Pediatric Occupational Therapy Milestones To Expect: Birth To Age 5

Becoming a parent means watching your little one hit milestone after milestone — from lifting their head for the first time to taking those wobbly first steps.

But what happens if some of those moments take a little longer to arrive?

It’s natural to wonder whether your child is developing at the pace they should be.

In this article, we’ll walk you through what occupational therapy milestones are, why they matter, and what kinds of skills your child might be mastering at each stage — from 3 months to 5 years old.

You’ll also learn when it might be time to check in with a pediatric occupational therapist for extra support.

At Little Feet Therapy, we’re here to help your child build the confidence and coordination they need to explore the world — one small (but mighty) milestone at a time.

What Is An Occupational Therapy Milestone?

First things first, what is a developmental milestone?

The U.S. Centers for Disease Control and Prevention (CDC) defines them as “[skills] that most children can do by a certain age”.

A 2023 article by Sevan Et Al. further classifies them into the following categories:

• Gross motor
• Fine motor
• Language
• Cognitive
• Behavioral

Previously, we talked about pediatric physical therapy milestones to expect.

Most physical therapy milestones are related to gross motor skills.

These are the larger movements of your body necessary for movements such as walking, jumping, crawling, and running, among others.

Gross motor skills are (mostly) the realm of pediatric physical therapy.

RELATED ARTICLE: Why Is Crawling Important For Child Development?

Conversely, speech therapists works with children with delays in their speech and language developmental milestones.

Occupational therapy milestones, on the other hand, require effective fine motor skills.

However, they also include a wide range of other skills.

Typically, we classify these skills into four general categories:

• Gross motor skills, which include the ways we use our body and muscles to maneuver in our environments
• Fine motor skills, which use the small muscles in our hands to do tasks such as writing, buttoning clothing, and picking up small items
• Visual motor skills, which involves coordination of the hands and eyes
• Self care skills, which include activities such as dressing, feeding, washing, and using the toilet

As mentioned above, gross motor skills are mostly the focus of pediatric physical therapy, but there is some overlap.

As a result, we’ve included some gross motor skills development as well.

What Pediatric Occupational Therapy Milestones Should My Child Be Reaching?

In this section, we’ll have a look at which milestones you might expect to see your child reach as they grow, and when to expect them.

By 3 Months

By three months of age, most children can:

• Grasp at objects that you place in their hands
• Lift their head and look from side to side
• Grasp at their blanket
• Roll from their back to their stomach

RELATED: Why Is Rolling Such An Important Developmental Milestone?

By 6 Months

At six months, some milestones include:

• Reaching towards objects with accuracy
• Bringing their hands to their mouth
• Drinking from a cup

with assistance

• Sitting up on their own

RELATED: Infant Feeding Therapy Services

By 10 Months

By 10 months of age, most children can:

• Feed themselves finger foods
• Grasp at small items
• Crawl on hands and knees
• Stand and walk while holding onto something, and stand alone for a brief period

By 12 Months

By one year of age, some milestones to watch for include:

• Being able to take off their shoes and socks on their own
• Picking up small items using their thumb and first two fingers
• Walking on their own
• Demonstrate improving balance skills
• Squatting down to pick up toys or other objects from the floor
• Drinking from a cup

RELATED ARTICLE: What Causes Children To Walk On Their Toes?

By 24 Months

At two years old, most children can:

• Scribble using a writing utensil
• Stack blocks
• Complete a simple puzzle
• Point at things with their index finger
• Use a spoon to feed themselves
• Throw and catch a ball
• Use stairs on their own
• Perform basic self care skills like brushing their teeth

By 36 Months

By 36 months of age, most children can:

• Turn the pages in their favorite book
• Draw basic objects, such as a circle or line
• Climb, jump, and run
• Open jars
• Dress themselves with limited help
• Use the toilet by themselves, but may still need help cleaning up

By 4 Years

By four years old, most children can:

• Copy letters and numbers
• Stay in the lines while coloring
• Fold paper
• Do tasks which require dexterity, such as cut using scissors or string beads together
• Catch a ball using just their hands
• Bathe and wash themselves (with supervision)
• Use the toilet independently
• Jump and gallop

By 5 Years

Finally, by five years of age, most children can:

• Balance on each foot for up to ten seconds
• Kick a ball with accuracy
• Complete more complex puzzles
• Undo buttons and fasteners on their clothing
• Identify letters and numbers
• Draw people and shapes
• Dress themselves
• Demonstrate basic handwriting skills

What If My Child Isn’t Meeting Their Developmental Milestones?

While reading the above lists, it’s important to remember that we mostly use these milestones as a general guideline.

All children develop at their own rate.

If your child isn’t meeting all their milestones at
precisely the right ages but still shows progress in these areas you likely don’t have too much to worry about.

Maybe they are crawling at eleven months instead of ten or aren’t catching a ball until a couple of months past their second birthday.

When development is a little later than usual, it’s usually nothing to be concerned about.

However, if your child is falling significantly behind or showing no real development, it could be a sign of an underlying condition.

For instance, you might notice that your child is toe walking or in an otherwise uncoordinated manner.

Or maybe you’re the parent of an autistic child who’s facing differences with their motor skill development.

In that case, it’s a good idea to…

Book Your Appointment With Our Pediatric Clinic Today

Every child develops at their own pace, but if your little one is missing multiple milestones or showing signs of delay, early support can make all the difference.

Pediatric occupational therapy is designed to help children build the fine motor, visual motor, and self-care skills they need to thrive.

At Little Feet Therapy, we offer personalized, play-based interventions tailored to your child’s unique developmental journey.

The earlier we intervene, the better the outcomes can be.

Book your appointment today and let’s take the next step together in supporting your child’s growth.