapist is observing a three-month-old infant in prone. Which movement pattern is expected at this age?
A physical therapist is observing a three-month-old infant in prone. Which movement pattern is expected at this age?
When assessing a three-month-old infant in supported sitting, you would expect to see:
When assessing a three-month-old infant in supported sitting, you would expect to see:
Which of the following is a key gross motor skill expected to emerge around four months of age?
Which of the following is a key gross motor skill expected to emerge around four months of age?
A four-month-old infant is placed in the prone position. What gross motor skill would you expect this infant to demonstrate?
A four-month-old infant is placed in the prone position. What gross motor skill would you expect this infant to demonstrate?
What is a typical gross motor skill observed in a four-month-old infant in the supine position?
What is a typical gross motor skill observed in a four-month-old infant in the supine position?
By four months of age, what advancement is typically seen when an infant is pulled to a sitting position?
By four months of age, what advancement is typically seen when an infant is pulled to a sitting position?
At five months, an infant begins to bear weight on extended arms while in prone. This skill directly contributes to which subsequent milestone?
At five months, an infant begins to bear weight on extended arms while in prone. This skill directly contributes to which subsequent milestone?
A five-month-old infant is in the prone position. Which of the following gross motor skills would you expect to observe?
A five-month-old infant is in the prone position. Which of the following gross motor skills would you expect to observe?
What is an expected gross motor achievement for a five-month-old infant in the supine position?
What is an expected gross motor achievement for a five-month-old infant in the supine position?
What are the common gross motor skills that is often observed in the upright position in a 5 month old infant?
What are the common gross motor skills that is often observed in the upright position in a 5 month old infant?
The parachute reflex typically emerges around which age?
The parachute reflex typically emerges around which age?
A six-month-old infant is observed to have good sagittal plane trunk control in sitting but poor transverse plane trunk control. What does this indicate about the infant's sitting abilities?
A six-month-old infant is observed to have good sagittal plane trunk control in sitting but poor transverse plane trunk control. What does this indicate about the infant's sitting abilities?
A six-month-old infant in the supine position is likely to demonstrate which of the following motor skills?
A six-month-old infant in the supine position is likely to demonstrate which of the following motor skills?
A child is able to bear full weight with assist and bounces. What is the developmental milestone?
A child is able to bear full weight with assist and bounces. What is the developmental milestone?
What is a typical gross motor skill observed in a seven-month-old infant in prone?
What is a typical gross motor skill observed in a seven-month-old infant in prone?
A seven-month-old is observed sitting. Based on typical gross motor development, which skill is the infant likely exhibiting?
A seven-month-old is observed sitting. Based on typical gross motor development, which skill is the infant likely exhibiting?
An eight-month-old infant is observed to creep on their hands and knees. What is primarily seen on their gross motor skills?
An eight-month-old infant is observed to creep on their hands and knees. What is primarily seen on their gross motor skills?
Standing and cruising are vital gross motor skills for which age group?
Standing and cruising are vital gross motor skills for which age group?
What is the most versatile gross motor skill for a 9 months infant?
What is the most versatile gross motor skill for a 9 months infant?
Which of the following statements is most accurate regarding the gross motor development of a ten-month-old infant?
Which of the following statements is most accurate regarding the gross motor development of a ten-month-old infant?
By 11 months of age, what advancement is typically seen when infant uses a 1/2 kneel position?
By 11 months of age, what advancement is typically seen when infant uses a 1/2 kneel position?
What gross motor skills should the therapist expect to see by 12 months?
What gross motor skills should the therapist expect to see by 12 months?
Which of the following gross motor skills is most characteristic of a twelve-month-old infant?
Which of the following gross motor skills is most characteristic of a twelve-month-old infant?
Can stand from the floor through quadruped without using hands at supporting surface. What age would you expect this skill to be achieved?
Can stand from the floor through quadruped without using hands at supporting surface. What age would you expect this skill to be achieved?
