Occupational Therapy Milestones



Age in months Fine motor skills Visual motor skills Self-care skills/ADL’s What parents can do to help
0-2 months -Closes finger in tight grasp.
-Grasps rattle.
-Tracking an object with eyes to both sides.
-Looks at hands/
-Coordinating suck, swallow, breath sequence.
-Developing sleep patterns.
-Communicating hunger.
-During the first months, when talking to baby, move your head slowly from side-to-side, so that baby will track your movements.
-Move colorful toys and objects from side-to-side to strengthen eye muscles.
-Encourage baby to lay on tummy.
3-6 months -Reaches for nearby object.
-Grasp reflex fades and is replaced by intentional grasping.
-Extends arm to reach towards rattle.
-While laying on back, brings hands to midline and close to grasp object within reach.
-Bringing objects to mouth.
-Communicating hunger and fears.
-Offer your baby a variety of toys of different textures, shapes and sizes to stimulate feelings in the palm of his/her hand, to practice various ways to grasp things.
-Continue to place baby on tummy for strengthening muscles necessary for further fine and gross motor skills.
-Get really close to babies face which helps them use their visual motor skills.
6-10 months -Begins to release objects voluntarily.
-Gasps pellet or small objects with thumb against side of curled index finger.
-Transfers objects from one hand to another.
-Bangs cubes together. -Pokes finger in hole of pegboard. -Begins to hold bottle.
-Feeding self small food items (puffs, crackers, etc.)
-Introduce sippy cup and/or open cup.
-Allow your baby to explore objects with his mouth to sharpen the senses in this area and exercise these important muscles.
-Offer a well-designed activity center that has a wide variety of activities to motivate your baby to use different skills, like pushing, pulling and striking.
10-15 months -Pincer grasp is developed to pick up small objects.
-Point to objects.
-Turn the pages in a book.
-Puts objects into a container.
-Can stack two blocks, one on top of the other.
-Can place a simple shape into a puzzle board (circle/square)
-Exposure to drinking from open cup should occur more frequently.
-Introduce utensils (spoon and fork) during meal time.
-Provide hand over hand assistance when drinking from an open cup to help with movement patterns.
-Allow child to use utensils with either hands.
-Correct grasp on utensils if grasp is incorrect.
-Play of the floor with your child.
-Demonstrate how to stack blocks and complete simple shape puzzles.
15-18 months -Grasp crayon with fisted grasp.
-Uses both hands to play.
-Scribbles spontaneously.
-Place rings on a ring stack.
-Cooperates during dressing changes by extending arms/legs.
-Attempting to brush teeth.
-Cleans face with cloth.
-Wash hands with help.
-Removes socks.
-Expose child to crayons, markers, colored pencils and allow for them to pick up writing utensils to explore.
-Encourage play with a variety of toys.
-Encourage outside play at parks, beach, backyard.
18-24 months -Turn several pages in a book.
-Can push, pull, dump things out.
-Stacks 4-6 block tower.
-Threads large beads on a string.
-Coordination of bringing food to mouth should be improving with less spillage occurring.
-Removes socks and shoes.
-Once shirt is over child’s head he/she can find arm holes and push arms through.
-Allow for additional time for child to attempt dressing tasks.
-Adjust grasp on utensils to prevent incorrect grasping patterns.
-Increase fine motor strength by hiding small objects in play-doh for children to locate.
24-36 months -Able to remove/twist lid on a container.
-Able to turn door knobs.
-Holding a crayon with thumb and fingers (no fist).
-Rolls, pounds, squeezes, and pulls playdough.
-Imitates drawing a vertical/horizontal lines.
-Snips paper with child safe scissors.
-Builds an 8-10 cube tower.
-Completes a 3-piece puzzle.
-Wash hands independently.
-Requires assistance to manage pullover clothes.
-Able to remove pants, coat, socks, and shoes without fasteners.
-Has few accidents during the day and can indicate when they need to go to the bathroom.
-Provide hand over hand when imitating lines for accuracy.
-Provide demonstration and frequent repetition of tasks.
-Increase fine motor skills by exploring with tongs, tweezers, clothespins to pick up small items.
3-4 years -Manipulates and builds Legos, block designs.
-Grasping writing tool with quadrupod grasp and/or tripod grasp.
-Copies circle.
-Imitates cross.
-Copies a square.
-Cuts along a straight line with.
-Independently dresses self, may need help with fasteners.
-Able to bathe self with the exception of washing own hair.
-Independent with toilet control and notification.
-Routine and consistency are important.
-Allow for enough time to practice skills.
-Allow child to watch family members perform self-care, fine motor, and visual motor tasks.
-Practice garment closures in front on child first, once that is mastered, practice with the garment on.
4-5 years -Colors in pictures, with control, staying inside the lines.
-Cuts along curved lines.
-Traces letters in name.
-Complete 12 piece puzzles.
-Draws a person with 2-4 body parts.
-Buttons, snaps, zips independently.
-Continue to refine self-care skills and independence.
-Opening containers, zip lock baggies.
-Timers may help to indicate how long they must tolerate an activity that is non preferred for child.
-Discuss with OT multisensory activities to improve handwriting.
5-6 years -Starts to use one hand consistently for fine motor tasks.
-Continue to refine all previous fine motor tasks.
-Forms letters in name with little assistance.
-Completes 12+ piece puzzles.
-Cuts out simple shapes.
-Supervision for all grooming and bathing tasks to ensure safety and quality. of performance.
-Completes household chores.
-Visual schedules of steps involved in daily routines may help with compliance and organization.
-Reward chart for independent completion of tasks.
7-9 years -Holding and using a pencil easily.
-Uses fingers to write and draw rather than whole arm.
-Constructing simple structures with tools (hammer, screw driver, etc.) with supervision.
-Forms letters in name with little assistance.
-Completes 12+ piece puzzles.
-Cuts out simple shapes.
-Writes within the lines.
-Cuts irregular shapes and uses glue accurately.
-Handwriting is legible.
-Provide encouragement and positive praise during tasks.
-Encourage hands on learning and limit the amount of screen time.
-Find healthy motivators that work for the child and stick to them.