The Individuals with Disabilities Education Act (IDEA) of 1986 Part C expanded the definition of “disabilities” to include children from birth to age 2 and their families and made them eligible to receive early intervention services. Included within these early intervention services was motor/physical development for infants and toddlers with developmental delays or at risk of delays. Currently, through IDEA approximately 350,000 infants and toddlers with disabilities are served. These intervention strategies for motor delays should be conducted by adapted physical educators. Further, adapted physical educators should also consider cognitive, language/speech, self-help skills, and emotional needs of the infant and toddler.
Shown below is an easy-to-follow assessment tool that adapted physical educators can use to identify possible delays and provides strategies for intervention. The assessment has physical, social, and language skills group by age appropriate expectations. Further, suggestions are given to help with intervention. For example, the assessment would identify a motor delay if a toddler 2 years old cannot stand and is just beginning to crawl. In this instance, intervention by an adapted physical educator could focus training on standing, cruising, and leg strength activities.
| Physical | Social | Language | Consultation & Intervention | |
| The 1st Month | Weight 7-8 lbs.
20 in. long Eats 6-8 times a day Movements are reflexive-sucking May sleep up to 18 hrs. a day |
Responds to comfort and pain
May smile Eye contact Purposefully turns head or eyes to parent’s voice |
Cries
Makes small throaty sound Responds to voices |
Provide prompt and immediate care
Nurture Talk in complete sentences Provide bright objects to look at Prone or Supine position changes Vestibular stimulation |
| The 2nd Month | Can lift head when on tummy
Head more stable May be awake 10 hours a day |
Visually fixates on a face
Smiles at a face (specially family) Shows distress, excitement, and delight Enjoys bath |
Cries
Coos Grunts |
Provide prompt and immediate care
Provide physical truck stimulation Don’t leave alone Change environment Provide mirrors Nurturing routines at bath, feeding, diapering |
| The 3rd Month | Holds head up against surface to stand
Sits supported Reaches and swipes at objects Sleeping and eating more regulated Plays with hands |
Smiles more
Cries less Recognizes parents |
Coos
Whimpers Gurgles Squeals Cries less |
Provide prompt and immediate care
Show pictures Give rattle or rings Hang items on the side of the crib Describe object Teaching loop (respond & help facilitate actions) Read and show pictures |
| The 4th Month | Rocks on tummy
May roll from stomach to back If pulled to stand extends legs and stands Sits supported longer Grasps-may hold small objects Bring hands to midline |
Shows anticipation
Quieted by music May smile at self in mirror Likes to vocalize Likes to be mobile Splashes on bath May show separation anxiety |
Coos longer, in different pitches
Begins babbling Squeals, grins Imitates several tones Vocalizes moods |
Provide prompt and total body sensory input
Move baby from room to room and outside during daily work Place cradle gym over crib Change nurturing routines “IF- Then teaching |
| The 5th Month | Rolls back from stomach to back
Can grasp objects Plays with rattle Aim good Swaps objects from hand to hand |
Enjoys being cuddled
Makes face in imitation Distinguishes between adults More playful May show signs of stranger anxiety |
Utters vowel sounds
Vocalizes to self and toys May babble to gain attention Watches mouths closely Tires to imitate inflections (song) |
Provide prompt and immediate feedback
Give teething beads Talk to him/her about what they are orienting Baby proof of your house Play “cause & effect” games |
| The 6th Month | Turns head freely
Rolls from back to stomach Creeps-propels self on tummy with legs Stands with support Sits with little support Manipulates objects Plays with feet |
Turns when hears name
Doesn’t like strangers Smiles and reaches to parents Likes to play pick-a-boo |
Varies volume and pitch
Grunts, growls, or complains Coos, gurgles with pleasure Squeals with excitement Giggles, belly laughs |
Provide prompt and immediate feedback
Make him feel loves and cared for Talk to him about what you’re doing Read aloud before sleep Play peek-a-boo Change nurturing routines |
