What are Gross Motor Milestones? And why should you know them?

gross motor milestones

What are Gross Motor Milestones? And why should you know them?

“There are two gifts we should give to our children, one is roots, and the other is wings”, said Maria Montessori. First, a good base of gross motor (GM) skills is essential, as gross motor skills are the foundation and roots on which fine motor skills, self-care skills, play, and social interaction can take place. Besides, a delay or difficulties in gross motor skills can not only impact a child’s independence, education, inclusion, and fitness, but they also cause low self-regard and affect their confidence.

Acquiring and honing gross motor skills has been vital to humans to be mobile, survive and thrive on this planet. Gross motor skills involve the use of large muscles in our core, our arms, and legs. Hence, they include our ability to sit, stand, walk, run, jump, kick, climb, throw, catch, ride, swim, and undertake exercise, among others. Also, assessing a child’s gross motor skills gives us information about a child’s postural control, muscle tone, strength, agility, flexibility, balance, and visual-motor coordination. 

Furthermore, these milestones develop on a well-established trajectory. Consequently, using this knowledge of gross motor milestones can help us identify developmental conditions such as Dyspraxia/DCD (Developmental Coordination Disorder). Also, the knowledge of gross motor skills can help us identify motor difficulties in neurodevelopmental conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and Learning Disabilities (LD). Delay in acquiring these milestones can also occur in various neurodevelopmental disorders such as Myopathies, Neuropathies, Muscular Dystrophies, and various syndromes. 

As one can appreciate, there is a wide variation in the achievement of gross motor skills. In this article, I have covered ‘gross motor milestones‘ in a typically developing child. But a note of warning before you read any further. While each milestone listed below is important, missing a single milestone in the absence of anything else may not be significant. Nevertheless, a delay in developing several of these milestones in a child deserves prompt attention and a thorough neurodevelopmental assessment.

0 – 3 months

  • They can turn their head side to side 
  • A child can bring their hands into the midline 
  • In a prone position, they can lift their chin and even lift their head up momentarily 
  • Also, in a prone position, they can prop themselves on the forearm with their face vertical 
  • They can push their feet against your hands
  • They can kick actively in bath
  • Many can roll from side to back
  • They can hold their head steady momentarily when held


3 – 6 months

  • Many can roll from front to their back 
  • This is followed by their ability to roll back to front
  • In a prone position, they can push themselves up on extended arms 
  • They begin to sit with some support to their trunk 
  • Later they can sit alone briefly
  • They can prop their arms in front for support while seated
  • Many can turn around when lying on the floor, i.e., they can pivot on their front


6 – 9 months

  • A child can now get into a sitting position
  • They have mastered the ability to sit steadily without support 
  • They can put their arms out to sides for balance if required 
  • Initially, they can try energetically to crawl
  • Followed by their ability to make progress crawling, either moving forward or back
  • This is then followed by their ability to commando crawl on their elbows and knees 
  • Followed by their capability to crawl on all four limbs, i.e., bear walks
  • A child can bounce on their feet when held
  • He/she have the capacity to stand when held up
  • They can pull themselves to stand up
  • They can stand holding on to furniture


9 – 12 months

  • They can pivot while seated 
  • They can climb on a low ledge or a step
  • Followed by their ability to crawl up some stairs
  • They can side-step inside of a cot or while holding onto rails
  • They can cruise around the furniture holding both hands
  • They can stand with one handheld
  • He/she can stand for a few seconds on their feet without assistance 
  • They can walk with both their hands held
  • Many can walk with one handheld


12 – 18 months

  • They can climb into a low seat
  • They can climb some stairs, both up and down, on all fours
  • They can stand up from sitting without support
  • They can walk with their arms high and out 
  • Followed by their capacity to walk independently 
  • Many can walk while carrying a toy 
  • Many can walk backwards while pulling a toy on a string
  • They can stoop to pick up a toy or object from the floor
  • They can run stiff-legged


18 – 24 months

  • They can seat themselves in a small chair
  • Many can run, with the ability to start and stop 
  • This is then followed by their ability to run well
  • He/she can kick a small ball with the demonstration
  • Followed by their ability to kick a ball on their own
  • They can walk up and down the stairs, 2 feet to a step 
  • Followed by their capability to walk up one foot to each step with one handheld
  • Many can jump off a step 
  • Many can throw a ball overarm
  • They can squat while playing


