Starting in the very first moments of their children's lives, parents watch their progress eagerly, anticipating each new physical challenge and waiting to see how they'll meet it. If a child takes her time reaching a milestone, Mom and Dad worry, worry, worry: Does it mean she's not smart enough? Is it possible she has some sort of disability? Parents can be reassured, however, that mastering motor milestones doesn't correlate with intelligence, says Dr. Judith Murphy, an associate clinical professor of pediatrics at Stanford University in California.
And though a series of missed milestones may signal an underlying problem, one or two slow steps along the way usually mean very little. "We don't isolate single activities," says Dr. Don Schiff, a professor of pediatrics at the University of Colorado School of Medicine in Denver and a former president of the American Academy of Pediatrics. "It's combinations of missed milestones that we think of as a warning sign."The range of what's considered normal for most motor milestones is also quite broad. Yes, it may be a bit frustrating if your best friend's son walks at 8 months when your 16-month-old has yet to take a step without clinging to a chair, but both the early bird and the late bloomer are well within the normal range for this milestone. Each is just exhibiting his own personal tendencies, which may even have a logical explanation: Perhaps one child has a more cautious personality or the family has a history of late walking. Or a few delayed milestones may simply indicate that a child is developing normally but isn't among the most athletically talented. "Some of us go to the Olympics, some of us don't," says Murphy.
If, however, you are losing sleep over what seems to be your child's lack of progress, talk to your pediatrician, who will observe her and may refer her for some form of testing. Meanwhile, you can help a child reach her motor milestones by providing her with a wealth of opportunities. Keep in mind, though, that she's on her own schedule - have fun encouraging her, but don't expect results. "Parents need to pay attention to a baby and interact with her," says Matia Firm-Stevenson, associate director of Yale University's Bush Center for Child Development and Social Policy in New Haven, Conn. "Babies need someone who is crazy about them, someone who delights in anything new they do." And what exactly do they do? Here are 20 of the most exciting achievements from birth to kindergarten, along with timelines and explanations of the physical developments required for each one.
Turns head from side to side
Birth to 1 month
Development of neck muscles
This is the earliest voluntary movement; if your child isnt doing it, mention your concern to her pediatrician, who will check the baby's muscle tone. In all but rare cases, there is little to worry about. If the baby's muscle tone is too slack or overdeveloped, however, the pediatrician may suggest an evaluation of the central nervous system, according to Claire Kopp, a professor of psychology at the Clairemont Graduate School in California and the author of "Baby Steps: The `Whys' of Your Child's Behavior in the First Two Years." "In most cases, though, low or high muscle tone is a temporary condition," Kopp adds.
HOW TO HELP: To motivate your baby to look from side to side, place eye-catching toys or knickknacks on either side of her, or put her next to a mirror where she can make faces at herself. You might also try lying down next to her until she looks at you, then switching sides.
Mini push-up
2 to 4 months
Development of shoulder muscles
One of the first ways that babies begin to explore their world is by pushing themselves up off the floor with their arms, a motion experts describe as the mini push-up. Joan Batista of Arlington, Mass., believes that her baby, Daniel, was late learning to push himself up because "he hated being on his stomach and would cry if I put him down in that position." Although Batista says Daniel was big for his age and had the strength to lift his head from very early on, he showed no interest in pushing up off the floor. Once Daniel finally attempted a mini push-up, at 31/2 months, says Batista, "he didn't even struggle." Interestingly enough, Batista's own mother now tells her that she learned how to do a mini push-up when she was a good 6 weeks younger than Daniel, even though she was a much smaller, weaker baby.
HOW TO HELP: To encourage your baby to lift his head high and survey his world, give him plenty of floor time. If a baby is having trouble developing this skill, it may be that he is spending too much time in a front-facing infant seat or on his back, says Stanford pediatrician Murphy. One way to help him along: Get down on the floor and lie facing the baby. Show him a toy, holding it up so he needs to push himself up slightly to see it.
Swipes at object
2 to 5 months
Control of hand muscles
Swiping requires an extraordinary number of different neurological impulses. "First, the baby has to be able to see the object, and then he has to connect what he sees with his own hand," says University of Colorado pediatrics professor Schiff. Learning to swipe also teaches babies cause and effect as they bat at a toy and then watch as it bounces and swings. Babies progress to swiping in their own individual ways, says Schiff, so parents shouldnt worry about their baby's timetable as long as they have evidence that his vision is fine and he is making attempts to interact.
