Objectives

Identify infant and toddler physical and motor developmental milestones and ways to support development for all infants and toddlers.
Describe the brain’s role in infant and toddler physical development.
Recognize influences of physical growth and development.

Learn

Know

Physical Development From the Start

When healthy babies are born, some of their internal systems, such as their ability to suck, swallow, and breathe, are developed and functional. To support the best possible physical development, all infants require responsive care from loving adults, proper nutrition, and appropriately stimulating environments. Infant and toddler physical development can occur quickly; so it is essential to understand the various stages of physical development.

From birth, infants want to explore their world. While each child has their own schedule for development and mastering new skills, infants are often eager early on to move their mouths, eyes and bodies toward people and objects that comfort or interest them. They continue to practice skills that let them move closer to desired objects. Ongoing observation and frequent conversations with their families can help you learn what infants and toddlers are able to do, what they are learning to do, and in what areas they could use your support.

Infants develop physically from the top down, starting with their head and neck. At birth, an infant has a very difficult time holding up their head because the neck muscles are not strong enough to provide support. As infants and toddlers grow, their determination to master movement, balance, and fine- and gross-motor skills remains strong. Rolling and crawling occur as infants develop skills in using large-muscle groups. Grasping and picking up objects with fingers are signs of small-muscle skill growth.

Influences on Early Physical Growth and Development

There is no exact age at which all infants should be able to grasp objects or hold up their heads without support. Physical development occurs at different times for all children depending on many factors, such as the child’s unique characteristics, the family’s values and culture, and available resources. However, many infants and toddlers experience developmental milestones at similar times. The chart below outlines information about what infants and toddlers are likely experiencing and learning during different periods:

Examples of Physical Development Milestones – Infants and Toddlers

2 Months

Holds head up when on tummy
Makes smoother movements with arms and legs
Relaxes hands from fists for short periods
Grasps adult finger
Kicks legs and wave arms while on back
Primitive reflexes present, including the rooting and sucking reflex

4 Months

Holds head steady without support
Brings hands to midline when laying on back
Holds and shakes toys; swings at dangling toys
Brings hands to mouth
Pushes up on elbows when lying on tummy

6 Months

Rolls from tummy to back & may begin rolling from back to tummy
Pushes arms straight when on tummy
Begins to sit with support
Supports weight on legs when standing with support
Holds a toy in both hands at once

9 Months

Sits without support
Moves into sitting position without support
Transfers items from one hand to another
Stands, holding on to adult or furniture for support
Squats to pick up a toy while holding onto furniture Picks up a toy using fingertips and thumb (pincer grasp)
Picks up a toy using fingertips and thumb (pincer grasp)

12 Months

Pulls up to stand and walks along furniture for support (“cruising”)
May take a few steps without support of an adult or furniture
May stand alone
Throws a ball with forward arm motion
Drinks from a cup without a lid with adult support

15 Months

Takes a few steps independently
Crawls over obstacles; including stairs
Feeds themself finger foods
Stacks several blocks
Makes marks on paper using a crayon

18 Months

Walks alone
Climbs on and off furniture independently
Tries to kick a ball after observing an adult
Turns the pages of a book
Drinks from a cup
Eats with a spoon

2 Years

Kicks a ball
Walks up and down stairs while holding on for support
Turns doorknobs
Strings small items onto string or shoelace
Runs
Jumps with feet together

Keep in mind that the milestones above are simply the average ages at which specific skills are observed.

Certain conditions must exist for an infant or toddler to grow and develop. A young child’s basic needs, or physical needs, include:

Food (nutritious and age-appropriate)
Shelter (protection from harm)
Warmth
Clean air and environment
Health and dental care
Activity and rest

We also know that the way we ourselves were raised is important to our understanding of how and in what contexts children develop. The values and beliefs held by our family and culture contribute to our knowledge of growth and development.

