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Motor
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Signs & concerns
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Signs & concerns
Key motor milestones in early childhood
Motor milestones split into gross motor (head control, rolling, sitting, crawling, walking, running) and fine motor (grasping, pincer grip, stacking, scribbling). They follow a broad order with wide normal timing — celebrate steady progress, and seek a friendly check if a child falls well behind or loses a skill.
Read the answer AnswerWhat are the red flags in motor development?
Motor red flags are patterns that persist or widen: unusual stiffness or floppiness, missing several movement milestones, a strong hand preference before 12 months, or losing a skill once gained. Many children simply move on their own timeline, so these are signs to observe and check — not diagnose at home. Loss of skills or sudden changes need prompt medical review; several delays together deserve a developmental screen.
Read the answer AnswerSigns of motor delay in a 12-to-18-month-old
By 12–18 months most toddlers pull to stand, cruise, take first steps and use hands to point and feed themselves. Seek a developmental check if your child isn't standing with support by 15 months, isn't walking by 18 months, seems unusually stiff or floppy, isn't using hands to grasp small things, or has lost a skill. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerSigns of motor delay in an 18-to-24-month-old
By 18 months most toddlers walk well alone, and by 24 months many run and climb. Seek a developmental check if your child isn't walking by 18 months, walks only on tiptoe persistently, falls or wobbles far more than peers, isn't climbing or kicking a ball by 24 months, shows a strong hand preference before 18 months, or has lost a movement skill once gained. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhat are the signs of motor delay in a 2-year-old?
By age two, most toddlers walk confidently, run a little, climb, kick a ball and scribble. Seek a developmental check if your child is not walking by 18 months, falls or wobbles far more than peers, has very stiff or floppy limbs, strongly favours one hand before 18 months, or has lost a movement skill. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhat are the signs of motor delay in a 3-to-6-month-old?
Between 3 and 6 months, babies build head control, rolling, reaching and pushing up in tummy time. Seek a developmental check if your baby's head still flops when lifted, hands stay tightly fisted, the body feels stiff or floppy, there's no reaching by 5–6 months, or no rolling by 6 months. These are reasons to assess early, not a diagnosis — early support works best at this age.
Read the answer AnswerWhat are the signs of motor delay in a 3-year-old?
By three, most children run, jump with both feet, climb stairs, kick a ball, scribble and stack blocks. Seek a developmental check if your child falls very often or walks unsteadily, cannot jump or climb stairs, isn't scribbling or holding a crayon, seems unusually stiff or floppy, or has lost a skill once had. These are reasons to assess early — not a diagnosis — because motor support works best when started young.
Read the answer AnswerSigns of Motor Delay in a 4-Year-Old
By four, most children run smoothly, climb stairs with alternating feet, hop on one foot, throw overhand, and use a crayon, fork and scissors. Seek a developmental check if your child falls often, tires quickly, avoids running or climbing, can't hold a crayon or dress themselves, or shows stiff, floppy or one-sided movement. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhat are the signs of motor delay in a 5-year-old?
By five, most children can hop on one foot, climb stairs one foot per step, catch a ball, and use crayons and scissors. Seek a developmental check if your child falls often or is very clumsy, cannot hop or balance, struggles to hold a pencil or use scissors, tires quickly, or needs lots of help to dress and feed. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerSigns of Motor Delay in a 6-to-9-Month-Old
By 6–9 months most babies gain head control, roll both ways, sit with growing steadiness and reach for toys. Seek a developmental check if your baby is persistently floppy or stiff, isn't rolling by 6 months, isn't sitting with support by 9 months, strongly favours one side, doesn't reach for objects, or loses a skill. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhat Are the Signs of Motor Delay in a 6-Year-Old?
By six, most children run, hop, balance, draw and dress with growing ease. Watch for frequent tripping or clumsiness, trouble hopping or catching a ball, an awkward or tiring pencil grip, difficulty cutting or copying shapes, or needing lots of help to dress. These are reasons to seek a gentle developmental check — not a diagnosis — because targeted support at this age works beautifully.
Read the answer AnswerSigns of Motor Delay in a 9-to-12-Month-Old
Between 9 and 12 months most babies sit without support, find a way to move across the floor, pull up to stand, take weight on their legs, and pick up small things with a thumb-and-finger pinch. Seek a developmental check if your baby isn't sitting, has no way of getting around, won't bear weight on the legs, strongly favours one side, has very stiff or very floppy limbs, or has lost a skill. These are reasons to assess early — not a diagnosis — because support at this age works best.
Read the answer AnswerWhat are the signs of motor delay in a newborn?