HOW TO HELP: To lure those little hands to reach out, hang a mobile just out of baby's reach above his crib. (You might want to have two or three different mobiles and change them weekly. Simple paper mobiles are fine; try making them yourself with shapes cut from construction paper.) A light ball or rattle hung from a string also encourages swiping. As your baby's skills improve, switch to a crib gym. You can make your own using paper clamps (the large size, so as not to pose a choking hazard) to attach light toys to a band of elastic stretched tightly across the crib. Change the objects hanging from the clamps frequently, but be careful to secure this toy well and remove it before your baby is able to grab it and pull it down.
Brings both hands together
2 to 5 months
Suppression of the tonic neck reflex
Babies come into the world armed with a series of instinctive reflex movements that protect them as they gain control over their bodies. When you place an infant on his back and turn his head to one side, the tonic neck reflex causes him to go into a "fencing" position, with the arm on that side extended, the knee on that side flexed and the opposite arm crooked. As he gradually overcomes the tonic neck reflex, a baby learns to use each side of his body separately and to watch and use his hands voluntarily. "It's important that this reflex be inhibited," says Kopp, "because as humans, we do our best work with our hands in front of us, where we can see them."
If a baby does not reach this milestone by 6 months, his pediatrician will probably check the growth of his brain by measuring his head circumference, and may evaluate him for metabolic abnormalities and cerebral palsy. Most of the time, though, it's just a question of waiting for his movements to become more purposeful.
HOW TO HELP: You can speed this process along, and have fun in the meantime, by showing him how to clap and play patty-cake.
Rolls in one direction
3 to 7 months
Development of trunk muscles
Since many parents are putting their babies to bed on their side or back as a result of warnings about SIDS (sudden infant death syndrome), it's becoming common for babies to master the more complex back-to-front roll before the simpler front-to-back roll. If this milestone shows up late, don't view it in isolation, cautions Schiff. "Most babies turn over from their tummy to their back at age 4 or 5 months. However, if I see a child who isn't turning over but is able to sit at, say, 6 months, I'm usually not concerned."
Ilsa Bradley of Milwaukee had not yet attempted a front-to-back roll when she surprised her parents, Mark Bradley and Anne Hansen, by rolling over from her back to her stomach at the age of 4 months. The day after she first demonstrated this ability, her parents were awakened by an unfamiliar flopping sound coming from her bassinet. When they peered in to investigate, says Bradley, "Ilsa was flipping herself back and forth from her stomach to her back looking so pleased with herself." Within a couple of months, rolling had become Ilsa's primary means of locomotion. "She would roll herself across the room to go after our two cats," recalls Bradley. "Then the cats would move, and she would roll herself after them again. It was pretty funny to watch." Ilsa rolled herself all over the house until she learned to crawl, when she was 7 months old.
HOW TO HELP: If you are putting your baby to sleep on her back, place her on her stomach to play at other times of the day. Make sure the surface is moderately hard and that there are no pillows nearby. You can gently roll your baby over and over, like a rolling pin, if she likes it.
Grasps objects
3 to 7 months
Suppression of the grasp reflex
Another immensely complex process, grasping progresses from a vague palming motion that involves the whole hand to a more specific pincers motion using several fingers and the thumb. "Grasping is important because we are a tool-using species," says Kopp. "And parents are eager for their babies to be able to play with all those cute toys."
HOW TO HELP: Provide a rattle, a teething ring that fits your baby's tiny hand, a light stuffed doll or any object that is easy to grasp - the noisier the better. Choose things that are safe to chew on, because at this stage, almost everything eventually finds its way to a baby's mouth. Many toy stores carry specialized child development toys designed to help babies practice grasping and transferring. Some of these come with pamphlets that discuss motor development and ideas for age-appropriate play. Starting when your baby is about 6 months old, you can give her cereal O's and other finger foods that will encourage her to use her thumbs.
