Tweedie Therapy

Comprehensive Pediatric Occupational Therapy
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The information below outlines developmental milestones and “red flags”. If you are concerned about your baby’s development please do not hesitate to call. We are here to answer your questions and teach you the skills to help your child. Below you will find a comprehensive summary of milestones and the links will provide you with more specific information.

Gross Motor

If your child is not…

  • Rolling by 6 months of age
  • Pushing up on straight arms, lifting his head and shoulders, by 7 months of age
  • Sitting independently by 7 months of age
  • Crawling (”commando” crawling–moving across the floor on his belly) by 9-10 months of age
  • Creeping (on all fours, what is typically called “crawling”) by 11 months of age or any abnormal creeping patterns like bottom shuffling or scooting.
  • Sitting upright in a child-sized chair by 9 months of age
  • Pulling to stand by 10 months of age
  • Standing alone by 12 months of age
  • Walking by 14 months of age
  • Jumping by 28 months of age
  • Independent on stairs (up and down) by 30 months of age
  • “Walking” their hands up their bodies to achieve a standing position

If your child is…

  • Only walking on their toes, not the soles of their feet
  • Frequently falling/tripping, for no apparent reason
  • Still “toeing in” at two years of age
  • Has an unusual creeping patterns
  • Any known medical diagnosis can be considered a “red flag”: Down’s syndrome, cerebral palsy, congenital heart condition, frequent ear infections, sensory avoiders, low muscle tone or high tone, etc.
Fine Motor

If your child is not…

  • Bringing both hands to midline (center of body) by 10 months of age
  • Banging objects together by 10 months of age
  • Clapping their hands by 12 months of age
  • Deliberately and immediately releasing objects by 12 months of age
  • Able to tip and hold their bottle by themselves and keep it up, without lying down, by 12 months of age
  • Using a mature pincer grasp (thumb and index finger, pad to pad) by 18 months of age
  • Imitating a drawing of a vertical line by 24 months of age
  • Able to snip with scissors by 30 months
  • Being able to move/open one hand/arm

If your child is…

  • Frequently in a fisted position with both hands after 6 months of age
  • Still using a fisted grasp to hold a crayon at 18 months of age
  • Using only one hand to complete tasks after 30 months
  • Drooling during small tasks that require intense concentration
  • Displaying uncoordinated or jerky movements when doing activities
  • Crayon strokes are either too heavy or too light to see
  • Any know medical diagnosis can be considered a “red flag”: Down’s Syndrome, cerebral palsy, low or high tone, other developmental delays.
Problem Solving

If your child is not…

  • Imitating body action on a doll by 15 months of age (ie, kiss the baby, feed the baby)
  • Able to match two sets of objects by item by 27 months of age (ie, blocks in one container and people in another)
  • Able to imitate a model from memory by 27 months (ie, show me how you brush your teeth)
  • Able to match two sets of objects by color by 31 months of age

If Your Child is…

  • Having difficulty problem solving during activities in comparison to his/her peers
  • Unaware of changes in his/her environment and routine
Sensory
  • Very busy, always on the go, and has a very short attention to task
  • Often lethargic or low arousal (appears to be tired/slow to respond, all the time, even after a nap)
  • A picky eater
  • Not aware of when they get hurt (no crying, startle, or reaction to injury)
  • Afraid of swinging/movement activities; does not like to be picked up or be upside down
  • Showing difficulty learning new activities (motor planning)
  • Having a hard time calming themselves down appropriately
  • Appearing to be constantly moving around, even while sitting
  • Poor or no eye contact
  • Frequently jumping and/or purposely falling to the floor/crashing into things
  • Seeking opportunities to fall without regard to his/her safety or that of others
  • Constantly touching everything they see, including other children
  • Hypotonic (floppy muscles, weak grasp, poor trunk tone, usually poor motor coordination)
  • Having a difficult time with transitions between activity or location
  • Overly upset with change in routine
  • Hates bath time or grooming activities such as; tooth brushing, hair brushing, haircuts, having nails cut, etc.
  • Afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, playdoh, etc.

Sensory integration/sensory processing issues should only be diagnosed by a qualified professional (primarily, occupational therapists). Some behaviors that appear to be related to sensory issues are actually behavioral issues independent of sensory needs.

Vision

Possible visual problems may exist if your child does not…

  • Make eye contact with others
  • Reach for an object close by

Possible visual problems may exist if your child does…

  • Avoids doing near work, poor at puzzles, and avoids eye contact
  • Holds objects closer than 3-4 inches from one or both eyes. Any eye turns in or out separate from another.
Self-Care

If your child is not…

  • Feeding him/herself finger foods by 14 months of age
  • Attempting to use a spoon by 15 months of age
  • Picking up and drinking from a regular open cup by 15 months of age
  • Able to pull off hat, socks or mittens on request by 15 months of age
  • Attempting to wash own hands or face by 19 months
  • Assisting with dressing tasks (excluding clothes fasteners) by 22 months
  • Able to deliberately undo large buttons, snaps and shoelaces by 34 months

If your child is…

  • Having difficulty biting or chewing food during mealtime
  • Needing a prolonged period of time to chew and/or swallow
  • Coughing/choking during or after eating on a regular basis
  • Demonstrating a change in vocal quality during/after eating (i.e. they sound gurgled or hoarse when speaking/making sounds)
  • Having significant difficulty transitioning between different food stages
Social/Emotional/Play Skills

If your child is not…

  • Smiling by 4 months
  • Making eye contact during activities and interacting with peers and/or adults
  • Performing for social attention by 12 months “in their own world”
  • Imitating actions and movements by the age of 24 months
  • Engaging in pretend play by the age of 24 months
  • Demonstrating appropriate play with an object (i.e. instead of trying to put objects into a container, the child leaves the objects in the container and keeps flicking them with his fingers)
Communication

If your child has...

  • Difficulty making and maintaining eye contact with an adult by 6 months
  • Any loss of speech or babbling or social skills (like eye contact) at any age

If your child lacks…

  • Big smiles or other warm, joyful expressions during interaction with another person by 6 months
  • Back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months
  • Babbling by 12 months
  • Back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months
  • Consistent responding to their names by 12 months
  • Words by 16 months
  • Following simple and familiar directions by 18 months
  • Two-word meaningful phrases without imitating or repeating & says at least 50 words by 24 months
  • Back-and-forth conversational turn-taking by 30 months

Most babies who are doing well with development exceed these milestones. If your child is demonstrating difficulty reaching these milestone please call for a consult. Your instincts are probably right and the sooner you call the sooner we can begin addressing your child’s and family’s needs! Please don’t wait.