Motor Skills: Development in Infancy and Early Childhood

Cibelle KMR Formiga, University of Gois State, Gois, Brazil

Maria BM Linhares, School of Medicine at Ribeiro Preto, University of So Paulo, So Paulo, Brazil
2015 Elsevier Ltd. All rights reserved.

Abstract
This article describes motor development in infancy and early childhood, especially highlighting the major motor skills in the
rst year of a childs life. The continuing development of motor skills in children means the acquisition of independence and
the ability to adapt to the physical and social environment. Motor skills in posture horizontal, vertical, and locomotor skills
allow the child greater body control and improvement of social skills and interaction. The motor behavior is the basis for the
development of other skills throughout childhood.

Introduction
Child development is a complex interaction process of biological aspects with various environmental inuences and
experiences. Theories have been developed to explain how
changes occur in the body of infants and in their ability to
interact with the environment.
The continuing development of motor skills in children
means the acquisition of independence and the ability
to adapt to the physical and social environment. Motor
skills and cognitive processes inuence each other and are
manifested mostly through behavioral motor modalities
(Flehmig, 1992).

Theories of Motor Development

Regarding the evolution of knowledge about the study of
child development, one can highlight the emergence of some
theories that attempt to explain how the behavioral learning of
the infant occurs from the prenatal period until the end of the
sixth year of postnatal life. In this respect, the most studied
theoretical frameworks are the neuromaturational theory (NT)
and dynamical systems theory (DST).
The NT of motor development is the traditional model and
remains the most frequently reported theory in textbooks
about motor development (Gesell and Amatruda, 1945;
McGraw, 1945). The central tenet proposes that changes in
gross motor skills during infancy result solely from the
neurological maturation of the central nervous system (CNS).
Advancements in the science of embryology led to the
discovery that the embryo developed in a symmetrical
manner, beginning from cephalocaudal and proximal to distal
directions (Gesell and Amatruda, 1945; McGraw, 1945). From
these observations, four assumptions have been formulated,
which characterize the neuromaturational model: primitive
movements for controlled movements, reex activities for
voluntary activities; motor development progresses in a cephalocaudal direction; movement is rst controlled proximally
and then distally; the sequence of motor development is
consistent among infants; and the rate of motor development
is consistent for each infant.

International Encyclopedia of the Social & Behavioral Sciences, 2nd edition, Volume 15

The DST emerged in the early 1980s as a new theoretical

explanation for the changes that occur over time in motor
behavior and motor skills of children (Thelen et al., 1987). The
theoretical framework includes all areas of development, being
derived from psychological theories, physics, chemistry, and
mathematics. Researchers have postulated that when a new
behavior is developing, it is dependent on an input of all
contributions of the systems. This behavior may have characteristics that could not have been determined by the evolution
of individual behaviors.
This observation was transferred to human movement by
Bernstein (1967). He noted that the joints and muscles never
work in isolation but with a coordinated synergy. It was
postulated that the brain controls muscle groups better than
individual units and that the muscle synergies themselves are
able to autonomously modify an independent movement.
This theoretical approach also recognizes the maturational
level of the CNS as an important component for success of the
task, but it is not the only factor. Other variables inuencing the
nal motor behavior include the emotional state of the infant,
the degree of motivation, cognitive awareness, the infants
posture, muscle strength, and biomechanical leverages. The
shape, size, and weight of the toy also determine how the
motor skill is executed. In contrast to the neuromaturational
model that recognizes only the inuence of the cerebral cortex,
the dynamic motor theory approach takes into consideration
all of the factors impinging on the motor outcome (Thelen,
1989; Thelen et al., 1990).
In summary, the systems approach to motor development
represents a holistic and advanced theoretical model. The
infant, the environment, and the functional signicance of the
task cannot be isolated from each other because they represent
a synthesized unit and the motor behavior observed as an
output is a product of their interactions. The system is capable
of autonomously modifying the motor skill, depending on the
constraints imposed on the system and the level of functioning
of each unit in the system. Elements composing the system
can mature in different ways, and any single factor can act as
rate limiting, delaying the emergence of a new motor skill
(Thelen, 1995).
The theoretical framework presented here provides professionals who work with infants an opportunity to reassess the

http://dx.doi.org/10.1016/B978-0-08-097086-8.23071-7

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Motor Skills: Development in Infancy and Early Childhood

traditional paradigm used to describe and understand the

motor development.