Why is physiological flexion important in a newborn's early motor development?
Why is physiological flexion important in a newborn's early motor development?
A one-month-old infant in prone is observed with their head consistently turned to one side. What is the MOST appropriate intervention?
A one-month-old infant in prone is observed with their head consistently turned to one side. What is the MOST appropriate intervention?
What is the significance of observing a one-month-old infant bringing their hand to their mouth?
What is the significance of observing a one-month-old infant bringing their hand to their mouth?
A therapist notices that a two-month-old infant exhibits asymmetry in their movements. Which of the following is the MOST important consideration for the therapist?
A therapist notices that a two-month-old infant exhibits asymmetry in their movements. Which of the following is the MOST important consideration for the therapist?
In a two-month-old infant, an increase in overall extension compared to flexion is noted. How does this influence their posture in the supine position?
In a two-month-old infant, an increase in overall extension compared to flexion is noted. How does this influence their posture in the supine position?
A physical therapist observes a two-month-old infant being pulled to sit. The infant demonstrates significant head lag but also shows initial attempts to flex their neck. What does this suggest about the infant's developing motor control?
A physical therapist observes a two-month-old infant being pulled to sit. The infant demonstrates significant head lag but also shows initial attempts to flex their neck. What does this suggest about the infant's developing motor control?
At three months old, an infant begins to demonstrate bilateral control of neck musculature. How does this influence their head position in the supine position?
At three months old, an infant begins to demonstrate bilateral control of neck musculature. How does this influence their head position in the supine position?
How does the emergence of antigravity flexor control impact a three-month-old infant's supine posture?
How does the emergence of antigravity flexor control impact a three-month-old infant's supine posture?
A three-month-old infant in prone is able to lift their head to 90 degrees and turn it freely. What does the ability to turn their head while on their forearms MOST directly contribute to?
A three-month-old infant in prone is able to lift their head to 90 degrees and turn it freely. What does the ability to turn their head while on their forearms MOST directly contribute to?
A four-month-old infant is showing increased lumbar extension and anterior pelvic tilt in the prone position. How does this affect the position of their legs?
A four-month-old infant is showing increased lumbar extension and anterior pelvic tilt in the prone position. How does this affect the position of their legs?
A four-month-old infant is beginning to demonstrate the ability to reach for their knees while in supine. What does this skill indicate about the infant's motor development?
A four-month-old infant is beginning to demonstrate the ability to reach for their knees while in supine. What does this skill indicate about the infant's motor development?
A four-month-old infant is able to maintain their head in midline and demonstrates improved head control. How does this advancement MOST affect their ability to interact with their environment?
A four-month-old infant is able to maintain their head in midline and demonstrates improved head control. How does this advancement MOST affect their ability to interact with their environment?
A five-month-old infant who bears weight on extended arms is MOST likely to start develop what?
A five-month-old infant who bears weight on extended arms is MOST likely to start develop what?
A therapist is working with a five-month-old infant. What strategies are MOST effective to support the infant's increasing weight shifting in the supine position?
A therapist is working with a five-month-old infant. What strategies are MOST effective to support the infant's increasing weight shifting in the supine position?
A five-month-old infant is in a supported sitting position. What is the MOST appropriate activity to promote trunk control?
A five-month-old infant is in a supported sitting position. What is the MOST appropriate activity to promote trunk control?
Which of the following describes the Landau reflex?
Which of the following describes the Landau reflex?
A six-month-old infant is observed rolling from supine to prone. What is required for this?
A six-month-old infant is observed rolling from supine to prone. What is required for this?
A therapist is working with a six-month-old infant who has increased stability in sagittal trunk control. What needs to be observed next?
A therapist is working with a six-month-old infant who has increased stability in sagittal trunk control. What needs to be observed next?
A seven-month-old infant demonstrates a commando crawl. What is MOST likely the progression?
A seven-month-old infant demonstrates a commando crawl. What is MOST likely the progression?
