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Can Washington Therapy Center Help My Child?

If your child is experiencing difficulties with day -to -day functioning at home, at school or in the community then WTC may be able to help. If your child is not reaching some of the below milestones, early intervention is encouraged. Early intervention into your child's developmental delay is essential. If you recognize that your child is not reaching the below Motor Skills Milestones and Speech, Language, Oral Motor and Feeding Milestones, you can call us at(252) 975-1993.

My child did not qualify for occupational therapy services in the school district, does that mean they do not need occupational therapy?

  • Answer:
    Not necessarily. Occupational therapy that is practiced in the school setting is different compared to occupational therapy services in other settings. Many times a student may not qualify for occupational therapy services in the school district. For a student to qualify they often need to show a significant skill deficit that impacts their ability to learn in the school setting. Many school districts do not offer occupational therapy services to students who do not have an IEP and are not serviced in Speech Therapy services. These students may show difficulties in the school setting but are not able to receive services because their difficulties lie within the occupational therapy area of practice. These students may need occupational therapy services and will not be able to receive them through the school district.

    The private area of practice is much broader and can impact the child as a whole instead of only focusing on their ability to perform in the school setting and complete school related tasks. A child will be able to receive occupational therapy services that relate to other skill areas that he or she is having difficulty with that a school may not be able to address.

Motor Skills Milestones

First Month

  • Baby orients visually when head is supported.
  • Baby moves both arms in wide, shoulder originating movements.
  • Elbows are flexed and recoil into flexion when passively extended.
  • During active periods, baby kicks with rhythmical and reciprocal patterns.
  • Baby's hips, knees and ankles recoil into flexion when passively extended When pulled to sit, baby changes facial expression to indicate awareness that something is wrong with head position.
  • Baby takes weight and extends the legs When leaned forward while standing, baby responds with well-organized reciprocal walking movements.


Third Month

  • Baby uses symmetrical and asymmetrical head movements.
  • Baby is alert and aware of the environment.
  • Baby consistently follows an object or face horizontally from side to side and vertically when head is actively stabilized at midline, visual convergence begins and baby can regard a toy in midline.
  • Baby uses symmetrical and asymmetrical upper extremity movements and postures.
  • Baby actively moves arms:
    • Shoulder external rotation 90 degrees and internal rotation onto body.
    • Shoulder abduction to 90 degrees, adduction to sides.
    • Elbow extension and flexion.
  • Baby brings hands to the body and explores mouth, body or clothing.
  • Baby kicks with symmetrical and reciprocal patterns.
  • Baby lifts head up 45 degrees to 90 degrees midline and maintains it without bobbing.
  • Baby moves elbows in line with or in front of the shoulders.
  • Baby usually assumes frog-legged position (Symmetrical hip flexion, abduction, external rotation, knee flexion, and ankle dorsiflexion and eversion).
  • Baby initially has a head lag, but as the baby comes closer to upright position, baby lifts head without chin tucking.
  • In sitting, baby extends back and maintains weight on the ischial turberosities.
  • Baby rights head with hyperextension and scapular adduction when the shoulders are in front of the hips.
  • Baby accepts weight on both feet.


Sixth Month

  • Baby actively flexes, reaches hands to feet, and plays in mid-positions.
  • Baby dissociates eye movements from head movements.
  • Baby can track an object with the eyes, without the head moving.
  • Baby flexes against gravity, lifting buttocks without flexing spine.
  • Baby reaches with one or both hands.
  • Baby reaches hands to lifted feet.
  • Baby grasps an object with one hand and explores it with the other hand.
  • Baby experiments in the hands-to-feet position.
  • Baby brings and holds hips close to 90 degrees of flexion.
  • Baby dissociates the lower extremities in supine, placing one foot on the opposite knee.
  • Baby maintains and recovers disturbed balance while legs are lifted in supine.
  • Baby actively rolls from supine to prone Baby pushes up onto extended arms.


Ninth Month

  • Baby is independent and functional in sitting.
  • Baby easily transitions in and out of sitting.
  • Baby's trunk control is well developed; therefore, baby uses a variety of shoulder and forearm movements for reaching and moving Baby uses an inferior pincer grasp, with thumb adduction to the lateral border of the index finger.
  • Baby uses crawling as primary means of locomotion to explore and to obtain and transport toys Baby assumes kneeling position with and without use of hands.
  • Baby can climb up into a chair but does not know how to turn and sit down.
  • Baby can ascend stairs but does not know how to descend. Baby lowers self from standing to retrieve toys from the floor.
  • Baby abducts face-side leg with hip flexion and knee extension and places foot on the floor.
  • Baby walks forward when supported at the hands in standing.


Twelfth Month

  • Baby easily moves in and out of sitting to quadruped, kneeling, squatting and standing.
  • Baby's release is smooth and graded for large objects but still clumsy for small ones.
  • Baby performs activities with two hands.
  • Baby begins to use hands in complementary asymmetric roles, such as using one hand to hold a jar while using the other hand to unscrew the lid.
  • Baby uses crawling to move quickly. Baby may use a squatting position for play.
  • Baby can rise from quadruped to stand without external support.
  • From standing, baby can lower the body with or without external support. Baby walks independently


Between Ages One and Two:

Gross Motor:

  • walks alone
  • walks backwards
  • picks up toys from floor without falling
  • pulls toys, pushes toys
  • seats self in child size chair
  • walks up and down stairs with hand held
  • moves to music.

