A-Z List

Gross Motor

Music may be used as a stimulus for the following gross motor activities to encourage smooth rhythmic movements. Some of the activities for walking may be adapted for marching or dancing.

Sitting - 6-8 mos.

Short-term Goal: Child will sit unsupported for 60 seconds.

  • Place the child in a sitting position and place her hands in front of her to prop herself up.
  • Position the child on the floor so she has something interesting to keep her attention (for example, play a musical instrument for her or place her in front of a group of other children who are singing).
  • Put the child on a small stool so her feet rest on the floor. Stabilize her around her hips until she gets her balance. Then remove you hands but be ready to catch her when she tires.

NOTE: When seated on the floor, the child’s legs should be in front of her with her legs straight and slightly apart. If she cannot tolerate this position try setting her in a ring position or try sitting tailor style.

Caution: Do not allow the child to sit with her feet behind her (w-sitting).

*Visually Impaired: Sit near the child on the floor until she feels secure. Gradually move away from the child, but keep talking or singing to her. Put familiar musical instruments within easy reach.

Standing - 6-8 mos.

Short-term Goal: Child will straighten her hips and knees and take most of her weight on her feet.

  • Suspend the child and bounce her on her feet until she takes some of her own weight. Lessen your support of her weight so she is required to take more, but continues to hold her trunk for balance.
  • When the child pulls to sitting, continue to pull her up so that the child comes to standing. Her feet should be on a firm surface. Do not continue to pull if the child resists.
  • Place the child in a baby bouncer or walker that offers sufficient trunk support for her size and weight and that allows her to put her feet on the floor.

Caution: These activities should not be done if the child has stiff or spastic lower extremities. It will only increase undesired tone.

Walking - 6-8 mos.

Short-term Goal: Child will raise one foot and attempt to step while standing.

  • Allow the child to hold onto a piece of furniture. Kneel or sit behind the child and hold her around her hips. Shift her weight from side to side.
  • Support the child under her armpits or at her hips so that her arms are out to the side. Kneel in front of the child and gently pull her towards you until she takes a step.

*Visually Impaired: Support the child firmly under the armpits. Talk and sing to her about her legs and feet. Ask her to move the foot that you touch. Consult a teacher for the visually impaired or mobility training specialist.

Balance - 6-8 mos.

Short-term Goal: Child will put her hands out to either side to protect herself if she is pushed or falls to the side while sitting (lateral propping).

  • Position yourself behind the seated child. Grasp her around her upper arm and move her to either side. At the same time bring her hand out to her side so it helps to prevent her from falling.
  • If the child should fall to her side, assist her in pushing back up to sitting.
  • When the child starts to do this automatically, gently push her to either side so she will develop quick reaction to a push.

Balance - 9-11 mos.

Short-term Goal: Child will put her hands behind her to catch herself when she has been pushed or falls to the real while sitting (posterior propping).

  • When the child is seated, position yourself behind her and slowly pull the child to the rear. At the same time, hold her upper arms and guide them to the rear so they can catch her.
  • Continue to play this game until the child automatically brings her arms behind herself and protects herself from falling to the rear.

Walking - 9-11 mos.

Short-term Goal: Child will take steps to the side as she holds on to furniture (cruising).

  • Using a crib or play pen, have the child pull up to standing and them move both hands to one side. If the child does not automatically take a step, help her move one leg. Wait to see if she takes a second step with the opposite leg. If not, help her move it. Repeat. Reverse directions in which you have the child move.
  • When the child does activity 1 by herself, stand her in the corner of her crib or play pen and move away from her. Encourage her to follow you in order to catch you. Repeat in opposite direction.
  • When the child has pulled up to a solid piece of furniture, position yourself beside it. Extend your hands for her to hang on to so that she must take one to two steps to the side and/or slightly forward.

*Visually Impaired: Ir is very important to allow the child to practice moving in a defined space (crib, play pen, or along a wall) to make her more secure with familiar surroundings. Tell her about barriers. Help her reach out to feel a barrier, like a corner of a crib. Help her turn her body and move in a new direction. Start to use a verbal labels (for example, “Now you are going to turn; “Move to the left”.).

Walking - 9-11 mos.

