Occupational Development Milestone
Children acquire Occupational skills at different rates. However, most follow a natural progression for mastering Occupational skills. Here are general Occupational stages:
Self Care Developmental Milestone
Developmental Progression of Grasp
0-6
Months
6-12
Months
12-18
Months
18-24
Months
24-36
Months
3-4
Years
4-5
Years
5-6
Years
6-10
Years
0-6 Months
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Reaches for and grasps objects
- Uses palmar grasping patterns (reflexively at birth)
- Brings objects to mouth
- Bangs objects on table
- Transfers objects from one hand to the other
- Plays with hands at midline
- Examines objects carefully with eyes
Gross Motor/Mobility
- Lifts head (3-4 months)
- Raises shoulders/belly when lying on stomach (4-6 months)
- Sits while propping on hands for support
- Bounces with both legs when held in standing position
- Rolls from back to belly and belly to back
Regulatory/Sensory Organization
- Quiets down when picked up
- Relaxes, smiles and vocalizes when held
- Cuddles
Cognitive
- Uses hands and mouth to explore objects
- Integrates information from multiple sensory systems
- Searches with eyes for sound
- Imitates actions for pleasure; i.e. peek-a-boo (emerging 6-8 months)
Social & Play
- Coos
- Smiles
- Laughs
- Cries to communicate needs
- Communicates simple emotions through facial expressions
- Social play focused on attachment and bonding with parents
- Predominantly sensorimotor play and exploration
6-12 Months
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Manipulates objects and plays with toys at midline
- Bangs objects together at midline
- Purposefully releases toys/objects into a container
- Takes objects out of container
- Uses a radial palmar or radial digital grasp
- Points or pokes with index finger
- Uses fingertips to pick up small objects
- Beginning to use tools, crudely
Gross Motor/Mobility
- Transitions from lying to sitting independently and sits unsupported
- Pivots/turns in sitting
- Stands, supported by holding on to furniture, objects or hands
- Plays in standing while leaning on something for support
- Crawls on belly and then on hands and knees (10 months)
- Walks with hand held assist
Regulatory/Sensory Organization
- Enjoys spinning/swinging
- Listens to speech and follows simple one step directions
Cognitive
- Responds to name being called
- Recognizes words, objects and family members’ names
- Imitates simple gestures
- Looks at picture book
- Plays purposefully with toys
- Imitates simple gestures
- Generalizes previous learned skills from past experiences
Social & Play
- Shows dependence on parents
- Emerging separation/stranger anxiety
- Interact briefly with other infants/children
- Lifts arms to be picked up
- Sensorimotor play evolves into functional play (using toys appropriately for their purpose; i.e. puts toy telephone to ear)
- Beginning to engage in social play with caregivers/ siblings
12-18 Months
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Scribbles with crayon
- Holds two small toys/objects in one hand
- Holds objects in both hands
- Stacks blocks
- Attempts simple puzzle
- Points to pictures with index finger
- Opens/closes boxes, containers, etc.
- Uses both hands in play; one to stabilize and one to manipulate toys/objects
Gross Motor/Mobility
- Sits in chair plays in standing without support
- Walks independently
- Squats to pick up objects/toys from floor
- Climbs on furniture
- Pulls toys while walking
- Bushes/pulls large toys or boxes/objects on floor
- Walks up stairs with hand held assist
- Beginning to run
Regulatory/Sensory Organization
- Enjoys messy activities
- Reacts to sensations such as temperature and sweet vs. sour
Cognitive
- Understands how objects work
- Understands function of objects
- Recognizes and identifies various body parts, i.e. head, nose, mouth, etc.
- Uses trial and error problem solving
- Pretend/symbolic play with real props, i.e. pretending to cook/eat/play with food; pretending a block is a car; emerging at 18 months
Social & Play
- Beginning to feel secure enough to move away from parents
- Exploring all spaces in the room
- Engages in simple pretend play directed toward self (pretending to eat/sleep)
- Beginning to engage with peers
- Parallel play; playing alongside peer but not interacting or cooperating/collaborating
18-24 Months
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Completes simple form puzzle
- Builds a 4-5 block tower
- Turns pages of a book
- Holds crayon in radial fingers (digital pronate grasp)
- Imitates vertical and horizontal lines as well as circular scribbles
- Strings large beads
- Radial digital grasp and pincers grasp to pick up small objects
- Uses simple tools, i.e. toy hammer
Gross Motor/Mobility
- Runs
- Squats during play
- Climbs on playground equipment and up slide ladders
- Kicks ball
- Throws ball at large target
- umps in place with both feet
- Walks up/down stairs independently
- Moves on ride - on toy without pedals
Regulatory/Sensory Organization
- Enjoys rough and tumble play
- Enjoys play-doh
Cognitive
- Can complete simple two step directions and complete multi-step tasks
- Begins to use non-realistic objects in pretend play
- Object permanence is developed completely
Social & Play
- Expresses affection and shows wide variety of emotions, i.e. fear, sympathy and anger)
- Enjoys solitary play, i.e. coloring, building with blocks, etc.
