A-Z List


Gross Motor

Head Control - 0-2 mos.

Short-term Goal: Child will turn her head to either side when placed on her stomach.

While the child is on her stomach, sing to her or play a musical instrument on the side to which you want her to turn her head.

Make up the appropriate songs to the following activities:

While the child is on her stomach, raise her shoulder on the side to which you want her to turn.

Stroke the child’s cheek near the corner of the mouth on the side to which you want the child to turn. This can elicit a rooting response in very young infants.

NOTE: Do all activities to both sides so the child can turn equally well to both sides.

*Visually Impaired: Motivate the child to turn his head by using musical sounds. Reward the child by gently patting and stroking him and continue to talk or sing to the child once he has turned toward you.


Rolling - 0-2 mos.

Short-term Goal: Child will turn from her side to her back (neck righting).

With the child placed on her side, try to get the child’s attention with a musical instrument so that she turns her head to track the object or follow the sound until she rolls over onto her back. Repeat for the other side of the body.

*Visually Impaired: Use musical instruments and your voice to motivate the child to turn her head. Reward the child by touching her or picking her up once she turns over onto her back.


Head Control - 0-2 mos.

Short-term Goal: Child will hold her head steady when held in an upright position.

With the child’s head resting against your shoulder, offer her a musical instrument such as a maraca or a jingle bell. Hold the object so she must lift her head away from your shoulder to see or hear it.

*Motorically Involved: If the child tends to become very stiff (throws her head back and arches her back), try holding her in a flexed position (knees bent to chest and arms crossed over her chest).


Head Control - 0-2 mos.

Short-term Goal: Child will raise her head when horizontally suspended face down (optical righting).

Place the child’s stomach over your lap or hold her suspended in the air using good support under her trunk. Have someone stand in front of the child and sing to her, singing her name and encouraging her to look up.

Place the child in the same position and show a brightly colored musical instrument to her. Slowly move the instrument upward. The child should raise her head to follow the object.

*Visually Impaired: Child will be getting stimulus from the labyrinthines in her ears to raise her head. Use strong auditory cues (your voice or a noisy toy) as an added incentive.


Head Control - 0-2 mos.

Short-term Goal: Child will lift head and hold it at a 45’ angle for at least 30 seconds when she is on her stomach.

Place a bolster or towel roll under the child’s chest to raise her head and chest slightly. Assist the child to lift her head if she is unable to do it herself. She will be able to hold it before she can lift it independently. Continue to encourage her to lift it independently.

Put a musical instrument in front of and slightly above the child’s head at a 45’ angle from the floor to motivate her to lift her head.

Sing to the child and play the instrument to encourage her to focus on it. Increase the length of time you expect her to hold her head at the 45’ angle.

Once the above activities have been accomplished, encourage the child to lift her head and turn to either side to locate a sound or toy.

NOTE: The bolster can be used in all of the above activities until the child gains sufficient head control to keep her head up for long periods of time without tiring. Use of the bolster frees the child’s hands for manipulation of musical instruments.

*Motorically Involved: Gradually build her tolerance to this position. If the child fatigues easily, give her frequent rest periods by removing the bolster and puttingher in a side –lying position.


Pre-walking - 0-2 mos.

Short term Goal: Child will move her legs in an alternating pattern when she kicks.

Tie bells to the child’s ankles or booties to encourage her to actively move her legs.

*Motorically Involved: If the child is very stiff, relax her before you attempt to move her by slowly rocking her or gently shaking her legs.


Head Control - 3-5 mos.

Short-term Goal: Child will push up while on her stomach, bearing weight on her forearms so that her head and chest are raised to 90’ (puppy position).

Place the child over a large enough bolster so that her chest is raised, but her forearms touch the floor. Encourage her to lift her upper chest and head.

Position the child with her elbows down and weight on her forearms. Help her to lift her head. Encourage her to hold her head up while you are playing a musical instrument held a little above her head. She will be able to hold this position before he can assume it.

While on her stomach, offer the child a musical instrument to encourage her to lift her head and trunk to look at the instrument and reach for it.

Rock the child from side to side while she is in the puppy position to encourage release of weight from one side and free the other arm for reaching. She should first reach for an instrument on the floor and then at shoulder level.

*Visually Impaired: Position yourself in front of the child. Use your voice and musical instruments as interesting sounds to encourage the child to lift her head up.


