7.5: Motor Development

Infants and children grow and develop at a rapid pace during the first few years of life. Infants are born with a set of reflexes (as seen in the section about the newborn). The development of both gross and fine motor skills helps a child go from a completely dependent newborn to an independently functioning toddler in about a 3-year span.[1]

Gross Motor Skills

Voluntary movements involve the use of large muscle groups and are typically large movements of the arms, legs, head, and torso. They are referred to as gross motor skills (or large motor skills). These skills begin to develop first. Examples include moving to bring the chin up when lying on the stomach, moving the chest up, rocking back and forth on hands and knees, and then crawling. But it also includes exploring an object with one’s feet as many babies do as early as 8 weeks of age if seated in a carrier or other device that frees the hips. At a few days after birth infants start to reach with their hands, but it is not until 6 months that you see coordinated reaching (Hadders-Algra, 2018)[2]. And sometimes an infant will try to move toward an object while crawling and surprisingly move backward because of the greater amount of strength in the arms than in the legs! This also tends to lead infants to pulling up on furniture, usually with the goal of reaching a desired object. Usually this will also lead to taking steps and eventually walking.[3]

Infancy Gross Motor Milestones

As stated above, children grow very quickly and meet physical milestones rapidly in the first few years of life. The following is a table of the major milestones (behaviors or physical skills seen in infants and children as they grow and develop that typically occur within normal range) that occur in children during those first formative years. [4]

Table \(\PageIndex{1}\): Gross motor development in infancy[5]

Typical Age	What Most Children Do by This Age
2 months	Can hold head up and begins to push up when lying on tummy Makes smoother movements with arms and legs
4 months	Holds head steady, unsupported Pushes down on legs when feet are on a hard surface May be able to roll over from tummy to back Brings hands to mouth When lying on stomach, pushes up to elbows
6 months	Rolls over in both directions (front to back, back to front) Begins to sit without support When standing, supports weight on legs and might bounce Rocks back and forth, sometimes crawling backward before moving forward
9 months	Stands, holding on Can get into sitting position Sits without support Pulls to stand Crawls
1 year	Gets to a sitting position without help Pulls up to stand, walks holding on to furniture (“cruising”) May take a few steps without holding on May stand alone
18 months	Walks alone May walk up steps and run Pulls toys while walking Can help undress self
2 years	Stands on tiptoe Kicks a ball Begins to run Climbs onto and down from furniture without help Walks up and down stairs holding on Throws ball overhand

Figure \(\PageIndex{1}\): Infants explore different textures with their hands and their movements.[6]

Early childhood gross motor development

Early childhood is a time when children are especially attracted to motion and song. Days are filled with jumping, running, swinging and clapping and every place becomes a playground. Even the booth at a restaurant affords the opportunity to slide around in the seat or disappear underneath and imagine being a sea creature in a cave! Of course, this can be frustrating to a caregiver, but it’s the business of early childhood.

Children continue to improve their gross motor skills as they run and jump. They frequently ask their caregivers to “look at me” while they hop or roll down a hill. Children’s songs are often accompanied by arm and leg movements or cues to turn around or move from left to right.

Here is a table showing the progression of gross motor skills that children will typically develop during early childhood:

Table \(\PageIndex{2}\): Gross motor development in early childhood[7]

Typical Age	What Most Children Do by This Age
3 years	Climbs well Runs easily Pedals a tricycle (3-wheel bike) Walks up and down stairs, one foot on each step
4 years	Hops and stands on one foot up to 2 seconds Catches a bounced ball most of the time
5 years	Stands on one foot for 10 seconds or longer Hops; may be able to skip Can do a somersault Can use the toilet on own Swings and climbs

Activities to Support Gross Motor Skills

Here are some activities focused on play that young children enjoy and that support their gross motor skill development.

• Tricycle
• Slides
• Swings
• Sit-n-Spin
• Mini trampoline
• Bowling pins (can use plastic soda bottles also)
• Tent (try throwing blankets over chairs and other furniture to make a fort)
• Playground ladders
• Suspension bridge on playground
• Tunnels (try throwing a bean bag chair underneath for greater challenge)
• Ball play (kick, throw, catch)
• Simon Says
• Target games with bean bags, ball, etc.
• Dancing/moving to music
• Pushing self on scooter or skateboard while on stomach

Figure \(\PageIndex{2}\): By early childhood, children’s developing motor skills allow them to ride tricycles and use other such equipment with some ease.[8]

Fine Motor Skills

More exact movements of the feet, toes, hands, and fingers are referred to as fine motor skills (or small motor skills). These include the ability to reach and grasp an object in coordination with vision. Newborns cannot grasp objects voluntarily but do wave their arms toward objects of interest. At about 4 months of age, the infant is able to reach for an object, first with both arms and within a few weeks, with only one arm. Grasping an object involves the use of the fingers and palm, but no thumbs.

