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Physical Developmental Milestones: Infants and Toddlers

Young children rapidly grow, develop, and achieve important milestones between birth and age 3, creating the foundation for later growth. Physical development is one domain of infant and toddler development. It relates to changes, growth, and skill development of the body, including development of muscles and senses. This lesson will introduce developmental milestones in addition to influences on early physical growth and development.

Objectives
  • Identify infant and toddler physical and motor developmental milestones and ways to support development for all infants and toddlers.
  • Describe the brain’s role in infant and toddler physical development.
  • Recognize influences of physical growth and development.

Learn

Know

Physical Development From the Start

Healthy babies are born with fully developed systems that allow their bodies to function, such as their ability to suck, swallow, and breathe. In order to support the best possible physical development, all infants require responsive care from loving adults, proper nutrition, and appropriate and stimulating environments. Infant and toddler physical development occurs rapidly over the first years of a child’s life. It is essential that caregivers understand the various stages of infant and toddler physical development so that they can respond to children’s needs appropriately.

Infants are born to explore the world around them. While each child will grow to master many of the stages in physical development on their own schedule, infants are often eager to progress from those innate abilities to further movement of their mouth, eyes, and bodies as they seek people and objects of comfort or interest. They continue practicing skills and building one form of physical movement upon another, step by step as they move closer to desired objects. Through ongoing observation and frequent conversations with families you can learn what infants are able to do, what they’re learning to do, and what areas they are needing your support in.

Infants develop physically from the top down, starting with their head and neck. At birth, an infant has a very difficult time holding up their head because their neck muscles are not strong enough to provide support. As infants and toddlers grow, their determination to master movement, balance, and fine- and gross-motor skills remains strong. Rolling and crawling occur as infants develop skill in using their large-muscle groups. Grasping and picking up objects with fingers are part of small-muscle growth.

Influences on Early Physical Growth and Development

There is no exact age at which all infants should be able to grasp objects or hold up their head without support. Physical development occurs at different times for all children depending on many factors, such as a child’s unique characteristics, the family’s values and culture, and access to available resources. However, many infants and toddlers experience developmental milestones within similar timeframes of growth. The information on the chart below is a comprehensive list of physical development milestones that children typically develop during infancy and toddlerhood . A brief version of this information aimed at parents can be found in an easy-to-use checklist from the Centers for Disease Control and Prevention in the Apply section.

Examples of Physical Development Milestones – Infants and Toddlers

2 Months
  • Holds head up when on tummy
  • Kicks both arms and legs while on back
  • Briefly relaxes hands from fists for short periods
  • Grasps adult finger
  • Raises head and chest while lying on stomach
  • Primitive reflexes present, including the rooting and sucking reflex
4 Months
  • Holds head steady without support
  • Maintains hold of a toy placed in their hands
  • Swings arm at objects
  • Brings hands to mouth
  • Pushes up from ground onto elbows when lying on tummy
6 Months
  • Rolls from tummy to back and may roll from back to tummy
  • Pushes arms straight when on tummy
  • Uses hands to support when sitting
  • Supports weight equally on legs when standing with support
9 Months
  • Moves into the sitting position without support
  • Transfers items from one hand to the other
  • Uses fingers as a “rake” to pull food and objects towards self
  • Sits without support
  • Lowers body with control while using support
12 Months
  • Pulls up to stand
  • Walks or “cruises” along furniture for support
  • Drinks from a cup without a lid with adult support
  • Uses thumb and finger “pincer grasp” to pick up small items
15 Months
  • Takes a few steps independently
  • Feeds themself finger foods
  • Squats to pick up an object from the floor and then stands up without support
  • Makes marks on paper using crayon
18 Months
  • Walks independently
  • Drinks from a cup
  • Tries to use a spoon
  • Climbs on and off furniture independently
  • Tries to kick a ball after observing an adult
24 Months/ 2 Years
  • Kicks a ball
  • Runs
  • Walks up and down the stairs while holding on for support
  • Eats with a spoon
  • Turns doorknobs
30 Months Years
  • Uses hands to twist and unscrew objects
  • Takes off loose clothing alone
  • Jumps off the ground with both feet
  • Can turn book pages one at a time
36 Months/ 3 Years
  • Strings items onto a string such as large beads or macaroni
  • Dresses self in loose clothing
  • Uses a fork
  • Pedals a tricycle
Source: Centers for Disease Control and Prevention (2021). Developmental Milestones. https://www.cdc.gov/ncbddd/actearly/pdf/FULL-LIST-CDC_LTSAE-Checklists2021_Eng_FNL2_508.pdf 

All children develop at different rates, so keep in mind that the milestones above are simply the average ages at which specific skills are observed.

