Gross Motor Milestones in Infants 0-14 Months

Introduction

Specific gross motor milestones have general timeframes for skill acquisition, however, each child will set their own timetable. Skill acquisition is acquired through the interplay of the individual, the task and the environment.

Social and cultural influences shape motor behaviors. fant motor development includes the acquisition of basic skills such as moving the head and eyes to look around, moving the arms and hands to grasp objects, and moving the body to sit up or go somewhere. here is no one-to-one correspondence between muscle activations and movement outcome. The same functional outcome can result from a variety of muscle activation patterns (e.g., the elbow can bend by contracting the biceps while relaxing the triceps or by cocontracting both pairs of muscles simultaneously), and the same muscle activation patterns can result in different movement outcomes (e.g., while moving an arm from a static position or while the arm is already in motion). When infants first begin walking, the side-to-side distance between steps often exceeds the distance from front to back. Gait is slow, halting, and inconsistent. Infants spend excessive amounts of time with two feet on the floor because they have trouble keeping balance with one foot in the air. With walking experience, infants’ steps become faster, longer, closer together from side to side, and less variable (Chang et al. 2006, Lee et al. 2018). These developments can be seen with the naked eye (compare the f

found differences in age of onset of motor milestones across countries motor milestones across countries.of early development might be attributed also to environmental aspects such as climate (e.g., Cintas, 1995; Atun-Einy et al., 2013) or housing conditions (Ammar et al., 2013). Moreover, cross-cultural differences exist in the way parents choose to shape children’s environment. For example, some cultures create settings that enable and even vigorously direct early sitting, while others avoid early sitting altogether (Keller et al., 2002; Karasik et al., 2015). Characteristics such as climate, housing, and landscape might influence parental choices regarding for example clothing, play surfaces, and means of transportation.

his subsystem covers parental choices for the activities they do or avoid doing with their infants, such as placing the infant in specific positions, using specific types of equipment, and attending classes or outdoor activities such as baby swimming. Altogether, there is empirical evidence for a relation between infant motor development and specific daily practices. For example, studies have consistently shown that active positions, such as prone and standing position, have positive effects on motor development, while spending much time in less active positions, such as supine and sitting position, is related to less advanced motor development (e.

For infants who are not yet mobile (e.g., crawling), an important type of physical activity is supervised time on the tummy or in the prone position while awake [3]. In the previously mentioned physical activity systematic review. as reported that more tummy time was consistently associated with more advanced motor development, including the earlier acquisition of some gross motor milestones as well as more advanced total developme

n of gross motor development is suggested since different cultures have diverse environmental contexts [18]. This means that gross motor development of infants should be assessed in familiar circumstances, and gross motor scores compared with peers raised in the same culture. Because of different child-rearing [19] and handling [5] practices among cultures, motor development may differ among young infants. Many studies have found that less time in the prone posture during awake time may also limit infants' opportunities to practice antigravity movements and postural control [5,12,18,20]. In addition, family and environment characteristics such as level of maternal education [[20], [21], [22], [23], [24]], household income [20,22,23], parental employment [24,25], number of family members [20,22,23], space for physical activity [20], sleep and play positions [26,27], and equipment used [20,[27], [28], [29]] could affect a child's motor development.

0-3 months

	OVERALL	1-2 MONTHS	2-3 MONTHs
SUPINE	physiologic flexion hip and knee; unable to hold head in midline	sporadic head to midline; sporadic cervical rotation; increased extensor activity; asymmetry of limbs	hands to midline; symmetrical movement patterns;
PRONE	increased physiologic flexion hip and knee; elbows posterior to shoulders; head to side	slight head lift to 45 degrees; unable to hold head in midline; flexion contractures decreased	able to push through hands; start to lift head and shoulders; head lift to 45 degrees
SITTING	weight of head pulls them anterior; shoulders anterior to hips; unable to hold head in midline wide base of support (ring sitting) need a lot of support at proximal trunk	pull to sit- head lag; not able to hold head in midline	pull to sit-able to tuck chin and hold in midline; vertical righting; weight bear through hands (propped sitting)
STANDING	supported standing; reflexive moment in response to stimuli on plantar aspect		begin to accept weight; astasia-abasia,

4-6 MONTHS

	OVERALL	5 MONTHS	6 MONTHS
ALL POSITIONS	better head control; symmetrical movements; less physiologic flexion; developmental spiralling; better trunk activation; co-activation of flexors and extensors;	rolling with rotation (roll as a unit/log roll)	weight shifting; protective reactions
SUPINE	elevating hands to knees; chink tuck; using abdominals; supine to sidelying	grabbing feet	hands away from body to reach for objects; transfer objects from one hand to the other
PRONE	cervical and thoracic extension; elbow extension when pushing up; elbows more in line with shoulders; good head and upper trunk control	shoulders off floor when pushing up	swimming motion; equilibrium reactions; scooting backwards; prone to quadraped; prone pivot
SITTING	narrower base of support; no head lag pull to sit; more extensor activity	unsupported sitting	sitting without support; pelvis in neutral;' weight-shifting; reaching for toys
STANDING	early weight-bearing and more upright posture	hips and knees less flexed; appear bow-legged ankles not in neutral position	upper and lower trunk control; bouncing in this supported position

7-9 MONTHS

	OVERALL	8 MONTHS	9 MONTHS
ALL POSITIONS	roll with rotation; lateral trunk control; prone pivoting		side prop position with weight through shoulder girdle;crawling emerging quadruped to half-kneeling; reciprocal creeping
SUPINE
PRONE		prone pivoting
SITTING	weight shifting; vertical righting; protective reactions;	unsupported sitting; narrower base of support;	sitting to prone position; sitting to quadruped; weight-shift to reach for toys
STANDING		pull to stand; supported standing on toes

10-14 MONTHS

	OVERALL	11 MONTHS	12 MONTHS	13 MONTHS	14 MONTHS
ALL POSITIONS	more dynamic control; good core and pelvic control; reciprocal extremity movement; reciprocal creeping faster and more efficient				stand from ground with support; walking
SITTING	ring sitting to side sitting; weight-shifting and moving in and out of various positions; v and w sit positioning		righting reactions
1/2 KNEELING	more upright trunk; more stable; hand support on higher surface
STANDING	static standing; standing with rotation; co-activation of trunk muscles; stand with unilateral upper extremity support; cruising; modified squat	standing without upper extremity support
WALKING	walking with hands held			stepping; hands up high inititally