Virginia Apgar‘s method of evaluating newborn infant

Virginia Apgar‘s method of evaluating newborn infant is now in standard use

to evaluate the newborn one minute after birth.
It is useful to make serial Apgar score: the longer the score remaine low the
worse the prognosis with regard to mortality or neurological sequel.
Total score:
8 – 10 Good
3 -7 Fair
0–2 Poor condition

Color Muscle Reflex Respiratory Heart rate Score

tone irritability effort
Pink Good Reflex irritability Normal cry 140 - 100 2

Pale Fair Moderately Irregular and 100 1

depressed shallow
Cyanotic Flaccid Absent Apnea for more No heart beat 0
.than 60 sec observed
 Month One:

Gross Motor Skills Fine Motor Skills

• Can lift chin slightly Hands fisted/reflexive

grasp
• Head lag in ventral suspension
• Flexion attitude in prone
lying position
 Month Two
Gross Motor Skills Fine Motor Skills

Wobbly head while sitting Swipes toys with /hands

Head Lag
Head lag when pull to sit
 Month Three

Gross Motor Skill Fine Motor Skill

Holds head steady in sitting Hands open

Rolls back to side Grasps/holds an object

Puts weight on arms while on tummy Hands play at midline

 Month Four
Gross Motor Skills Fine Motor Skills
Sits on propped arms Reaches with both arms/hands

Rolls tummy to side Brings fingers/hands in mouth

No head lag seen when pulled Squeeze grasp emerging
to sit
 Month Five
Gross Motor Skills Fine Motor Skills
Rolls tummy to back Reaches with good aim
Puts objects/toys in mouth
Pushes up with arms Picks up spoon or cup by handle
while on belly Starts grabbing feet
Sits propped on hands

Gross Motor Skills
Sits briefly independently
Sits in a highchair
Rolls over both ways
Month Six
Fine Motor Skills
Reaches precisely and grasps objects
Transfers toys from hand to hand
Bangs a cup on a table
 Month Seven
Gross Motor Skills Fine Motor Skills
Sits unsupported~30 seconds Crosses midline when reaching
Rocks on all fours Uses whole hand to rake in objects
Pivots in a circle while on tummy Thumb to finger grasp emerging
 Month Eight
Gross Motor Skills Fine Motor Skills
Transitions tummy to sit Bangs cubes together
Crawls forward Uses a three-fingered grasp
Reaches while on tummy
 Month Nine
Gross Motor Skills Fine Motor Skills
Transitions sit to tummy Uses thumb to index grasp (crude)
Pulls to stand while holding on Crude release of objects
Creeps on all fours Drops toys and objects
Stands while leaning on furniture Points index finger
 Month Ten
Gross Motor Skills Fine Motor Skills
Cruises along furniture Pokes with fingers
Stands unsupported briefly Uses thumb to index finger
grasp (precise)
Transfers from crawl to sit Stacks objects
 Month Eleven
Gross Motor Skills Fine Motor Skills
Stands unsupported Releases a cube at well.
Walks with hands held
 Month Twelve
Gross Motor Skills Fine Motor Skills
First independent steps Puts objects in a container
Stands unsupported~12 seconds Releases an object precisely

Assumes/maintains kneeling Stacks two one-inch cubes

 Months Twelve-Fifteen
Gross Motor Skills Fine Motor Skills
Walks independently Throws objects
Creeps/climbs stairs Places rings on a peg
Tries to climb out of highchair Makes marks with crayons
Squats to play Holds large crayon in fisted grasp
Kneels Builds a 2 block tower
 Months Fifteen-Eighteen
Gross Motor Skills Fine Motor Skills
Walks in circles/backwards Directional scribble using crayons
Walks up stairs with help Throws a ball
Balance reactions in standing Builds a 3-block tower
Scribbles spontaneously Midlinhuse(1stabilizes/1manipulates)
Tries to kick balls
Climbs on furniture
Pulls toy while walking
 Months Eighteen-Twenty-Four

Gross Motor Skills Fine Motor Skills

Runs Unwraps things

Jumps in place/off a step Strings large, one-inch beads
Pedals a tricycle Builds a 6-block tower
Kicks a stationary ball Holds crayon with thumb and fingers
Walks up stairs independently Turns 2-3 pages at a time

Throws a ball overhand Imitates vertical stroke with crayo

 Months Twenty-Four-Thirty-Six(2-3 years old)
Gross Motor Skills
Hops on one foot
Walks up stairs alternating feet
Walks down stairs alternating feet
Walks backward
Balances on one foot briefly
Throws overhand at a target
Catches a rolled ball
Throws a small ball 2 feet
Rides a tricycle using pedals
Fine Motor Skills
Turns pages one at a time
Builds a 9 block tower
Strings small ½ inch beads
Unscrews lid of a jar
Imitates horizontal line, cross circle
Holds pencil in hand instead of fist
Makes snips with scissors
Unbuttons
Places pegs in a pegboard