- Demonstrates emerging sense of humor and shared enjoyment
- Engages in parallel play in groups
- Imitates others in play
- Watches other children
- Beginning to take turns
24-36 Months
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Snips with scissors
- Imitates pre-writing strokes including horizontal and vertical lines and cross
- Imitates/copies circle
- Colors, attempting to stay within boundaries of large forms
- Builds 6-10 block tower
- Completes simple 4-5 piece puzzle
Gross Motor/Mobility
- Rides tricycle
- Catches large ball against chest
- Jumps from small step
- Begins to hop on one foot
Regulatory/Sensory Organization
- Enjoys feeling various textures
- Plays with water/sand
- May experience difficulty with transitions
Cognitive
- Imaginative play; completing entire scenarios and scripts
- Matches pictures
- Sorts by single, simple attribute (i.e. shape or color)
- Beginning to understand same/different
Social & Play
- Predominantly parallel and associative play (participate in similar or same game or activity but without direct collaboration/cooperation/organization)
- Beginning to engage in cooperative play with peers (working together to achieve common goal; taking turns (emerging skills)
- Small group play
- Shows interest in peers
- May be shy around strangers
3-4 Years
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Uses mature grasp (tripod or quadrupod) on writing utensils, i.e. crayon, marker, pencil
- Colors within the lines
- Copies simple shapes and pre-writing strokes including circle, square, triangle and “X”
- Beginning to copy uppercase letters
- Cuts along a straight line and beginning to cut out some basic shapes
- Imitating three dimensional block designs
- Increased dexterity and in- hand manipulation skills, i.e. moving objects from Palm to fingertips and back
Gross Motor/Mobility
- Jumps
- Climbs
- Runs
- Can stand on one leg briefly
- Beginning to skip and hop
- Walks up/down stairs independently, alternating feet
Cognitive
- Uses imaginary objects in play
- Categorizes and sorts objects
Social & Play
- Attempts activities perceived as challenging or difficult
- Prefers to play with other children
- Group play begins to replace parallel play
- Awareness of social norms emerging
- Follows turn taking in play and conversation
- Shows increased interest in having friends
- Prefers same gender playmates
4-5 Years
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Uses dynamic tripod or quadrupod grasp
- Draws simple shapes - circle, square and triangle emerging
- Uses both hands to work together to perform different tasks (bilateral integration)
- Cuts out simple shapes while turning paper with other hand
- Begins to draw people (stick figures)
- Copies own name
- Strings small beads
- Can fold paper with crease
Gross Motor/Mobility
- Jumps down from high step
- Can hit a target when throwing a ball
- Skips
- Can walk up and down stairs reciprocally without rail
Cognitive
- Understands rules to game play
- Able to remember rules with some reminding
- Participates in planning a group activity (executive function)
- Beginning to use abstract thought and reasoning to solve problems (executive function)
- Makes up stories that involve role playing with other children
Social & Play
- Enjoys joking and being playful
- Participates in goal-oriented cooperative play with 2-3 other children
- Role playing games
- Takes pride in work/belongings
- Shows interest in goal of activity
- Social and dramatic play
- Plays dress up
- Engages in storytelling
- Continues to engage in pretend play, now incorporating imaginary characters
5-6 Years
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Writes name independently in tile case (John vs JOHN)
- Cuts along line for basic shapes and unspecified designs, such as ice cream cone
- Draws triangle and diamond
- Completes complex (up to 20 piece) puzzles
- Copying most uppercase and lowercase letters
Gross Motor/Mobility
- Hops and skips with good balance for long distances
- Stands on one foot for up to 10 seconds
- Catches ball with both hands
- Kicks with accuracy
Cognitive
- Reasons through simple problems
- Participates in organized games
- Demonstrates deferred imitation (imitation of an observed action at a later date)
- Sorts objects by different characteristics (more than one way)
Social & Play
- Demonstrates understanding of others feelings
- Engages in cooperative and competitive games
- Elaborates imaginary play
- Dramatic play - reconstructs real world in play
6-10 Years
Fine Motor/In-hand Manipulation/Visual-Motor/Perceptual
- Good dexterity for crafts and constructing
- Good bilateral coordination
- Precision and motor planning evident in drawing
Gross Motor/Mobility
- Runs with speed and endurance
- Catches ball with accuracy
- Throws ball long distances
Cognitive
- Abstract reasoning
- Flexible problem solving
- Solves complex problems
Social & Play
- Cooperative - requiring problem solving and abstract thinking
- Less impulsive and better able to regulate emotions and demonstrate coping skills