Motor Skills in Infancy

The motor development of infants is divided into quarters or
months, dening the motor behavior of the infants at each
stage. However, these steps are not xed and depend on the
interaction with the infants environment and experiences. The
time in which the infant is able to perform various motor acts
depends to some extent on the opportunities to rehearse them,
varying according to the environment and the way the child
was stimulated (Shepherd, 1995).
Each infant demonstrates his or her characteristic development pattern once inherent characteristics suffer constant
inuence of the interplay between child and environmental
context. There is also considerable individual variation among
children of different ages, as well as within the same age group.
Yet, there are particular characteristics that allow an assessment
of the level and quality of the performance (Gallahue et al.,
2011).
The acquisition of motor skills is among the most
remarkable achievements in the rst years of life. Motor
milestones such as the emergence of sitting without support
or the rst independent steps provide a framework for
developmental monitoring of children in health supervision
visits because these milestones belong to the most salient and
best demarcated markers of developmental processes that
parents and health care professionals can observe. In clinical
practice, general pediatricians, child neurologists, and developmental professionals are often asked to predict future
outcomes on the basis of early developmental milestones
(Jenni et al., 2013).
Currently, motor development has been studied more as
a process than as a product (Tani, 2005). In this sense, the idea
of motor milestones does not offer a poor measure to know in
detail the complexity of motor skills in the rst years of a childs
life (Adolph and Robinson, 2013). There is a recent trend in
enhancing the quality and control of movements by the child
than just whether or not this carries certain motor behavior.
Moreover, one cannot fail to consider the cross-cultural inuence on motor development. The rate of motor development
may differ between children of different cultures, such as
Chinese, African, or American. However, the product development appears to be similar and compatible among them
(Karasik et al., 2010).
Despite the existence of motor milestones, when studying
motor development of the child, it is necessary to verify the
cultural context and not just follow Western standards of
reference (Harkness et al., 2011). The professional or researcher
should also give attention to the type of measuring instrument
that is used for the evaluation of the child or parents or both.
Each culture has its own organization, language, and habits of
life. Therefore, not all instruments are easily applicable in all
countries (Gladstone et al., 2009).
Considering the environmental characteristics in development, nutrition is also an important factor for healthy growth
and development in childhood. The study by Angulo-Barroso
et al. (2011) investigated the gross and ne motor

development at 9 months of children from the urban area of

China, Ghana, and the United States (African-American) who
were iron decient. The study revealed that African children
had better performance in gross motor skills, such as standing
with support and walking with support, and ne motor skills.
These results are also supported by previous studies in which
infants in Africa may have an advantage due to the early
stimulation with balance and postural control that is typical of
many cultures in Africa (Bril, 1986; Super, 1976; Werner, 1972;
WHO Multicentre Growth Reference Study Group, 2006).
Regarding the screening for developmental disabilities,
Bornstein and Hendricks (2013) conducted a survey of
172 000 families in 16 developing countries and concluded
that developmental disabilities vary by child age and country,
and younger children in developing countries with lower
standards of living are more likely to screen positive for
disabilities.
The development of children in the rst year of life has
been strongly marked by the explosion of gross motor skills. A
device used in evaluating this age range has been the Alberta
Infant Motor Scale (AIMS). This scale has been used in children in many cultures and has presented different results in
their interpretation of early motor development. To Japanese
children, the AIMS percentile ranks of motor development
showed results below the expected range (Uesugi et al., 2009).
In a study conducted in Brazil with 795 children between
0 and 18 months, the results were almost similar to the
Japanese study, in which children had lower mean motor skills
according to the standardization sample of the scale for most
months evaluated in the rst year of life (Saccani and
Valentini, 2012). Fleuren et al. (2007) assessed 100 children
and concluded that new percentiles should be dened for
Netherlands because the motor performance scores they
observed were below the Canadian standard. In contrast,
Syrengelas et al. (2010) conducted a study with 424 full-term
Greek infants and found that their development path was
similar to that of the Canadian children, demonstrating that
the AIMS reference values could be used without loss of
important clinical information.
The study of Tripathi et al. (2008) compared the normal
motor development scores of 300 children from Mangalore,
India, between birth and 60 months of age, on the Peabody
Developmental Motor Scales-2 (PDMS-2) with the normative
scores provided with the instrument. The authors founded
that the Indian childrens scores varied with some differing
from the normative sample, whereas others did not differ
across age groups and the different subtests of the PDMS-2.
The study concluded that it is not possible to develop
assessment tools that are culturally sensitive across different
geographical regions and environments, but it is necessary to
evaluate the cultural sensitivity of such tests for use in
a particular region and ethnic group, especially when these
assessment tools are being used to diagnose and plan treatment for a child.
To study the development of children above 2 years of age,
ethnic or cultural differences seem to be more related not only
to motor development, exclusively, but also to other areas
such as language, social and cognitive skills, product of the
interaction between organism and social environment. In
addition, each assessment tool for motor development has its

Motor Skills: Development in Infancy and Early Childhood

psychometric properties that need to be taken into account in

the analysis of the infant motor development.
In the following, the motor development will be presented
according to the process of skill acquisition in accordance
with the body posture, rather than motor milestones at ageskeys.