A seven-month-old can assume sitting. What does this suggest about quadruped?
A seven-month-old can assume sitting. What does this suggest about quadruped?
What is the significance of an eight-month-old infant creeping on their hands and knees?
What is the significance of an eight-month-old infant creeping on their hands and knees?
An eight-month-old infant is observed pulling to stand through kneeling. What additional motor skill is a therapist MOST likely to observe next?
An eight-month-old infant is observed pulling to stand through kneeling. What additional motor skill is a therapist MOST likely to observe next?
What would be the MOST effective intervention for a nine-month-old infant who is hesitant to transition from sitting to other postures?
What would be the MOST effective intervention for a nine-month-old infant who is hesitant to transition from sitting to other postures?
A nine-month-old infant is able to maintain sitting balance. Which of the following protective extension reactions would you expect to observe?
A nine-month-old infant is able to maintain sitting balance. Which of the following protective extension reactions would you expect to observe?
A ten month gross motor skill that therapist expect to see is:
A ten month gross motor skill that therapist expect to see is:
How might a ten-month-old infant adapt their sitting posture to improve upper extremity function for a complex task?
How might a ten-month-old infant adapt their sitting posture to improve upper extremity function for a complex task?
An eleven-month-old infant uses a 1/2 kneel position during play. What is the MOST appropriate intervention to promote further motor development from this position?
An eleven-month-old infant uses a 1/2 kneel position during play. What is the MOST appropriate intervention to promote further motor development from this position?
An eleven-month-old transitions to stand by holding onto furniture. What advancement in motor skill is MOST likely to be observed?
An eleven-month-old transitions to stand by holding onto furniture. What advancement in motor skill is MOST likely to be observed?
A therapist observes an eleven-month-old infant with varied sitting positions, what would be MOST appropriate?
A therapist observes an eleven-month-old infant with varied sitting positions, what would be MOST appropriate?
A twelve-month-old child demonstrates consistent use of high guard position during ambulation. What strategy would help with this pattern?
A twelve-month-old child demonstrates consistent use of high guard position during ambulation. What strategy would help with this pattern?
Which is the motor consideration that is MOST beneficial from standing from quadruped, without UE support?
Which is the motor consideration that is MOST beneficial from standing from quadruped, without UE support?
After observing a 1-month old infant, what is the MOST appropriate recommendation?
After observing a 1-month old infant, what is the MOST appropriate recommendation?
A therapist notes that a two-month-old infant appears to have less control of their body compared to when they were one month old. What is the MOST likely reason for this?
A therapist notes that a two-month-old infant appears to have less control of their body compared to when they were one month old. What is the MOST likely reason for this?
A three-month-old infant is kicking both legs together while in supine. The therapist recommends the parent position the infant in sidelying. What is the goal of this recommendation?
A three-month-old infant is kicking both legs together while in supine. The therapist recommends the parent position the infant in sidelying. What is the goal of this recommendation?
A therapist observes a four-month-old infant with emerging ability to have forward propped on extended arms and weight shifts are beginning to develop. What does this advancement MOST directly contribute to?
A therapist observes a four-month-old infant with emerging ability to have forward propped on extended arms and weight shifts are beginning to develop. What does this advancement MOST directly contribute to?
What is the BEST intervention for a five-month-old infant who is frequently in the asymmetrical tonic neck reflex (ATNR) pattern?
What is the BEST intervention for a five-month-old infant who is frequently in the asymmetrical tonic neck reflex (ATNR) pattern?
Six-month-old infant has difficulty sitting independently. The therapist notices that the child collapses into flexion. What is the appropriate cue to use?
Six-month-old infant has difficulty sitting independently. The therapist notices that the child collapses into flexion. What is the appropriate cue to use?
What is the significance of the Body Righting on Head reaction?
What is the significance of the Body Righting on Head reaction?
