Child development milestones are skills most children reach by a certain age, like sitting, walking, holding a crayon or putting on a jacket. They help parents and doctors spot when a child may need extra support.
This guide covers movement, hand skills and self-care milestones from birth to six years, the areas occupational therapists work on most. It’s based on widely used milestone guidance, including the CDC’s milestone checklists and the Indian Academy of Pediatrics’ developmental guidance.
How to use this checklist
- Milestones are ranges, not deadlines. The ages below are when most children, not all, have reached the skill.
- Look at the overall picture. One late skill is rarely a concern. Several late skills across areas deserve attention.
- Correct for prematurity. If your baby was born early, use their corrected age until about age two.
- Loss of skills is always a concern. If your child stops doing something they used to do, speak to your doctor promptly.
Milestones by age
| Age | Movement | Hand skills | Self-care and play |
|---|---|---|---|
| 2 months | Holds head up during tummy time | Opens hands briefly | Calms when spoken to or picked up |
| 4 months | Holds head steady without support | Holds a toy placed in hand; brings hands to mouth | Smiles to get attention |
| 6 months | Rolls from tummy to back; pushes up on straight arms | Reaches for toys; passes objects hand to hand (around 6–9 months) | Enjoys looking in a mirror |
| 9 months | Sits without support | Rakes small food towards self | Looks for objects dropped out of sight |
| 12 months | Pulls to stand; walks holding furniture | Picks up small items with thumb and finger (pincer grasp) | Drinks from a cup you hold |
| 18 months | Walks alone; climbs on and off a sofa | Scribbles; tries to use a spoon | Feeds self with fingers |
| 2 years | Kicks a ball; runs | Stacks a few blocks | Eats with a spoon |
| 3 years | Climbs well; pedals a tricycle (around 3) | Strings large beads; copies a circle | Puts on some clothes alone; uses a fork |
| 4 years | Catches a large ball most of the time | Holds a crayon between fingers and thumb, not in a fist | Unbuttons some buttons; pours water with supervision |
| 5 years | Hops on one foot | Copies a square and triangle; cuts along a line | Buttons some buttons; dresses with little help |
| 6 years | Rides a bicycle with or without stabilisers | Writes own name; draws a recognisable person | Dresses independently; begins tying shoelaces |
When to talk to your doctor or an occupational therapist
Speak to your paediatrician, and consider an OT assessment, if your child:
- Isn’t sitting without support by 9 months.
- Isn’t walking by 18 months.
- Still uses a fist grip on crayons at 4–5 years.
- Can’t manage basic dressing by 4 years.
- Seems much clumsier than peers, or avoids physical play.
- Has lost skills they already had.
For signs beyond movement and hand skills, read our age-by-age list of signs your child needs occupational therapy.
Why early support matters
A child’s brain develops fastest in the first few years. Support during this window, known as early intervention, often helps children catch up faster than support started later. Waiting to see if a child grows out of a delay can cost valuable time. Learn more about our early intervention programme.
Simple ways to support development at home
- Tummy time every day from birth, for strong neck, shoulders and core.
- Floor play instead of walkers so babies learn to roll, crawl and pull up.
- Playdough, tearing paper and posting coins into a box for hand strength.
- Letting children try to feed and dress themselves, even when it’s messy and slow.
- Outdoor play such as climbing, swinging and running for balance and coordination.
Our parent’s guide to pediatric occupational therapy has more ideas.
Milestone assessments at Percept
If you’re unsure whether your child is on track, our occupational therapists in Indirapuram can carry out a play-based developmental assessment. You’ll get a clear picture of your child’s strengths, any areas of delay, and practical next steps.
CTA: Book an assessment for child development therapy in Indirapuram. Download the free printable milestone checklist [link to PDF]. Call +91 88604 60038.
Frequently asked questions
What are the main types of developmental milestones?
Milestones are usually grouped into movement (gross motor), hand skills (fine motor), language and communication, social and emotional, and thinking and learning.
My child skipped crawling. Is that a problem?
Some children skip crawling and walk on time with no issues. If your child also has other delays, or seems weak or uncoordinated, mention it to your doctor.
When should a child hold a pencil correctly?
Most children move from a fist grip to holding a crayon between fingers and thumb around age 4, with a mature grip developing by around 5–6.
How do I use corrected age for a premature baby?
Subtract the number of weeks your baby was born early from their actual age. Use this corrected age for milestones until about age two.
Can occupational therapy help a child catch up on milestones?
Yes. OT helps children build motor, sensory and self-care skills, and early support often leads to faster progress.
