Start Your Engines: Gross Motor Skill Assessments

Each time you take your child to the pediatrician for a “well baby” visit, the doctor will be examining her carefully to make sure her development is on track. Though every child develops at his or her own pace, meeting developmental milestones in order—even if “late” compared to the charts—shows that your child is progressing as she should. These milestones include physical characteristics like height and weight, social skills such as language and facial expressions, and motor skills—both fine and gross.

What are motor skills?

Basically, motor skills are movements, and come in two varieties: fine and gross.

• Fine motor skills are smaller movements using smaller muscles, like the hands, wrists and fingers. These skills include grabbing and holding with a fist, waving, pinching an item between the thumb and forefinger, etc.
• Gross motor skills are big movements using the large muscle groups, like those found in the arms and legs. Think rolling over, crawling, walking, jumping, big baby hugs, etc.

How are gross motor skills assessed?

In the early months, the pediatrician may have given you a questionnaire or asked you questions about skills your baby had mastered, could almost do or hadn’t tried yet. Your pediatrician also watched your baby’s movements during the checkup. As your little one grows and becomes more able to do things on her own, the doctor may ask you to guide your child in demonstrating her new skills. Some examples might include:

• Transferring an object from one hand to the other
• Sitting without support
• Rolling a ball
• Going from a sitting to a hands-and-knees position
• Creeping or crawling (or scooting)
• Supporting her own weight on her legs (while you hold her hands)
• Pulling up and standing with support
• “Cruising” while holding onto furniture
• Standing alone
• Walking heel to toe

Typically, your child’s movements are compared to established guidelines or rated on a standard assessment scale. When children are young, there are wide variations in development that still fall well within the so-called “normal” range. Your pediatrician will tell you if there are any concerns, and you should ask them directly if you have concerns of your own. If a motor delay is suspected, the doctor may refer your child to a specialist, or just have you watch for particular movements. Early treatment of developmental delays can help a struggling child to catch up with her peers.

Should you watch for “red flags"?

Probably not. Delayed milestones are usually the result of a child working more intently on other skills. Sometimes, a child may take longer to reach a certain milestone because she just needs more time to develop all of the smaller component skills. Think about it: walking requires good visual skills, balance, a good sense of touch, coordination of large muscle groups with smaller ones—along with the right motivation, a distraction-free environment, and other variables we probably can’t even think of. Some babies would much prefer to crawl alongside the family dog, or happily sit and roll a ball around, rather than using energy on something so mundane as walking.