A 10 month old child sitting is observed to be "fixing" with the lower extremities. What would be MOST effective to increase the active use of the trunk muscles?
A 10 month old child sitting is observed to be "fixing" with the lower extremities. What would be MOST effective to increase the active use of the trunk muscles?
What is the primary factor that limits the active movements of a one-month-old infant?
What is the primary factor that limits the active movements of a one-month-old infant?
Why might positioning a one-month-old infant on their side be beneficial?
Why might positioning a one-month-old infant on their side be beneficial?
What is the primary reason that head control is limited in a one-month-old infant during the pull-to-sit maneuver?
What is the primary reason that head control is limited in a one-month-old infant during the pull-to-sit maneuver?
A physical therapist is working with a two-month-old infant who has a strong preference for turning their head to the right. What strategy is MOST appropriate to promote midline head control?
A physical therapist is working with a two-month-old infant who has a strong preference for turning their head to the right. What strategy is MOST appropriate to promote midline head control?
Why is the presence of astasia-abasia in a two-month-old infant significant during assessment?
Why is the presence of astasia-abasia in a two-month-old infant significant during assessment?
Considering the influence of the ATNR on a two-month-old infant in the supine position, what is a likely observation regarding their head and arm position?
Considering the influence of the ATNR on a two-month-old infant in the supine position, what is a likely observation regarding their head and arm position?
A three-month-old infant is able to position both hands at midline MOSTLY because of:
A three-month-old infant is able to position both hands at midline MOSTLY because of:
A therapist observes a three-month-old infant consistently kicking their legs reciprocally. What intervention should therapist consider?
A therapist observes a three-month-old infant consistently kicking their legs reciprocally. What intervention should therapist consider?
In a four-month-old infant, the ability to sustain forearm weight bearing in prone is FIRSTLY due to:
In a four-month-old infant, the ability to sustain forearm weight bearing in prone is FIRSTLY due to:
An infant is 4 months old is showing increased balance of flexors and extensors in the gross motor skills in supine. How should the therapist facilitate this?
An infant is 4 months old is showing increased balance of flexors and extensors in the gross motor skills in supine. How should the therapist facilitate this?
Why is the integration of the Moro reflex significant for gross motor development around five months of age?
Why is the integration of the Moro reflex significant for gross motor development around five months of age?
A therapist is working with a five-month-old infant who has difficulty with weight shifting in prone. What activity to promote facilitates weight shifting?
A therapist is working with a five-month-old infant who has difficulty with weight shifting in prone. What activity to promote facilitates weight shifting?
What adaptation is MOST crucial for infants transitioning from forearm weight bearing to reaching with one arm while in prone at six months?
What adaptation is MOST crucial for infants transitioning from forearm weight bearing to reaching with one arm while in prone at six months?
Following the development of assuming quadruped independent, what would therapist expect next from a seven-month-old child?
Following the development of assuming quadruped independent, what would therapist expect next from a seven-month-old child?
An eight-month-old infant is starting to pull to stand. What is a critical next step to work on?
An eight-month-old infant is starting to pull to stand. What is a critical next step to work on?
What is the primary benefit of sitting for a nine-month-old infant?
What is the primary benefit of sitting for a nine-month-old infant?
A ten-month-old infant is walking with two hands held but exhibits excessive hip internal rotation and adduction. What intervention should the therapist consider?
A ten-month-old infant is walking with two hands held but exhibits excessive hip internal rotation and adduction. What intervention should the therapist consider?
How does the refinement of cruising skills around eleven months of age support the development of independent walking?
How does the refinement of cruising skills around eleven months of age support the development of independent walking?
Why is it important for a twelve-month-old infant to develop the ability to move in and out of squat?
Why is it important for a twelve-month-old infant to develop the ability to move in and out of squat?
What is the MOST important advancement that a twelve-month-old need to exhibit when standing up from the floor?
What is the MOST important advancement that a twelve-month-old need to exhibit when standing up from the floor?