In the newborn weeks, movement is reflex-led and jerky — that is normal, not delay. Clinicians watch for very floppy or very stiff muscle tone, a baby who barely moves, strong one-sidedness, weak reflexes, or feeding and breathing difficulty. These are reasons for a calm check, never a diagnosis, and early support works beautifully.
Read the answer AnswerCerebral Palsy red flags warranting referral in young children
Refer for cerebral palsy assessment when a persistent motor abnormality — delayed gross-motor milestones, abnormal tone, asymmetry, or atypical posture — does not resolve. Act most urgently on early hand preference before 12 months, loss of motor skills, or a high-risk perinatal history with abnormal neurological signs.
Read the answer AnswerClinical red flags for DCD that warrant referral
Refer for DCD when motor coordination is well below age and opportunity, interferes with daily living, schooling or play, and isn't explained by a neurological condition, intellectual disability or visual impairment. Late milestones, frequent falls, fine-motor struggles and impaired motor learning across settings — with preserved effort and intellect — warrant referral; act first on any regression or focal neurological signs.
Read the answer AnswerFine Motor Delay: Clinical Red Flags Warranting Referral
Refer a young child for fine motor delay when there is persistent asymmetry of hand use, loss of acquired skills, fisting beyond 3-4 months, no purposeful reach by 5-6 months, absent pincer grasp by ~12 months, or fine motor function discordant with gross motor and language progress. Regression, marked tonal abnormality or early hand preference before 18 months warrant prompt paediatric and developmental-therapy referral.
Read the answer AnswerClinical Red Flags for Gross Motor Delay Referral
Refer for gross motor delay when milestones are clearly delayed for corrected age — no head control by 4 months, not sitting by 9 months, not walking by 18 months — or when there is abnormal tone, asymmetry, persistent primitive reflexes, or loss of acquired skills.
Read the answer AnswerClinical Red Flags for Hypotonia Warranting Referral
Hypotonia in a young child warrants prompt referral when red flags accompany it: feeding or respiratory compromise, weak cry, persistent severe head lag, areflexia, fasciculations, developmental regression, dysmorphism, or acute/progressive weakness. Distinguish central from peripheral patterns to guide investigation (CK, SMN1, neuroimaging, EMG/NCS). Acute-onset hypotonia is an emergency. Isolated mild low tone in a thriving, on-track infant can be monitored, but any clustering of features should trigger paediatric neurology and developmental review with concurrent therapy referral.
Read the answer AnswerClinical Red Flags for Motor Planning Difficulties Warranting Referral
Refer a young child for praxis assessment when difficulty planning and sequencing novel motor actions persists across settings, is disproportionate to strength or tone, and impairs daily function. Red flags include trouble learning new motor tasks, inconsistent day-to-day performance, poor carry-over despite practice, and functional avoidance of dressing, drawing or playground play. These signal impaired ideation/planning/execution rather than weakness, and warrant onward developmental and OT assessment.
Read the answer AnswerPersistent Toe-Walking — Clinical Referral Red Flags
Refer a persistent toe-walker for asymmetric gait, restricted passive dorsiflexion or fixed equinus, hyperreflexia or spasticity, calf hypertrophy or Gower's sign, motor regression, or co-occurring developmental and social-communication concerns. Idiopathic toe-walking is a diagnosis of exclusion.
Read the answer AnswerRed flags for Stereotyped Movement Disorder warranting referral
Refer for Stereotyped Movement Disorder when rhythmic, purposeless movements persist beyond age 3, impair function, cause self-injury, or arise with developmental concern — most urgently with self-injury, regression, abrupt onset, or features suggesting seizure rather than stereotypy.
Read the answer AnswerTourette Syndrome red flags for referral in young children
Refer when multiple motor and at least one vocal tic show a waxing-and-waning course beyond 12 months — most urgently when tics impair function, cause injury, or coexist with ADHD, OCD or anxiety. Atypical or abrupt onset warrants prompt neurology review.
Read the answer AnswerWhat developmental conditions can toe-walking point to?
Persistent toe-walking beyond age 2 can point to idiopathic habitual toe-walking, cerebral palsy, autism spectrum disorder, neuromuscular disease such as Duchenne muscular dystrophy, tethered cord, or global/language delay. Asymmetry, contracture, hypertonia, calf hypertrophy or regression warrant prompt medical referral.
Read the answer AnswerWhat does a delay in Balance mean for my child?
A delay in balance means your toddler is taking longer to build the steadiness needed to stand, walk, climb and play — not a diagnosis. Balance develops at different paces, and many toddlers simply need more time and practice. When it appears with other movement concerns, it is a reason for an early developmental check, because gentle support works best early.
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