Development in Prone and the Neck Control

In prone position, since the rst days after birth the infant
begins to lift the head, an act of protective head tilt that is
designed to keep the mouth and the nose free. However, the
infant demonstrates an improved ability to lift the head when
held against the caregivers shoulder than when lying on the
mattress. This demonstrates that even early on, the movement
becomes easier under ideal mechanical conditions.
The neonate who spends some time exercising in prone
develops extensor muscle strength, and the ability to extend the
head and trunk develops rapidly. Within a few weeks, the
infant is able to activate the extensors of the neck and the upper
portion with enough strength to lift the head and look around.
Initially, the baby can lift the head to 45 at 2 months of age,
reaching 90 at 3 months. At this age, the maintenance of the
head in midline is possible by bilateral contraction of the
paraspinal muscles (Bly, 1994).
By 34 months of age, the baby can lift the head and chest
in prone and push himself up. As head control increases in the
prone position, visual attention enhances and the infant can
follow an object horizontally to 180 . At 5 months, the baby
can keep the head upright and can roll from prone to supine
position.
At 6 months of age, the baby can push up on the wrists
in prone and begin to perform a new activity in this posture:
the pivoting. Pivoting is when the baby moves in the frontal
plan with spine lateral exion, often inuenced by visual
interest. In this activity, the baby weight shifts on extended
arms.
At 7 months, the baby can achieve extended-arm weight
bearing and upper extremity weight lifting and reach for toys.
There is good pelvic weight shifting and lower extremity
dissociation. Increased trunk and pelvic-femoral controls
enable the baby to assume quadruped and rock in this position. From 8 months of age on, the baby will experience
changes in posture, and will rarely be static when in prone
position (Bly, 1994).

Development in Supine and to Roll

At birth, the posture of the arms and legs is predominantly
a exion pattern and such a pattern predominates during the
rst weeks of life. In a few months, the pattern turns into
semiexion, extension, and nally a posture without
a predominant pattern (Flehmig, 1992).
At 2 months of age, functional activities are still somewhat
limited, consisting of active head turning and semicontrolled
extremity movements. Visual attentiveness and visual reaching
are two of the babys most functional activities. At 2 months,
the head is rarely in midline, which may be due to the increased
cervical spine mobility. This rotation is accompanied by an
increased head extension and chin lifting.

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At 3 months of age, the baby demonstrates symmetry and

midline head orientation. The upper extremities are often
characterized by bilateral exion, bilateral abduction, and
external rotation. There is more alignment of the ribs because
there is activation of the abdominal muscles. When the
knees approach the chest from triple exion, there is an
increase in abdominal contraction that promotes the lowering
of the ribs.
At 4 months, the baby can easily alternate between
extension and exion. Head and trunk symmetry, midline
orientation, and bilateral symmetrical extremity movements
are dominant and enable the development of coordination
between the two sides of the body. At this age, the ocular
control is becoming more rened as a result of increased head
control and vice versa. The eyes are more active during
reaching for objects, though the upper limbs still lack the
coordination and control needed for reaching.
Visual xing increases head stability and ensures its
proper orientation in space. The alternating symmetrical
movements of the lower extremities and the alternating activation of trunk extensors and exors facilitate anterior and
posterior tilting of the pelvis. These pelvic movements will
provide a basis for further normal development of lower
extremity movements. The baby is also able to extend the
elbows and reach hands to knees when the hips and knees are
exed (Bly, 1994).
At 5 months, the baby can actively roll from supine to side
lying. The action is initiated with total symmetrical total
exion, similar to that of the fourth month, but when the baby
reaches side lying, the symmetry changes to asymmetry. The
lower leg extends while the top leg remains exed, and the baby
momentarily laterally rights the head (laterally exing against
gravity). The baby can bring the feet to the mouth and the
hands to the feet, using the control of upper and lower
extremities, which helps in the development of body awareness
and tactile stimulation.
Increased control for lateral exion allows the 6-month-old
to shift weight in the trunk and pelvis and assume dissociated
lower extremity position. This enables the baby to roll toward
side lying and maintain the position there. Side lying is a more
functional position for upper extremity use. The baby is also
beginning to use the lateral and dissociated movements to lift
into quadruped from prone. These dissociated lower extremity
movements mobilize the lumbar and thoracic spine.
Mobility throughout the spine, pelvis, and knee joint is
necessary to achieve reciprocal extremity movements of the
extremities during locomotion. Up to 6 months, the baby can
pull to sitting when holding the examiners hand. The baby has
sufcient antigravity control and synergistic ex control to ex
and lift the head, arms, and legs independently. At the end of
the sixth month, rolling from supine to prone is initiated by
exion, rotation, and lateral weight shift. These components
occur most frequently in the head and the lower extremities
(Piper and Darrah, 1994).
As mentioned in the earlier part of this article, motor
development is not exactly the same for all children in all
cultures. In terms of motor ability to roll, the study by Nelson
et al. (2004) found that Hong Kong Chinese infants roll from
supine to prone before they roll from prone to supine. Mean
ages of rolling over were 5.1 months for supine to prone and

