By supporting each stage of physical development, pediatric physical therapy for gross motor development helps children gain the strength, coordination, and confidence they need to reach their milestones. PT helps children who may experience delays keep pace with their peers and feel more successful as they explore and engage with the world around them. Over time, this foundation not only promotes physical growth but also boosts their self-esteem and independence in everyday activities.
Our physical therapy team is experienced in supporting individuals of all ages and developmental stages. Whether your child has a mild developmental delay or a more complex medical diagnosis, we are dedicated to tailoring each session to meet their unique needs.
Gross Motor Development
Gross motor developmental milestones are key movement skills that involve large muscle groups, which enable babies and young children to gain control over their bodies, balance, and coordinate movement. These milestones provide a foundation for more complex physical activities as children grow. Below are some general gross motor milestones by age:
0-3 Months
- Lifting Head: By around 1 month, babies begin lifting their heads briefly when placed on their stomachs. By 3 months, they can lift their head and chest while on their tummy.
- Kicking Legs: Babies begin to kick their legs vigorously while lying on their back.
- Moving Arms Purposefully: Early movements of arms and hands are more controlled, building a foundation for future skills.
3-6 Months
- Rolling Over: Babies typically begin rolling from tummy to back by around 4-5 months and may roll from back to tummy around 6 months.
- Head Control: By 4-5 months, babies generally have good head control and can hold their head steady without support.
- Propping Up on Forearms: Around 3-5 months, babies push up on their forearms while lying on their stomach, strengthening their upper body.
6-9 Months
- Sitting with Support, then Independently: Most babies can sit with some support by 6 months and without support by around 8 months.
- Reaching and Pivoting: Babies begin to pivot on their bellies and reach for toys, developing core strength and coordination.
- Starting to Crawl: By around 7-9 months, many babies start crawling or moving toward toys, which may include army crawling, scooting, or traditional hands-and-knees crawling.
9-12 Months
Pulling to Stand: Between 9-12 months, babies often pull themselves to a standing position using furniture or a caregiver’s hands.
Cruising: By around 10-12 months, many babies “cruise” by holding onto furniture and walking sideways.
Standing Independently: Some babies may begin standing independently for a few seconds by around 11-12 months.
First Steps: Many children take their first steps between 12-15 months, though this varies widely.
12-18 Months
Walking Independently: Most children are walking on their own by 12-15 months, gaining balance and confidence over time.
Squatting and Standing Back Up: Around 15-18 months, children begin to squat to pick up toys and stand back up without support.
Climbing: At this stage, children start climbing on furniture, stairs (with supervision), and low objects.
Throwing a Ball: By 18 months, children can throw a ball underhand.
18-24 Months
- Running: Around 18-24 months, toddlers begin to run with better coordination, although they may still have frequent falls.
- Kicking a Ball: By 24 months, most children can kick a ball without losing their balance.
- Walking Up and Down Stairs: At 2 years, many children can walk up and down stairs with support, often stepping one foot at a time.
2-3 Years
- Jumping with Two Feet: Around age 2-3, children can jump with both feet off the ground.
- Climbing More Confidently: By 2-3 years, children become more adept at climbing on furniture, playground equipment, and stairs without much assistance.
- Running and Stopping with Control: As they near 3 years old, children can run more smoothly and stop with improved balance.
- Riding a Tricycle: Some children start pedaling a tricycle around 3 years old, developing coordination and strength.
3-4 Years
- Balancing on One Foot: By age 3-4, children can balance on one foot for a few seconds, an early indicator of improved balance.
- Hopping and Galloping: Around 4 years, children can hop on one foot and begin to gallop.
- Throwing and Catching a Ball: Children become better at throwing and catching a ball with both hands, improving hand-eye coordination.
- Navigating Play Structures: They gain confidence in climbing and navigating playground equipment.
4-5 Years
- Skipping: By age 5, many children can skip, which involves alternating coordination of both sides of the body.
- Standing on One Foot Longer: Children can now balance on one foot for up to 10 seconds or more.
- Running with Agility: Running becomes more agile and controlled, with better ability to change direction and stop smoothly.
- Jumping Over Obstacles: They can jump forward and over small objects or obstacles with control.
- Riding a Bike with Training Wheels: Many children begin riding a bike with training wheels around this age, further developing balance and coordination.
Gross motor milestones are crucial for overall physical development, coordination, and independence. Meeting these milestones allows children to explore their surroundings, engage in social play, and build confidence in their physical abilities. If a child shows significant delays in reaching these milestones, a physical therapist can assess their needs and help them progress, often using fun, play-based activities to build the necessary strength, coordination, and balance.
Building Strength and Stability
Many developmental milestones require muscle strength and core stability. For example, sitting up and standing both need strong back and core muscles. PTs use playful exercises and activities, such as tummy time, obstacle courses, or reaching games, to build strength in a fun, engaging way. This strength helps children achieve and maintain positions like sitting, crawling, or standing independently.
Improving Balance and Coordination
Milestones like walking, running, and climbing involve balance and coordination. Physical therapists use exercises that improve these skills, including activities that involve stepping, balancing on one leg, or navigating uneven surfaces. For young children, this might mean practicing stepping stones, riding toys, or playing on a balance beam, all of which build the body awareness and control needed to move confidently.
Improving Motor Planning
Motor planning involves thinking about and then executing a physical action, like deciding how to crawl over to a toy or navigate a playground. PTs help children develop motor planning by introducing obstacle courses, games, and activities that challenge them to problem-solve and figure out how to move their bodies in new ways.
Practicing Weight Bearing and Alignment
For certain milestones, like standing or walking, children need to practice weight-bearing and alignment to ensure their muscles and bones are developing properly. PTs guide children through exercises that help them build tolerance for putting weight on their feet or hands, which can be important for standing, pulling to stand, and eventually walking.
Torticollis
Torticollis is characterized by a tightness or imbalance in the neck muscles, specifically the sternocleidomastoid muscle, which runs along the side of the neck. This tightness causes the child’s head to tilt to one side, while their chin points in the opposite direction. Pediatric physical therapy is highly effective in treating torticollis, particularly when intervention begins early. Physical therapy focuses on gentle, non-invasive techniques to stretch the tight muscles, strengthen the weaker side, and improve overall range of motion. Here’s how therapy can help:
- Stretching Exercises: One of the primary treatments for torticollis is gentle stretching exercises to lengthen the tight neck muscles. A pediatric physical therapist will guide you through specific stretches to perform with your baby, helping them improve their ability to turn their head in both directions. These stretches are crucial for correcting the head tilt and promoting proper alignment.
- Strengthening Activities: In addition to stretching the tight muscles, physical therapists focus on strengthening the muscles on the opposite side of the neck. This helps create balance between both sides, allowing the child to hold their head upright and move it freely in all directions.
- Positioning Techniques: Therapists may recommend positioning strategies to encourage your baby to look in the less favored direction. This could involve altering how you hold, feed, and place your baby during tummy time and playtime. Positioning your baby’s toys or activities on their non-preferred side can also encourage movement and help improve head control.
- Tummy Time: Tummy time is an essential activity for babies with torticollis. Spending time on their stomach helps strengthen the muscles of the neck, shoulders, and back, all of which are important for overall motor development. Physical therapists often provide guidance on how to make tummy time more enjoyable and effective for your baby.
If your baby has torticollis, the earlier treatment begins, the better the chances of fully resolving the condition. Pediatricians typically recommend physical therapy if the condition is detected at the newborn stage or during well-child visits. Most babies respond very well to physical therapy, and with consistent stretching, strengthening, and positioning exercises, they can achieve full head movement and proper alignment over time.
