Child First Occupational Therapy Services

DEVELOPMENTAL MILESTONES

2 years old

• Runs safely on whole foot, stopping and starting with ease.
• Squats with complete steadiness to rest or to play with an object on the ground and rises to feet without using hands.
• Pushes and pulls large toys with wheels easily, and is usually able to walk backwards pulling the handle. Pulls a small-wheeled toy by the cord with obvious appreciation of direction.
• Climbs on furniture to look out of window or to open doors and can get down again.
• Shows increasing understanding of size of self in relation to size and position of objects in the environment.

• Walks upstairs & downstairs holding on to rail; 2 feet to a step.
• Throws small ball overhand and forwards, without falling.
• Walks into large ball when trying to kick it.
• Sits on small tricycle, but cannot use pedals. Propels vehicle forwards with feet on floor.

• Good manipulative skills; picks up tiny objects accurately and quickly, and places down neatly with increasing skill.
• Builds a tower of six or seven cubes.

• Holds a pencil well down shaft towards point, using thumb and first two fingers. Mostly uses preferred hand.

• Spontaneous circular scribble as well as to and fro scribble and dots; imitates vertical line and sometimes “V” shape.

• Enjoys picture books, recognising fine details in favourite pictures. Turns pages one at a time.

• Recognises familiar adults in photograph after shown once, but not usually self.

• Feeds self competently with a spoon, but is easily distracted. Drinks well without spilling. Asks for food and drink.
• Puts on hat and shoes.
• Intensely curious regarding environment. Little comprehension of dangers.
• Follows parent or carer around house and imitates domestic activities.
• Spontaneously engages in simple role or imitative play.
• Often demanding parent or carer’s attention. Clings tightly in affection, fatigue or fear.
• May take turns, but as yet has little idea of sharing either toys.
• Plays contentedly near other children but not with them (parallel play).
• Resentful of attention shown to other children, particularly by people the child is familiar with.
• Unwilling to postpone immediate gratification of wishes.

DEVELOPMENTAL MILESTONES

2 ½ years old

• All mobility skills rapidly improving. Walks upstairs confidently and downstairs holding the rail, two feet to a step. Runs well and climbs easy playground equipment.
• Pushes and pulls large toys skilfully but may have difficulty steering them around obstacles.
• Can jump with two feet together from a low step. Can stand on tiptoe if shown.
• Throws a ball somewhat stiffly at body level. Kicks large ball, but gently and lopsidedly.

• Builds tower of seven or more cubes using preferred hand.
• Recognises fine details in picture books.
• Holds pencil in preferred hand, with improved tripod grasp.
• Imitates horizontal line and circle, and usually “T” and “V”.
• Recognises self in photographs once shown.

• Eats skilfully with a spoon and may start to use a fork.
• Exceedingly active, independent and resistive of restraint. Has little understanding of common dangers or need to postpone immediate wishes.
• May throw tantrums when upset and redirection is less effective.
• Emotionally still very dependent on adults.
• More sustained role-play, such as putting dolls to bed, washing clothes, driving cars, but with frequent reference to a friendly adult.
• Watches other children at play with interest, occasionally joining in for a few minutes, but as yet has little idea of the need to share playthings or an adult’s attention.

DEVELOPMENTAL MILESTONES

3 years old

• Walks alone upstairs using alternative feet, comes downstairs two feet to a step, and can carry a toy.
• Climbs easy playground equipment in a co-ordinated manner.
• Can move around obstacles and corners while running, and also while pushing or pulling large toys.
• Walks forwards, backwards and sideways with confidence.
• Appreciates size and movements of own body in relation to external objects and space.
• Rides a tricycle using pedals and can steer around wide corners.
• Can stand and walk on tiptoe.
• Can stand momentarily on one foot.
• Can sit with feet crossed at ankles.
• Can throw a ball overhand & catch large balls with arms extended.

• Builds tower of nine or ten cubes.
• Can close fist and wiggle thumb in imitation, both right and left hands.
• Holds pencil near the point in preferred hand, between the first two fingers and thumb (static tripod grip), and uses it with good control
• Copies circles, also letters ‘V’, ‘H’, and ‘T”. Can imitate a cross.
• Draws person with head and usually indicates one or two other features and parts.
• Matches two or three primary colours; usually red and yellow, but may confuse blue or green. May know the names of colours.
• Enjoys painting with a large brush on an easel, covering the whole page with colour.