Figure \(\PageIndex{3}\): Infants and toddlers are still developing fine motor skills such as eating using a spoon.[10]

Fine Motor Milestones in infancy

While fine motor skills are slower to develop (in accordance with proximodistal development), pretty remarkable progress is made in fine motor development during the first two years. As stated above, in the first few years of life children go from having no intentional fine motor control to being able to manipulate objects to play and learn, as well as beginning to care of themselves. The following is a table of the major milestones in fine motor development.

Table \(\PageIndex{3}\): Fine motor development in infancy[11]

Typical Age	What Most Children Do by This Age
2 months	Grasps reflexively Does not reach for objects Holds hands in fist
4 months	Brings hands to mouth Uses hands and eyes together, such as seeing a toy and reaching for it Follows moving things with eyes from side to side Can hold a toy with whole hand (palmar grasp) and shake it and swing at dangling toys
6 months	Reaches with both arms Brings things to mouth Begins to pass things from one hand to the other
9 months	Puts things in mouth Moves things smoothly from one hand to the other Picks up things between thumb and index finger (pincer grip)
1 year	Reaches with one hand Bangs two things together Puts things in a container, takes things out of a container Lets things go without help Pokes with index (pointer) finger
18 months	Scribbles on own Can help undress herself Drinks from a cup Eats with a spoon with some accuracy Stacks 2-4 objects
2 years	Builds towers of 4 or more blocks Might use one hand more than the other Makes copies of straight lines and circles Enjoys pouring and filling Unbuttons large buttons Unzips large zippers Drinks and feeds self with more accuracy

Early childhood drawings

Figure \(\PageIndex{4}\): Early scribbles.[1]

Figure \(\PageIndex{5}\): Creatures with heads.[2]

Figure \(\PageIndex{6}\): A detailed face.[3]

Fine Motor Skills in early childhood

Fine motor skills are also being refined as they continue to develop more dexterity, strength, and endurance. Fine motor skills are very important as they are foundational to self-help skills and later academic abilities (such as writing).

Here is a table showing how fine motor skills progress during early childhood for children that are typically developing.

Table \(\PageIndex{4}\): Fine motor development in early childhood[4]

Typical Age	What Most Children Do by This Age
3 years	Copies a circle with pencil or crayon Turns book pages one at a time Builds towers of more than 6 blocks Screws and unscrews jar lids or turns door handle
4 years	Pours, cuts with supervision, and mashes own food Draws a person with 2 to 4 body parts Uses scissors Starts to copy some capital letters
5 years	Can draw a person with at least 6 body parts Can print some letters or numbers Copies a triangle and other geometric shapes Uses a fork and spoon and sometimes a table knife

Activities to Support Fine Motor Skills

Here are some fun activities that will help children continue to refine their fine motor abilities. Fine motor skills are slower to develop than gross motor skills, so it is important to have age appropriate expectations and play-based activities for children.

• Pouring water into a container
• Drawing and coloring
• Using scissors
• Finger painting
• Fingerplays and songs (such as the Itsy, Bitsy Spider)
• Play dough
• Lacing and beading
• Practicing with large tweezers, tongs, and eye droppers

Figure \(\PageIndex{7}\): Children’s fine motor skills in early childhood are expressed in coloring, peeling, and sticking in art work.[5]

Middle childhood

Children between ages 6 and 9, show significant improvement in their abilities to perform motor skills. This development growth allows children to gain greater control over the movement of their bodies, mastering many gross and fine motor skills that were beyond that of the younger child. Riding a bike that is bigger or running longer and further is a big improvement in gross motor skills. Eye-hand coordination and fine motor skills allow for children to become better at writing and cutting. Sports and extracurricular activities may become a part of the lives of children during middle childhood due to their physical growth and capabilities.