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Motor Skills: Development in Infancy and Early Childhood

5.7 months for prone to supine. Age of rolling over from supine
to prone was not inuenced by usual sleep position, infants
sex, mothers intention to breast-feed infant, number of
siblings, marital status, main daytime caregiver, or feeding
method over 9 months.

Development of the Baby to Sit

Head support in the sitting position occurs at around 3 months
of age. When pulled to sit, the baby uses the optical or cervical
righting by xing the eyes on the examiner as if to reinforce
head stability. The upper extremities resist passive extension,
being inconsistently active in assisting by pulling into elbow
exion. When elbow exion occurs, it is usually observed
during the rst half of the movement. When the head becomes
stable and exes forward, active elbow exion decreases.
During pull to sit, asymmetrical reactions in the extremities are
common.
When head and trunk control have improved, head movements do not disturb the balance. The baby will use bilateral
scapular adduction to reinforce trunk stability. This response is
needed for postural stability, and stability precedes hand use.
The baby can visually track objects, but cannot catch it, and will
fall forward if left unsupported. There is a minimal resistance in
the hips, lumbar, and lower thoracic areas for forward bending.
However, the head and upper trunk do respond and resist
(Bly, 1994). When held by the forearms and pulled to sit, the
baby has the optical righting reaction and tries to reinforce
the head-righting ability by visually xing on the examiner.
At the end of the movement, the baby stabilizes the sitting
posture after passing through the erect vertical position
(Gallahue et al., 2011).
At 5 months, the baby displays increasing balance between
the exors and extensors. Erect sitting at 5 months is possible
only when the babys hands are held or the trunk is supported.
The baby can maintain trunk extension, the arms exed
forward, and the scapulae abducted.
The 6-month-old has sufcient trunk and hip control to sit
erect without support and uses a ring position of the lower
extremities for stability. The upper extremities are freed from
the postural system and can be used for reaching, manipulation, or forward protective extension. When sitting, the baby
has control of the head and trunk movements on the sagittal
plane (exion and extension). On the frontal and transverse
planes, the baby has head control, but no trunk control. When
the baby rotates the head, weight is shifted to the same side to
which the head turns. This frequently causes the baby to fall to
the side.
At 7 months, the baby can sit independently with the back
and pelvis straight. Because of increased hip and trunk control,
unsupported sitting is becoming a more functional position
in which the baby can hold and manipulate toys. However,
the baby does not yet have full sitting balance. Some babies
at this age pull themselves to stand, accomplishing this by
transitioning from quadruped to kneeling while leaning on
furniture (Shepherd, 1995).
At 8 months, the baby may use the positional stability in
sitting. The femoral-pelvic muscles and trunk muscles are
sufcient to stabilize the posture. Consequently, the baby
experiments with and uses a variety of lower extremity

positions when sitting, such as ring sitting, side sitting, long

sitting, and sitting in W position (Bly, 1994; Flehmig, 1992).
At 9 months, sitting is often a transitional state for babies
as they continue to explore the environment actively. The
baby can also transition to quadruped by rotating the trunk
and pelvis over the femur. This transition requires marked
pelvic-femoral mobility.
Static sitting is rare for 10-month-olds. When babies are
quiet in sitting, they are usually eating or exploring a toy. They
spend most of the time moving in and out of sitting, retrieving
toys, and transporting them to a new location. Wide abduction
of the legs is also possible during long sitting. This posture
provides additional positional stability, but it requires marked
mobility in the hip adductor muscles (Bly, 1994).
Between 11 and 12 months, the baby may be observed
sitting quietly when engaged in dressing, eating, or a ne motor
task. Trunk rotation occurs preferably through a greater range
than in previous months, and does not interfere with sitting
stability. Trunk rotation enables the baby to reach for objects at
the side and behind.

