Psychomotor Development 1

Psychomotor development

- Definition: developmental milestones are a set of functional skills or age specific tasks that
most children can do at certain age range.

- Classification of psychomotor developmental milestones:

1- Gross motor
2- Fine motor
3- Language and cognition
4- Social

- Gross motor
o Such as stand, walking, running, upstairs, setting, and rolling.

Gross motor Age

Supports Head 3 to 5 months
Rolling front to back 4 to 6 months
Rolling back to front 5 to 7 months
Sitting with support 5 months
Sitting independently 6 months
Creeping on tummy 7 to 10 months
Crawling hands and knees 8 to 11months
Pulls to a stand 9 to 12 months
Walking 12 to 18 months
Running 18 to 20 months
Jump on two feet 24 months
Kicks Ball, climbs stairs with 2 feet per step 24 months
Climbs stairs with alternating feet 36 months
Peddles tricycle 36 months
Jump on one foot 4 year

o Some babies never crawl … that is normal if he do next milestones.

 Crawl indicate axial power
 Psychomotor Development 2

- Fine motor
o Such as eating, drawing, dressing, playing, and writing

Fine Motor/Adaptive Age

Follows object 90° 1 month
Hands unfisted, grasps 3 to 4 months
Follows object from side to side (180°) 3 to 4 months
Reaches 4 to 5 months
Transfers objects 5 to 6 months
Mouths “put things in mouth” 6 to 7 months
Pincer grasp 9 to 12 months
Voluntary release 12 months
Helps with dressing 12 months
Spoon feeds 15 months
Undresses self 36 months
Toilet training 24 to 36 months
Draw circle 3 years
Draw cross 4 years
Draw Rectangle 4.5 year
Draw square 5 year
Draw triangle 5-6 year
Draw diamond shape 6-7 year
Age = Cups / 3
Putting cups above other 3 cups at age 1 year
6 cups at age 2 years
9 cups at age 3 years

o At birth hand should be fisted (due to grasp reflex)

o Persistence of grasp reflex beyond 6 months may indicate hemiplegia.
o Voluntary release is not always present.
o Spoon feeds depend on culture “learning to use spoon” .
o Toilet training best start after ability of standing (if he tired, he can move) , by age of 1 y.
 Psychomotor Development 3

- Language:
o Way of communication by speaking and body language
o Language doesn’t mean speaking ability because child might be deaf (and so mute) or
live in environment lack of speech (as if foreign homemade take care of him) but he can
communicate with other through body language.

Speech & Language Mean

Cooing 3 months
Laugh 4 months
Turns to voice 3 to 4 months
Babbling 6 to 8 months
Dada/mama non-specifically 8 months
Localizes sound 9 months
Gesture games 9 months
Mama/dada specifically and says ONE word 10- 12 months
with meaning
Jargoning 13 to 18 months
Points to body parts 18 months
Puts two words together 24 months
Pronouns appropriately and say sentences 36 months

o Localizing sound period useful to detect hearing problems.

- Cognition
o Such as thinking skills, Remembering, Reasoning, Abstracting and problem-solving.
 Psychomotor Development 4

- Social
o Include interaction with others, relationship with family, friends, teachers, and playing
with other children.

Social/Emotional Age
Social smile 2 to 3 months
Stranger anxiety 8 to 12 months
Looks for fallen toys. 9 months
Understands “NO!”
Affective sharing and Waves “Bye bye” 10 months
Independence 18 months
Parallel play (Play near other children 24 months
but not with them.)
Cooperative play ( Plays with others) 36 months

o Absent of stranger anxiety occur in autistic child and in child live in extended family
(crowded environment)
o Autistic child will not play will others, he will play around other children but not with
them.

- Mother came with her 4 year old boy complain that her boy life round about monsters, he
took with monster, is that normal?
o Yes this is normal

Denver scale
 It is one of screening test for cognitive and behavioral problems in preschool children.
 Useful for research.
Psychomotor Development 5
 Psychomotor Development 6

1- A 2 years old child, can do all of the e- 18 months

following except: 9- When do you consider that this child
a- Tower of three cubes may have language developmental
b- Peddling a tricycle * delay:
c- Say Two word sentences a- Say 2-word phrases at age of 2
d- Jumps with two feet b- Say 10 words at age of 18 months
st
2- Which of the following is 1 in c- Say few words at age of 3 *
development: d- Have articulation problem
a- Passing and transferring objects persisting to age 4
th th
b- Separation anxiety 10- Which is not considered within 90 -95
c- Social smile * percentile in a child development:
d- babbling a- Walk 11-14 month
3- grasp reflex may disappears at age: b- Eat himself with spoon 6-12
a- 3 month * months *
b- 12 month c- smile 0-6 weeks
c- 6 month 11- a 5 year old child can do all of the
d- 9 month following except:
4- 1 year child can: a- write his name
a- Build 4 cubes b- alternate in stairs
b- Stands alone * c- draw in 3 dimensions.*
c- Go upstairs d- put 9 cups above others
d- Walks alone 12- Child can walk and claim the stairs up
5- Infant sit with minimal support ,roll from +down how old is he:
supine to prone , no pencil grasp : a- 12 month
a- 12 month b- 81month
b- 4 month c- 42month *
c- 6 month * d- 81month
d- 9 month 13- Milestones (25th, 75th) centile all correct
6- Infant 6 month had history of exchange ex???:
transfusion due to hyperbilirubnemia a- social smile 0-6 w ??
can babble but cannot say mama baba: 14- at which age 75% of the child talk is
a- Reassure the mother * understandable :
b- Refer patient to pediatric a- 2 years
neurologist b- 3 years *
c- Refer patient to pediatric c- 4 years
hematology d- 5 years
d- Do complete CNS examination 15- all true about development in 1 year
with brain CT except
7- Child can say his sex & name is : a- build 6 bricks *
a- 2 years b- beginning to walk alone
b- 3 years * c- point to object
c- 4 years d- help with dressing
d- 5 years 16- the correct match of a child
8- When do you expect the child to set un- development
supported a- handedness = 18 months
a- 3 months b- tell a story = 3 year
b- 4 months c- pincer grip = 12 months *
c- 7 months * d- social smile = 5 months
d- 9 months
 Psychomotor Development 7

17- a 3 year old child can do all of the following , except :

a- named one color
b- copy a square *
c- undress himself
d- 9 cups tower
18- An 8-month-infant can do:
a- Walks unsupportive
b- Three cubes tower
c- Spoon feed
d- Roll over back to front *
19- One of the following is not used to assess gross motor development:
a- Walking
b- Feeding by spoon *
c- Crawling
d- running
20- Baby can go upstairs and take off her own shoes…she is most likely:
a- 1yr old
b- 2yr old *
c- 3yr old
d- 4 yr old
21- A child can draw a triangle…he is
a- 1yr old
b- 2yr old
c- 3yr old
d- 4yr old
e- 5yr old *
22- 9 month old can do all except:
a- sit unsupported
b- Walk alone *
c- Use thumb and forefinger to hold small objects
d- Pull to stand
23- a child who is crawling, able to reach large objects, and able to transfere objects from hand to
hand. The expected age is:
a. 5 months
b. 9 months *
c. 11 months
d. 18 months
24- what is the age of baby, who can hold a bottle, can sit with minimal support, hold a cup with
help, his head circumference is 44 cm:
a- 10 months
b- 6 months *
c- 4 months
d- 1 year