Standing - 3-5 mos.

Short term Goal: Child will straighten her legs and take some weight on her feet when held upright.

Hold the child firmly about the chest and bounce her on her feet until you can feel her take some of her own weight. Sing to her or play music as you help her dance.

Caution: Do not stimulate the bottoms of her feet if the child appears to have stiff or spastic lower extremities. This will only increase undesired tone.


Rolling 3-5 mos.

Short-term Goal: Child will roll from her stomach to her back.

When the child is on her stomach, entice her with a musical instrument to encourage her to actively roll over to her back. Give her practice in rolling over to the right and left.


Creeping - 3-5 mos.

Short-term Goal: Child will push her head and trunk up when she is on her stomach, so that her elbows are straight. Hips should remain straight (integration of symmetrical tonic neck reflex).

Lay the child face down over your lap. Offer the child a musical instrument which will encourage her to do a push up in order to see it. Child should be able to hold head and chest raised with her elbows straight for increasingly longer periods of time.

*Motorically Involved: Keep the child’s hips straight at all times. If raising the head and straightening the elbows increases bending at the hips, have the child stay in a bent elbow position.


Integration of Reflex - 3-5 mos.

Short-term Goal: Child will reach for her feet and bring them to her mouth when she is on her back (integration of tonic labyrinthine reflex).

Tie bells on the child’s feet. Help her reach for her feet by lifting her legs and wiggling her feet until she notices them. She will later begin doing this on her own.

*Visually Impaired: Help the child to find her feet by playing with and manipulating them.


Integration of Reflex - 3-5 mos.

Short-term Goal: Child will keep both hands at the middle of her chest (midline) while she turns her head to either side (integration of asymmetrical tonic neck reflex).

Present a musical instrument to the child at the midline and encourage her to take it with both hands or to transfer it from one hand to the other.

NOTE: This activity is designed to break up the asymmetrical tonic neck reflex (ATNR), i.e., child assumes a fencing position when her head is turned to one side: the arm on the skull side bends; the arm on the face side straightens. This reflex should not dominate the child’s pattern of movement after the fifth month.

*Motorically Involved: If the child is unable to do the activity when he is seated or on his back, position the child in a side-lying position. Consult a therapist regarding further activities to break up undesired reflexive posture.

Children with a strong asymmetrical tonic neck reflex should be held alternately in right and left arm for feeding.


Sitting - 6-8 mos.

Short-term Goal: Child will sit in a high chair or three sided child’s size chair without slumping over.

Sit on the floor and put the child between your legs. Your abdomen and legs should completely support him. Give the child a musical instrument to play with or let her look in a mirror.

*Visually Impaired: Use an infant seat with a tray in front. This additional boundary will give the child security. Place a musical instrument on the tray for the child to play. The tray should have built-up sides (1-2 inches) to prevent toys from slipping off.

Head Control - 6-8 mos.

Short-term Goal: Child will lift his head when he is on his back.

Use a folded towel or small pillow under the child’s head to give a holding it so that she must lift her head to look at it.

Position yourself at the child’s feet. Play a musical instrument, holding it so that she must lift her head to look at it.

*Motorically Involved: If the child is spastic and has a tendency to throw her head back, bring her knees to her chest and fold her arms across her body. Try to hold her in this position by using your body and one hand. Help her lift her head by placing your free hand on top of her head or by placing your hands on either side of her head. Pressure on the back of her head will increase her tendency to push back.


Head Control - 6-8 mos.

Short-term Goal: Child will spontaneously lift his head to vertical when suspended face up (optical righting).

Have someone sing the child’s name or show her a musical instrument to see if she will lift her head while you are holding her well supported under her trunk, but suspended face up in the air.

Caution: Do not try this activity unless the child has developed good head control when being pulled to sitting. Also, avoid this activity if the child suddenly stiffens or straightens her whole body so that her back is arched.

*Visually Impaired: The blind child will get input from the labyrinthines in her ears instead of from optical cues. Her response should also be to immediately raise her head.


Rolling - 6-8 mos.

Short-term Goal: Child will roll from her back to her stomach (integration of neck righting; body-on-body righting begins).

Entice the child with a musical instrument so she starts to reach across her body for it. Hold her hips back until her trunk starts to twist or rotate. Then allow her hips to follow to complete the roll.

