Motor Milestone Age Ranges & Your Child’s Development
What To Expect From Birth through the First 3 Years
As a pediatric physical therapist specializing in birth to 3 years, AND a mom of 3 myself - I completely understand how overwhelming understanding our children’s development can feel at times.
When it comes to your child’s milestone, if you’ve found yourself wondering things like…
Should they be rolling yet?
How long should my baby be able to do tummy time?
Should I be worried that my niece is sitting and my baby is the same age and isn’t?
Should I talk to my pediatrician about this?
Should I push if I’m concerned but they aren’t?
….this blog is for you!
So, let’s start at the top and unpack all of it - what to expect, when to expect it, when to advocate, and how to support them every step of the way.
First - check out our FREE 0-3 Year Milestone Checklist, which covers exactly when to expect all the big milestones in those crucial years in development and is a great starting point to understanding all the amazing things going on in your little’s brain and body!
Let’s talk about milestone ranges.
Milestone ranges refer to the time frames in which we expect the majority of babies & children will meet a milestone. For example, the expected time range for crawling to emerge is between 8-10 months. And while I know those ranges can be stressful if your child is falling on the earlier side, the later side, or starting to meet milestones outside those ranges (or need some support to get there!) - BUT those ranges are there for a reason and are so important to consider. Let’s unpack that….
The truth is, development follows a fairly predictable trajectory and has done so since the beginning of human civilization. We know that milestones occur in a typical order and at specific times, and that is because each earlier milestone mastered works to lay the foundation for the next higher level skill to develop, and to develop with compensations or asymmetries.
Knowing those ranges and what to expect at a given time can be helpful not only in monitoring our child’s development, but also understanding what they are working toward, what they’re currently doing that supports that (we’re going to talk more about ministones in just a moment!!), and what YOU can do to support them every roll, crawl and step of the way.
Here’s the thing - often times, we get caught up on the big milestone - like rolling, crawling, sitting, walking. If we’re not seeing that milestone, the stress usually starts to ramp up, BUT…there are SO many things happening before that big milestone emerges that prepare the body for it to occur. I refer to those ‘earlier things’ that lay the foundation for the big milestone to occur as ‘ministones’.
You may be thinking…’ministones’, KC? What the heck is that made up nonsense?
Admittedly, ‘ministones’ is absolutely a word I made up - hah! BUT it’s because they are so important….maybe even more important than the big milestone, if I’m being honest. And shifting our focus towards ministones, in my experience, can be an amazing way to focus on all the amazing things our little IS doing, rather than what they may not be doing quite yet.
Ministones are ALSO extremely helpful to consider when thinking about:
Where our child is falling within the expected milestone ranges
Whether referral is appropriate
Whether we should be concerned & keeping a close eye, & more.
Because even though the big milestone may not be present yet, if you are seeing ministones present, often times it's a pretty strong sign that they are working towards the bigger skill, even in those times that a little one may be trending falling towards the later end of ranges, (which might just be their norm!).
But, if we aren’t seeing those milestones or ministones, baby is starting to fall outside of the expected age ranges, we’re not seeing progress, attempts at independent exploration, or are seeing them move in a different way than we’d expect - having the background information you need to advocate for your little is HUGE. Being empowered and armed with the information you need to identify a concern AND nip it in the bud before it snowballs or impacts other areas of development is HUGE, and something I feel so strongly we have to shift toward as a society, rather than the unfortunately very common ‘wait and see’ (without tangible tips in the waiting period) approach.
Because the truth is - all the ‘wait and see’ approach does is a disservice to both parents AND children. All the ‘wait and see’ approach does is prolong worry, create stress, and hold back our children from reaching their maximum potential. Instead, shifting to ‘let’s just see’ allows us to address things earlier through available motor resources (I got you!!) and/or more formal support, like Early Intervention programs!
As an aside, If you have concerns about your child’s development, you can find your county’s Early Intervention contact number HERE) - I recommend asking one, do you need a physician referral to start the process as a concerned parent, and two, is there any cost associated to you (typically no, but best to be sure!).
So…let’s get back to more about what that important background information is.
The Pyramid of Motor Development
A truly incredible, uniquely human experience that fascinates me. I love to explain motor development to parents & caregivers as a pyramid - where each earlier milestone (& associated ministones) met work to lay the foundation for the next, higher level skill to emerge. When we’re looking at development through the lens of prevention, considering this pyramid can help us quite literally stop milestone hiccups in their tracks - stop them from snowballing into a true delay, impacting other areas of development, or becoming something that requires formal intervention.