• Eats with a fork and spoon.
• Washes own hands but needs adult supervision with drying.
• Can pull pants down but needs help with the buttons and other fastenings.
• May like to help adults with domestic activities.
• Complex make-believe play, including invented people and objects.
• Enjoys playing on the floor with bricks, boxes, toy trains, dolls and prams etc…alone or in the company of others.
• Joins in active make-believe play with other children. Understands sharing toys.
• Shows affection for younger siblings.
• Shows some appreciation of difference between present and past and developing the ability to wait.

DEVELOPMENTAL MILESTONES 

 4 Years Old 

 Posture and large movements

• Walks or runs independently up and downstairs, one foot to a step. Navigates skilfully, turning sharp corners, running, and pushing and pulling.
• Climbs ladders and trees.
• Can stand, walk and run on tiptoe.
• Rides tricycle well, executing sharp ‘U’-turns easily.
• Stands on one foot for 3 to 5 seconds and hops on preferred foot.
• Sits with knees crossed.
• Shows increasing skill in ball games, throwing, catching, bouncing, kicking etc…including the use of a bat.

• Builds tower of ten or more cubes. Builds a block model of three steps with six cubes after demonstration.
• Imitates touching thumb to each finger in opposition, both right and left hands.
• Holds and uses a pencil with good control in adult fashion.
• Copies a cross and also the letters V H T O.
• Draws a person with head, legs and trunk and usually arms and fingers.
• Draws a recognisable house on request or spontaneously.
• Beginning to name drawings before production.
• Matches and names four primary colours correctly.

• Eats skilfully with spoon and fork.
• Washes and dries hands.
• Brushes teeth.
• Can dress and undress except for laces, zips and possibly buttons.
• General behaviour is more independent and strong-willed.
• Shows sense of humour and talks during activities
• Dramatic make-believe play and dressing up is preferred.
• Constructive out-of-doors building with any materials available
• Needs companionship of other children with whom he/she is alternately co-operative and aggressive, as with adults, but understand the need to argue with words rather than blows.
• Understands taking turns as well as sharing.
• Shows concern for younger siblings and sympathy for playmates in distress.
• Appreciate past, present and future time.

DEVELOPMENTAL MILESTONES

5 years old

• Walks easily on narrow line.
• Runs lightly on toes.
• Active and skilful in climbing, sliding, swinging, digging and doing various “stunts”.
• Skips on alternate feet.
• Can stand on one foot eight to ten seconds, right or left. Stands on preferred foot with arms folded.
• Can hop two or three metres forwards on each foot.
• Moves rhythmically to music.
• Can bend and touch toes without flexing knees.
• Plays variety of ball games with considerable ability, according to accepted rules.

• Picks up and replaces small objects.
• Builds elaborate models when shown, such as three steps with six cubes; sometimes four steps with ten cubes.
• Good control in writing and drawing with pencils and paint brushes.
• Copies square and, at 5 ½ years, a triangle.
• Beginning to copy letters “V”, “T”, “H”, “O”, “X”, “L”, “A”, “C”, “U”, “Y”. Writes a few letters spontaneously.
• Draws recognisable person with head, trunk, legs, arms and features.
• Draws a house with door, windows and roof.
• Colours pictures neatly, staying within the lines.
• Counts fingers on one hand with index finger of other.
• Names four or more primary colours and matches ten or twelve colours.

• Uses knife and fork competently.
• Washes and dries face and hands, but needs help or supervision for the rest.
• Undresses and dresses alone.
• Understands the need for order and tidiness, but needs constant reminder.
• Domestic and dramatic play continued alone or with other children.
• Floor games become very complicated.
• Plans and builds constructively both inside and outside.
• Chooses own friends. Cooperative with companions most of the time and understands need for rules and fair play.
• Shows definite sense of humour.
• Appreciates meaning of time in relation to daily programme.
• Comforts other children who are in distress.