NOTE: Practice in rolling should be done both to the right and left sides.


Balance - 6-8 mos.

Short-term Goal: Child will adjust her body to remain upright when tipped to either side (optical righting).

Sit in a chair and hold the child so her legs straddle on of your knees. Hold her firmly around her hips and tip her to one side. Initially the child will let you tip her, but encourage her to bring head back up if she does not automatically start to do so. The child can be either facing out or facing you, looking in a full-length mirror or at another person. Be sure to tip the child to both sides. Sing a song to the tune of “Did You Ever See a Lassie,” and instead use the phrase “Have you ever seen _______, sway this way and that way.”

NOTE: As the child’s righting improves, his head will remain in midline.

*Visually Impaired: The child must learn to use information from labyrinthines in her ears to keep her head in a normal position. Help the child move to correct her position. Tell her when her head is in the right position so she actively experiences it in the correct position.


Crawling - 6-8 mos.

Short-term Goal: Child will turn in a circle (pivot) while she is on her stomach.

Use a surface that will make it easier for the child to turn (linoleum, or a smooth mat). Interest the child in a musical instrument and put it out of her reach to one side and down towards her hip. If she does not automatically start to bend her hip and knee on the opposite side, help her do this as you continue to entice her with the instrument. Once the child starts to move, continue to move the instrument away from her, encouraging her to move in a complete circle. Then encourage her to move in the opposite direction. Let her attain the instrument occasionally.

NOTE: If the child attempts to roll, keep your hand over her lower back to keep her on her stomach, but allow her to bend her hips.


Crawling - 6-8 mos.

Short-term Goal: Child will move herself forward, keeping her stomach on the ground.

Once the child can pivot easily, position a musical instrument in front of the child, just out of reach, and encourage her to move forward.

Give the child a jingle tap or other small musical instrument to hold while she crawls so she can learn how to carry something and still move.

*Visually Impaired: Work on directed reaching using a sound cue. Auditorily directed reaching must be accomplished before the child will move her body toward a sound cue.


Standing - 6-8 mos.

Short-term Goal: Child will bounce up and down when she is offered good support in a standing position.

Grasp the child around her chest and start to help her move, or bounce, up and down as you sing a song about moving up and down.

Position yourself behind the child. Help her get into a squat position so that her feet are flat. Play jack-in-the-box. Use one hand to stabilize her feet and/ or knees and the other hand to help lift the child’s trunk. Sing a song about up and down, and as you say the word up, help her stand up. Practice going up and down.

Hold the child’s hands and encourage her to bounce up and down by gently moving her arms until she does it by herself.

NOTE: At the point the child should no linger need to keep her knees stiffly locked to maintain an upright position while bearing her full weight.

Caution: These activities are not appropriate for children with spastic or stiff legs. They will only increase undesired tone.

Suggested Songs:

“Wheels On The Bus”--The people on the bus go up and down.

“Stand Up, Squat Down”--As the child becomes more adept at her ability to

change positions, gradually increase the speed with which she changes positions until she is able to perform the verses

From “Stand up, stand up, stand up, ________,

Squat down, squat down, squat down, _______.”

To: “Stand up, squat down, stand up, _______,

Squat down, stand up, squat down, ______.”


Creeping - 9-11 mos.

Short-term Goal: Child will creep forward on her hands and knees.

Place a desired musical instrument out of the child’s reach so that she must creep increasingly longer distances to retrieve the instrument.

NOTE: As the child gains in this skill, she should start to move her right arm/ left leg or left arm/ right leg together instead of using distinct motions.

Caution: Do not allow the child to bunny hop, i.e., move hands together, then feet together. This will reinforce undesirable patterns present in neurologically damaged children.

*Visually Impaired: Motivate the child to rock back and forth or move her arms and legs by trying musical instruments such as jingle bells on her hands and feet. Consult a teacher for the visually impaired or mobility training specialist.


Setting - 9-11 mos.

Short-term Goal: Child will sit steadily for at least 10 minutes without using her hands or any other support.

Give the child musical instruments to play so she becomes involved in manipulating them rather than in using her hands for support.

Offer a musical instrument so that the child must reach out to the front, to either side or over her head to get it. This will give her practice shifting and recovering her center of gravity.

*Motorically Involved: Children with cerebral palsy are often given specific exercises for their legs and arms, but their trunk is also stiff. The third activity should be stressed. If the child loses his balance, put him in side sitting position to both left and right sides.

