- physiological flexion (NO active flexion against gravity)

- lots of random movements

- reflexes: rooting, sucking, automatic walking, gag, bite, moro, palmar grasp, tonic labyrinthine (overpowered in supine by physiological flexion

- lays with head at the side

- legs are flexed with pelvis high, which shifts weight anterior onto head

- can "scoot"

- symmetrical flexion of arms and legs

- hands and arms synergistically coupled

- may roll to side with neck righting (not segmental rotation)

- positive supporting reaction

- automatic walking/primitive stepping

- elbows flexed, hips behind shoulders, feet close together

- can fixate on an object about 10-12 in

- track slow moving object briefly

- better laterally

- likes strong contrasts

- decreased shoulder protraction

- decreased hip flexion unless fixing

- uses head and neck hyperextension to lift head and it takes much effort

- head is usually turned toward ths side

- neck righting

- PTS still has no flexor control, but baby more alert

- briefly attmepts to lift head but it falls forward

- back rounded and pelvis perpendicular

- bears some weight on legs, feet DF and pronated

- can track from lateral toward midline

- will use a reflex grasp to hold object placed in hand-- drop or pried out

- hypotonia and asymmetry

- head extension improving but not maintained in midline

- labyrinthine and optical righting, ATNR

- lift head 45 degress but cannot maintain extension

- bears weight on hands and forearms if placed in that position

- thighs rest on support surface

- head increased rotation to side but rarely held in midline

- arms move away from body and soles of feet on support surface

- smiles with entire body

- swipes at objects with arms

- head movments are often directed by visual attention

Sitting:

- PTS tries to assist

- holds head up but it bobs

- no neck

Standing:

- may or may not take weight on legs

- poor foot orientation

- holds head up with capital extensors

Vision:

- visually attentive, affordance, developing binocular vision

- beginning to track across midline

- beginning symmetry (ATNR lessening)

- stronger labyrinthine and optical righting

- decreased neck righting

- head can be held up 90 degrees in midline

- easier to lift head, but if child looks down head may fall

- head roration causes weight shift to face side, may cause child to roll supine

- supports self on forearms

- cannot use hands in prone

- hold head briefly in midline

- hands together in midline

- frog legged

PTS: eyes try to fix on examiner, elevate shouldes, arms assist but not LE or abs

Sitting:

- head up with increased back extension but pelvis still perpendicular

- leands forward due to low tone in low back and hips

- can move head and still maintain supported sitting

- takes some weight on feet again

- holds head up

- scapula adduction and "high guard"

- toes curled, feet pronated

Vision:

- does not yet have control to look down

- can track 180 degrees in prone but with upward gaze

Fine Motor:

-swipes at toys that give feedback

- explores mouth, clothing, bodies with hands

- increased symmetry

- increased antigravity flexion and extension

- Landau may be present

- VISION is dominant

- increased extension into lumbar area

- FOREARM weight bearing with head in midline (cannot yet reach)

- head rotation with downward visual gaze

- legs in line with trunk

- rolls to side and may accidentally rol to supine

- good midline orientation of head with chin tucked but can't yet lift head off mat

- brings hands to knees

- rolls to side and plays => stimulates lateral head righting

PTS: increased flexor control and symmetry, head in midline, fixes with eyes, arms and a little abs

Sittting:

- head in midline but neck not fully elongated

- can sit very briefly UNSUPPORTED

- cannot coordinate reaching from sitting

- head roation causes weight shift to face side => usually a fall

- can be held by upper arms rather than trunk

- pelvis behind shoulders

- legs not stiff

- toes curl

Vision:

- sustained MIDLINE CONVERGENCE

- occular control is refining

- reaches with eyes

- can track objects without turning head

Fine- ulnar grasp

Oral- some ceral may be introduced

- FUNCTIONAL position

- bears weight on extended arms

- can REACH out from POE without falling over

- weight shift to SKULL side

- rocking

- legs in line with trunk

- rolls PRONE => SUPINE

- lifts hands up to mommy

- brings feet to mouth

- rolls supint to side with LE dissociation (body righting on head)

PTS: initiates chin tuck, arms pull, abs active, legs flex at hips and knees

Sitting:

- back extension (leans forward from hips)

- support trunk with arms in front but some short bursts of unsupported sitting (high guard)

- legs WBOS with ring sitting

Five Months Standing

- takes almost full weight on legs

- alternates between volitional extension and collapse

- rotate head to face side and will fall

- hips almost in line with shoulders

- strong antigravity control but spine is becoming balanced by abs

- equilibrium reactions in prone (feedback and feedforward)

- bears weight on EXTENDED ARMS

- can bear weight on extended arms and reach forward but reverts to prone on elbows for hand use

- beginning to pivot backward and sideways

- rotate head causes weight shift to FACE side arm

- can also use shoulder girdle to weight shift

- PUSH UP with strong extension but push back when meaning to go forward

-assumes QUADRUPED (rocking)

- PRONE TO SUPINE AND SUPINE TO PRONE

- reaches for toy with one or two hands and transfers toy from hand to hand

- rolls supine to prone (LE dissociation)

PTS: can lift head independently with cervical and capital flexors

- pulls with UEs

- obliques critical

Sitting:

- sits with trunk and full head control if low support is given

- protective extension FORWARD

- sits without UE support briefly

- scapula moves freely

- hip extensors prevent collapse forward, WBOS

- rotate head may cause weight shift to face side and fall

Standing: Takes FULL weight, hands can be held

Vision: parameters in ALL directions

Fine Motor: vision controls hand during transport and prepare to grasp

- no in hand manipulation

- palmar radial grasp

- antigravity control and movment in all three planes in horizontal positions

- protective extension to FRONT and SIDE

- asymmetrical while playing with lateral weight shift

- COMBAT crawl (on belly)

- pivots

- may assume Quadraped (rocking)

- moving between sit and quadruped TUCKS LEGS and reaches FORWARD

- may pull self to stand from quadruped

- does not like

- can lift head and sustain briefly

- can chin tuck and maintain shoulder depression

-PTS: ALONE

Sitting: can sit UNSUPPORTED but uses LEGS for Stability

- modify ring sit

- shoulder girdle initiates reaching when trunk is stable

- head rotation causes trunk rotation

- working on trunk rotation

- can play with hands

- weight shift controlled by active ER of skull side leg

- equilibrium reactions still developing

- sitting to prone

- sit to quadruped: tucks WB lef under and sits back

- full weight on legs but uses arms for stability and control

- hip flexors and back extensors FIX pelvis

- quadruped to stand

- bounces but does not laterally weight shift

- PLOPs to floor

- may cruise

- protective extension SIDEWAYS in sitting

- does not like supine

- prefers quadruped to prone

- equilibrium reactions beginning

- CREEPS well

- can reach

- quadruped to sitting uses lateral righting

- KNEELs and 1/2 KNEELS with UE support but cannot extend hips fully (fixing)

- 1/2 kneeling during climbing

- reaches well

- can alter leg position in sitting

- rotation counterbalanced by sideways protective extension or equilibrium reactions

- sitting to quadruped to sitting easy

Standing: pulls to stand through 1/2 kneeling

- initiates rotation with head causing weight shift over face side

- stands with ONE hand held

Walking: TWO hands held, STEPPAGE GAIT

- leads with own trunk forward

- CRUISES SIDEWAYS with fixed shoulders

- small objects are interesting

- thumb and finger opposition

- can also release objects

- BANGS objects

- reache well in sitting

can eat finger foods and feed self

- reaching over head and for objects out of reach in a variety of ways = good trunk control

- PROTECTIVE EXTENSION IN REAR

- most functional position

- side sits, w sits, plays with ant/post shift

- in long sitting, rotate to face side but still uses ER of skull side leg

- fine manipulative skills in sitting

- CREEPING

- sitting to quad to sitting easy

- can get in and out of quadruped with rotation of trunk over pelvis

Kneeling: hip extension incomplete, uses for climbing and going up steps

Pulls to Stand: arms a lot, goes through 1/2 kneel

Standing: CRUISES along and changes directions

- semi turns in direction going

- FALLS TO FLOOR

- Walks with TWO hands held

- fixed shoulders and steppage gait

- LE abd and ER decreasing

Climb: can go up steps

- vouluntary release starting

- loves to drop objects

- increased use of fine UE skills but may use more stable LE positions

- may regress in gross motor skills

- UE mirroring during fine motor skills

- does not sit long but can do a VARIETY of positions

- trunk ROTATION in long sitting

- creep over obstacles (judgement of safety not present)

- loves to climb

- Creep DOWN STAIRS BACKWARD

- kneel without UE support (active hip extensors and quads; maybe some fixing)

- transitions easily out of and into 1/2 kneel

Standing:

- ONE arm support

- PTS legs very active and UE used for balance

- lowers self from standing using UE support

Walking:

- TWO hands held

- cruises sideways and forwards along furniture (forward- needs LE dissociation)

- cruises around corners creating perceptual challenges

- starting to use pelvic rotation and LE stride

General:

- explores

- EQUILIBRIUM reactions in SITTING and QUADRUPED

Sitting;

- long sit, side sit, ring sit, w sit

- continues to rotate trunk more and bring it more over the femur when reaching

- trunk more stable for UE activities

Quadruped:

- carries toys while creeping

- in and out of containers by creeping

Kneeling:

- NO UE support needed

- HIP EXTENSORS now stabilize trunk on femurs

- uses kneel and 1/2 kneel to SQUAT to STAND

Standing:

- WBOS

- may stand alone without UE support

- squat to stand without UE

Walking:

- CRUISES and reaches for things out of reach

- one or two hands held

- BOS depends on UE support

- can climb onto adult size furniture, turn around and sit and then back down when climbing down

- drink from open cup

- finger feeding

- hold cup

- righting reactions in all movements

- equilibrium reactions in all positions except standing

- smooth trunk rotation in sitting and reaching across midline

- TRUNK ROTATION from sit to stand

- reach in kneeling

- SQUAT during play

Standing:

- no UE support needed for rising or lowering

-  cam stamd WITHOUT UE support

- can weight shift and LIFT ONE LEG BRIEFLY

Walking:

- few steps alone or independent (12-14 mo walk usually)

- WBOS, high guard, fall, distance limited, cannot negotiate uneven terrain or obstacles

- climbing improving