Short term Goal: Child will walk forward with external support for stability and balance.

  • Support the child under his armpits or at is hips or at her hips so that her arms are out to the side. Stand behind the child and prompt her to walk forward by giving her a gentle push forward. If the child does not take alternate forward steps, use your feet to push one leg forward as you help her shift her weight to the opposite leg.
  • Using the method of support described in activity 1, help the child walk toward another person or musical instrument stationed a few feet away. Gradually increase the distance.
  • Encourage the child to walk on his knees. This helps build upright balance without having to control both the knee joint and hip joint.
  • Have the child walk between 2 people with each person holding one of her hands.

Note: If parallel bars that are suitable for the child’s height are available, let her practice walking in them.

Walking - 9-11 mos.

Short-term Goal: Child will walk with one hand held.

Have the child practice walking while you gradually decrease the amount of support the child needs for stability and balance.

Walk along a wall having the child hold on to you with one hand and the wall with the other hand. As she gains confidence, lead her away from the wall.

Walk behind the child. Hold one of the child’s hands, and hold you free hand out in front of the child just out of her reach.

Holding one of the child’s hands, go for walks of increasing lengths ove a variety of surfaces (grass, carpet, sidewalks).

Note: Allow the child to walk barefoot unless she walks with her weight on the inner border of her feet so her ankles roll in. If this condition exists, consult with a pediatrician regarding the advisability of orthopedic or sturdy high-top shoes.

Balance - 9-11 mos.

Short-term Goal: Child will adjust her trunk when the supporting surface on which she is seated is tripped (equilibrium reaction).

Seat the child on a rocking board and rock the board from side to side.

Put the child in a sturdy cardboard box and rock the box from side to side.

Seat the child with her legs straddling one of your knees. Tip her from side to side.

Note: The child should adjust to the tipped supporting surface by keepig his head in midline and curving his spine. The spine’s concave side will be on the high side. His arm and leg on the high side should raise up and out for balance; his arm and leg on the lowered side should be used to catch herself while falling.

Walking - 12-15 mos.

Short-term Goal:

  • With the child standing, initially offer support under the child’s arms or around her hips. Gradually decrease the amount of support you offer until just your fingertips touch the child and she feels secure enough to try to stand on her own and take a few steps.
  • Give the child something which will not tip over that she can push – for example, a weighted baby carriage, chair, or stroller – or use something that you prevent from tipping over.
  • Once the child is standing, position yourself just out of her reach. Hold your hands out and encourage her to let go and to take a step toward you. Gradually increase the distance between yourself and the child so that she takes an increasing number of steps to reach you.
  • Give the child a stick or rope to hold on to while you hold the other end. Let go of your end when the child is walking well.

strong>“ Let the child explore a new area by either creeping on her own or by holding your hand so she familiarizes herself with the environment.

Standing - 12-15 mos.

Short-term Goal: Child will stand up by herself in the middle of the floor.

  • Kneel, facing the child. Have her practice coming to a kneeling position from a side-sitting position or from all fours. Offer only minimal assistance to keep her balanced. She should start to use external support for balance rather than to pull up.
  • In the kneeling position, help the child to move to half-kneeling with one foot flat, and then to a standing position.
  • Help him get into a squat position. Play jack-in-the – box game in which the child uses her own muscle poser to stand up, using you for balance only.
  • When the child is seated on the floor or in an all-fours position, encourage her to stand up. Extend your hand just out of her reach.

Walking - 12-15 mos.

Short-term Goal: Child will walk backward.

  • Demonstrate walking backward while you hold the child’s hand. Encourage her to imitate and give her a descriptive word for walking backward.
  • Give the child a toy (for example, a push-pull toy, a toy on a string, or a doll buggy) that can be used when she walks backward. Tell the child to walk backward. Reward for any attempts.

Walking - 16-19 mos.

Short-term Goal: Child will walk upstairs with one hand held.

  • Allow the child to hold a rail or wall shile you hold his other hand. Hold both hands if a railing in not available. Practice stepping up on to a wide platform, step, or curb (just one step).
  • Introduce the child to a small set of stairs or a longer staircase. Encourage the child to hold a rail and walk up with you. At this stage she will lead up with the same foot each time. This will take longer than alternating feet, so give her time.
  • Practice going up a staircase where there is no railing, wtill holding on to one of her hands.