Culture Affects How We See and Interpret Behaviors and Development

Understanding the practices, beliefs, and values of the families you support can help you understand how culture shapes so many parts of an infant’s and toddler’s development. Without this understanding, it is difficult to interpret the infant’s or toddler’s behaviors and development. For example, you may believe it is important to help toddlers learn to become independent and begin to feed themselves using their fine-motor skills. A family, however, may not view independence as important because they believe it is more valuable to depend upon one another.

Other influences on infant and toddler physical growth and development are:

Prenatal care and development, including genetic inheritance, family patterns, exposure to drugs and alcohol, birth experience
Prematurity (birth before the 38th week of development) and low birth weight may result in respiration difficulties, vision problems, feeding and digestive problems
Temperament, or the ways an infant or toddler approaches his or her world
Family’s composition, lifestyle, level of education, and housing
Maturation, or the genetic or biological development that reflects a pattern of growth from conception through adolescence
Developmental delays or disabilities, including health and medical concerns

Review the handout, Infant and Toddler Physical Development located below in the Learn activities section to learn more about important milestones in physical development, as well as variations in the rate of physical development of infants and toddlers.

The Brain’s Role in Physical Development

You can easily observe infants making movements with their bodies and refining their motor skills. Thanks to advances in research and technology, we can now also see how the brain changes and grows as young children develop. At birth, the brain is 25 percent of its adult size, and by age 5, it reaches 90 percent of adult size. Early-life interactions and experiences of infants and toddlers help them make sense of the world and form connections between different parts of the brain.

These supportive experiences and connections help improve coordination and strengthen muscles. Research tells us that as infants repeat and practice different movements, such as turning their heads or reaching for an object, they are building and maintaining connections between brain cells. The brain is busy making sense and learning from the experience.

It is important for infants and toddlers to have time for these new experiences and to explore the world around them with you, a trusted and caring adult caregiver. The repeated experience of safely exploring together helps infants and toddlers learn they can trust you, while also ensuring that their brains focus on learning, developing, and making connections. If infants and toddlers do not have nurturing and responsive adults to help make them feel safe, their brains will instinctually focus on survival and they will have less opportunity to create and strengthen connections for further skill development, including physical growth.

Supporting Physical Development for All Learners

Physical development, including gross- and fine-motor skills, consumes the interest of infants and toddlers as they practice learned skills and look to develop new ones. Healthy physical development is dependent on adequate nutrition, brain development, the central nervous system, muscles, bones, and the interactions and experiences offered to infants and toddlers. By recognizing developmental delays during infancy or toddlerhood, early intervention may be more effective than if the delays are not acknowledged until later in childhood. Below are some characteristics of possible physical concerns or developmental delays:

Signs of Impaired Physical Development - Infants & Toddlers

By 2 months	Does not respond or startle to loud noises Does not visually track the movement of objects Does not smile at others Does not bring hands to mouth Cannot lift head up while on tummy
By 3 months	Does not notice hands Cannot support or hold head well Does not smile at people Does not follow movement by turning head
By 4 months	Does not coo or make sounds Does not bring objects to mouth Does not occasionally push down with legs when feet placed on a firm surface Has trouble moving eye or eyes in all directions Crosses eyes most of the time (occasional crossing of eyes normal in early months) Does not pay attention to faces, or seems very frightened by new faces or environment Difficulty sucking
By 6 months	Not gaining weight or growing in height Not responding to sounds and voices Does not bring objects to mouth Does not roll over from front to back or back to front Stiff limbs (arms, legs) with tight muscles Weak limbs (arms, legs) or body feels floppy like a rag doll Not using hands to grasp or hold objects Does not attempt to reach for objects Shows no affection for caregivers Does not make vowel sounds like "ah," "eh," and "oh"
By 9 months	Does not bear weight on legs with support Does not sit with help Does not babble (“mama”, “baba”, “dada”) Does not play any games involving back-and-forth play Does not respond to own name Does not seem to recognize familiar people Does not look where you point Does not transfer toys from one hand to the other
By 12 months	Cannot stand with help Does not search for things you hide Does not say single words like “dada” or “mama”, and does not imitate your sounds Does not imitate gestures like waving hands, clapping, or shaking head Not pointing to communicate needs or ideas Not crawling or sitting on own Not picking up small objects Loses skills once had
By 18 months	Cannot walk Does not know what familiar things are used for (brush, spoon, cup) Not imitating sounds or gestures Not playing with toys Not self-feeding Does not have at least six words and does not learn new words Not playing with toys Loses skills once had Does not seem to mind when caregiver leaves or comes back
By 24 months	Not physically active Not scribbling or stacking blocks Not showing interest in playing with toys Extra sensitive to or avoids a variety of textures Does not walk steadily Does not use 2-word phrases (for example, “drink milk”) Does not follow simple instructions Loses skills once had
By 36 months	Clumsy or inactive Not feeding self Not helping dress or undress self Not interested in playing with other children or a variety of toys Drools or has very unclear speech Does not speak in sentences Does not make eye contact Does not play pretend or make-believe Loses skills once had

