Occupational Milestones

A child may benefit from seeing an occupational therapist if they are having difficulty with the everyday skills needed to play, learn, and take care of themselves. Occupational therapy helps children become more independent in their daily lives. Children that have difficulties with tying shoes, sensory barriers and handwriting may need occupational therapy. See how your child is developing by looking at the occupational therapy milestones chart.

Birth-6 Months

  • Reflexive grasp (at birth)

  • Global ineffective reach for objects (3 months)

  • Voluntary grasp (3 months)

  • 2 handed palmar grasp (3 months)

  • 1 handed palmar grasp (5 months)

  • Controlled reach (6 months)

Risks of Missing Milestone

  • Poor muscle development and control

  • Delayed ability to play independently

  • Delayed sensory development due to delayed interaction with toys and other sensory objects

6-12 Months

  • Reaches, grasps, puts object in mouth

  • Controlled release of objects

  • Static Pincer grasp (thumb and one finger)

  • Picks things up with pincer grasp (thumb and one finger)

  • Transfers objects from one hand to another

  • Drops and picks up toys

Risks of Missing Milestone

  • Poor development of hand and finger strength

  • Poor manipulation of objects resulting in delayed play skills

  • Delayed sensory development due to lack of sensory play experiences

1-2 years

  • Builds tower of three small blocks

  • Puts four rings on stick

  • Places five pegs in pegboard

  • Turns pages two or three of a book at a time

  • Scribbles

  • Turns knobs

  • Paints with whole arm movement, shifts hands, makes strokes

  • Self-feeds with minimal assistance

  • Able to use signing to communicate

  • Brings spoon to mouth

  • Holds and drinks from cup independently

Risks of Missing Milestone

  • Poor development of hand and finger strength

  • Delayed independent play skills

  • Delayed development of self care skills (such as eating)

  • Delayed manipulation skills

2-3 years

  • Strings four large beads

  • Turns single pages of a book

  • Snips with scissors

  • Holds crayon with thumb and fingers (not fist)

  • Uses one hand consistently in most activities

  • Imitates circular, vertical, and horizontal strokes

  • Paints with some wrist action, makes dots, lines, circular strokes

  • Rolls, pounds, squeezes, and pulls playdough

  • Eats without assistance

Risks of Missing Milestone

  • Delayed self-care skills (such as eating)

  • Delayed pre-writing skill development

  • Delayed manipulation of small objects such as toys, pencils and scissors

  • Frustration when manipulating small toys and objects

3-4 years

  • Builds tower of nine small blocks

  • Copies circle

  • Imitates cross

  • Manipulates clay material (rolls balls, makes logs, cookies)

  • Uses non-dominant hand to assist and stabilise the use of objects

  • Snips paper using scissors

Risks of Missing Milestone

  • Delayed pre-writing skill development

  • Frustration and/or avoidance of pencil based tasks

  • Poor pencil grasp and pencil control

  • Poor self-care skills (such as eating)

  • Delayed drawing skills

4-5 years

  • Cuts on line continuously

  • Copies cross

  • Copies square

  • Writes name

  • Writes numbers 1-5

  • Copies letters

  • Handedness is well established

  • Dresses and undresses independently

Risks of Missing Milestone

  • Difficulties holding and manipulating a pencil

  • Difficulties learning to write name and other letters of the alphabet

  • Dependence on caregivers for every day activities such as dressing

  • Frustration and/or avoidance of pencil based tasks

5-6 years

  • Cuts out simple shapes

  • Copies triangle

  • Colours within lines

  • Uses a 3 fingered grasp of pencil and uses fingers for moving

  • Pastes and glues appropriately

  • Can draw basic pictures

Risks of Missing Milestone

  • Difficulties learning to form letters and numbers correctly

  • Poor handwriting

  • Difficulties demonstrating academic ability on paper

  • Fatigue during pencil based tasks

  • Frustration and/or avoidance of pencil based tasks

6-7 years

  • Forms most letters and numbers correctly

  • Writes consistently on the lines

  • Demonstrates controlled pencil movement

  • Good endurance for writing

  • Can independently build Lego and square blocks

  • Ties shoelaces independently

Risks of Missing Milestone

  • Difficulties getting ideas down on paper

  • Experiences fatigue during handwriting tasks

  • Difficulty keeping up in class due to slow handwriting speed

  • Poor legibility of handwriting

  • May impact on self-esteem when comparing work to peers

  • Possible frustration and/or behavior difficulties due to avoidance of pencil based tasks

“Every student can learn, just not on the same day, or the same way.”

― George Evans

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Have questions about your child’s development?

Call 707.674.5090 or send us an email. Ask about a free consultation!