Certain conditions must exist for an infant or toddler to grow and develop. A young child’s basic physical needs, include:

  • Food (nutritious and age-appropriate)
  • Shelter (protection from harm)
  • Warmth
  • Clean air and environment
  • Health and dental care
  • Activity and rest

We also know that the way we ourselves were raised is important to our understanding of how and in what contexts children develop. The values and beliefs held by our family and culture contribute to our knowledge of growth and development.

Culture Affects How We See and Interpret Behaviors and Development

Understanding the practices, beliefs, and values of the families you support can help you understand how culture shapes so many parts of an infant’s and toddler’s development. Without this understanding, it is difficult to interpret the infant’s or toddler’s behaviors and development. For example, you may believe it is important to help toddlers learn to become independent and begin to feed themselves using their fine motor skills. A family, however, may not view independence as important because they believe it is more valuable to depend upon one another.

Other influences on infant and toddler physical growth and development are:

  • Prenatal care and development including, genetic inheritance and makeup, family growth patterns, exposure to drugs and alcohol, and birth experience
  • Prematurity (birth before the 38th week of development) and a low birth weight may result in respiration difficulties, vision problems, feeding and digestive problems
  • Temperament, or other ways an infant or toddler approaches and interacts with their world
  • Family’s composition, lifestyle, level of education, and housing
  • Maturation, or the genetic or biological development that reflects a pattern of growth from conception through adolescence
  • Developmental delays or disabilities, including health and medical concerns

Review the handout, Infant and Toddler Physical Development located below in the Learn activities section to learn more about important milestones in physical development, as well as variations in the rate of physical development for infants and toddlers.

The Brain’s Role in Physical Development

You can easily observe infants making movements with their bodies and refining their motor skills. Thanks to advances in research and technology, we can now also see how the brain changes and grows as young children develop. At birth, the brain is 25 percent of its adult size, and by age 5, it reaches 90 percent of adult size. Infants’ and toddlers’ early-life interactions and experiences help them make sense of the world and form connections between different parts of the brain.

These supportive experiences and connections help improve coordination and strengthen muscles. As infants repeat and practice different movements, such as turning their heads, rooting, or reaching for an object, they build and maintain connections between brain cells. In essence, the brain is busy making sense of surroundings and learning from experiences.

It is important for infants and toddlers to have time for these new experiences and to explore the world around them with a trusted and caring family child care provider. Repeated exposure to experiences with trusted caregivers allows children to feel safe and secure, and allows them to focus on experimenting, developing, and mastering new skills. The safe place that you create for their exploration ensures that their brains are able to focus on learning, developing, and making connections. If infants and toddlers do not have nurturing and responsive adults to help make them feel safe, their brains will instinctually focus on survival. This kind of stress on a child’s brain may make them more hesitant to engage in exploration, and experimentation; causing them to have less opportunities to create and strengthen connections in the brain that further their growth and skill development.

Supporting Physical Development for All Learners

Physical development, including gross and fine motor skills, consumes the interest of infants and toddlers as they practice learned skills and look to develop new ones. Healthy physical development is dependent on adequate nutrition, brain development, the central nervous system, muscles, bones, and the interactions and experiences offered to infants and toddlers. All children develop at their own pace but recognizing signs of possible developmental delays during infancy or toddlerhood allows early intervention to be more effective than if the delays are not acknowledged until later in childhood. Below are some characteristics of possible physical concerns and developmental delays by various sources:

Signs of Impaired Physical Development - Infants & Toddlers

By 2 months

  • Does not respond or startle to loud noises
  • Does not visually track the movement of objects
  • Does not smile at others
  • Cannot lift head up while on tummy

By 3 months

  • Does not notice hands
  • Cannot support or hold head well
  • Does not smile at people
  • Does not follow movement by turning head

By 4 months

  • Does not coo or make sounds
  • Does not bring objects to mouth
  • Does not occasionally push down with legs when feet placed on a firm surface
  • Has trouble moving eye or eyes in all directions
  • Crosses eyes most of the time (occasional crossing of eyes normal in early months)
  • Does not pay attention to faces, or seems very frightened by new faces or environment
  • Difficulty sucking
  • Does not show interest in toys in front of them