Flashcards
Gross motor skills at birth
Gross motor skills at birth
Dominated by physiological flexion and limited range of motion.
Movement at birth
Movement at birth
Movements are random and total in pattern (all flexion or all extension).
Gross motor skills in prone position
Gross motor skills in prone position
Physiologic Flexion dominates while in a prone position.
One month: supine position
One month: supine position
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One month: head position
One month: head position
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One month: pull to sit
One month: pull to sit
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One month: upright position
One month: upright position
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One month: kicking patterns
One month: kicking patterns
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Two months: muscle tone
Two months: muscle tone
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Two months: prone position
Two months: prone position
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Two months: body control
Two months: body control
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Two months: supported sitting
Two months: supported sitting
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Pull to sit: two months
Pull to sit: two months
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Two Months: Upright
Two Months: Upright
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Two Months: less control
Two Months: less control
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Three months: neck
Three months: neck
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Three months: head
Three months: head
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Three months: supine
Three months: supine
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Three months: supported sitting
Three months: supported sitting
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Three months: prone
Three months: prone
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Four months: prone position
Four months: prone position
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Four months: midline
Four months: midline
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Four Months: Sitting
Four Months: Sitting
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Five months: equilibrium
Five months: equilibrium
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Five months: supine position
Five months: supine position
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Six Months: upper body
Six Months: upper body
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Seven Months: supine position
Seven Months: supine position
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Seven Months: sitting position
Seven Months: sitting position
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Seven Months: standing position
Seven Months: standing position
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Eight Months: hands and knees
Eight Months: hands and knees
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Eight Months: upright position
Eight Months: upright position
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Nine Months: sitting
Nine Months: sitting
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Nine Months: reaction
Nine Months: reaction
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Nine Months: upright position
Nine Months: upright position
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Ten month old: upper extremities
Ten month old: upper extremities
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Ten Month: upright position
Ten Month: upright position
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Eleven months: squat
Eleven months: squat
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12 Months: standing up
12 Months: standing up
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12 Months: gait
12 Months: gait
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Study Notes
Learning Objectives
- Describe the typical sequence of gross motor development from birth to 12 months.
- Identify expected age ranges for key gross motor skills like head control, rolling, sitting, crawling, pulling to stand, cruising, and walking.
- Explain the influence of postural control, strength, sensory integration, and movement patterns on acquiring gross motor milestones.
- Understand how to apply knowledge of motor development to clinical decision-making in evaluating and treating infants in physical therapy.
Birth to One Month
- Infants in the first month are dominated by physiological flexion with decreased range of motion.
- Active movements are limited by the available range of motion.
- Movements appear random and total, occurring in either full flexion or full extension patterns.
Birth to One Month: Gross Motor (Prone)
- Physiologic Flexion is dominant.
- Babies typically keep their head turned to the side.
- Head preference is typical.
- Head and neck extension begin to emerge via antigravity activation.
- Babies bring their mouth to their hand.
- Upper extremities are adducted and flexed, with shoulders elevated near the ears.
- Lower extremities are flexed with an elevated pelvis and weight shifted to the face.
Birth to One Month: Gross Motor (Supine)
- The head is turned to one side.
- Gross swiping motions occur in the upper extremities.
- Kicking patterns in the lower extremities range from rhythmical and reciprocal to random and variable.
Birth to One Month: Gross Motor (Sitting)
- Full support is required to sit.
- Babies exhibit a fully rounded back, flexed neck, and poor active head control (head bobbing).
- Pull-to-sit maneuver presents significant head lag and minimal upper extremity traction.
Birth to One Month: Gross Motor (Upright)
- Requires full upper trunk support.
- The head bobs in and out of the vertical position.
- Visual tracking is limited to horizontal and vertical movements in very small ranges.
- A positive support reaction can be observed, accepting weight briefly on the lower extremities.
- Automatic stepping motion is present.