Development of Manual Skills

The neonate is able to xate and track an object briey as well
as track a face from side to side if it is close enough. According
to Shepherd (1995), it is likely that the coordinated control of
the eye and the hand, i.e., the ability to grasp and to observe the
hand is the beginning of the hand functional use.
The audio-visual-cephalic coordinations are present in fullterm neonates when they are around 2 months of age. Due to
the palmar grip reex, all neonates display closing of the hands.
However, when they are around 2 months of age, grasping
movements become more relaxed and more nger extension is
observed. The child begins to acquire intersegmentar hand
mouth coordination from the rst month of life, becoming
more evident in the second month.
The rst way to grasp (handobject coordination) is with
one hand, with the three ulnar ngers (fth, ring, and index
ngers) exed against the palm, where the infant only grabs the
object when it touches the hand.
At 3 months, the baby can bring hands together in midline
(handhand coordination) and ex and reopen them. The
grasp reex is gradually inhibited and at around the fth month
the child can consciously drop the object. The coordination
hand-handkerchief on the face, in which a diaper may be put
on the babys face and is withdrawn by him, begins at
approximately 4 months of age and the coordination hand
foot is present at 6 months of age.
At 7 months, the infant can also achieve a grip hook pattern
(hand grip without thumb opposition). The thumb and index
nger participate in a radial-palmar grip and both hands can be
used simultaneously. In the next phase of development, the
baby will be able to pick up small objects using all ngers, as it
is no longer necessary to compress the object against the palm.
Later, the child begins to use a pincer grasp formed by the
thumb and index nger to pick up a small object. At 9 months,
the child also displays a complete handgrip and does not return
an object in order to explore it visually and tactically. At
12 months, the baby will return the object if requested, and up
to this age most objects given to the child will be placed in the

Motor Skills: Development in Infancy and Early Childhood

mouth. From 9 months on, some babies eat independently with

a spoon, but most do it at around 15 months of age (Bly, 1994).

975

play in half-kneeling. Assumption of this posture demonstrates

the babys increased control of lower extremity dissociation
(Bly, 1994).

Development of Quadruped Position and Crawling

The quadruped position begins to be experienced by the child
some time before crawling, i.e., at around 67 months of age.
According to Shepherd (1995), not every baby crawls, but for
those who do, this method provides the primary means of
locomotion to be rehearsed. Crawling requires the child to be
capable of making adjustments in kneeling position supported
on four points. At 7 months, the baby likes new discoveries and
toys that move, as well as small objects and household utensils
and initiates transitions from sitting to quadruped and also
from prone to quadruped (Bly, 1994).
Once in quadruped, the baby can rock forward, backward,
and sideways. Rocking requires sufcient back stability to
permit scapular freedom and mobility. Rocking at rst utilizes
large movements with falling, then it changes to smaller
movements without falling. Additionally, rocking provides
vestibular, proprioceptive, and kinesthetic stimulation and
strengthens the shoulder and hip muscles (Piper and Darrah,
1994).
Diaments studies (1976) indicate that crawling begins at
8 months of age. However, some babies begin to crawl before
this age. At 8 months, the baby can move easily from sitting to
quadruped, starting this transition exing the leg and foot
under the body. The other leg remains exed, abducted, and
externally rotated, providing stability to the pelvis. The trunk
remains symmetrically extended, and movement occurs in the
sagittal plane. Marked mobility of the hip joint is necessary for
this transition. The ability to crawl is a very efcient way for the
baby to move from one place to another. They use the reciprocal extremity movements, which require a diagonal and
counterrotation control in the trunk. Crawling and its weightlifting components provide varied input into the hands,
which may contribute to the development of the palmar arches.
Between 7 and 8 months, the baby can roll over, creep, and
crawl in a matter of seconds. By the ninth month, the baby has
become quite procient at crawling. Reciprocal extremity
movements and trunk rotation continue to be used. Speed and
control during crawling are quite rened. The baby can move at
varied speeds and can quickly change directions. Crawling is
the primary means of locomotion, and the baby uses this skill
to explore the environment and to obtain and transport toys
(Gallahue et al., 2011).
At 10 months, crawling and climbing are the main activities
of the baby. These movements demonstrate and develop the
babys coordination between the trunk and the extremities. The
baby now has greater motor and body awareness to maneuver
the body over, around, or onto obstacles that may obstruct
a toy. If babies encounter obstacles while crawling, they can
continue their forward progression by climbing up onto or over
the obstacle. Infants encounter obstacles of different weights,
sizes, and stability and will thus be challenged to develop
problem-solving repertoire through experimental behaviors.
Kneeling without external support is a common occurrence
for the 10-month-old. Contraction of the quadriceps is needed
to elevate the body. Hip extensors are needed to stabilize the
trunk. The 10-month-old infant can easily transition into and

