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
Grasping
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"
