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CHILD DEVELOPMENT CHECKLIST

Child’s name:…………………………………………………………………………………………
Date:……………………………………………………………………………………………………
Age:…………………………………………………………………………………………………….

NUM. ITEM TICK NOTES


PHYSICAL DEVELOPMENT YES NO

GROSS MOTOR SKILL


1. Hops on both feet without
assistance
2. Kick ball with one leg

3. Runs around objects /corners


without falling
4. Stands on one foot for 5-8 second

5. Walks up & down stairs without


holding rail
6. Push/pull objects

FINE MOTOR SKILL


7. Throwing with one hand

8. Catch objects with hand and chest

9. Pickup & inserts objects

10. Demonstrate eye hand coordination


in manipulative play (string small
beads)
11. Control muscles in hand to
manipulate small objects
(fork/scissors)
12. Traces object with a marker

13. Eat with a spoon

14. Button and zips zipper haltingly

15. Dress and undresses independently

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