Sits unsupported
5 to 9 months
Development of trunk muscles and improved balance
Pediatricians often want to see a demonstration of this key milestone. If a baby isn't sitting up by 8 or 9 months, says Schiff, "we would look for signs that the child is moving his limbs in a coordinated fashion and is hearing and seeing well, and we would check that he has appropriate muscle tone, head circumference and weight gain to determine if there indeed is a problem." Potential causes, Schiff says, could include primary muscle diseases such as muscular dystrophy, cerebral palsy or rare metabolic diseases that can lead to mental retardation or sluggishness in brain growth.
Other explanations are possible, however. Sam Sontag of San Francisco learned to sit at the late end of the normal range and was slow again when it was time to walk. His father, Jerry, remembers comparing Sam with his more active cousin of the same age: "I picked up his cousin and he was springing his legs, bounding around. Sam didnt have that direct connection between his legs and torso. He was more like a warm loaf of bread - delicious, but not so integrated."
The explanation for Sam's lack of physical prowess? At birth, his height and weight were in the 25th percentile, while his head was in the 70th percentile, so it took a lot of muscle development before Sam could control his head successfully. And Sam's build is not that of a wiry athlete. Even today, when Sontag watches Sam, now 4, and a playmate climb stairs, he notices that while Sam is confident, "it's more work for him to flex his hips, and he can't run up the stairs quickly like many of his peers."
HOW TO HELP: Once your baby is sitting pretty, don't be tempted to surround him with pillows and walk away, as he could still fall into the pillows. Instead, take the opportunity to interact with your little one. Sit him on your lap looking out, or position him on a low table looking at you. You can also sit behind your baby and support him by holding his hips and thighs, or play a game in which you pull him by the hands from his back into a sitting position - "Row, row, row your boat" makes a great accompaniment.
Bangs two objects together
6 to 10 months
Combination of grasping and bringing hands together
Some developmental experts don't use this milestone, but others find it particularly useful because it is so unambiguous: If a child is banging objects together, you'll hear about it. "There is a wide age span in demonstrating this," says Murphy, "but when they do it, you know it."
HOW TO HELP: To get your little percussionist started, give her a couple of plastic or wooden blocks that are easy to hold. Small pot lids are even more satisfying, if you can stand the cacophony.
Creeps, crawls or elephant walks
6 to 12 months
Coordination of arm and leg muscles
Babies may skip one - or even all - of these forms of locomotion, and this is nothing to worry about. The fears of a few decades ago have been put to rest, and most doctors no longer believe that lack of crawling is connected to dyslexia or other perceptual problems. The modem explanation for skipping this step: Some babies gain strength simultaneously in their hips, legs, arms and shoulders, rather than developing upper-body strength first, and so are likely to focus on cruising and walking instead.
In rare cases, there is cause for concern when a baby only scoots about in a sitting position. For a very small percentage of such babies, particularly those who were also premature, such scooting may be an indicator of cerebral palsy. But, say experts, it is unlikely that cerebral palsy would have remained undiagnosed in a baby this age.
In most cases, lack of crawling expertise means nothing more than a preference for being upright. "Humans were not designed to creep or crawl, we were designed to walk" says Kopp.
"We shouldn't get hung up on babies' creeping." Jennifer Wooley didn't crawl until she was 11 months old, and three days later she stood up and walked, recalls her mother, Mary Jean Wooley of Endwell, New York. She theorizes that Jennifer, now 8, was late in developing sufficient upper-body strength: "She was a very petite child. She had skinny arms, skinny legs, skinny everything," Wooley says.
HOW TO HELP: One way to make crawling more comfortable - especially important in a house with wood floors - is to protect your baby's knees with thick, soft pants or elasticized knee pads. You can also tempt her toward mobility with a toy that escapes from her grasp, such as a small beach ball or a toy with wheels.
Pulls self to stand
7 to 13 months
Muscles around critical joints are able to lock into place
Before a baby can pull himself up to a standing position, he needs to develop adequate coordination and a sense of balance as well as sufficient muscle strength in his legs and arms.
HOW TO HELP: To get your baby into training, hold him standing on your lap, allowing him to flex his knees. Keep your baby barefoot as much as possible - this gives him a better feel for the floor and more confidence. If it's cold, dress him in socks with nonskid bottoms. Thick carpeting may give babies trouble; let him practice on kitchen or bathroom linoleum instead. And never underestimate the power of peer pressure: Seeing other children perform a task and realizing that it's possible may spark a child to forge ahead. Once a baby can stand up while holding on to the furniture, it's only a matter of time before he will start cruising around. To encourage his newfound mobility, provide your baby with stable handholds, such as stools, ottomans and low tables without sharp corners.
