Gross Motor Milestones in Infants 0-14 Months

Original Editor - Robin Tacchetti based on the course by Krista Eskay
Top Contributors - Robin Tacchetti and Jess Bell

Introduction

This page summarises motor development in infants aged between 0 and 14 months. While skill acquisition typically follows a specific trajectory, and each skill builds on the previous skill, every child follows their own schedule. Thus, this page provides time "windows" for these developmental skills.

Motor development and skill acquisition are discussed in detail here. It is important to note that motor development depends on the interplay of three constraints: the individual, the task and the environment. Gross motor development is also affected by a range of factors, including:

• Culture
• Child-rearing practices
• Household-income
• Parental involvement
• Infant handling
• Opportunities to practise
• Maternal education
• Number of family members
• Space for physical activity
• Sleep and play positions
• Equipment used

Research shows there is a direct relationship between daily practice and motor development. Children who spend more time in active positions, such as prone and standing, have more advanced motor development outcomes than children who spend more time in less active positions, such as supine and sitting. For example, decreased tummy time (i.e. prone posture) during awake time limits an infant's opportunity to practise postural control and antigravity movements.

Acquisition of each motor skill facilitates new opportunities for learning and exploration. Because infants are learning new skills in a body that continues to change/grow, they must learn "to adapt behavior to the current status of the body at every moment." The following tables detail the progression of gross motor milestones during the first 14 months of life.

0-3 months

	OVERALL	1-2 MONTHS	2-3 MONTHS
SUPINE	Physiologic flexion of the hips and knees; 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 of the hips and knees; 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; Starts to lift head and shoulders; Head lift to 45 degrees
SITTING	Weight of head pulls the infant anteriorly; Shoulders anterior to hips; Unable to hold head in midline; Wide base of support (ring sitting); Needs 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 head in midline; Vertical righting; Weight bears through hands (propped sitting)
STANDING	Supported standing; Reflexive movement in response to stimuli on the plantar aspect of the foot		Begins to accept weight; Astasia-abasia (inability to stand upright unassisted or walk)

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; Chin tuck; Using abdominals; Supine to sidelying	Grabbing feet	Hands away from body to reach for objects; Transfers 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; Appears bow-legged, Ankles not in neutral position	Upper and lower trunk control; Bouncing in a 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
PRONE		Prone pivoting
SITTING	Weight shifting; Vertical righting; Protective reactions; Kneels with support	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 is faster and more efficient				Stands from ground with support; Walking
SITTING	Ring sitting to side sitting; Weight-shifting and moving in and out of various positions; V and W siting position		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 initially

General Summary of Gross Motor Milestones

The following lists provide a summary of motor milestones in different positions. Average time frames for the acquisition of these skills are also given.

Prone Motor Milestones

• Forearm propping 3-4 months
• Weight-bearing extended elbows 4-5 months
• Rolling to supine 5-8 months (first without rotation)
• Pivot prone 6-8 months
• Crawling 7-9 months
• Quadruped rocking 7-9 months
• Extended four-point (bear walk) 7-9 months
• Creeping 8-10 months

Supine Motor Milestones

• Asymmetry 2 months
• Head midline/hands to chest 3 months
• Hands to knees 4 months
• Hands to feet 5 months
• Rolling to prone 5-8 months (first without rotation)

Sitting Motor Milestones

• Sitting upright, lower trunk-support 4 months
• Propped sitting, minimal support 5 months
• Sitting without support 6-7 months
• Sit well in high chair 6 months
  • Early independent sitting
  • Falls easily
• Sits with arms free 7-9 months
  • Side sitting
  • Moves out of sitting

Standing Motor Milestones

• Stands with support, wide base 4-5 months
• Kneels with support 7-9 months
• Pull to stand 8-10 months
• Cruising 9-11 months (first without rotation)
• Independent standing 11-12 months
• Stands up without support from squat 12-13 months
• Walks one hand held 11-13 months
• Pushes "walk behind toy" 10-12 months
• Independent steps 12-14 months

Resources

• Pathways.org: Milestones
• Motor Development Principles
• Child Development