In general, the Pyramid of Motor Development looks like this:
You can see in the above image we’ve created, tummy time is SO, so important & the foundation of all the skills to come. In fact, we are literally wired to be on belly down first because of the in utero position of baby being all flexed up into a nice tight little ball. This in utero position functions to prepare the back muscles to be ready to work FIRST during tummy time because before a muscle can develop STRENGTH, it has to have LENGTH (ie: those back muscles get alllll nice and stretched out for 9 months in utero and come out ready to WORK! 💪)
Baby is in tummy time, starting to lift their head & press up through hands, which when combined with the weight of their head (it’s the heaviest part of their body at this stage!) AND that the front muscles haven’t strengthened yet, helps create a weight shift for the belly to back roll to happen AND works to lengthen the muscles on the front of the body, helping to prepare them for back to belly rolling ministones & milestone to occur once baby rolls off their belly.
So - tummy time ✔️, belly to back rolling ✔️…now baby is on their back playing.
While on their back, they’re starting to bring hands together at the middle of their body. Starting to bring hands to mouth, starting to swat at toys above them, beginning to develop more & more head & neck control, grab their knees & feet, roll back to side like the ‘happy baby’ pose, and eventually as they become more and more mobile on their back, ultimately the roll from back to belly.
Once they’re on their belly again, now we see pre-crawling ministones begin to emerge, like pivoting in a clockwise & counterclockwise direction, pushing themselves backwards or army crawling forward, and beginning to work on being able to get into and out of a sitting position on their own.
When it comes to crawling & sitting, there is a lot of controversy & opinion about which *should* come first, whether we should be placing baby in a sitting position before they can get in/out on their own, etc - but ultimately, without getting into each & every factor, the reality is that most would agree being able to sit at least briefly when placed by around 6 months of age is important to work towards, especially when it comes to safely introducing solids.
In general - either they’re going to master crawling first and then learn to push themselves backwards into a sitting position, where protective reactions to stop from a fall in sitting and the ability to transition independently into/out of sitting will then happen. OR, from a sitting position they’ll start to develop those protective reactions that will ultimately help them get out of sitting back to their belly so they can work towards crawling.
Now, baby is crawling & experiencing their world in an entirely new way and it becomes much easier to move through their world & see things at different levels, which drives the motivation to work on pulling to stand with hand support. This is why we often see crawling & pulling to stand emerge around the same time!
Then, we see the progression of upright skills to take us from hands & knees to walking on two feet. They’ll start by cruising along furniture with hand support, beginning to let go with one and then both hands, learn how to balance, rise into/out of standing independently, and finally take those precious first steps!
From here, we see things like single limb stance emerge, which lays the foundation for higher level skills like stair climbing, kicking, jumping, running, hopping, etc.
Is that incredible or what?! Literally - humans are designed in a way that connects us all, even when we are all individuals and will have unique aspects to our journey through those milestones.
Ultimately, reflecting on the pyramid of development can help guide us in understanding what to expect, when to expect it, when to consider intervention, and how to support each stage.
What about when motor development isn’t quite going how we’d expect?
To explain this best, I want to share one of the most common things I evaluate. And before I do, please consider the disclaimer that I am in NO way insinuating that milestone or developmental delays are a parent or caregiver’s fault.
However, what I’m about to share is a very, very common situation I see play out, where a milestone ‘hiccup’ (that often starts wayyyyy before we become concerned!) snowballs into something it doesn’t have to, especially if parents have the right supports.
To recap, we just covered the typical milestone trajectory and how each skill lays the foundation for the next skill to emerge. But let’s say, for example, it can be so common for babies to hate tummy time, right? (Which as an aside - is often because parents aren’t given the right information to make tummy time enjoyable!).
So, baby hates tummy time. Maybe they have reflux, maybe they just have some belly discomfort, but either way, often times you’ll see them arching & extending when on their belly in an attempt to get off their belly and get away from that discomfort. Many times, that arching combined with the weight of their head & the lack of flexor muscle strength at that stage causes them to roll off their belly. Woohoo, they’re rolling, right?! 🫤 Unfortunately, not so much.
Because often times, if they are rolling from arching & extending, it’s not a true roll, it’s a compensatory movement pattern, meaning it’s not done intentionally, with control & with the use of the muscles needed to truly lay the foundation we need.
Now….baby hates tummy time, often arching & rolling right out of it, and because parents are human and love their sweet baby so much, we don’t want them to cry! AND we think they’ve checked off that belly to back roll milestone, so baby starts to spend a lot of time on their back. They’re on their back, working through pre-rolling ministones & then all of sudden, nails the back to belly roll and is right back to being belly down and HATING it.