*Motorically Involved: If the child is a hemiplegic cerebral palsied child, teach her to step up with the nonaffected foot.

*Visually Impaired: Help the child step up by encouraging her to feel with her foot how high she has to step up. Practice just placing her foot up and back down back down until she seems confident to go on.

Balance - 16-19 mos.

Short-term Goal: Child will balance on one foot with help.

  • Stand, facing the child and holding both his hands. Encourage her to lift up one foot by demonstrating what you want her to do. If she has problems, help her lift one leg until she gets the idea.
  • Holding the child’s hands, tell her to lift up her foot. Reward her for trying and encourage the child to lift up her other foot.

Note: Practice with both right and left legs.

Balance - 16-19 mos.

Short-term Goal: Child will adjust her trunk when being moved to the side, front, and back.

Stand behind the child, gasping her upper arms. Move her to either side.

In the same position, move the child to the front and back.

Have the child stand on a tilt board. Rock it while she tries to keep her balance.

Note: If the child stands on the floor, she should take steps to the side you are pushing to prevent herself from being tipped over. Her head and upper trunk should stay in midline. If the child is on the tilt board, she should adjust her trunk so that her head stays in the midline. The concavity of the spine will be on the high side; her arm on the high side will raise.

*Visually Impaired: Avoid this activity until the child can move freely around in her environment. Do not persist if the child is frightened.

Stair Climbing - 16-19 mos.

Short-term Goal: Child will creep backward down a flight of stairs.

  • Have the child climb down from a large chair so she gets the idea of getting down feet first.
  • Have the child go up on a step (preferably wide platform). Help him get on all fours and feel the floor behind her with her feet.Help her lower herself to the floor.
  • Once the child has crept (or walked) up a few steps, position her so she can start back down the stairs, feet first. Encourage her to hold on and to feel for each step behind her. Repeat this activity, gradually increasing the number of steps.
  • An alternative approach: teach the child to sit on the stairs and descend by going down in a seated position.

Stair Climbing - 20-23 mos.

Short-term Goal: Child will walk down stairs with one hand held.

  • Hold the child’s hand and allow her to practice stepping down from a platform, one step, or a curb. You should step down with her.
  • Introduce a longer flight of stairs. Hold her hand and step down with her. She should lead down with the same foot. This is usually her nondominant one. Also encourage her to hold the railing if one is available.
  • As the child gains confidence, increase the number of steps to reach the bottom until she can complete the entire flight.

*Motorically Involved: If the child is a hemiplegic cerebral palsied child, she should be encouraged to step down with the most affected foot.

*Visually Impaired: Give the child the opportunity to practice placing one fooor down. Call the child’s attention to feeling the depth of step.

Balance - 24-27 mos.

Short-term Goal: Child will stand on balance beam and attempt to step.

  • Tape four-inch wide masking tape to the floor. Demonstrate standing on it and them walking the line (take sideways steps and facing forward steps).
  • Put beam on the floor and encourage the child to stand on the beam, take sideways steps and forward steps.
  • Let the child just stand on the balance beam witch is off the floor. She may feel more secure if you hold her hands, but encourage her to let go so she can use her arms for balance.
  • Demonstrate taking side steps on the beam. The child should stand facing you and step sideways. Walk along with the child, but encourage her to not hold on to you.
  • Demonstrate walking on the beam facing forward, moving one foot in front of the other. Hold her hand while she does the same thing. Encourage her to try to step forward.

Stair Climbing - 24-27 mos.

Short-term Goal: Child will go up and down stairs alone (may hold rail).

Let the child practice stepping up and down on just one wide step on her own.

Encourage the child to hold a rail and go up and down stairs alone without holding your hand.

Note: If the child is fearful or unsteady, stand behind her as she goes up and in front of her as she goes down (you will back down ghe stairs) until she gains confidence.

*Visually Impaired: Help the child to count the steps as she goes up and down so she gets a sense of few or many. Encourage her to hold on to the rail and feel with her foot to determine if there are many more steps.

Balance - 24-27 mos.

