2403 Main Drive, #5
Fayetteville, AR 72704

P: 479.966.4883 | F: 479.445.6130

pediatric therapy
- Gross Motor Development Milestones
- Fine Motor Developmental Milestones
- Speech/Language Milestones

When should a parent pursue physical therapy?

Parents should consider seeking an evaluation with a Physical Therapist if their child demonstrates any of the following:

Birth to 2 months:
- Doesn't lift head in prone position (while lying on their stomach)
- Does not turn head to one side in prone position
- Does not turn head to both sides in supine position (lying on back)

3 months:
- Does not hold head up 90 degrees in prone position (lying on stomach)
- Does not extend both legs or kick reciprocally
- Does not roll to back when placed on their side

4 months:
- Does not place weight on forearms in prone position (lying on stomach)
- Does not rotate or extend head
- Is unable to grasp a rattle
- Cannot bring both hands together

5 months:
- Does not roll over one way
- Does not hold head up when pulled to sitting
- Is unable to hold head steady in supported sitting position
- Does not bear weight on legs

6 months:
- Is unable to keep head level with body when pulled to a sitting position
- Does not demonstrate balance reactions
- Cannot bear weight on hands in prone position (lying on stomach)
- Does not move head actively in supported sitting position

7 months:
- Does not roll over either way
- Does not bear weight on legs
- Cannot lift head or assist when pulled to sitting position
- Demonstrates little balance reactions or protective extension of arms

8 months:
- Does not roll over both ways
- Cannot sit with little or not support
- Does not hold weight on one hand while in the prone position (lying on stomach)
- Cannot bear weight on legs and bounce

10 months:
- Cannot get to sitting position without assistance
- Does not assume crawling position (hand-knee position)
- Does not show interest/motivation to crawl
- Cannot sit on own without hand support

12 months:
- Does not pull to stand using furniture
- Cannot switch positions from sitting to prone
- Does not creep on hand and knees
- Cannot pivot while in sit position to retrieve toy
- Cannot pass an object from one to the other
- Cannot stand holding on to someone or something
- Cannot pick up small objects

15 months:
- Does not walk with one hand held
- Cannot stand alone well
- Does not demonstrate balance reaction while in kneeling position
- Does not walk alone one to two steps
- Does not demonstrate motor planning by climbing on furniture
- Has a hard time picking up small objects

18 months:
- Does not attempt to creep upstairs
- Does not walk without support
- Cannot throw ball
- Does not bend down to retrieve objects
- Does not demonstrate balance reaction in standing

24 months:
- Does not run
- Cannot walk upstairs with one hand held
- Cannot carry large toy while walking
- Does not squat in play
- Cannot retrieve toy off of floor from standing position
- Does not climb onto furniture, turn and sit
- Cannot build tower of six blocks
- Does not use utensils well

30 months:
- Does not jump in place with both feet
- Does not stand from sitting by rolling on side
- Cannot catch large ball
- Has difficulty with gait and balance
- Does not walk downstairs using rail for support
- Does not have wide range of movement
- Does not run and stop without holding
- Does not avoid objects when running

36 months:
- Cannot kick stationary ball
- Is not able to stand on one foot for two seconds
- Cannot build tower of 9 blocks
- Cannot complete 5-6 piece puzzle
- Is not using utensils properly
- Does not attempt to ride tricycle
- Does not demonstrate grasp of crayon


When should a parent pursue occupational therapy?

Parents should consider seeking an evaluation with an Occupational Therapist if their child demonstrates any of the following:

Birth to 2 months:
- Does not grasp objects placed near palm of hand

3 months:
- Resists being held
- Hands closed or in fists majority of time
- Does not follow objects with eyes

4 months:
- Does not bring hands to midline
- Does not bring objects to mouth
- Does not reach for objects

5 months:
- Does not hold own bottle

6-8 months:
- Does not actively grasp larger objects
- Does not transfer object from hand to hand
- Frequently drops objects

10 months:
- Is not excepting a variety of textures (especially food)
- Gets upset easily when being handled
- Not beginning to pick up smaller objects