*Visually Involved: Reaching out in space for a sound cue is a necessary precursor to any type of locomotion. These activities provide practice from a secure position.


Standing - 9-11 mos.

Short-term Goal: Child will pull to standing using a stable support.

Place a desired musical instrument out of the child’s reach--for example, on the seat of a chair. If the child is in a seated position, put her in a side sitting position and help her shift her weight over her knees. Once she is kneeling, help her lift her leg so one foot is on the floor. Then she should pull up wuth her arms and push with one leg until she is standing.

Some children move through a squat position, when going from sitting to standing.

NOTE: Child should stand with her feet spread apart to maintain a stable base of support, but her weight should be equally distributed on both feet.


Standing - 9-11 mos.

Short-term Goal: Child will lower herself to the floor once she has pulled herself to Standing.

Sit behind the child and help her sit down in your lap. The child may hold on and move slowly at first. Sing, “Sit down ______, sit down _____, sit down in my lap.

Encourage the child to let go before sitting in your lap. Sing a song about standing up and sitting down, making a game out of the activity.

Help the child lower herself to the floor. If she falls down, but is not too upset, laugh and sing, “You went boom!” so the child will learn not to be afraid of falling. If she cries, comfort her and repeat the activity. Encourage her to hold on longer so she will slow down her fall.

*Hearing Impaired: Allow the child to watch your face as you say “up” and “down.” Use an appropriate gesture. This builds links between words and her actions.


Balance - 9-11 mos.

Short-term Goal: Child will let go of support and stand alone.

Place musical instruments on the top shelf of a short table so that the child can lean on the table and gain standing tolerance as she plays the instruments.

When the child is standing and holding on with one hand, offer her a large musical instrument, such as a drum, and encourage her to hold it with both hands.

When the child is holding a musical instrument in one hand, offer her a second instrument that will require her to let go with the other hand in order to get it.


Stair Climbing - 12-15 mos.

Short-term Goal: Child will creep up stairs.

Use a low platform or one wide step. Place a desired musical instrument at the far end of it. Help the child rest her elbows and upper chest on the platform, lift up one leg, and scoot forward until his knee rests on the platform. Reward her by letting her play the instrument.

Using a stair case, use a musical instrument to entice the child on an upper step. Be sure you stand behind her to guard against falls. Help the child reach for the first step with her arms while at the same time moves her knees to the step below it.

Show the child how she can turn around and sit on a step to rest, perhaps giving him a musical instrument to play with while he is resting.

Note: If the child can creep or crawl, this is a good activity to increase coordination and strength; the child need not walk in order to try this.


Throwing - 12-15 mos.

Short-term Goal: Child will throw a ball with some propulsion or cast.

As you sit about throwing a ball, sit on the floor behind the child and help her push the ball away from herself as that she gets used to the idea of using some force to move objects away from her. Then face her so she pushes the ball to you with some direction… reward her.

Move away from the child and have her throw you the ball.

*Motorically Involved: Allow the child to sit well supported or sit alone if she is stable in that position.

*Visually Impaired: Have the child hold the ball while you take her arm through the throwing routine, using some force.

Walking - 12-15 mos.

Short-term Goal: Child will be able to walk well enough to control when she starts, stops, and turns.

Give the child musical instruments such as a jingle bell or maracas to carry in her hands while she is walking.

Sing a song about “stop and go”. Have the child walk toward you until the song says stop. Put your hands out in front of the child and prevent her from going for a few seconds. Then lift your arms and sing go. When the child seems to understand stop and go, omit the physical gestures.

Play music while the child is walking, ask her to stop walking when the music stops. Ask her to go when the music begins again. Assist with the activity until she is able to do it independently.

Play music while you are walking in front of the child. Encourage her to follow you as you turn in different directions.

Walking - 16-19 mos.

Short-term Goal: Child will run or walk very fast.

Introduce games in which the child “runs” to bring a musical instrument to you.

Play “catch me” or chase games with a drum to encourage the child to move quickly in order to hit the drum.

Demonstrate running and encourage the child to imitate you.

NOTE: This goal is the first step toward moving quickly while maintaining balance and precedes true running which occurs at a later age.

Caution: If the child tends to walk on her toes during normal activity, discontinue this activity until you have consulted with a doctor or therapist.