Uses index finger to point
Differentiation of index finger from rest of fingers
This skill is influenced by social interaction. Encourage your baby to point to toys, and respond enthusiastically when she does. This lets her know that pointing is a useful skill that gets results. "Pointing is a great way for babies to learn that their hands are tools to communicate with," says Kopp.
HOW TO HELP: Once babies learn to point, it's hard to get them to stop, and that's OK. It's certainly a more pleasant way to get their point across than screaming. Forget your manners and point along with them.
Walks unsupported
8 to 17 months
Development of balance
Walking early may demonstrate that a child has an exploratory personality and is eager to push the bounds of what he is physically ready for. "But the level of parent protectiveness does play a role in either encouraging or restricting a child's explorations," says Jere Gallagher, an associate professor of motor development at the University of Pittsburgh. Small adventurers may fall more often than more cautious children, but they're unlikely to get seriously injured, says Gallagher, who adds that particularly heavy babies may also walk later than their peers. Willy Meyer of San Francisco, now 4, didn't start walking until the end of his 16th month. His mother, Julie Stevenson, had been worried for some time and told herself that when he reached 17 months old she was going to consult a specialist. But one morning, Willy walked across the living room with nary a wobble, and soon after was running with confidence. Part of the delay, Stevenson says, was due to his personality. "Willy sits and watches things and takes them all in before he does them. He's always been cautious, not unlike his father." A scare can also cause a child to become extra cautious. Stevenson remembers that at about 1 year of age, Willy attempted to pull himself up a metal slide and ended up in the hospital getting a row of stitches.
HOW TO HELP: A time-tested strategy to encourage your baby to walk: Hold out your arms and coax him to come to you. A push toy can provide some support, or you can try handing your baby a toy while he is standing, which might distract him enough that he takes a step. Another motivator: Move furniture apart to make it harder for him to cruise. But none of these ploys are necessary, says Kopp. "Humans are going to walk."
Builds a tower
10 to 18 months
Hand-eye coordination and spatial awareness
Stacking blocks is a big step. `This is the first time a child demonstrates the idea of one object on top of another," says Murphy. But, she cautions, this milestone is achieved as much from desire as from development; some children will sit for hours stacking up blocks and knocking them down, while others just can't be bothered.
Because children's individual characters play such a large role in determining when they reach this milestone, pediatricians allow a lot of time to pass before becoming concerned, and they also take into account a child's physical adeptness. "Some babies aren't that coordinated," says Kopp, "and this is not a big deal."
HOW TO HELP: Old-fashioned stacking cups, graduated alphabet blocks or even a selection of plastic storage containers all make it fun to practice this skill.
Scribbles
11 to 21 months
Coordination combined with opportunity
This milestone depends on circumstances - a child with easy access to crayons and markers or with brothers and sisters who draw, for example, may start to scribble at the early end of the age range.
Jeffrey Traeger of Woodside, Calif., now 7, didn't scribble until he was almost 5. He also didn't show any interest in construction toys or puzzles, and he couldn't confidently cut with scissors until he was 6. His mother, Sharon, wasn't really concerned, feeling his lack of skill was due to disinterest, but when he was tested for first-grade entry at a private school, she was referred for more extensive developmental testing. The conclusion: a variety of problems in fine-motor skills caused by a difficulty in right-left brain coordination. Jeffrey (who did get accepted to the school) is now receiving occupational therapy and is struggling to improve his writing, drawing and reading abilities.
HOW TO HELP: You might start toddlers on the road to creativity with fingerpaints - or just ketchup on the highchair tray. Then move to a fat crayon, with paper taped to the table.
Climbs
14 to 22 months
Balance and opportunity
A child who has stairs to climb at home may hit this milestone on the early side, but parents should use gates and supervise all attempts to scale heights. By the late end of the range, even most children who have never seen steps will be able to climb them the first time they have the chance.
Kids have a natural urge to climb that may take unsuspecting parents by surprise. One afternoon when her daughter, Abby Wirbel, was 18 months old, Carol Rumsey of Colorado Springs thought her child was peacefully napping in her crib. Then Rumsey, chatting on the phone, heard a voice on the monitor in the baby's room say, "I got up." Rushing upstairs, Rumsey found Abby calmly walking away from her crib, which had its high rails still in place.