So…because they’re struggling And often upset on the floor, we start to explore putting them in sitting as an option. But because they can’t yet get into or out of sitting on their own and they missed out on that crucial rolling period where they develop that trunk and core strength, when we put them there, there they stay.
Now, we’re stuck in sitting, but we are SMART, right? We’re MOTIVATED to move and get the toy that we want, so what does baby start to do?
They’re either going to get out of sitting through a split (a compensation that bypasses the trunk & core strength they missed from rolling which then begins to impact mobility & hip range of motion), OR they’re going to start to do things like bum scooting or hitch crawling to move in that sitting position.
See how that one thing…that difficulty with tummy time & not addressing the underlying issue, can snowball?
They’re stuck in sitting and they really want something because they’re smart - and here’s the thing, movement truly impacts every area of development.
Because if you can't get to something, it's really hard to manipulate it and develop that fine motor strength and control.
If you cognitively want to get to something to bring it to someone, but you're missing that step where you can get there, now you’re missing opportunities for social emotional skill development, for communication development by bringing you a toy and having you help activate it. Movement & motor development is the driving force for humans. Humans have to move. We are made to move.
So, baby is kind of stuck in sitting but wants that toy - so they start to scoot on their bottom. And while any movement is a good thing, in my opinion - compensatory movement patterns like bottom scooting continue to create more atypical patterns & strength. They continue to drive the ability to move in more stable planes of movement, they’re using a wider and wider base of support for stability, further hindering the ability to develop crucial strength and movement patterns. Now they’re butt scooting and see something they want to try to pull to stand on. But being able to transition into standing requires trunk rotation & the ability to move in diagonal, more complex planes - so their option is to muscle themselves up using their arms. BUT….their arms aren’t strong enough because they missed out on all that pressing up & strengthening during tummy time.
This is where they typically get flagged. That baby that has been struggling for literally 8-9 months at this point gets flagged because they start to fall behind in their upright skills. They can’t pull up to stand, they can’t get into/out of sitting or hold a hands and knee position - but it’s not because of something happening now. It’s because of all those little things that have snowballed because tummy time just wasn’t happening. And if we had addressed tummy time way back when, if we’d given parents the support & resources they need- we could have modified tummy time, set up the environment intentionally to support strengthening & coordination, and helped them work through that foundation of development without compensations that are now pushing them towards true delays impacting all of the domains of development, needing interventions, and having to overcome reinforced & atypical movement pattern
What could we have done differently?
Give 👏 parents 👏 the 👏 Support & resources they deserve!!
Give parents a resource to understand what to expect & when from their child’s development so those common ‘hiccups’ are recognized and stopped in their tracks, because those resources also have what to do to support each ministone & milestone, how to troubleshoot, and how to master milestones through play, all from the comfort of your home.
Because of this trusted resource, parents feel confident that at this stage, my baby should be doing xyz. If they're not doing it, they know why. If they’re struggling, they can figure out why.
Need to modify something? I give you that information.
Need to understand exactly how to support them? I give you that information.
Need to set their play environment up intentionally to encourage the skill you’re looking for or getting over that milestone ‘hiccup’? I give you that information. I give you the information & support you need so you can implement it and keep on moving.
When parents are supported and have the knowledge that empowers them to know what to expect for their baby, when to expect it, and how to help, and more than anything, when to intervene or when to advocate if things aren't progressing, I truly believe it would change our entire system.
And the saddest truth of it is?
We're up against a really broken system. Unfortunately, the help families deserve just isn’t going to come. With a broken system, tons of provider shortages, tons of kids on wait lists, and tons of kids not getting the services that they are legally entitled to. And unfortunately, I don't see that changing - I just see more and more of it falling onto families.
It shouldn't fall on parents, but unfortunately, it is. And I think it's going to continue to.
That’s my why. That’s the why behind milestone ranges, ministone focus, motor development, and the creation of resources I have poured my heart, brain & expertise into- as a mom and pediatric PT that gets it.
I know coming at our child's development from the lens of prevention can make a world of difference. I know empowering parents will help combat a broken system that leaves our babies behind every. Single. Day. But that requires parents to have the support that they need, and I’ve got your back with exactly that.
Looking for More Milestone Support?
If you’re ready to master your little one’s milestones with confidence and FUN, all from the comfort of your home, you’re in the right place! Just click the link below to join my FREE virtual training - all about Mastering Milestones With Confidence. I can’t wait to see you there ❤
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