Paediatrics: Gross motor development

Gross motor development

Key motor developmental milestones

Head control

·  Newborn: head lag on pulling to sit; head extension in ventral suspension.

·  6wks: lifts head on lying prone and moves it from side to side.

·  3mths: infant holds head upright when held sitting.

Primitive reflexes ‘Primitive’ reflexes are found in normally developing infants that disappear by 4–6mths.

Sitting

By 6–8mths an infant usually can sit without support. To achieve this, the baby must have developed two reflexes:

·  Propping or parachute reflex in response to falling.

·  Righting reflex to position head and body back to the vertical on tilting.

Children not sitting by 9mths should be referred for evaluation

Locomotor skills

An infant initially becomes mobile, usually by crawling, but some will bot-tom shuffle and others will commando crawl (creep).

·  By 10mths infants are usually cruising round the edge of furniture.

·  By 12mths 50% of infants are walking independently; however, the age range for this is broad.

Children not walking by 18mths must be referred for evaluation

Further development of motor skills

Children learn to run and jump and by 24mths they start to kick a ball

·  Age 3yrs: can jump from a bottom step, stand on one leg briefly, and pedal a tricycle.

·  Age 4yrs: can balance on one leg for a few seconds, go up and down stairs one leg at a time, and pedal a bicycle with stabilizers.

Age 5yrs: can skip on both feet.