Delays in physical development may affect more than gross- and fine-motor skills. For example, if an infant is unable to smile at parents or lift their arms to be picked up, this could affect social and emotional development in terms of relationship building. Recognizing some of the delays listed above can be critical to a child’s development. The connections in a baby’s brain are most adaptable in the first three years of life. These connections, also called neural circuits, are the foundation for learning, behavior, and health. Over time, these connections become harder to change. Getting children the help they need is much more effective earlier in life rather than later.

If you have concerns about an infant’s or toddler’s physical development, be sure to speak with your coach, trainer, administrator and/or the child’s parent. They may wish to share your concerns with the child’s health-care provider. Early intervention can help children improve their abilities and learn new skills. To find your state or territory’s early intervention contact information, go to: cdc.gov/FindEI

For more information, including what to say when you contact early intervention and how to get support for your family, visit: cdc.gov/Concerned.

See

Physical Development in Infants and Toddlers

Watch this video to learn what infants and toddlers can do with their bodies.

Do

How can you make sure you are providing age-appropriate experiences to support infant and toddler physical development? Take a moment to read and review the sets of guidelines on the following webpage from SHAPE America (Society of Health and Physical Educators, formerly known as the National Association for Sport and Physical Education, or NASPE): https://www.shapeamerica.org/standards/guidelines/activestart.aspx. Next, try one or more of the following activities with the infants or toddlers in your care:

When an infant is awake and active, offer tummy time — lay the baby on the floor on his or her tummy while you interact with the infant. Provide stimulating and high contrast toys or pictures for the infant to look at. Because suffocation is swift and silent, remember to never leave an infant alone when they are on their stomach—not even for a second.
Hold an infant or dance with a toddler to music. Toddlers can also swing colorful scarves in the air, dance or play maracas while the music is playing.
Encourage imitation of gestures and other movement experiences in which mobile infants and toddlers can use their bodies to interact and play.
Have toddlers experience kicking, catching, rolling, and bouncing balls.
Encourage toddlers to scribble on paper with crayons.

Incorporate daily physical play into your daily routines. Infants and toddlers enjoy being active!

Infant and Toddler Physical Development

Know the progressive path of physical milestones in the first three years

Explore

Review the handout, Scenarios – Gross and Fine Motor Development. Read the scenarios, then consider what you have learned throughout this lesson. Which characteristics or behaviors would be considered fine-motor skills and which would be considered gross-motor skills? Write these down and then think about possible ways you could support each of these young children. You can also review the handouts in the Learn section for additional ideas.

Once finished, share your thoughts and responses with your trainer, coach or family child care administrator.