24 – 36 months

  • They can kick a ball with some force 
  • He/she can turn around obstacles while running
  • They can pedal a tricycle 
  • They can walk up with alternating feet but come down 2 feet to a step 
  • They can balance on one leg momentarily 
  • Many can stand and walk on their tiptoes 
  • He/she can catch a large ball with extended arms
  • They can jump off the bottom step
  • They can jump in place
  • He/she can throw overhand
  • Many can stand with both feet on a balance beam


3 – 4 years

  • Many can walk or run up and down the stairs with alternating feet
  • They can balance on one leg for 3–5 seconds 
  • They can hop 
  • They can throw and catch a large ball, bounced from another person 
  • She/he can start using a bat
  • They can sit cross-legged on the floor
  • They can walk on a straight line for 4-6 steps
  • Many can run and kick a medium size ball
  • Many can jump off the last 2 steps


4 – 5 years

  • They can now balance on one leg for 8–10 seconds 
  • They can walk downstairs one foot to each step
  • He/she can walk heel-to-toe along a straight line 
  • They can throw, catch, and bounce a large ball 
  • She/he can hop on each foot for 3+ hops
  • They can bend and touch their toes, keeping their knees straight
  • Many can run fast while outdoors


5 – 6 years

  • He/she can run upstairs
  • Many can jump off the last 3 steps of a staircase and land on both feet
  • They now have the ability to balance on each leg for 15–20 seconds 
  • Many can ride a bicycle
  • With a tennis ball, they can throw, catch, and bounce to self
  • They can jog at a steady pace in a playground
  • They can hop-skip
  • He/she can walk in a march, swinging arms with opposite legs
  • They can now hop on one foot for 12-15 feet
  • Many can skip using a rope


6 – 8 years

  • They can run downstairs
  • They can walk backwards heel-to-toe
  • Many have the ability to jump backwards
  • They now have the capability to balance on one leg for 20+ seconds 
  • They can throw a tennis ball up and catch
  • They can hop-skip in an open area
  • Many can jump off the last 4 steps on a staircase
  • Many can skip with a rope for 3+ skips
  • Many have the capacity to do somersaults


Some things you could do to help

Children learn best through play. Providing them opportunities to practice and experiment help. Be patient. Praise their efforts. Break down the task into smaller chunks and offer them cues and feedback. Increasing muscle strength in their core, arms and legs through exercise and therapy is hugely beneficial.


As you can see from the above, the agility, strength, balance, control, and motor skills of children gradually increase and refine as they grow. A thorough neurodevelopmental assessment will assist in identifying fundamental difficulties and conditions affecting the acquisition of gross motor skills. Failure to acquire these milestones can occur in various neurodevelopmental disorders such as DCD, ASD, or ADHD. A neurodevelopmental paediatrician would also distinguish the nature and the severity of delay in a child. After a neurodevelopmental assessment, a paediatrician will recommend any investigations that need undertaking where required and or recommend physiotherapy. 

A physiotherapist will then be able to see your child and offer you a tailored programme of play and activities that are not only fun but will also improve your child’s day-to-day functioning. Consistent practice of physiotherapy exercises can help improve your child’s muscle strength, balance, coordination and movement.  

I regularly see children with gross motor difficulties who are in secondary school but have not met the gross motor milestones for a 6–7-year-old. Recognising and tackling these motor delays can avoid developing several consequences for a given child, such as disengagement from learning, low self-esteem, low mood, anxiety, and poor psychological health.  On the other hand, earlier identification and effective interventions can help the child acquire these fundamental skills, build on their learning and gain valuable qualifications and employment.  Hence, good knowledge of gross motor milestones is crucial. 

Further reading

  1. Gada S. Community Paediatrics. Oxford Specialist Handbook in Paediatrics. Oxford University Press. ISBN 978 0 19 969695 6. Published Sept 2012.  
  2. Aites J, Schonwald A, Augustyn M, Torchia M. Developmental-behavioural surveillance, and screening in primary care. UpToDate Inc. Wolters Kluwer. Accessed on May 2021.
  3. National Center on Birth Defects and Developmental Disabilities (NCBDDD) Fiscal Year 2018 Annual Report. www.cdc.gov/ncbddd/aboutus/report/
  4. Weissman L et al. Autism Spectrum Disorder: Surveillance and screening in primary care. UpToDate Inc. Wolters Kluwer. Accessed on May 2021.
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