Systems approach as it applies to motor development

Systems approach suggests that interacting motor, perception and cognition changes occur. Consider that in the infant the changes are to overcome gravity (from the prenatal stages where all movements were possible until space constricted them). Once posture is stable, the infant can move and it gives them new vantage points for perception and exploration.

As posture control changes, arms and hands become available for reaching, holding and manipulating objects so that infant can develop more knowledge about textures, sizes and 3-dimensionality.

Posture also influences perception because the infant develops greatly changed vantage points from the prone to the sitting to the standing.

Posture is influenced by perception, for example when walls sway, we move our muscles to counteract that swaying and maintain balance. Infants do that also, but not as smoothly as adults do.

Stepping has been believed to be a reflex that appears at 2 mos, disappears, and then walking develops later. But claim is that if the infant gets upright practice, the stepping never would disappear. In Western culture infants spend lot of time supine, they do kick in the air – which is the same as the stepping movement – but they develop more fat than muscle in their legs making it difficult to walk. So changes in the body, not the brain (change in cortical control acc to the reflex proponents) explains development of walking.

Infants use various strategies for locomotion. Motivated by their caregiver for example and the initial position they are put in (tummy down for example) they try out various ways to move including log rolling, pivoting, turning etc to look at and get to where they want to. When they have to get off steep places they try out different things like sliding or backing down (which is harder because they have to coordinate backward movements and have no visual feedback). They also use (or choose not to use) handrails when trying to maintain balance in creative ways.

Walking is very much influenced by practice (massage and exercise of the kind in African and Caribbean cultures. Infants learn the balance issues – first walk with feet wider apart, more time standing, less time with one foot in the air etc. With practice, children learn to walk and run much faster than in Western cultures. In East Africa women and in Nepal both genders learn to walk with much larger than own body weight loads with reduced energetic cost.

Many studies have been done to test locomotion with deep drop offs using not just the visual cliff apparatus (because infants will learn after the first time that there is glass there). What is found is that infants don’t generalize the perceptual information from one locomotive skill to another. For example even though they know what to do while crawling, they will keep falling for weeks while walking the same situation.

So locomotion is not hardwired or reflexive, but rather extremely plastic and responsive to caregiving practices, as well as creative. Every infant discovers unique solutions for locomotion, given their own particular environment.

Manual and Facial control

Infants reach with both hands and feet (actually earlier with their feet but of course that disappears). Their control improves over time and with practice. They try to judge where a moving object will be and flap out at it. However hand control doesn’t develop till later of course. Once infants can hold objects, they flap their arms to make a sound with hard objects and move soft ones across surfaces. In the beginning they only bring object up to face and mouth it, but later move it from hand to hand and palpate and so on. At first arm and hand movements are random and exploratory, and they become more goal directed as they grow.

Facial muscle coordination is really marvelous because newborns need to suck, swallow and breathe once they are out of the amniotic fluid and need to suck for sustenance! Because solid foods require more than just lateral movement of the jaw and also experience with food of different consistency and texture, there is real danger of choking etc.

Facial expressions are similar to adult ones like wrinkling of nose and furrowed brows to noxious environment. Many parts of the face are used to show expressions, perhaps because those are so important for social interaction. So even infants with severe developmental or structural problems are still able to produce recognizable smiles, cries and interest expressions.

Coordinating looking movements have been calculated and studied by researchers. Infants and toddlers tend to engage more in opportunistic looking so in this sense arrangement of the environment also influences what they are more likely to see. Researchers have studied where infants look, and how they track objects and how that becomes smoother with infant age and practice. Infants are also closer to the floor so they tend to look more at it while they are smaller.

“The developmental systems perspective encourages researchers also to consider a larger context that includes the physical and social/cultural environment and to view motor behaviors as potentially both cause and consequence of developmental change in other psychological domains”

A different perspective on reflexes and culture

Theorists like McGraw, Fiorini, Forssberg and Gesell (as cited in Pimentel, 1996) believed that infants are born with reflexes that are controlled by subcortical regions of their brains. They further theorized that as the infant cortex matures, these reflexes necessarily disappear and more controlled movement becomes possible, giving way to external circumstances rather than strict subcortical CNS control. This is called the traditional view of reflexes.

On the other hand, Milani-Comparetti and Connolly (as cited in Pimentel 1996) believe that there is simply a gradual development of locomotion through an integrated escalation of abilities. According to Milani-Comparetti and Connolly, the fetus becomes ready to get into position prenatally, and those abilities of movement become affected by gravity and finally develop into creeping and walking.