Development of the Baby to Stand and to Walk

Some authors report the onset of orthostatic position at
7 months of age (Diament, 1976). Thus, the child stands
independently and is supported at 9 months, and stands
unsupported at 11 months. At 10 months, the child is able to
stand by holding on to furniture, assumes a wide base of
support of the feet, and can go hand in hand with an adult,
evolving to one-hand support. With the continuing environment exploration guided by the ability of moving around in
space, primarily through creeping and crawling, motor skills to
stand and walk begin. The ability of rising to stand requires
good muscle activation of the legs and begin at 7 months, but
with the help of the upper extremities.
Subsequently, at 8 months, hip control on weight bearing
must be sufcient to initiate the weight shift and stabilize the
pelvis as the other leg is freed to move. The pelvic-femoral
muscles must dynamically stabilize the pelvis and femur in
the vertical position, rotate the pelvis over the femur, and
maintain external rotation of the weight-bearing leg. If the hip
muscles maintain the hip in extension and external rotation,
the weight will be transferred to the medial side of the foot.
These lower extremity actions resemble and may be precursors
to the support and balance phases of gait.
At 10 months, the upper extremities seem to be used more
for balance when rising to stand. From half-kneeling, the baby
shifts forward on the exed leg, which demonstrates good
concentric control in the quadriceps. Once in standing, the
baby uses leg muscles and minimum attendance of one hand
to control posture. The arms and hands are free for exploration
and manipulation. This eventually enables the baby to stand
without upper extremity support. The baby spontaneously
relinquishes hand support when presented with a toy that
requires two hands. For bilateral hand use to be successful, the
baby must preadjust posture for stability. Increased ankle
movements are noted in standing, especially active plantar
exion (Flehmig, 1992).
At 10 months, the ability to control their posture and lower
extremities in standing enables them to continue to vary the
cruising pattern. They may cruise sideways with lower extremity
abduction as they did in previous months, or they may turn so
that they can face the direction in which they are going. This
causes the baby walk forward holding with one hand instead of
walking to the side holding it with both hands. Motor planning
skills are being developed and practiced in standing as well as
in other activities.
At 11 months, standing without external support is a new
accomplishment for the baby. It usually occurs automatically
when babies become very interested in a toy and they want to
hold or explore it with both hands. Wide abduction of the legs
assures a wide, stable base of support. These postural adjustments occur automatically before the baby lets go of the hands.
With practice, the babys independence in walking increases
quickly.
The development during infancy of independent upright
walking is a long and arduous process that requires months

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Motor Skills: Development in Infancy and Early Childhood

of experience to reach a full exible and adaptable movement.

From a biomechanical point of view, also the gait pattern can
be changed depending on the childs experience of walking
(Bonneuil and Bril, 2012).
During initial attempts at independent walking, the
movement components tend to regress to those used in early
supported walking. The baby assumes a wide base of support
with the feet, abducts the arms, and exes the elbows. The
upper trunk xing pattern that the baby uses depends on
the goal. The most common pattern of shoulder elevation,
scapular adduction, and elbow exion is used when the
babys goals are more nonspecic, when the baby intends to
grab a toy, for instance. Because balance is poor in early
walking, the baby moves quickly and usually falls or is caught
in the arms of a parent. This does not discourage the baby or
the parents, and walking workouts are practiced until the baby
is independent (Bly, 1994).
At 12 months, the baby can lower the body with or without
external support. To do this, the baby shifts the weight posteriorly, as if sitting down. The baby exes the hips and knees but
not the ankles. The quadriceps, hip extensors, and abdominals
are also active in maintaining control. If the weight is shifted
posteriorly without the knees being exed, the baby will fall to
sitting.
Standing presents new postural challenges to the baby
because the base of support is different. When the baby is
sitting, the hips are the base of support. When the baby is
standing, the babys feet are the base of support. Initial postural
stability can be achieved through toe curling.
Most babies walk independently by or during the 12th
month. Early independent walking usually has the following
characteristics: fast speed, short stride length, short step length,
high cadence, short swing phase, wide base of support, and no
reciprocal arm swing (Flehmig, 1992; Shepherd, 1995).
At around 1314 months of age, children stand independently. A 15-month-old child can walk and move up the stairs
while held by the hands. Toe-off impulse at gait while standing
is achieved at about 16 months, and the lifting of the toes while
in bipedalism is observed at 17 months of age.
At 18 months of age, the child can climb on a chair and sit,
and can also run. These dates are not xed and maybe some
children do not go through the same developmental process of
the groups studied by the authors. Therefore, the occurrence of
unsupported walking before 12 months of age and shortly
thereafter (around 14 months) can be considered within the
normal range, taking into consideration that the child was
a full-term newborn and has no signs of neurological
impairment.
The emergence of the gait is still motivating great discussion
among the authors. The act of walking is related not only to the
maturation of the nervous system, but also to sensory experiences, and cultural factors related to genetics (Adolph and
Robinson, 2013). Every human being has a unique temperament and ability to perform the movements of locomotion and
adaptation to the environment can also be related to the
psychological characteristics of the developing child.
In addition, the performance of previous motor milestones
can be related to the acquisition of independent walking.
Study by Kimura-Ohba et al. (2011) examined the relationship between motor development milestones with the age of

