Gross Motor Skills



Gross Motor Outcomes of Children Born Prematurely in Northern Ontario and Followed by a Neonatal Follow-Up Programme.

During their time in the neonatal unit, a premature infant’s brain is undergoing some of its most complex and rapid growth and is particularly vulnerable to injury. Compared with infants born full term, premature infants are at increased risk of long-term developmental difficulties in a number of areas including cognition (thinking), language (talking), motor (movement), and social-emotional development.

This article was focused on the gross motor development of infants born prematurely across the first two years of life. The percentage of children scoring within the average range on an assessment of gross motor skills varied at different ages with almost 60% of children showing age appropriate gross motor skills at 2 years corrected age. Gross motor skills develop over time and while many children born prematurely will go on to have normal gross motor development, close monitoring across early childhood is important. As a child grows, the activities they and their peers will participate in will increase in complexity and require more advanced gross motor skills (e.g. climbing on play equipment, kicking or throwing a ball). It is during this time that a child’s difficulty with gross motor development may become evident as they find it challenging to complete certain movements or tasks. Monitoring gross motor development and identifying difficulties early can support access to early intervention therapies which can optimise a child’s ability to physically engage and interact with their world.


Gross motor skills are abilities that allow children to do things that involve using the large muscles in the torso, arms and legs to complete whole-body movements. These skills enable children to walk, run, stand, jump, hop, kick, lift, sit upright, climb, throw, catch as well as many other movements. These gross motor skills and the movements they enable a child to perform are crucial to a child’s ability to participate in everyday tasks such as playing in a playground, riding a bike or scooter, or competing in sport. They are also essential for completing self-care tasks such as toileting, getting dressed, putting a school bag on their back, packing away toys and climbing onto a bus. Acquiring these skills is an essential part of a child’s development and allows children to successfully take part in activities and reach age-appropriate developmental milestones.

For some children, reaching these milestones will happen later to that of other children of a similar age. Here are some signs that your child may have difficulties with their gross motor development:

  • Avoidance of physical tasks that are challenging or engaging in these activities for only a brief period of time (e.g. riding a bike or playing catch)
  • Inability to complete the same activities as their peers or shows a lower level of proficiency as other children their age
  • Difficulty following multi-step instructions to complete a physical task e.g. obstacle course
  • Unable to follow or copy an activity that has a sequence of steps e.g. throwing a ball into the air and then hitting it with a racquet
  • Experiences more falls and accidents than other children of a similar age
  • Tires quickly when doing tasks that they find challenging
  • Stiffness in arms and legs
  • Floppy limbs and trunk
  • A delay in reaching developmental milestones e.g. sitting, crawling, walking, running, hopping, jumping

A delay in a child’s gross motor development may be an indicator of other conditions such as Cerebral Palsy (CP), Global Developmental Delay (GDD) or genetic disorders and therefore it’s important to speak to your GP or your child’s health care professionals if you have concerns.


It is important to remember that all children develop at different rates. Some children may meet their developmental milestones early while others need a little extra time to catch up. Developmental milestones are a general guide as to the age in which children achieve different skills.

There are many ways that you can encourage the development of your child’s gross motor skills each day. These include:

  • Throwing and catching games
  • Obstacle courses
  • Encouraging participation in community activities such as swimming, karate
  • Playground climbing, including swings
  • Offering physical alternatives to activities such as screen time
  • Gradually increasing the duration of physical play
  • Playing games that do not involve winning or losing
  • Playing games such as Simon Says, Hopscotch, wheelbarrow races

If you are concerned that your child may be experiencing gross motor difficulties and a potential delay, speak to your GP, your child’s health care professional or teacher. They may recommend a referral to a physiotherapist or occupational therapist who can provide a detailed assessment of your child’s motor development and if needed, provide early intervention to support your child’s developing skill set. With early identification and the right intervention, children have the best opportunity to thrive and reach their developmental milestones.

CLICK HERE to watch a video explaining and comparing gross motor and fine motor skills.

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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances.To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].