PHYSICAL THERAPY
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Pediatric physical therapy helps to improve a child’s ability to explore their environment by increasing mobility and function.  The physical therapist will first complete an evaluation to identify your child’s needs and then develop the best treatment techniques for your child.  The physical therapist may need to consult with other professionals such as DME (durable medical equipment) suppliers, an orthotist (to make inserts or braces), or orthopedic specialists possible.  It is our hope that by improving strength, ROM (range of motion), balance, endurance, energy conservation, muscle control and coordination, the child will better be able to participate in age-appropriate activities. 

Our physical therapists also offer orthopedic services in order to recover from injuries (i.e. breaks, sprains and concussions) improve strength and conditioning for optimal athletic performance, decrease joint pain and improve quality of life.

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Developmental Gross Motor Skills Schedule

0-2 Months

• Lying on back, bends and straightens legs (alternately or together) twice • Rolls to back from both right and left sides • Bends and straightens arms (alternately or together) • When held in standing position, bears weight with knees flexed and feet flat • Elevates head and upper trunk 45 degrees, bearing weight on forearms or hands • Lifts and turns head so opposite cheek touches surface • Holds back in rounded position when sitting • Holds head so at least 45-degree angle exists between back of head and back • Holds head in midline through more than 75% of movement cycle • Raises head at midline and holds it in alignment when suspended vertically • Holds head in midline for 2 to 3 bounces • Lifts one foot, then the other in walking movement



3-5 Months

• Maintaining midline head and body posture, brings both hands to the midline while lying on back • Elevates head and upper trunk 45 degrees, bearing weight on forearms to see toy • Rolls from back to left and right sides with opposite arm crossing the midline • Lying on stomach, extends arms and legs (alternately or together) off surface • Brings both feet to mouth for play or grabs feet with hands while lying on back • Raises arms and legs (alternately or together) in smooth, fluid movements • Holds head in alignment when tilted sideways • Holds trunk off legs when sitting • Holds head aligned while rotating head to follow toy • Maintains balance while sitting • Does not move his or her arms and legs when head is turned



6-8 Months

• From stomach, raises upper trunk, shifts weight to side, lifts free arm, and reaches toward toy • Grasps both feet and holds them • From stomach, elevates head and stomach, bearing weight on palms •Lying on back, shifts weight to side and supports self with arm while extending opposite arm to reach for toy • Rolls from back to stomach • Rolls from back to stomach, leading with hips and thighs, followed by stomach and then shoulders • Uses arms to move forward 3 feet • Maintains balance while moving hands and arms to grasp toy • Pulls up to sitting position holding adult’s fingers • Sits unsupported • Retrieves toy, returns to upright sitting, and maintains balance • Raises head above horizontal plane, extends trunk, and symmetrically raises hips and legs into full extension • Extends arms, straightens elbows, and bears weight on palms when tilted forward • Breaks fall by extending arm and supporting self with open palm when tilted to one side • Breaks fall by extending one or both arms and supporting self with open palm when tilted forward



9-11 Months

• Raises and bears weight on hands and knees and rocks back and forth twice • Creeps 5 feet on hands and knees with opposite arms and legs moving together • Maintains sitting posture and uses hands and legs to scoot forward 3 feet • Using stable object for support, raises to standing position • Creeps completely over adult’s legs • Lowers from standing to a sitting position without falling • Takes 4 alternating steps in place or forward with trunk support • Frees hand and body from support and maintains balance in standing position for 5 seconds • Takes 4 alternating steps in place or forward • Maintains balance while sitting and maniuplating toy • Pulls up from lying on back to sitting position using chair for support • Lying on stomach, raises to sitting position to reach toy • Extends arms and head forward to recover balance and returns to upright sitting position when pulled backward • Stops fall by extending arm(s) backward and supporting weight on open palm(s) when pushed backward



12-14 Months

• From sitting cross-legged on floor, stands without turning body more than 20 degrees • Uses alternating steps to walk 8 feet while holding adult’s hand • Walks unaided for 5 steps • Picks up toy, returns to standing, and takes 3 steps without losing balance • Creeps up 2 steps on hands and knees • Walks 10 feet with narrow base of support, heel-toe gait, using reciprocal pattern for 5 feet • In kneeling position, maintains balance while rotating head • Without losing balance, corrals 8-inch ball with arms and/or hands • Using hand/arm contact, rolls 8-inch ball forward • Throws 3-inch ball in any direction by extending arm at shoulder or elbow



19-24 Months

• Runs forward 10 feet • Stands on 2-inch line with one foot in front of other; toe of back foot is within 3 inches of front foot •Walks sideways for 10 feet, leading with same foot • Walks with 1 foot on 4-inch line for 6 feet • Jumps forward 4-inches without falling • With feet together, jumps up 2-inches • Jumps down 1 step without assistance (1 foot may lead) • Walks up 4 steps without support from wall or rail (may place 1 or both feet on each step) • Kicks ball forward 3 feet • Throws small ball overhand 3 feet forward before it touches floor