walking in 290 healthy and term infants born in the district of

Osaka City, Japan. Three milestones (rolling over, sitting, and
crawling) were observed in the laboratory in infants aged 4
and 9 months by a pediatrician and a developmental
psychologist, and the age of walking was conrmed in questionnaires lled in by the parents at 18 and 27 months. The
authors found those children who could roll over at 4 months,
and sit and crawl at 9 months, walked earlier than children
who could not roll over, sit, and crawl. With regard to crawling, children who were creeping had a 1-month delay in
walking, and those who could not move forward had a 2month delay compared to typical crawlers. On multiple
regression analysis, these three milestones were positively
associated with walking. The study concludes that the age and
the patterns of sitting, crawling, and rolling over were all
related to the age of independent walking among Japanese
infants. Consideration of milestone denition and variations
is essential in medical check-up.

Development of Motor Skills after Gait

After walking independently, the child progresses to other skills
such as running, jumping, throwing, and receiving, in
a successive progression from easier skills to the most difcult
ones until being able to combine them all.
Walking has often been dened as the process of continuously losing and recovering balance in erect position. Once
independent walking has been achieved, the child progresses
rapidly to the elementary and mature stage of walking. The gait
can be considered mature in a certain moment in the motor
development of children between 4 and 7 years of age
(Gallahue et al., 2011).

See also: Child Care and Development across Cultures; ChildDirected Speech: Inuence on Language Development;
Cognitive Development During Infancy and Early Childhood
across Cultures; Cross-Cultural Research Methods in
Psychology; Infancy and Human Development; Longitudinal
Analyses of Sexual Development through Early Adulthood;
Pretend Play and Cognitive Development; Self in Culture: Early
Development; Self-Development in Childhood and
Adolescence; Social and Emotional Development in the Context
of the Family.

Bibliography
Adolph, K.E., Robinson, S.R., 2013. The road to walking: what learning to walk tells us
about development. In: Zelazo, P. (Ed.), Oxford Handbook of Developmental
Psychology, vol. 1. Oxford University Press, New York, pp. 403443.
Angulo-Barroso, R.M., Schapiro, L., Liang, W., Rodrigues, O., Shar, T., Kaciroti, N.,
Jacobson, S.W., Lozoff, B., 2011. Motor development in 9-month-old infants in
relation to cultural differences and iron status. Developmental Psychobiology 53
(2), 196210.
Bernstein, J.A., 1967. Co-ordination and Regulation of Movements. Pergamon Press,
New York.
Bly, L., 1994. Motor Skills Acquisition in the First Year: An Illustrated Guide to Normal
Development. Therapy Skill Builders, Tucson, AZ.
Bonneuil, N., Bril, B., 2012. The dynamics of walking acquisition: a tutorial. Infant
Behavior & Development 35, 380392.
Bornstein, M.H., Hendricks, C., 2013. Screening for developmental disabilities in
developing countries. Social Science & Medicine 97, 307315.