*Visually Impaired: These children need to gain confidence in moving about familiar surroundings. Introduce running in a barrier free environment when the child appears ready, so she will be assured of not running into unexpected obstacles. Later sounds may be used to warn child that she is approaching an object.


Walking - 16-19 mos.

Short-term Goal: Child will walk sideways.

Play circle games such as “Ring-Around-the Rosy,” circling to the right and left, which requires the child to take side steps.

*Visually Impaired: Introduce barriers to the child. Allow her to feel the wall, the table, and the amount of space in between each of them. Help her turn her body to fit in the space. Sounds may be used to indicate to the child that she is approaching a barries.


Balance - 16-19 mos.

Short-term Goal: Child will seat herself in a child size chair.

Put an adult sized chair next to a child sized chair. Demonstrate sitting down as you sing the song “Stand Up, Sit Down.” Encourage the child to imitate you. If the child does not imitate you, try to gently push her down.


Balance - 20-23 mos.

Short-term Goal: Child will be able to squat down and resume standing.

If the child cannot seat herself in a child-sized chair, she should practice that activity before attempting this one.

Demonstrate squatting down and then standing up as you sing about going up and down. Encourage the child to imitate. Hold her hands if she has problems with balance.

Ask the child to pick up musical instruments scattered on the floor and place them in a basket. Encourage her to squat down by herself.

*Visually Impaired: When the child squats down, encourage her to feel the floor. This will help build her perception of her body in relationship to external things.


Balance - 20-23 mos.

Short-term Goal: Child will jump in place.

Hold the child’s hands. Demonstrate standing on one foot and then the other. Start slowly and build up the speed of the change. Encourage the child to imitate as you sing a song about jumping.

Hold the child’s hands or have her hold on to a stable support when she practices jumping.

Let go of the child’s hands and ask her to jump. Repeat your demonstration of jumping, stressing the use of both feet.

*Visually Impaired: Try moving the child through the activity by telling her to jump while you lift her off the floor. Encourage her to bend her knees and do more of the work by gradually decreasing the assistance.


Balance - 24-27 mos.

Short-term Goals: Child will kick a ball with right or left leg.

Demonstrate kicking a large, lightweight ball as you sing a song about kicking a ball. Place the ball at the toe of the child’s foot and ask her to kick it. Hold the child’s hand if she has difficulty maintaining her balance.

Gradually decrease the size of the ball and allow the child to practice with both her right and left legs.

Roll the ball towards the child so she must kick it while it is moving. Reward any attempt.

*Motorically Involved: If the child is a hemiplegic cerebral palsied child, encourage her to kick with the non-affected foot. You may have to hold her hand to increase her balance.

*Visually Impaired: Help the child feel the ball with her toe and help her to kick it. When you roll the ball to the child, give her a verbal cue, such as “Here it comes”.


Balance - 28-31 mos.

Short-term Goal: Child will walk on her tiptoes for a distance of 10 feet.

Put musical instruments just out of the child’s reach on a table-top. Encourage the child to hold on to the table and to stand on her tiptoes. The child may initially pull up with her arms. When the child has moved within reach of the musical instrument, reward her by letting her play it. Eventually she should be encouraged to let go or to use the table only for balance.

Demonstrate standing on tiptoes as you sing an adapted version od “Tip Toe Through the Tulips”. Hold the child’s hand for support and ask her to stand up on her tiptoes.

Gradually increase the distance the child is expected to walk. This should be done barefoot, or with flexible shoes.

Caution: This activity should be avoided with children who tend to walk on their toes as part of their normal pattern, or if this form of walking increases the child’s tendency to excessively straighten her knees. This latter problem is seen in children who lack muscle tone, such as in Down’s Syndrome children.


Balance - 32-35 mos.

Short-term Goal: Child will stand on one foot and balance for 2 to 3 seconds.

Have the child kick a ball. She must stand on one foot to do this. Have the child kick with her right foot and then her left foot.

Have the child practice stepping up and down an 8- inch step leading with both the right and left feet.

Stand in front of the child and demonstrate standing on one foot. Encourage the child to imitate, holding her arms to the side fir balance.

Have the child practice standing on either foot while you count off the seconds, making a game of the activity.

*Visually Impaired: Explain what you want and help lift her leg for her. Initially allow her to hold on to a chair or low table for balance.