Transcript Slide 1

Gross Motor
Milestones
2 – 5 Years
Group 1
Gross Motor Milestones
2 – 5 Years
During the Second Year:
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Jumps in place with both feet
Jumps down from a bottom step
Kicks a large ball forward
Tosses a large and small ball
Develops a consistent heel strike in gait
True running emerges with a non-support phase,
stops are difficult requiring a large turn area
Gross Motor Milestones
2 – 5 Years
During the Second Year:
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Stands on one foot 1-3 seconds
Catches a large ball using arms and body
Walks on tiptoes
Walks backwards
Goes up and down stairs independently using a rail
Pushes a riding toy with feet while steering
Gross Motor Milestones
2 – 5 Years
Gait Pattern Matures During the Third Year:
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Narrower BOS
Feet closer together
Heel toe progression
Shoulders in neutral
Elbows extended
Hips and knees extended
Reciprocating arm swing
Gross Motor Milestones
2 – 5 Years
Gait Pattern Matures During the Third Year:
• Pelvic rotation
• Out-toeing reduced
• Consistent heel strike and knee flexion present in early
stance.
• Walking velocity for height is consistent with that of an
adult.
• Cadence decreases, velocity increases
• Step length and stride length increase
• Balance mechanisms when walking continue to be refined as
single leg stance balance is immature.
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Gross Motor Milestones
2 – 5 Years
During the Third Year:
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Goes up steps alternating feet w/o rail
Goes down steps marking time w/o rail
Climbs up and down slide independently
Makes sharp turns while running
Pedals a tricycle
Gross Motor Milestones
2 – 5 Years
During the Third Year:
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Catches ball with outstretched arms
Balances on toes in standing
Stands with one foot in front of the other
Stands on one foot up to 5 seconds
Hops on one foot 1-3 times
Gross Motor Milestones
2 – 5 Years
During the Fourth Year:
• Gallops
• Goes down stairs without w/o a rail alternating
feet
• Stands on one foot 8 seconds
• Catches smaller balls
• Rides 3-wheeled toys
• Catches bounced ball most of the time
Gross Motor Milestones
2 – 5 Years
During the Fifth Year:
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Skips
Stands on one foot 10 seconds
Runs on tiptoes
Long jumps
Interested in performing dance steps
Capable of learning complex body
coordination skills like swimming, roller
skating, and riding bicycles
• Overhand throwing accomplished
Balance
• Steady State
• Body morphology of child = top heavy =
more sway. COM = T 12 instead of L5-S1.
• Study 2-14 y.o. amplitude of sway and
variation of sway decrease with increasing
age
• Adult values at 9-12 with eyes open and 1215 with eyes closed.
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Balance cont.
• Dynamic
– Anticipatory
• 9 mo-activation of postural muscles of trunk in most
reaching movements while sitting.
• 12-15 mo-postural muscles of trunk activate before
reaching in standing.
• Postural reactions seen before step initiation with
as little as 1-4 mo of walking experience.
• 4-6 years, anticipatory reactions essentially mature.
• Between 1-4 yo, shift from “enbloc” to “articulated”
mode of anticipatory balance
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Balance cont
– Head and Trunk Stability
• Until 6 yo - “en bloc” mode - head moves with
trunk, reactive balance organized from feet up
using proprioceptive and cutaneous clues
• By 7 yo - “articulated” mode - head moves
freely, reactive balance organized top down
using vision and vestibular info.
– Reactive
• Study 15 mo - 10 yo showed younger children to
have increased coactivation and slower, longer,
and more variable responses to a moveable
platform. Mature responses by 7-10 years.
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Balance cont.
• Activation of monosynaptic stretch reflex until 2.5
yo when reduces and gone by 4 yo
• 4-6 yo responses slower and more variable.
Theory due to dimensional growth changes but
more likely due to developmental changes in
nervous system itself.
• Independent steps do not translate into stepping
strategy. Begins with 1- 3 mos walking experience
and is refined after 6 mos experience.
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Balance cont.
– Proactive
• Has been suggested that children acquire feedback
control of balance before feed forward control
• Very little research
– Run, Gallop, Hop, Skip
• develop in order, each requiring additional strength
and balance.