Fukuda and other researchers (as cited in Pimentel, 1996) suggested that the reflexive behaviors continue to underlie behavior into adulthood, and are activated by environmental demands when greater force is necessary. This is to say that those reflexes never disappear but are simply covered up by greater cortical development. The idea here is that the CNS builds volitional movement out of reflexes (Easton as cited in Pimentel, 1996). This is the transitional view.

However, the systems view incorporates the role of the environment more centrally using training studies with infants, comparisons of full term and preterm infants, and cross cultural studies. As reported by Pimentel, Zelazo et al found that when they exercised infants’ stepping reflex for 8 weeks of training, the reflex did not disappear, and that these infants walked at 10 months as opposed to controls who walked at 12 months. In line with the transitional view, the idea is that those earlier reflexes are simply built upon for future volitional movement. Zelazo also suggested that it is because of infants in Western societies (those who are largely studied) being given things to hold and suck that we see a cephalocaudal pattern of development – not that there is anything maturational or universal about that pattern.

Super, Konner, and Hopkins & Westra’s studies (as cited in Pimentel, 1996) performed in Kenya, Botswana and Jamaica show quite conclusively that in these cultures parents practice infants’ reflexive stepping and upright behaviors, and that those infants sit, stand and walk earlier – while often completely missing the creeping/crawling phase because this is not encouraged. This suggests that child rearing practices very much influence both the timing and sequence of skills thought to be universal in humans, and that the reflexes are not simply maturational blips that occur on a specific timetable and always disappear when the cortex matures and takes over.

Thelen and Heriza’s research (as cited in Pimentel, 1996) with preterm and full term infants (in water) suggest that as infants grow and their body mass increases, the amount of energy needed to produce the stepping reflex increases which is the reason for the disappearance/timing of the reflex. Thelen et al concluded with a dynamic systems approach suggesting that volitional movement development is influenced by multiple subsystems – “arousal levels, neuromuscular activation, body build characteristics such as limb weight and length, muscle strength, passive viscoeleastic properties of muscles, balance, posture or position of the infant with respect to gravity, the infant’s perceptual processes and social environment, and dynamically changing forces that act on the limbs as they move.” (Pimentel, 1996)… “the system can be said to be self organizing” not organized at some higher level.

All of these ideas challenge the idea of an invariant sequence of movement development. We need to consider the demands of the environment more thoroughly and provide opportunities for all infants taking into account their specific abilities, characteristics and experiences.

References:

Adoph, K.E. & Franchak, J.M. (2016). The development of motor behavior. WIREs Cognitive Science, 8, 1-18. doi:101002/wcs.1430

Pimentel, E.D. (1996) The disappearing reflex: A reevaluation of its role in normal and abnormal development, Physical & Occupational Therapy In Pediatrics, 16(4), 19-42. doi: 10.1080/J006v16n04_02

Attributions:

Child Growth and Development by Jennifer Paris, Antoinette Ricardo, and Dawn Rymond, 2019, is licensed under CC BY 4.0 (for main chronological milestones up to but not including systems approach to motor development)

[1] Image by Wikimedia is licensed under CC BY-SA 3.0

[2] Image by torange.biz is Licensed under CC-BY 4.0

[3] Image by torange.biz is Licensed under CC-BY 4.0

[4] Developmental Milestones by the CDC is in the public domain

[5] Image by Spangdahlem Air Base is in the public domain

[1] Children’s Development by Ana R. Leon is licensed under CC BY 4.0

[2] Hadders-Algra, M. (2018). Early human motor development: From variation to the ability to vary and adapt. Neuroscience & Biobehavioral Reviews,90, 411-427. https://doi.org/10.1016/j.neubiorev.2018.05.009.

[3] Children’s Development by Ana R. Leon is licensed under CC BY 4.0

[4] Developmental milestones record by the U.S. National Library of Medicine is in the public domain

[5] Developmental Milestones by the CDC is in the public domain

[6] Image by Andres and Antoinette Ricardo used with permission

[7] Developmental Milestones by the CDC is in the public domain

[8] Image by Hanscom Air Force Base is in the public domain

[9] Children’s Development by Ana R. Leon is licensed under CC BY 4.0

[10] Image by Matt Preston is licensed under CC BY-SA 2.0

[11] Developmental Milestones by the CDC is in the public domain