HOW TO HELP: If you don't have steps in your home, find a place where your child can practice climbing so she can do it safely when necessary. You could also buy a small slide with a few steps to climb, or just pile up cushions from the couch.
Jumps with both feet
18 months to 2 1/2 years
Coordination
Reaching this and other physical milestones late doesn't mean a child won't excel athletically later on, says Gallagher. "Not only do kids mature at different rates, but they need plenty of practice to achieve these skills. Just because a child is late jumping with two feet doesn't mean he won't be a future Michael Jordan," she says.
It's always amusing to watch toddlers work on this skill, calling out, "Look at me jumping, Mommy!" while their feet never leave the ground. Many tots will work very hard to accomplish this task and are very proud when they finally do. "They can feel their success, and it's fun," says Murphy.
Throws ball overhand
18 months to 3 years
Whole-arm coordination and opportunity
While pediatricians commonly use throwing as a developmental test, a weak pitching arm probably just means that coaching this skill hasn't been a major priority for parents - and that's just fine.
Daniel Beer was "born to throw," laughs his mother, Karen Freifeld of New York City. "It wasn't something we encouraged, but there is nothing he loves better." Daniel started throwing balls before his first birthday and now, at the age of 2, looks for balls wherever he goes. If he doesn't find one, he creates one. Most recently he crumpled a box from a deck of cards and began pitching it. "He puts his whole body into it, complete with follow-through, and can already catch and bat," Freifeld says.
This kind of early fascination with a particular skill is absolutely normal, says pediatrics professor Schiff. "When a child performs a motor activity early, it's never a cause for worry."
HOW TO HELP: Parents who want to prepare a toddler for future Little League glory might invest in a variety of light balls of different sizes, or buy or make a soft beanbag to throw in the house.
Strings beads
18 months to 3 years
Coordination and attention span
It's a proud moment for many toddlers the first time they hold up a string of beads they have threaded themselves. But while bead-stringing certainly requires a high degree of dexterity and hand-eye coordination, skipping this step may not be a sign of klutziness - just a lack of interest in this type of play.
HOW TO HELP: Toy stores are filled with games aimed at teaching this ability, starting with rings that go over a rod and progressing to beads and other objects that thread on laces. It's also easy to create your own stringing games from shoelaces and items found around the house - anything from curtain rings to empty sewing spools to large pasta shapes.
Balances on one foot
2 1/2 to 5 years
Coordination and balance
Pediatricians have long relied on this milestone to measure neurological development, though experts agree that most neurological problems show up before a child is old enough to even attempt this test. Balancing is also a little scary; children who have trouble with this skill may simply be intimidated. Good balance can also be related to the size of a child's feet, reports Gallagher: "Children with bigger feet have a wider base of support." But the most important point for parents to understand, she says, is that good balance is not an inherent ability but one that children learn. "It's a matter of strength, experience, practice, and exposure."
HOW TO HELP: Small children love pretending to be tightrope walkers or gymnasts, and this is a great way to practice balance. You might try suggesting that your child walk down a line on the sidewalk or floor, or help her along a balance beam at the playground. You can also make a balance beam at home by setting a long, wide board on top of a couple of bricks, cinder blocks, or sturdy books. Don't discourage your child's efforts to walk on curbs or low walls - just lend a light touch for confidence.
Cuts with scissors
3 to 5 years
Coordination
The use of a tool requires manual dexterity as well as an interest in doing this type of controlled task. Cutting with scissors is often used as a sign of readiness for kindergarten because it indicates a level of patience and self-discipline necessary for success in school. "This task has something of a different flavor than the others because it relates to school readiness," says Murphy. "Children who can't be bothered with fine motor skills like this may have a terrible time sitting still in class and might not do as well in kindergarten."
HOW TO HELP: A stack of old magazines is a treat for a child interested in learning to cut; give her a pair of child-sized safety scissors and let her go to town. You can make a collage with the pictures for a more lasting reward.
If You're Worried . . .
A developmental-milestones checklist helps chart your baby's progress in motor skills. To receive one free of charge, send a self-addressed, stamped envelope to the American Academy of Pediatrics, Department C: Developmental Milestones, P.O. Box 927, Elk Grove Village, IL 60009.