Every child develops on their own timeline. Your child may master certain new skills quickly, but may need more time to get the hang of others.
When development doesn’t always move in a straight line, it can be difficult to know what to expect at different ages. It may be hard to tell whether challenges like frustration, avoiding certain tasks, or needing more help in some areas are just temporary stumbling blocks or signs of a developmental delay.
Occupational therapy can help your child strengthen the foundational skills they use every day by addressing the areas where they need extra support. This helps them participate in age-appropriate activities and thrive in daily life.
What Are Developmental Delays?
A developmental delay means a child is having difficulties reaching certain age-related milestones. Pediatric therapists use developmental milestones as helpful guideposts to understand how skills typically emerge over time.
These milestones are not strict deadlines, and children often reach them with some variation. The following examples reflect general age ranges therapists use to understand when OT-related foundational skills commonly begin to develop.
By 12 to 18 months:
- Drinks from a straw
- Copies other children when playing
- Transitions from sitting on the floor to standing without falling
- Transitions from standing to sitting on the floor without falling
- Grasps a thick crayon or pencil
- Turns a page in a cardboard book
- Pulls off socks and shoes
- Feeds self finger foods
- Puts objects into others
- Explores toys using hands and mouth
- Feeds themselves with fingers
- Walks
- Shows interest in simple play routines
By 2 to 3 years:
- Jumps down off a low surface, such as a curb
- Jumps forward 4 inches
- Goes up stairs without using a rail, with both feet placed on each step
- Throws ball 3 feet in air
- Kicks a ball 3 feet forward
- Rides a push bike (bike without pedals)
- Runs, climbs, and explores movement
- Drinks from a regular open cup
- Zips and unzips if someone latches it to get started
- Takes off own clothes
- Helps with dressing tasks such as pushing arms through sleeves
- Scribbles without going off paper
- Builds block tower with 4-6 blocks
- Can sit down to perform an activity, look at a book, or play a game
- Climbs and explores the playground
- Uses feeding utensils (may be messy)
- Imitates actions during play
By 3 to 4 years:
- Goes up stairs without using a rail, placing one foot on each step
- Rides a tricycle
- Hops on one foot
- Jumps down from 2 feet
- Climbs well on a jungle gym
- Grabs a pencil/crayon with a grasp that looks more like an adult grasp
- Screws and unscrews jar lids
- Eats with utensils
- Pours from one container to another accurately
- Completes a simple puzzle
- Can dress and undress with loose clothing
- Cuts paper in half with scissors on a mostly straight line
By 4 to 5 years:
- Walks downstairs without using a rail, placing one foot on each step
- Stands on each foot for 5 seconds with good balance
- Rides a 2-wheeled bike with training wheels
- Walks backwards for over 4 feet
- Climbs well on a jungle gym
- Puts shoes on correctly (not including laces)
- Colors circle well
- Draws a person with >3 body parts
- Dresses and undresses without much help
- Copies a cross and square
- Cuts simple shapes
- Buttons and unbuttons
- Independent for toileting, washing hands, and clothing management
- Engages in pretend/make believe play
- Participates in cooperative play with peers
- Follows routines and transitions between activities
By early school age:
- Maintains attention for seated activities
- Can skip, complete jumping jacks, pushups, sit ups
- Independent with zipping
- Copies some letters and a triangle
- Brushes teeth independently
- Uses hands for writing and classroom tasks
- Participates in group activities with peers
How Developmental Delays Impact Your Child
Children use a combination of motor skills, attention, sensory regulation, and coordination to participate in everyday activities. When a child has difficulty developing skills in one or more of these areas, it can affect how they participate through daily routines at home, during play, and in learning environments.
Developmental skills also build on one another over time. When an early skill is harder to develop, it can impact development of more complex skills later on. For example, difficulty with early fine motor skills like scribbling with a crayon can make learning to write during the school years more challenging. In the same way, delays in movement, attention, or sensory regulation can affect a child’s ability to keep up with classroom routines, social interactions, and academic demands.
Signs of Developmental Delays in Children
If your child is having difficulties in any of the following areas, it may be beneficial to complete an evaluation with a pediatric occupational therapist. Though an occupational therapist cannot diagnose a developmental delay, they can strengthen those skills to set your child up for success in the future!
- Have difficulty staying seated or engaged during meals, play, or group activities
- Have limited interest in toys, exploring their environment, or hands-on play
- Struggle to follow directions or complete tasks with multiple steps
- Need more help than expected for their age with self-care routines such as dressing or feeding
- Become easily frustrated or overwhelmed when activities feel challenging
- Avoid participating with peers or group play
- Have difficulty transitioning from one activity to another
How Occupational Therapists Treat Developmental Delays
Occupational therapists help children with developmental delays build the foundational skills needed for independence in daily life. Treatment focuses on strengthening the areas where a child needs extra support, including:
- Motor skills: strength, balance, and coordination
- Sensory processing and regulation: processing sensory input, such as what they touch, hear, or taste (and more!) to feel regulated and ready to learn
- Fine motor and hand skills: grasping, drawing, using utensils, and managing classroom tools
- Play, attention, and participation: following directions, taking turns, and staying engaged in activities
- Independence in daily routines: dressing, feeding, organizing belongings, and managing transitions
What Occupational Therapy May Look Like
Therapy begins with an evaluation to understand your child’s strengths, areas of growth, interests, and daily routines. From there, the occupational therapist creates an individualized plan that uses play-based activities to support development in meaningful ways.
Treatment is made up of activities that help build strength, coordination, attention, and/or independence in ways that feel engaging and achievable. While therapy may look like play on the surface, each activity is chosen intentionally to support the skills your child uses every day.
For example, a therapy session may include:
- Movement-based activities such as climbing, crawling, pushing, or pulling to support the strength, balance, and body awareness needed for active play and safe movement
- Fine motor skill activities like puzzles, stacking games, drawing, or using tools to strengthen the hand skills needed for tasks such as feeding, dressing, and classroom work
- Sensory-related activities such as playing with different textures, playing in dynamic environments with different visual and auditory inputs, and engaging in movement activities to provide proprioceptive and vestibular inputs for regulation
- Attention-building activities that encourage following directions, taking turns, staying engaged, and completing activities from start to finish
- Daily routine practice such as dressing, feeding, organizing belongings, or transitioning between activities by breaking tasks into manageable steps
Your child’s occupational therapist will also give you practical ways to work with your child at home so they can practice their new skills during everyday routines such as mealtimes, playtime, and getting ready for the day. This helps your child strengthen what they learn in therapy and gain confidence and a sense of accomplishment when they successfully apply what they learn to their daily lives.
Reach Out to More To Say Pediatric Development & Therapy for Help
If you have concerns about your child’s development and are in the Branford or Oxford, CT, area, the team at More To Say Pediatric Development & Therapy can help. Not local to those areas? No problem! We offer telehealth services to families that live in Connecticut! Call us at (203) 828-6790 to speak to our intake coordinator to schedule an evaluation. We’re here to help your child develop the skills they need for independence and to thrive in daily life.