Scenarios – Gross- and Fine-Motor Development

Challenge yourself to support the physical development of a young infant, mobile infant, and toddler

Required: Complete and review this document with your trainer, supervisor, or administrator

Apply

Consider using the following resources in your family child care program. Use the Milestone Moments document to monitor the physical development of the children in your program. Parents may be interested in the Milestone Tracker Mobile App from the CDC, which they can access here: https://www.cdc.gov/ncbddd/actearly/milestones-app.html. The resource, What Grown-Ups Understand About Child Development, is a national benchmark survey sponsored in part by ZERO TO THREE. Read over the survey findings of this study and think about your work with families and the way you gather and share information with them regarding the physical development of the infants and toddlers in your care.

Milestone Moments

Know the developmental milestones from age 2 months to 5 years

Milestone Moments - Spanish

Conoce los hitos del desarrollo desde los 2 meses hasta los 5 años

What Grown-Ups Understand About Child Development

Read about a study that examines what adults understand (and misunderstand) about child development

Glossary

Developmental milestones:

A set of skills or behaviors that most children can do at a certain age range

Fine-motor development:

The development of skills that involve the use of smaller muscles in the arms, hands, and fingers that allows a child to perform tasks such as drawing, cutting with scissors, stringing beads, tying, zipping, or molding

Gross-motor development:

The development of skills that involve the use of large muscles in the legs or arms, as well as general strength and stamina; examples of such skills include jumping, throwing, climbing, running, skipping, and kicking

Rooting reflex:

An infant’s turning of the head toward things that touch her or his cheek

Sucking reflex:

An infant’s sucking at things that touch her or his lips

References & Resources

Allen, K. E., & Marotz, L. (2001). By the ages: Behavior and development of children pre-birth through eight. Clifton Park, NY: Thomson Delmar Learning.

Berger, S. E., & Adolph, K. E. (2003). Infants use handrails as tools in a locomotor task. Developmental Psychology, 39: 594-605.

Blakemore, C. (2003). Movement is essential to learning. Journal of Physical Education, Recreation and Dance, 74(9): 22-25, 41.

Bosco, F. M., Friedman, O., & Leslie, A. M. (2006). Recognition of pretend and real actions in play by 1- and 2-year-olds: Early success and why they fail. Cognitive Development, 21: 1-10.

Bourgeois, K. S., Akhawar, A. W., Neal, S. A., & Lockman, J. J. (2005). Infant manual exploration of objects, surfaces, and their interrelations. Infancy, 8: 233–252.

Centers for Disease Control and Prevention. (2022). Developmental milestones. https://www.cdc.gov/ncbddd/actearly/milestones/index.html

Claxton, L. J., Keen, R., & McCarty, M. E. (2003). Evidence of motor planning in infant reaching behavior. Psychological Science, 14: 354-356.

Clearfield, M. W., Osborne, C. N., & Mullen, M. (2008). Learning by looking: Infants’ social looking behavior across the transition from crawling to walking. Journal of Experimental Child Psychology, 100: 297-307.

Comfort, R. L. (2005). Learning to play: Play deprivation among young children in foster care. Zero to Three, 25: 50-53.

The National Early Childhood Technical Assistance Center (NECTAC). (2011). The importance of early intervention for infants and toddlers with disabilities and their families. https://files.eric.ed.gov/fulltext/ED522123.pdf

Squires, J. & Bricker, D. (2009). Ages & stages questionnaires: A parent-completed child monitoring system (3rd ed.). Brookes Publishing Co.

Ward, M., Lee, S., & Lipper, E. (2000). Failure to thrive is associated with disorganized infant-mother attachment and unresolved maternal attachment. Infant Mental Health Journal, 21(6): 428-442.

Waters, E., Weinfield, N., & Hamilton, C. (2000). The stability of attachment from infancy to adolescence end early adulthood: General discussion. Child Development, 71(3): 703-706.

Zeanah, C. (Ed.). (2000). Handbook of Infant Mental Health (2nd ed.). New York: The Guilford Press.

Physical Developmental Milestones: Infants and Toddlers