Birth to One Month: Reflexes/Reactions
- Sucking reflex persists until 7 months.
- Rooting reflex persists until 9 months.
- Palmar Grasp reflex persists until 4 months.
- Plantar Grasp reflex persists until 12 months.
- Moro reflex persists until 6 months.
- ATNR (Asymmetrical Tonic Neck Reflex) persists until 5 months.
- STNR (Symmetrical Tonic Neck Reflex) persists until 5 months.
- Crossed Extension reflex persists until 2 months.
- Neck Righting reflex persists until 4 months.
- Positive Support Reaction persists until 2 months.
- Primary Standing reflex persists until 3 months.
- Primary Walking reflex persists until 5 months.
- Placing Rxn Foot reflex persists until 4 months.
- Flexor Withdrawal reflex persists until 2 months.
- Survival Instinct reflex persists until 12 months.
- Tonic Labyrinthine Prone and Supine reflex persists until 4 months.
Two Months
- General hypotonia generally dominates this period.
- Overall, there is reduced flexion.
- The baby presents with increased extension.
- Asymmetry is prominent.
- Babies appears to have less control over their body.
Two Months: Gross Motor (Prone)
- Upper extremities show increased external rotation and abduction, with elbows maintained behind the shoulders.
- Hips are more extended, and the pelvis moves closer to the surface.
- Weight shifts caudally towards the shoulders.
- By the end of this month, the baby lifts its head up to 45 degrees asymmetrically.
- Head lifting and activation may be driven more by visual righting reflexes.
Two Months: Gross Motor (Supine)
- Upper extremities are held in increased external rotation and abduction, gravity-assisted.
- Reduced physiologic flexion results in increased extension of the lower extremities.
- Head is rarely held in midline due to the influence of the ATNR.
Two Months: Gross Motor (Supported Sitting)
- Significant head lag is still present when pulled to sit, though the baby initiates neck flexion.
- They can briefly hold the head erect but continues to bob.
Two Months: Gross Motor (Upright)
- Babies are unable to support their weight on their legs.
- Less control can be observed than at one month.
- Display of Astasia-Abasia exist which includes disorientation in standing and lack of stepping.
Two Months: Reflexes/Reactions
- Labyrinthine Righting Reaction emerges (12 mo.+):
- With the infant held vertically and tilted, their head orients to a vertical and steady position.
- Body Righting on Body emerges (12 mo.+):
- Rotation at one lower extremity across the pelvis results in segmental rotation of the body.
- Body Righting on Head emerges (7 mo.).
Three Months
- Beginning of symmetry
- Bilateral control over neck musculature begins
- Antigravity flexor control begins
- There is a midline orientation of head
- Increased alertness and awareness of environment
Three Months: Gross Motor (Supine)
- Upper extremities are able to be brought to the midline on the chest.
- Lower extremities are held with the soles of the feet together in a "Frog Leg" position.
Three Months: Gross Motor (Prone)
- Babies are able to push their heads up to 90 degrees and turn freely, initiating weight shift.
- The ability to turn the head on the forearms allows for the initiation of subtle weight shift.
- The upper extremities are increasingly horizontally abducted/ adducted, which aids forearm weight-bearing.
- The lower extremities are positioned with the pelvis close to the surface and a wide base (frog leg).
Three Months: Gross Motor (Supported Sitting)
- Babies present with increased flexion control during pull to sit.
- The head is held up, the trunk leans forward with the scapular retraction present.
Four Months
- Increased Symmetry
- Bilateral control over extensor and flexor muscles leads to increased motor control.
- Babies has much improved head control.
- Controlled and purposeful movement begin.
Four Months: Gross Motor (Prone)
- Increasing antigravity control emerges.
- Extension through the back and neck is increased.
- Babies can hold their head in the midline with cervical elongation and reduced neck hyperextension.
- Forearm weight-bearing can observed, with extended arms pushing up and weight on hands.
