Gross Motor Milestones2 – 5 Years During the Second Year: • 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 Milestones2 – 5 Years During the Second Year: • 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 Milestones2 – 5 Years Gait Pattern Matures During the Third Year: • Narrower BOS • Feet closer together • Heel toe progression • Shoulders in neutral • Elbows extended • Hips and knees extended • Reciprocating arm swing
Gross Motor Milestones2 – 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.
Gross Motor Milestones2 – 5 Years During the Third Year: • 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 Milestones2 – 5 Years During the Third Year: • 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 Milestones2 – 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 Milestones2 – 5 Years During the Fifth Year: • 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 12-15 with eyes closed.
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
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.
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.
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.
Fine Motor/Self Help Milestones 2-5 years Group 1
Fine Motor Manipulation Milestones2 – 5 Years By 2 years of age: • 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
Self Help Milestones2 – 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
Fine Motor Manipulation Milestones2 – 5 Years By 3 years of age: • 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
Self Help Milestones2 – 5 Years By three years of age: Dressing • Independent doffing clothing items • Dons front opening shirt/coat, needs assistance to don pullover clothing • Unfastens large buttons and zippers Toileting • Assistance for clothing management and hygiene • Daytime control, night time requires diapers Bathing/Grooming • Participates in washing self but not independent • Washes hands at sink with supervision and cues • Assists with but often resists grooming Feeding Able to self-feed independently
Fine Motor Manipulation Milestones2 – 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
Self Help Milestones2 – 5 Years • By four years of age: Dressing: • 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: • Day and night time control • Assist may be needed for appropriate hygiene and to manage fasteners Bathing/Grooming: • 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) Feeding: • Able to use a fork independently, • Arranges items on table correctly
Fine Motor Manipulation Milestones2 – 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
Self Help Milestones2 – 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
Speech and Language Milestones2-5 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?”)
Speech and Language Milestones2-5 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.
Speech and Language Milestones2-5 years • By 3 years of age: • Understands differences in meaning • Ex. “go-stop”, “in-on”, “big-little”, “up-down” • Follows two requests • Ex. “Get the book and put it on the table.” • 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.
Speech and Language Milestones2-5 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.
Speech and Language Milestones2-5 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
Speech and Language Milestones2-5 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
Speech and Language Milestones2-5 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
Speech and Language Milestones2-5 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
Social and Emotional Milestones2-5 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
Social and Emotional Milestones2-5 years • By the end of 2 years (cont): • Separation anxiety increases toward midyear then fades
Social and Emotional Milestones2-5 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
Social and Emotional Milestones2-5 years • By the end of 3 years (cont): • Separates easily from parents • Objects to major changes in routine
Social and Emotional Milestones2-5 years • By the end of 4 years: • 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
Social and Emotional Milestones2-5 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
Social and Emotional Milestones2-5 years • By the end of 5 years: • 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
Social and Emotional Milestones2-5 years • By the end of 5 years: • Sometimes demanding, sometimes eagerly cooperative
Typical Developmental Skills2 – 5 year olds References
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