OCCUPATIONAL MILESTONES

Age in months	Fine motor skills	Visual motor skills	Self-care skills/ADL’s	What parents can do to help
0-2 months	-Closes finger in tight grasp. -Grasps rattle.	-Tracking an object with eyes to both sides. -Looks at hands/	-Coordinating suck, swallow, breath sequence. -Developing sleep patterns. -Communicating hunger.	-During the first months, when talking to baby, move your head slowly from side-to-side, so that baby will track your movements. -Move colorful toys and objects from side-to-side to strengthen eye muscles. -Encourage baby to lay on tummy.
3-6 months	-Reaches for nearby object. -Grasp reflex fades and is replaced by intentional grasping.	-Extends arm to reach towards rattle. -While laying on back, brings hands to midline and close to grasp object within reach.	-Bringing objects to mouth. -Communicating hunger and fears.	-Offer your baby a variety of toys of different textures, shapes and sizes to stimulate feelings in the palm of his/her hand, to practice various ways to grasp things. -Continue to place baby on tummy for strengthening muscles necessary for further fine and gross motor skills. -Get really close to babies face which helps them use their visual motor skills.
6-10 months	-Begins to release objects voluntarily. -Gasps pellet or small objects with thumb against side of curled index finger. -Transfers objects from one hand to another.	-Bangs cubes together. -Pokes finger in hole of pegboard.	-Begins to hold bottle. -Feeding self small food items (puffs, crackers, etc.) -Introduce sippy cup and/or open cup.	-Allow your baby to explore objects with his mouth to sharpen the senses in this area and exercise these important muscles. -Offer a well-designed activity center that has a wide variety of activities to motivate your baby to use different skills, like pushing, pulling and striking.
10-15 months	-Pincer grasp is developed to pick up small objects. -Point to objects. -Turn the pages in a book. -Puts objects into a container.	-Can stack two blocks, one on top of the other. -Can place a simple shape into a puzzle board (circle/square)	-Exposure to drinking from open cup should occur more frequently. -Introduce utensils (spoon and fork) during meal time.	-Provide hand over hand assistance when drinking from an open cup to help with movement patterns. -Allow child to use utensils with either hands. -Correct grasp on utensils if grasp is incorrect. -Play of the floor with your child. -Demonstrate how to stack blocks and complete simple shape puzzles.
15-18 months	-Grasp crayon with fisted grasp. -Uses both hands to play. -Scribbles spontaneously.	-Place rings on a ring stack.	-Cooperates during dressing changes by extending arms/legs. -Attempting to brush teeth. -Cleans face with cloth. -Wash hands with help. -Removes socks.	-Expose child to crayons, markers, colored pencils and allow for them to pick up writing utensils to explore. -Encourage play with a variety of toys. -Encourage outside play at parks, beach, backyard.
18-24 months	-Turn several pages in a book. -Can push, pull, dump things out.	-Stacks 4-6 block tower. -Threads large beads on a string.	-Coordination of bringing food to mouth should be improving with less spillage occurring. -Removes socks and shoes. -Once shirt is over child’s head he/she can find arm holes and push arms through.	-Allow for additional time for child to attempt dressing tasks. -Adjust grasp on utensils to prevent incorrect grasping patterns. -Increase fine motor strength by hiding small objects in play-doh for children to locate.
24-36 months	-Able to remove/twist lid on a container. -Able to turn door knobs. -Holding a crayon with thumb and fingers (no fist). -Rolls, pounds, squeezes, and pulls playdough.	-Imitates drawing a vertical/horizontal lines. -Snips paper with child safe scissors. -Builds an 8-10 cube tower. -Completes a 3-piece puzzle.	-Wash hands independently. -Requires assistance to manage pullover clothes. -Able to remove pants, coat, socks, and shoes without fasteners. -Has few accidents during the day and can indicate when they need to go to the bathroom.	-Provide hand over hand when imitating lines for accuracy. -Provide demonstration and frequent repetition of tasks. -Increase fine motor skills by exploring with tongs, tweezers, clothespins to pick up small items.
3-4 years	-Manipulates and builds Legos, block designs. -Grasping writing tool with quadrupod grasp and/or tripod grasp.	-Copies circle. -Imitates cross. -Copies a square. -Cuts along a straight line with.	-Independently dresses self, may need help with fasteners. -Able to bathe self with the exception of washing own hair. -Independent with toilet control and notification.	-Routine and consistency are important. -Allow for enough time to practice skills. -Allow child to watch family members perform self-care, fine motor, and visual motor tasks. -Practice garment closures in front on child first, once that is mastered, practice with the garment on.
4-5 years	-Colors in pictures, with control, staying inside the lines.	-Cuts along curved lines. -Traces letters in name. -Complete 12 piece puzzles. -Draws a person with 2-4 body parts.	-Buttons, snaps, zips independently. -Continue to refine self-care skills and independence. -Opening containers, zip lock baggies.	-Timers may help to indicate how long they must tolerate an activity that is non preferred for child. -Discuss with OT multisensory activities to improve handwriting.
5-6 years	-Starts to use one hand consistently for fine motor tasks. -Continue to refine all previous fine motor tasks.	-Forms letters in name with little assistance. -Completes 12+ piece puzzles. -Cuts out simple shapes.	-Supervision for all grooming and bathing tasks to ensure safety and quality. of performance. -Completes household chores.	-Visual schedules of steps involved in daily routines may help with compliance and organization. -Reward chart for independent completion of tasks.
7-9 years	-Holding and using a pencil easily. -Uses fingers to write and draw rather than whole arm. -Constructing simple structures with tools (hammer, screw driver, etc.) with supervision.	-Forms letters in name with little assistance. -Completes 12+ piece puzzles. -Cuts out simple shapes.	-Writes within the lines. -Cuts irregular shapes and uses glue accurately. -Handwriting is legible.	-Provide encouragement and positive praise during tasks. -Encourage hands on learning and limit the amount of screen time. -Find healthy motivators that work for the child and stick to them.