- Increased lumbar extension and anterior pelvic tilt aligns the legs more closely with the trunk.
- Weight-bearing shifts more into the pelvis.
- Swimming movements emerge.
Four Months: Gross Motor (Supine)
- Gains improved balance of their flexors/extensors
- Increasing midline position of hands.
- The ability to reach for the knees emerges.
- Presents with active hip and knee flexion
- Abdominal control emerging with decreasing hip abduction
Four Months: Gross Motor (Sitting)
- Babies are able to pull to sit with increasing symmetry.
- There is increased abdominal and lower extremity activity.
- The back straightens more, and the arms move forward in a ring sitting position.
Five Months
- Babies begin to see equilibrium reactions.
- Bears weight on extended arms.
- Babies present with weight shifts on propped forearms.
- Babies can pivot prone.
- Rolling occurs, from prone to supine.
Five Months: Gross Motor (Supine)
- Babies can bring their feet to their mouth.
- There is increased weight shifting leads to increased proprioceptive feedback.
Five Months: Gross Motor (Sitting)
- Can pull towards the sitting position and can use their abdominals and arm strength to assist with pulling.
- Increased back extension and the can forward lean at hips.
- Abducted hips provide stability.
- May sit alone for short periods.
Five Months: Reflexes/Reactions
- Parachute reaction emerges (12 mo.):
- When held above surface in ventral suspension, the baby extends their arms to protect from possible fall.
- Landau reflex emerges (12 mo. +):
- When supported horizontally in air in the prone position, extends back and hip in sequence.
Six Months
- Shifts weight on extended arms while prone.
- Unilateral reaching is seen in close to ground prone postures.
- Babies can lifts their head from a surface independently
- Rolls supine to prone with dissociation of lower extremities.
- Pulls to sit motion.
Six Months: Gross Motor (Sitting)
- As a baby pulls to sit, they can initiate the motion with their arms while tucking their head and flexing their legs.
- Arms are free for both play and protective extension.
- Presents good sagittal plane posture, but poor transverse plane trunk control.
Six Months: Gross Motor (Upright)
- Babies can take full weight with assistance and bounce.
Seven Months
- The child spends very little supine
- Babies are more interested in other postures, readying themselves for increased mobility.
- Can can assume a sitting position from a quadruped position
- Trunk rotation is present while sitting
- Sitting can be transitioned into a prone position.
- Attains quadruped with abdomen off floor, and initiates rocking.
- Brief 'commando' crawling.
Seven Months: Gross Motor (Upright)
- Babies will pull themselves to stand against any stable surface, but lack the control to lower themselves back into sitting.
Eight Months
- Creeps on hands and knees.
- May crawl backwards at first.
- Decreased "fixing" of their lower extremities while sitting.
- Pulls to stand thru half-kneel.
- Cruises on an support surface.
- Can stand with one hand held.
- Stepping gait with both hands held.
Nine Months
- Sitting is the more versatile for the baby
- Protective Extension, backward emerges
- The child can turn semi in the standing position and will do walking with two hands-held, with a decreased base of support.
Ten Months: Gross Motor (Sitting)
- Begins using their upper extremities for more detailed fine motor activities.
- Stabilization of the lower extremities ("fixing") increases.
- can lower oneself into a sitting from standing and while walking starts to develope pelvic rotation.
Eleven Months
- Babies present with varied lower extremity positions.
- Babies present with controlled trunk rotation.
- Will 1/2 kneel and kneel more.
- Transitions exist between stand and squat positions as baby holding on.
Eleven Months: Gross Motor (Standing)
- Babies stand alone with wide base of support and lower extremity abduction Cruising is refined, and reaching away from surface is seen.
Twelve Months: Gross Motor
- Can stand from the floor through quadruped without hands supporting.
- The child is now able to weight shift and can lift one leg from the surface.
- May attempt ambulation with a high guard on upper extremities and wide feet for support.
- Child may be able move in and out of a squatting.
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