Motor Skills: Development in Infancy and Early Childhood

Bril, B., 1986. Motor development and cultural attitudes. Themes in Motor Development 35, 297313.
Diament, A.J., 1976. Evoluo Neurolgica Do Lactente Normal. Edart, So Paulo.
Eckert, H.M., 1987. Motor Development, third ed. Brown & Benchmark Publisher, USA.
Flehmig, I., 1992. Normal Infant Development and Borderline Deviations: Early Diagnosis and Therapy, fourth ed. G. Thieme Verlag, New York.
Fleuren, K.M., Smit, L.S., Stijnen, T., Hartman, A., 2007. New reference values for the
Alberta infant motor scale need to be established. Acta Paediatrica 96, 424427.
Gallahue, D., Ozmun, J., Goodway, J., 2011. Understanding Motor Development:
Infants, Children, Adolescents, Adults, seventh ed. Hardcover.
Gesell, A., Amatruda, C.S., 1945. The Embryology of Behavior: The Beginnings of the
Human Mind. Harper & Brothers, New York.
Gladstone, M., Lancaster, G., Umar, E., Nyirenda, M., Kayira, E., van den Broek, N.,
Smyth, R.L., 2009. Perspectives of normal child development in rural Malawi
a qualitative analysis to create a more culturally appropriate developmental
assessment tool. Child: Care, Health and Development 36 (3), 346353.
Harkness, S., Zylicz, P.O., Super, C.M., Welles-Nystrm, B., Bermdez, M.R.,
Bonichini, S., Moscardino, U., Mavridis, C.J., 2011. Childrens activities and their
meanings for parents: a mixed-methods study in six western cultures. Journal of
Family Psychology 25 (6), 799813.
Jenni, O.G., Chaouch, A., Caisch, J., Rousson, V., 2013. Infant motor milestones: poor
predictive value for outcome of healthy children. Acta Paediatrica 102 (4), 181184.
Kimura-Ohba, S., Sawada, A., Shiotani, Y., Matsuzawa, S., Awaya, T., Ikeda, H.,
Okada, M., Tomiwa, K., 2011. Variations in early gross motor milestones and in the
age of walking in Japanese children. Pediatrics International 53 (6), 950955.
Karasik, L.B., Adolph, K.E., Tamis-LeMonda, C.S., Bornstein, M.H., 2010. WEIRD
walking: cross-cultural differences in motor development. Behavior and Brain
Sciences 33 (23), 9596.
McGraw, M.B., 1945. The Neuromuscular Maturation of the Human Infant. AppletonCrofts, New York.
Nelson, E.A., Yu, L.M., Wong, D., Wong, H.Y., Yim, L., 2004. Rolling over in infants:
age, ethnicity, and cultural differences. Developmental Medicine & Child Neurology
46 (10), 706709.

977

Piper, M.C., Darrah, J., 1994. Motor Assessment of the Developing Infant.
W. B. Saunders Company, EUA.
Saccani, Raquel, Valentini, Nadia C., 2012. Reference curves for the Brazilian Alberta
infant motor scale: percentiles for clinical description and follow-up over time.
Jornal de Pediatria 88 (1), 4047.
Shepherd, R.B., 1995. Physiotherapy in Pediatrics, third ed. Butterworth-Heinemann.
Super, C.M., 1976. Environmental effects on motor development: the case of Africa
precocity. Developmental Medicine and Child Neurology 18, 561567.
Syrengelas, D., Siahanidou, T., Kourlaba, G., Kleisiouni, P., Bakoula, C.,
Chrousos, G.P., 2010. Standardization of the Alberta infant motor scale in full term
Greek infants: preliminary results. Early Human Development 86, 245249.
Tani, G., 2005. Comportamento Motor: aprendizagem e desenvolvimento. Guanabara
Koogan, Rio de Janeiro.
Thelen, E., Ulrich, B.D., Jensen, J.L., 1990. The developmental origins of locomotion.
In: Woollacott, M.H., Shumway-Cook, A. (Eds.), Development of Posture and Gait
Across the Life Span, second ed. University of South Carolina Press, pp. 2647.
Thelen, E., 1989. The (re) discovery of motor development: learning new things from
an old eld. Developmental Psychology 25, 946949.
Thelen, E., 1995. Motor development: a new synthesis. American Psychologist 50 (2),
7995.
Thelen, E., Kelso, J.A.S., Flogel, J.A.S., 1987. Self-organizing systems and infant
motor development. Developmental Review 7, 3965.
Tripathi, R., Joshua, A.M., Kotian, M.S., Tedla, J.S., 2008. Normal motor development
of Indian children on Peabody Developmental Motor Scales-2 (PDMS-2). Pediatric
Physical Therapy 20 (2), 167172.
Uesugi, M., Tushima, E., Shimada, T., 2009. Percentile ranks of the Alberta infant
motor scale for Japanese infant. Rigakuryoho Kagaku 24 (1), 1519.
Werner, E.E., 1972. Infants around the worlds: crosscultural studies of psychomotor
development from birth to two years. Journal of Cross-cultural Psychology 2 (3),
111134.
WHO Multicentre Growth Reference Study Group, 2006. Assessment of sex differences
and heterogeneity in motor milestone attainment among populations in the WHO
Multicentre Growth Reference Study. Acta Paediatrica Supplement 450, 6675.