| The 7th Month | Pushes up on hands and knees-may rock back and forth
Creeps with object in hand May crawl May pull self to stand May sit alone Hold two objects |
Reaches and pats mirror image (play)
Begins to show humor-teases Resists pressure to do something he doesn’t want Distinguishes friendly and angry voices Chews fingers |
Vowels and consonants occur at random
Tries to imitate sound or sound sequence Listens to own vocalizations and those of others |
Be encouraging and supportive
Pace feedings to baby’s wishes Put toy just out of reach to encourage crawling Place on floor-daily Provide a balls for play Teach right and wrong |
| The 8th Month | Crawls
Stands with support Pulls up to stand Sits alone Grasps block Picks up string with thumb and forefinger |
Shouts for attention
Pushes away from something he doesn’t want May manipulate parents Bites and chews everything, explores |
Babbles
Mimics mouth & jaw movements Turns head to familiar sounds (name, T.V., etc.) |
Be encouraging and supportive
Provide small objects to hold, drop & put together Teach what no means Redirect to desired behavior Be consistent Provide strategy toys (puzzles, in & out shapes) |
| The 9th Month | Crawls with one hand full
May stand alone Sits well Grasps well May side step along the furniture (cursing) |
Recognizes parent’s and self in mirror
Anticipates feeding Performs for home audience Repeats act if applauded May cry if other children cry Plays pat-a-cake |
Imitates
Coughs, tongue clicks, hisses Says dada or mama Listens to conversation or singing May understand no-no |
Be encouraging and supportive
Don’t do everything for them- aid them May have fears so respond quickly Begin teaching limits Change Nurturing routines |
| The 10th Month | Stands with little support
Walks holding two hands Sits down from standing Carries two small objects |
Shows moods
Likes music Prefers one toy May show tenderness for a doll or stuffed toy Helps hold cup for drinking Waves bye-bye |
Learns words and appropriate gestures (no-no shakes head)
May say two words besides mama and dada Understands & follows some commands |
Be encouraging and supportive
Play hide and seek- may use a toy Accident proof the kitchen, living room, and bathroom (make safe) Don’t leave alone or unsupervised for extended time |
| The 11th Month | Stands alone
May stand and wave Climbs up stairs Squats and stoops Walks holding 1 or 2 hands Carries spoon to mouth Casting/throwing balls or objects |
Increases dependence on primary caregiver
Obeys commands Seeks approval Not always cooperative Learns the meaning of no: (why no) Plays parallel to others |
Imitates inflections
Says a few more words May use a single word for thought Recognizes words as symbols for objects |
Be encouraging and supportive
Talk-Allow time for imitating Show approval for “good” behavior disapproval for “bad” Look at things from baby’s point of view Cooperate with the baby |
| The 12th Month | Walks alone
May walk and carry toys Lowers self to sit (from up to down) Climbs up and down stairs Prefers one hand May push objects |
Expresses emotions
Fears strangers and some places Gives affection to humans and objects Usually insists on self-feeding |
Controls patterns of intonation
Aware of function of expressive language Says 4-10 words Babbles “sentences” |
Be encouraging and supportive
Be sensitive to their needs Praise for walking Change Nurturing Routines |
| 12-15 Months | Moves to rhythm
May sit on small chair Dislikes restraint Can put cubes in-and-out of cup Pokes, bangs, pulls, turns and twists everything within reach Wants to hold things May try to tip toe |
Demands personal attention
Loves an audience Drops objects from high-chair Plays pat-a-cake Laughs when chased or found Imitates housework Offers toys to others but usually wants them back |
Gives a toy on request
Looks in appropriate place when asked Jabbers with expression Attempts to repeat any word Indicates wants assertively May listen to a jingle or rhyme |
Serve finger-food-don’t rush
Play chase Roll the ball with them Provide music Allow water play Provide a ball, cup, and box for play Provide firm and consistent discipline |
| 15-18 Months | May insist on self-feeding
Trots Tries to kick a ball Hurling of balls/objects Retrieves balls/objects for self Sits in a chair Likes to lug, tug, and drag things Squats down smoothly Physically venturesome Builds tower of 3-4 blocks Shows hand preference |