• These milestones have been said to be better
indicators of balance development than chronological
age.
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Fine Motor/Self Help
Milestones
2-5 years
Group 1
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Fine Motor Manipulation
Milestones
2 – 5 Years
By 2 years of age:
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Uses a mature pincer grasp to hold tiny objects
Uses radial palmar grasp to pick up a 1” cube
Pronated finger grasp on cylindrical objects
Able to point isolating the index finger
Beginning in-hand manipulation (finger to palm)
Controlled release of objects (inserts large puzzle pieces,
stacks 3-5 blocks)
• Scribbles when given a crayon
• Uses both hands to hold and carry objects, clap hands
together
• Can stabilize with one hand and manipulate with the
other
• Able to turn pages of a book
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Self Help Milestones
2 – 5 Years
By two years of age:
Dressing
• Dresses/undresses self in simple clothing with assistance
e.g. finds arm hole, doffs socks, shoes, hat, holds leg out to
assist with putting pants on, helps doff pants
Toileting
• Indicates need to go to the bathroom
• Indicates when wet/soiled
Bathing/Grooming
• Enjoys bath time but may resist grooming tasks
Feeding
• Uses spoon with minimal spillage and drinks from a
sippy cup
• Begins to drink from small cup without lid
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Fine Motor Manipulation
Milestones
2 – 5 Years
By 3 years of age:
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In hand manipulation develops (palm to finger translation)
Controlled release with shoulder, elbow, and wrist stability
Stacks 4-7 1” blocks
Opens simple containers with lids
Winds wind-up toys
Can string large beads
Copy a simple line and circle
Colors large forms
Snips with scissors
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Self Help Milestones
2 – 5 Years
By three years of age:
Dressing
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Independent doffing clothing items
Dons front opening shirt/coat, needs assistance to don pullover clothing
Unfastens large buttons and zippers
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Assistance for clothing management and hygiene
Daytime control, night time requires diapers
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Participates in washing self but not independent
Washes hands at sink with supervision and cues
Assists with but often resists grooming
Toileting
Bathing/Grooming
Feeding
Able to self-feed independently
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Fine Motor Manipulation
Milestones
2 – 5 Years
By four years of age:
• In hand manipulation improves rapidly (moves small objects
efficiently with one hand, can hold small objects in palm and
move objects with fingers-translation with stabilization)
• Able to manipulate large buttons
• Mature tripod or quadropod grasp on a pencil (clear hand
preference)
• Cuts out large shapes with scissors
• Colors in the lines
• Copies simple shapes
• Stacks tower of 9-10 blocks
• Draws tadpole images of people
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Self Help Milestones
2 – 5 Years
• By four years of age:
Dressing:
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Independently undresses
Occasional cues for clothing orientation for pull over clothing
Dons shoes and socks independently
Manipulates zippers independently after set-up (zipper is engaged), able to fasten
large buttons
Toileting:
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Day and night time control
Assist may be needed for appropriate hygiene and to manage fasteners
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Supervision in the bathtub, needs assist to wash hair
Independently washes hands/face at the sink
Assists with grooming tasks (tooth brushing, nose wiping, brushing hair)
Bathing/Grooming:
Feeding:
• Able to use a fork independently,
• Arranges items on table correctly
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Fine Motor Manipulation
Milestones
2 – 5 Years
By five years of age:
• Hand dominance is usually established
• Draws a person with 6 parts
• Can print their name, copy some numbers, and simple words
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Self Help Milestones
2 – 5 Years
• By age five:
Dressing:
• Assistance with clothing selection, belts, back zippers
• Learns to tie shoelaces (between ages 5-6)
Toileting:
• Complete independence
Bathing/Grooming:
• Set-up and supervision for bathing (for safety)
Feeding:
• Manages soup with a spoon
• Can drink from an open cup without spilling
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Speech/Language
Developmental Milestones
Group 1
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Speech and Language
Milestones
2-5 years
• By the age of 2:
– Points to a few body parts when asked
– Follows simple commands and understands
simple questions (ex. “Roll the ball,” “Kiss the
baby,” “Where is your shoe?”)