By 6 months

  • Not gaining weight or growing in length
  • Not responding to sounds and voices
  • Does not bring objects to mouth
  • Does not roll over from front to back
  • Stiff limbs (arms, legs) with tight muscles
  • Weak limbs (arms, legs) or body feels floppy like a rag doll
  • Not using hands to grasp or hold objects
  • Does not attempt to reach for objects
  • Shows no affection for caregivers
  • Does not make vowel sounds like “ah,” “eh,” and “oh”

By 9 months

  • Does not bear weight on legs with support
  • Does not sit with help
  • Does not babble
  • Does not respond to own name
  • Does not seem to recognize familiar people
  • Does not transfer toys from one hand to the other
  • Loses skills once had

By 12 months

  • Cannot stand with help
  • Does not search for things you hide
  • Does not say single words like “dada” or “mama”, and does not imitate your sounds

By 15 months

  • Does not imitate gestures like waving hands, clapping, or shaking head
  • Not pointing to communicate needs or ideas
  • Not crawling or sitting on own
  • Not picking up small objects
  • Loses skills once had
  • Does play social games such as “pat-a-cake"
  • Does not say “mama” or “dada” when asking for a parent
  • Unable to self-feed some foods
  • Does not look for hidden objects
  • Loses skills once had

By 18 months

  • Cannot walk
  • Does not know what familiar things are used for (brush, spoon, cup)
  • Not imitating sounds or gestures
  • Not playing with toys
  • Not self-feeding
  • Does not have at least three words and does not learn new words
  • Loses skills once had
  • Does not seem to mind when caregiver leaves or comes back

By 24 months

  • Not physically active
  • Not scribbling or stacking blocks
  • Not showing interest in playing with toys
  • Extra sensitive to or avoids a variety of textures
  • Does not walk without holding on for support
  • Does not use 2-word phrases (for example, “drink milk”)
  • Does not follow simple instructions
  • Loses skills once had

By 30 months

  • Does not show interest in other children
  • Does not use simple gestures
  • Unable to use a spoon to eat
  • Unable to problem-solve simple tasks such as opening a door
  • Is not physically active
  • Lose skills once had

By 36 months

  • Clumsy or inactive
  • Not feeding self
  • Not helping dress or undress self
  • Not interested in playing with other children or a variety of toys
  • Drools or has very unclear speech
  • Does not speak in sentences
  • Does not make eye contact
  • Does not play pretend or make-believe
  • Loses skills once had

Delays in physical development may affect more than gross and fine motor skills. For example, if an infant is unable to smile at parents or lift their arms to be picked up, this could affect social and emotional development in terms of relationship building. Recognizing some of the delays listed above can be critical to a child’s development. The connections in a baby’s brain are most adaptable in the first three years of life. These connections, also called neural circuits, are the foundation for learning, behavior, and health. Over time, these connections become harder to change. Early intervention can help children improve their abilities and learn new skills.

If you have concerns about an infant’s or toddler’s physical development, be sure to speak with your coach, trainer, administrator and/or the child’s parent. They may wish to share your concerns with the child’s health-care provider. Early intervention can help children improve their abilities and learn new skills. To find your state or territory’s early intervention contact information, go to: https://www.cdc.gov/ncbddd/actearly/parents/states.html

For more information, including what to say when you contact early intervention and how to get support for your family, visit:  https://www.cdc.gov/ncbddd/actearly/concerned.html

See

Physical Development in Infants and Toddlers

Watch this video to learn what infants and toddlers can do with their bodies.

Do

How can you make sure you are providing age-appropriate experiences to support infant and toddler physical development? Take a moment to read and review the sets of guidelines on the following webpage from SHAPE America (Society of Health and Physical Educators, formerly known as the National Association for Sport and Physical Education, or NASPE): https://www.shapeamerica.org/standards/guidelines/activestart.aspx.

Next, try one or more of the following activities with the infants or toddlers in your care:

  • When an infant is awake and active, offer tummy time — lay the baby on the floor on his or her tummy while you interact with the infant. Provide stimulating and high contrast toys or pictures for the infant to look at. Because suffocation is swift and silent, remember to never leave an infant alone when they are on their stomach—not even for a second.
  • Hold an infant or dance with a toddler to music. Toddlers can also swing colorful scarves in the air, dance, or play maracas while the music is playing.
  • Encourage imitation of gestures and other movement experiences in which mobile infants and toddlers can use their bodies to interact and play.
  • Have toddlers experience kicking, catching, rolling, and bouncing balls.
  • Encourage toddlers to scribble on paper with crayons.

Incorporate daily physical play into your daily routines. Infants and toddlers enjoy being active!