Demands on personal attention
Follows a simple command Seeks help when in trouble Opposes parent with “no” Doesn’t understand sharing Behavior dependent on parents Emotional reaction |
Imitates simple sounds
Uses 2 word phrases “no” is chief word Names or points to familiar objects in picture books Points to one named body part May hum spontaneously |
Support and encourage
Read nursery rhymes Provide picture books for use in play and instruction Play chase and hide and seek Encourage outside interest Praise desired behavior Provide firm and consistent discipline Change Nurturing Routines |
| 18-21 Months | Walks up and down stairs
Can kick a ball Climbs on everything Jumps in place Pushes, pulls, throws, and carries objects while walking Picks up objects from floor without falling |
Demands personal attention
Likes to help with housework Likes to remove clothes and run around naked Responsive to cuddling May fear dogs, thunder, and lightning |
Has vocabulary of 20 or more words
Uses word combinations Asks “What’s that?” Enjoys hearing nursery rhymes Echoes 2 or more last words Can point to 5 body parts |
Support and encourage
Let help with house work Be patient Hide objects and let them find Name everything Use full sentence after they use phrases |
| 21-24 Months | Can walk on tip toe
Climbs out of crib Can walk backwards Bends at waist to pick up something Pedals small tricycle Builds a tower of 6 or more block Has fully developed right or left handedness Imitative play with objects about self |
Can accept share attention
Can cooperate-sometimes Comes when called Likes to help with housework Doesn’t like to share Still dependent on adults for major needs Desires independence |
Has vocabulary of 50 plus words
Asks for food Can associate names with objects Enjoys listening to stories Understands more words than able to use Understands and asks for “more” or “another” |
Support and encourage
Tells stories Let scribble with crayons Help locate areas of baby’s body used for hearing, smelling, seeing, and eating Make simple puzzles Let them make some decisions Develop games together – let them guide the activity Change Nurture Routines |
| 24-30 Months | Claps hands
Copies circles, draws crosses on paper Rides 3 wheel toys Turns doorknob Removes simple garments when loosened Brushes teeth |
Behavior may be inconsistent-aggressive or quiet
Occasionally imitates others he’s watching Names mirror images of another May cuddle & imitate caring behaviors (or aggressive) of baby doll or stuffed toy |
May be able to give first and last name
Learns the meaning of up-down, in-out, front-back Names 10-15 objects Asks “why” – does not wait for an answer. |
Provide love, protection, and understanding
Provide opportunity to practice skills Reinforce success- Praise Play ball Tell stories Consistent discipline |
| 30-36 Months | Balances on one foot
Gets around, under, & over objects Puts on clothing with assistance Sucks liquid from cup using a straw Unscrews nesting toys Puts together 6-7 piece puzzle |
More independent & less “clingy”
Prefers solitary play Complies with simple requests Attempts to get attention (usually parents) Resists suggestions from other-cooperates ½ of the time Helps put things away |
Uses 3-4 word phrases
Uses pronouns correctly Answers simple questions Expresses 2 thoughts combined “When…I will” |
Provide new words and play word games
Let child undress himself Allow peer companions during play activities Help identify “big” and “little” Help label objects & tell uses Let put things away Encourage make-believe Recreational activities (swimming, playground, gymnastics) |
For more information read Palaestra Vol. 27, No. 3 Fall 2013 p.37 “Early Intervention Developmental Assessment”
Sources
Barber, L.W. & Herman, W. (1981). Your Baby’s First 30 Months. New York, NY: Penguin Group
Charner, C., Murphy, M. & Clark, C. (2006). The encyclopedia of infant and toddler activities: for children birth to 3. Beltsville, MD: Gryphon House.
Frank, C. & Theresa, C. (1995). The first twelve months of life: Your baby’s growth month by month. New York, NY: Banton Books.
Frank, C. & Theresa, C. (1982). The second twelve months of life: Your baby’s growth month by month. New York, NY: Banton Books
White, B.L. (1995). The First Three Years of Life. New York, NY: Simon & Schuster.
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