25-30 Months

• Walks down 4 steps with support (may place 1 or both feet on each step) • Walks backward 10 feet without heels touching toes • Jumps up and touches line 2 inches above standing reach • With hands on hips and without heels touching toes, takes 3 steps forward on 4-inch line • Placing 1 foot on each step, walks up 4 steps (may use wall or rail for support) • Jumps down from object 16 in. high without assistance (1 foot may lead) • With hands on hips and without heels touching floor, walks on tip-toes for 5 steps • Runs 30 feet • Presenting extended arms directly in front, palms facing upward or facing each other,
attempts to catch 8-inch ball by bending arms toward chest • Initiates overhand throw by moving arm upward and back; small ball travels 7 feet before touching floor • Initiates underhand throw by moving arm down and back; small ball travels 7 feet before touching floor • Using opposing arm and leg movements and initiating kick by extending leg back with bent knee, kicks ball forward 6 feet



31-36 Months

• Using 2-footed takeoff and landing, jumps forward 24 inches • Jumps down from object 18-inches high without assistance using 2-footed takeoff and landing • Using 2-footed takeoff and landing, jumps over string 2 inches off floor with tripping • With hand on hips and without heels touching floor, walks on tip-toes 8 feet on 4-inch line • Placing foot on each step, walks up 4 steps without support • With hands on hips, stands on 1 foot for 3 seconds • Catches 8-inch ball with arms extended



37-42 Months

• Runs 15 yards in 6 seconds or less • Using 2-footed takeoff and landing, jumps forward 26-inches • With hands on hips and without heels touching toes, walks forward 4 feet on 4-inch line without stepping off • Runs with arms moving back and forth across body and below waist, balls of feet used to push forward, toes pointed forward, a high knee and heel lift, and trunk leaning forward • With hands on hips, without heels touching toes, and without swaying more than 20 degrees, walks forward 8 feet on 4-inch line without stepping off • With hands on hips, stands on 1 foot for 5 seconds • Using upper trunk rotation, arms and legs moving in opposition, and initiating overhand throw by moving arm up and back, throws small ball 10 feet forward • Using an underhand toss, hits target with small ball • With arms bent at 45 to 90 degrees at elbows and palms up or facing each other, catches 8-inch ball with hands, securing it to chest if necessary



43-48 Months

• Placing 1 foot on each step, walks down 4 steps without support from wall or rail • Without letting other foot touch floor, jumps forward 6-inches on 1 foot • Jumps up and touches line 3-inches above standing reach • Runs and stops without falling • With hands on hips and without heels touching toes, walks backward 4 feet without stepping off 4-inch line • Using 2-footed takeoff and landing, jumps forward at least 30-inches • Hops forward on 1 foot, then hops forward on other foot • With arms held overhead and without moving feet, stands on tiptoes • With hands on hips and without swaying more than 20 degrees, stands on 1 foot • Using an overhand toss, hits target from 5 feet • Using upper trunk rotation and moving arms and legs in opposition, throws small ball underhand 10 feet



49-54 Months

• With hands on hips and with toes touching heels, walks backward 5 steps with stepping off 4-inch line • Completes forward roll without turning more than 15 degrees to either side • With weight transferred smoothly and evenly, gallops 10 feet • Using 2-footed takeoff and landing, jumps forward 36-inches • With hands on hips and body not swaying more than 20 degrees, jumps and turns so feet land in opposite direction from starting position • Hops 3 feet forward on 1 foot, changes feet, and hops back • With arms held overhead, without moving feet, and without swaying more than 20 degrees, stands on tip toes • With hands on hips and without swaying more than 30 degrees, stands on 1 foot then stands on other foot • Using an overhead toss, hits target from 12 feet away • Bounces small ball so it bounces once and then hits wall from 5 feet away • With arms bent and using hands only, catches small ball thrown from 5 feet away



55-60 Months

• Using 2-footed takeoff and landing, jumps over string 10-inches off floor without tripping • Runs 10ft., picks up can, and returns to starting line without tripping or dropping can • Maintaining balance, using opposing arm and leg movements, and using alternating feet, skips 8 steps • With hands on hips, with feet together, and without touching line or pausing between jumps, jumps back and forth across line taped on floor • Accurately imitates arm positions • With hands on hips and without swaying more than 20 degrees, stands on each foot for 10 seconds • Completes 3 sit-ups



61-72 Months

• Maintaining balance and rhythm, using opposing arm and leg movements, and using alternating feet, skips 10 feet • Without losing balance or letting free foot touch floor, hops 20 feet in 6 seconds or less • Completes 5 sit-ups • Performs 8 push-ups • Using opposing arm and leg movements and initiating kick by extending leg back with bent knee, kicks ball so it travels 12 feet in air • Bounces and catches small ball



6-10 Years

• Participates in cooperative and competitive play in groups/teams of children; winning and skills are emphasized • Runs with speed and endurance • Jumps, hops, skips • Throws ball well at long distances • Catches ball with accuracy



15-18 Months

• Creeps backward down 3 steps without support • Walks up 4 steps without support (may place 1 or both feet on each step) • Walks 10 feet quickly • Walks backward 5 steps (may pull toy) • With support only from adult’s finger, walks down 4 steps (may place 1 or both feet on
each step) • Lifts foot and contacts 8-inch ball • Maintaining balance, throws 3-inch ball by extending arm