12 months:
- Isn't able to pick up small object with thumb and index finger
- Excessively upset by loud sounds
- Not interested in exploring age appropriate toys

15 months:
- Cannot stack 2 blocks

18 months:
- Cannot turn pages of a thick book
- Cannot point to obvious body parts
- Cannot stack 4 blocks

24 months:
- Cannot pull on pants without help
- Cannot remove socks without help
- Plays with toys by throwing

30-36 months:
- Cannot imitate drawing a vertical line
- Does not pretend during play
- Cannot stack 8-10 blocks
- Does not remove pull on clothing after help with fasteners

When should a parent pursue speech therapy?

Parents should consider seeking an evaluation with a Speech/Language Pathologist if their child demonstrates any of the following:

Birth to 2 months:
- Does not cry when hungry or uncomfortable
- Does not make comfort sounds or sucking sounds
- Cry does not vary in pitch, length and volume to indicate different needs
- Difficulty establishing/maintaining a rhythmical suck/swallow pattern
- Significant loss of breast milk/formula out of side of mouth during feeding

3 - 5 months:
- Vocalizes separately from body movements (sound is not a response to body movement)
- Inability to establish or maintain face to face communication during feeding
- Does not vocalize in response to sound stimulation
- Has not begun to laugh by 5 months in response to play
- Difficulty with feedings such as above

5 - 7 months:
- Does not babble during play or in response to stimulation (may suggest a hearing problem)
- Does not use voice to vocalize attitudes other than crying
- Does not respond to sound stimulation (indicative of hearing problems)
- Difficulty with swallowing early solids or other feeding issues

7 - 9 months:
- Does not look towards sounds or own name
- Is not babbling double consonants (bababa....)
- Difficulty with textures in foods (gagging, choking, etc.)
- Is unable to participate in conversations with adults using babbling noises
- Does not say "mama" or "dada" non-specifically
- Does not use different inflections to produce exclamations

9 - 12 months:
- Is unable to successfully eat early finger foods or munch/bite on foods
- Cannot babble single consonants such as "ba" or "da"
- Does not respond to words/language appropriately
- Does not experiment with language when playing independently
- Does not participate in conversations by responding with vocalizations

12 - 15 months:
- Does not use inflection during vocalization
- Is not experimenting with language during play
- Is not using 1 to 3 words spontaneously while repeating additional words
- Does not vocalize or gesture to communicate needs
- Is not using "no" emphatically and meaningfully
- Is not using exclamatory expression such as "oh-oh", "No-no", Ta-da", etc.

15 - 18 months:
- Is not attempting to sing songs
- Cannot use 10-15 words spontaneously
- Is not using vocalization in conjunction with gestures
- Does not use language to communicate needs
- Is not repeating sounds or words or imitating environmental sounds
- Is not jabbering tunefully during play
- Continues to demonstrate eating problems (swallowing issues, choking, etc.)

18 - 24 months:
- Is not using jargon with good inflection
- Cannot label 2-4 pictures while looking at a book
- Is not putting 2-4 words together to form short sentences or communicate needs
- Does not understand nouns, verbs and modifiers an their uses
- Is not using itelligible words to communicate needs
- Cannot imitate 2-4 word phrases
- Does not relay experiences using jargon, words and/or gestures
- Does not have at least 50 - 100 words

24 - 36 months:
- Cannot sing phrases of songs
- Is not using three word sentences
- Is not using a wide range of consonant and vowel sounds
- Does not use past tense words "He runned"
- Is not expressing frustration at not being understood
- Does not use up to or more than 50 expressive words
- Is not imitating phrases or experimenting with new words
- Words are not clearly articulated

33 - 36 months:
- Is not responding to questions when asked things
- Is not producing correct beginning sounds of words
- Is having a hard time understanding prepositions
- Is not speaking in complete sentences
- Does not use plurals to refer to more than one (even if not correct)
- Is not participating in storytelling
- Does not have expressive vocabulary of 200 - 1000 words
- Is not using expressive vocabulary to communicate all needs
- Is not using sentences to communicate


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