Explore

Review the handout, Scenarios: Gross and Fine Motor Development below, and consider what you have learned so far throughout this lesson. In the activity, think about which characteristics or behaviors would be considered fine motor skills and which would be considered gross motor skills. Then write these down and think about possible ways you could support the young children in each scenario.

You can also review the Infant and Toddler Physical Development handout in the Learn section for additional ideas.

Once finished, share your thoughts and responses with your trainer, coach or family child care administrator.

Apply

Consider using the following resources in your family child care program. Use the Milestone Moments document to monitor the physical development of the children in your program. Parents may be interested in the Milestone Tracker Mobile App from the CDC, which they can access using this link: https://www.cdc.gov/ncbddd/actearly/milestones-app.html. The resource, What Grown-Ups Understand About Child Development, is a national benchmark survey sponsored in part by ZERO TO THREE. Read over the survey findings of this study and think about your work with families and the way you gather and share information with them regarding the physical development of the infants and toddlers in your care.

Glossary

Developmental milestones:
A set of skills or behaviors that most children can do at a certain age range
Fine motor development:
The development of skills that involve the use of smaller muscles in the arms, hands, and fingers that allows a child to perform tasks such as drawing, cutting with scissors, stringing beads, tying, zipping, or molding
Gross motor development:
The development of skills that involve the use of large muscles in the legs or arms, as well as general strength and stamina; examples of such skills include jumping, throwing, climbing, running, skipping, and kicking
Primitive reflexes:
The actions that are exhibited by typical developing infants, that are not present in adults, in response to particular stimuli. Examples include the rooting and sucking reflex.
Rooting reflex:
An infant’s turning of the head toward things that touch her or his cheek
Sucking reflex:
An infant’s sucking at things that touch her or his lips

Demonstrate

True or false? Infants develop from the top and then move down (starting at the head and neck, then the shoulders, knees, and toes).
Which of the following is not a factor that may influence the physical development of infants and toddlers?
Finish this statement. It is important to understand how culture influences an infant’s or toddler’s development because ...
References & Resources

Allen, K. E., & Marotz, L. (2001). By the ages: Behavior and development of children pre-birth through eight. Clifton Park, NY: Thomson Delmar Learning.

Berger, S. E., & Adolph, K. E. (2003). Infants use handrails as tools in a locomotor task. Developmental Psychology, 39: 594-605.

Blakemore, C. (2003). Movement is essential to learning. Journal of Physical Education, Recreation and Dance, 74(9): 22-25, 41.

Bosco, F. M., Friedman, O., & Leslie, A. M. (2006). Recognition of pretend and real actions in play by 1- and 2-year-olds: Early success and why they fail. Cognitive Development, 21: 1-10.

Bourgeois, K. S., Akhawar, A. W., Neal, S. A., & Lockman, J. J. (2005). Infant manual exploration of objects, surfaces, and their interrelations. Infancy, 8: 233–252.

Centers for Disease Control and Prevention. (2021). Developmental milestones. https://www.cdc.gov/ncbddd/actearly/pdf/FULL-LIST-CDC_LTSAE-Checklists2021_Eng_FNL2_508.pdf

Claxton, L. J., Keen, R., & McCarty, M. E. (2003). Evidence of motor planning in infant reaching behavior. Psychological Science, 14: 354-356.

Clearfield, M. W., Osborne, C. N., & Mullen, M. (2008). Learning by looking: Infants’ social looking behavior across the transition from crawling to walking. Journal of Experimental Child Psychology, 100: 297-307.

Comfort, R. L. (2005). Learning to play: Play deprivation among young children in foster care. Zero to Three, 25: 50-53.

Paul H. Brookes Publishing Co., Inc. (2002). Ages and stages questionnaire(ASQ).
https://agesandstages.com/

The National Early Childhood Technical Assistance Center (NECTAC). (2011). The importance of early intervention for infants and toddlers with disabilities and their families. https://files.eric.ed.gov/fulltext/ED522123.pdf

Ward, M., Lee, S., & Lipper, E. (2000). Failure to thrive is associated with disorganized infant-mother attachment and unresolved maternal attachment. Infant Mental Health Journal, 21(6): 428-442.

Waters, E., Weinfield, N., & Hamilton, C. (2000). The stability of attachment from infancy to adolescence end early adulthood: General discussion. Child Development, 71(3): 703-706.

Zeanah, C. (Ed.). (2000). Handbook of Infant Mental Health(2nd ed.). New York: The Guilford Press.