Short-term Goal: Child will jump from raised step (8-12 inches) with both feet together (2-foot take-off and landing).

  • Start with a four-inch platform and increase the height as the child gains skill. Demonstrate stepping down from a step without holding on. Have the child imitate this until she is confident of not falling.
  • Demonstrate jumping. Offer to catch the child when she practices. Introduce the verbal command, “jump!” The child should step off with one foot, remain suspended a few seconds, and land on both feet.
  • When the child is proficient in the second activity, call attention to two-foot take-off by demonstrating and them reminding her to jump with both feet.

Note: Do not attempt these activities until the child can descend stairs by herself.

“Visually Impaired: Let the child feel length of platform with her hands. Then let her practice stepping up and down several times before you take her through the jumping sequence.

Balance - 28-31 mos.

Short-term Goal: Child will take a few alternate steps on the balance beam.

  • Put four-inch masking tape on the floor. Demonstrate standing on it and walking on it like a tightrope. Encourage the child to imitate.
  • Place a six-foot piece of 2-by-4 lumber on the floor. Have the child practice walking on the board, taking alternate steps. Stabilize the board if it moves.
  • Use the board as a balance beam. I.e., raised 4 inches off the floor. Hold the child’s hand and encourage her to practice walking forward along the length of the beam, leading with one foot.
  • Demonstrate walking on the beam taking alternating steps. Encourage imitation. She will probably step off the beam but urge her to continue. The child will gain confidence when she realizes stepping off will save her from falling.

Walking - 32-35 mos.

Short-term Goal: Child will walk with a heel-toe gait.

Have the child practice walking on her heels.

Practice marching and walking with an exaggerated heel strike.

Allow the child to practice walking on his tiptoes.

Demonstrate exaggerated heel-toe gait. Encourage the child to imitate.

Note: This is a normal gait and usually is seen by the time a child is three. If a child is slow to walk, these activities are not necessarily appropriate. This child should be allowed to walk and run to build up dynamic balance, without concerning her with correct patterns.

*Motorically Involved: These activities ae most appropriate for a child with a mild hemiplegia where a correct pattern is of concern. If a child has any type of muscle weakness, walking on tiptoes will increase strength in her calf muscles.

Walking - 32-35 mos.

Short-term Goal: Child will walk with a reciprocal arm seing (right leg and left are move together; left leg and right are move together).

Sing “Follow-the-Leader”’ standing in front of the child and marching in place as you swing your arms. Encourage the child to imitate.

Use music and make a game of marching so that your movements are exaggerated. Child’s attention should be paid to swinging her arms.

Caution: Be sure that the child does not assume a toe-walking gait due to her concentration on marching and swinging her arms. Toe walking should be discouraged.

Stair Climbing - 32-35 mos.

Short-term Goal: Child will go up stairs using alternating feet.

  • Using a platform, have the child practice stepping up, leading with the foot she does not normally use to lead.
  • Allow the child to hold the banister. Stand behind her and remind her to use one foot, then the other. Initially you may need to help stabilize her when she uses the foot with which she is not accustomed to lead or you allow her to hold your hand.
  • Demonstrate walking up stairs using alternating feet. Encourage imitation, increasing the number of stairs the child can climb.

Caution: This activity should be introduced only when the child can balance on either leg for 2 to 3 seconds, or when done under careful supervision to increase balance when the child is not unduly frightened of climbing stairs in this fashion.

*Visually Impaired: Introduce terms like up, left foot, right foot. Blind children must learn good laterality and directionality to learn independent mobility skills. Help the child count the number of steps she must go up.

Running - 32-35 mos.

Short-term Goal: The child will run.

The child must have achieved success in each of the previous activities in order to run.

Incorporate the concept of running into appropriate games: tag, hide-and-seek, and catch me.

Demonstrate running. Encourage imitation.

Note: True running means that at various points both of the child’s feet will leave the ground and his arms will move reciprocally. This indicates a stage of dynamic balance, coordination, and sufficient muscle strength to give propulsion.

Caution: If a child has mild cerebral palsy, urging her to move faster may increase abnormal patterns (walking on toes, bending her arms in a stiff manner). In the case of hemiplegia, that side will lag behind and running should be discouraged except under supervision and advice of a therapist.