Fine Motor:

  • builds tower of three small blocks
  • puts four rings on stick
  • places five pegs in pegboard
  • turns pages two or three at a time
  • scribbles
  • turns knobs
  • throws small ball
  • paints with whole arm movement, shifts hands, makes strokes

Between Ages Two and Three:

Gross Motor:

  • runs forward well
  • jumps in place with two feet together
  • stands on one foot (with aid)
  • walks on tiptoe
  • kicks a ball forward.

Fine Motor:

  • strings four large beads
  • turns single pages
  • snips with scissors
  • holds crayon with thumb and fingers (not fist)
  • uses one hand consistently in most activities
  • imitates circular, vertical, horizontal strokes
  • paints with some wrist action; makes dots, lines, circular strokes
  • rolls, pounds, squeezes, and pulls clay

Between Ages Three and Four:

Gross Motor:

  • runs around obstacles
  • walks on a line
  • balances on one foot for five to ten seconds
  • hops on one foot
  • pushes, pulls, steers wheeled toys
  • rides tricycle
  • uses slide independently
  • jumps over six inch high object and lands on both feet together
  • throws ball overhead
  • catches a bounce ball.

Fine Motor:

  • builds tower of nine small blocks
  • drives nails and pegs
  • copies circle
  • imitates cross
  • manipulates clay material (rolls balls, snakes, cookies)

Between Ages Four and Five:

Gross Motor:

  • walks backward toe-heel
  • jumps forward 10 times without falling
  • walks up and down stair independently, alternating feet
  • turns somersault

Fine Motor:

  • cuts on line continuously
  • copies cross
  • copies square
  • prints some capital letters

Between Ages Five and Six:

Gross Motor:

  • runs lightly on toes
  • walks on balance beam
  • can cover 2 meters hopping
  • skips on alternate feet
  • jumps rope
  • skates

Fine Motor:

  • cuts out simple shapes
  • copies triangle
  • traces diamond
  • copies first name
  • prints numerals 1 to 5
  • colors within lines
  • has adult grasp of pencil
  • had handedness well established
  • pastes and glues appropriately

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Speech, Language, Oral Motor and Feeding Milestones

By Three Months

  • Oral Motor Feeding
    • Establishing a feeding routine that is typically stress free and showing adequate weight gain.
  • Language
    • Briefly gazes at people.
    • Becomes quiet when picked up.


By Six Months

  • Oral Motor Feeding
    • Enjoys mealtime.
    • No longer loses liquid during sucking from bottle or breast.
    • Showing interest in other people‚Äôs food.
  • Language
    • Babbles for attention.
    • Turns and looks in direction of sound.
    • Makes many different sounds.


By Twelve Months

  • Oral Motor Feeding
    • Liquids are primarily from a cup even though may still be breast or bottle feeding.
    • Eating coarsely chopped table foods, including easily chewed meats.
    • Enjoys cookies, crackers and cereals for snacks.
  • Language
    • Using 2-6 words other than Mama and Dada.
    • Imitates familiar words.
    • Understands simple instructions.
    • Recognizes word/object relationship.


By Eighteen Months

  • Oral Motor Feeding
    • Enjoys most table foods safely.
    • Self feeding with some assistance.
    • Drinking from an open cup with some assistance with minimal loss of liquid.
  • Language
    • Uses 10-20 words, including names.
    • Points to toes, eyes and nose.
    • Imitates words and sounds more precisely.


By Two Years

  • Oral Motor Feeding
    • No loss of liquid when drinking and cup is removed.
    • Chews and swallows with no food or saliva loss.
    • Swallows solid foods, even those with combinations of texture with lips closed.
  • Language
    • Has about a 300-word vocabulary.
    • Listens for the meaning of words.
    • 2-3 word sentence length.
    • Asks "What" and "Where" questions.
    • Asks for drink, toilet or food.


By Two and a Half Years

  • Oral Motor Feeding
    • Eats the same foods as the rest of the family.
    • Drooling is not present.
  • Language
    • Has a 450 word vocabulary.
    • Gives first name.
    • Uses past tense.
    • Likes to hear the same story repeated.
    • Talks to children and adults.
    • Can name common pictures and things.


By Three Years

  • Has a 1000 word vocabulary.
  • Uses 3-4 word sentences.
  • Can relay or tell a story or idea.
  • Can stay on task for 8-9 minutes.


By Four Years

  • Uses 4-5 word sentences.
  • Asks "who" and "why" questions.
  • Identifies some colors and shapes.
  • Stays on task for 11-12 minutes.


By Five Years

  • Uses 5-6 word sentences.
  • Knows full name and address.
  • Uses all speech sounds correctly.
  • Asks questions to get information.
  • Uses all types of sentences.
  • Understands spatial relationships.

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