– Listens to simple stories, songs, and rhymes
– Points to pictures in a book when named
– Says more words every month
– Uses some one- or two- word questions
(ex. “Where’s kitty?” “Go bye-bye?”)
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Speech and Language
Milestones
2-5 years
• By 2 years of age (cont):
– Puts two words together (ex. “more
cookie”, “no juice”, “mommy book”)
– Uses many different consonant sounds
at the beginning of words.
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Speech and Language
Milestones
2-5 years
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By 3 years of age:
Understands differences in meaning
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Ex. “go-stop”, “in-on”, “big-little”, “up-down”
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Ex. “Get the book and put it on the table.”
Follows two requests
Listens to and enjoys hearing stories for
longer periods of time.
Has a word for almost everything
Uses 2- or 3- words to talk about and ask for
things.
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Speech and Language
Milestones
2-5 years
• By 3 years of age (cont):
– Uses /k, g, f, t, d, and n/ sounds.
– Speech is understood by familiar
listeners most of the time.
– Often asks for or directs attention to
objects by naming them.
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Speech and Language
Milestones
2-5 years
• By 4 years of age:
– Hears you when you call from another room
– Hears television or radio at the same loudness
as other family members
– Answers simple “who?”, “what?”, “where?”, and
“why?” questions
– Talks about activities at school or at friends’
homes
– People outside of the family usually understand
the child’s speech
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Speech and Language
Milestones
2-5 years
• By 4 years of age (cont):
– Uses a lot of sentences that have 4 or
more words
– Usually talks easily without repeating
syllables or words
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Speech and Language
Milestones
2-5 years
• By 5 years of age:
– Pays attention to a short story and answers
simple questions about it
– Hears and understands most of what is said at
home and in school
– Makes voice sounds clear like other children’s
– Uses sentences that give lots of details (ex. “I
like to read my books.”)
– Tells stories and are able to stay on topic
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Speech and Language
Milestones
2-5 years
• By the age of 5 years (cont):
– Communicates easily with other children and
adults
– Says most sounds correctly (except perhaps
certain ones such as /l, s, r, v, z, ch, sh, th/)
– Uses the same grammar as the rest of the
family
Reference:
http://www.asha.org/public/speech/development/language
speech.htm
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Social and Emotional
Milestones
2-5 years
• By the end of 2 years:
– Imitates behavior of others, especially adults
and older children
– Is more aware of self as separate from others
– Is more excited about the company of other
children
– Demonstrates increasing independence
– Begins to show defiant behavior
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Social and Emotional
Milestones
2-5 years
• By the end of 2 years (cont):
– Separation anxiety increases toward
midyear then fades
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Social and Emotional
Milestones
2-5 years
• By the end of 3 years:
– Imitates adults and playmates
– Spontaneously shows affection for familiar
playmates
– Can take turns in games
– Understands the concept of “mine” and
“his/hers”
– Expresses affection openly
– Expresses a wide range of emotions
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Social and Emotional
Milestones
2-5 years
• By the end of 3 years (cont):
– Separates easily from parents
– Objects to major changes in routine
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Social and Emotional
Milestones
2-5 years
• By the end of 4 years:
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Interested in new experiences
Cooperates with other children
Plays “Mom” or “Dad”
Increasingly inventive in fantasy play
Dresses and undresses
Negotiates solutions to conflicts
More independent
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Social and Emotional
Milestones
2-5 years
• By the end of 4 years (cont):
– Imagines that many unfamiliar images
may be “monsters”
– Views self as a whole person involving
body, mind, and feelings
– Often cannot tell the difference
between fantasy and reality
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Social and Emotional
Milestones
2-5 years
• By the end of 5 years:
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Wants to please friends
Wants to be like his/her friends
More likely to agree to rules
Likes to sing, dance, and act
Shows more independence and may even visit a
next-door neighbor by self
– Aware of gender
– Able to distinguish fantasy from reality
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Social and Emotional
Milestones
2-5 years
• By the end of 5 years:
– Sometimes demanding, sometimes
eagerly cooperative
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Typical Developmental
Skills
2 – 5 year olds
References
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References
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