0-3 Month Milestones
GROSS MOTOR MILESTONES
Key Developmental Milestones
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General Movements: writhing movements | moves whole body | squirms | waves arms | legs kick up and down
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Prone: able to prop on forearms | elbows underneath shoulders | head lifted 45° - 90°
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Supine: able to maintain head in midline | bring hands to midline | attempts to swipe at dangling objects
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Sitting: able to maintain head control in supported sitting | spine predominantly extended except lumbar spine region
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Standing: momentary support of weight through legs
The following videos and links explain and demonstrate expected gross motor milestones of infants at 0-3 months.
Further Diagnostic Testing / Referral
Proceed to examine the ‘tone’ and ‘reflexes and reactions’ component of the Hammersmith Infant Neurological Examination (HINE) if the infant:
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Feels floppy
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Has difficulty lifting head
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Has stiff legs with little or no movement
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Pushes back with head when supine
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Note: For a 0-3-month-old infant the following is expected:
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Pull to Sit: expect minimal head lag | chin tuck of ≥ 45° | head remain in midline | slight activation of abdominals | slight upper limb participation | initial lifting of lower limbs | anticipation of movement toward upright position
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Ventral Suspension: expect trunk and lower limbs to be in the same plane | spine remain straight | head above body looking forward | able to maintain forward looking position
Video 1-2. Gross Motor Skills
(Larsen & Stensaas, 2019a)
Video 3-4. Pull to Sit and Ventral Suspension (Larsen & Stensaas, 2019a)
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FINE MOTOR MILESTONES
Key Developmental Milestones
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Able to open and close fists
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Able to grasp object placed into hands
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Able to bring hands to mouth
The following video and links explain and demonstrate expected fine motor milestones of infants at 0-3 months.
Further Diagnostic Testing / Referral
Refer to a Paediatrician and Occupational Therapist if the infant:
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Fists remain predominantly closed
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Lacks arm movement
Video 5. Fine Motor Skills
(Larsen & Stensaas, 2019a)
COGNITIVE MILESTONES
Key Developmental Milestones
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Social smiles and laughs
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Visually tracks a slow-moving target for a brief period
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Looks toward direction of sound
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Looks at edges, patterns with light/dark contrast and faces
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Imitates adult tongue movements when being spoken to
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Learns through sensory experiences
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Repeats actions but unaware of ability to cause actions
The following video and link explains and demonstrates cognitive milestones of infants at 0-3 months.
Further Diagnostic Testing / Referral
Refer to a Paediatrician if the infant:
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Does not visually track objects
Video 6. Cognitive Milestones
(Larsen & Stensaas, 2019a)
COMMUNICATION MILESTONES
Key Developmental Milestones
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Coos and gurgles
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When content makes small throaty noises
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Turns head toward sounds or voices
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Cries differently for different needs (Eg. hungry vs tired)
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May start to copy sounds
The following link explains and demonstrates expected communication milestones of infants at 0-3 months.
Further Diagnostic Testing / Referral
Refer to a Paediatrician and Speech Pathologist if the infant:
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Has not started to make sounds
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Does not cry when hungry or uncomfortable / cries more than expected
Refer for a hearing test if the infant:
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Does not respond to sounds
SOCIAL / EMOTIONAL MILESTONES
Key Developmental Milestones
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Social smiles and laughs
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Makes eye contact when held with face about 20cm from the face of an adult looking at them
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Alert and shows interest in faces
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Shows excitement as parent prepares to feed
The following video and links explain and demonstrate expected social / emotional milestones of infants at 0-3 months.
Further Diagnostic Testing / Referral
Refer to a Paediatrician if the infant:
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Does not make eye contact or smile at caregiver
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Does not respond to familiar faces
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Does not show interest or respond when played with
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Frequently resists being held
Video 7. Social and Emotional Skills
(Larsen & Stensaas, 2019a)
PRIMITIVE REFLEXES
Key Developmental Milestones
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Asymmetric Tonic Neck Reflex: when the infant’s face is turned to one side, the ipsilateral arm and leg will extend, and the contralateral arm and leg will flex
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Rooting Reflex: when the infant’s cheek or lip is touched, the infant will turn their head in the direction of the stroke
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Sucking Reflex: when the roof of the infant’s mouth is touched, the infant will start to suck
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Moro Reflex: in response to a loud sound or movement, the infant will extend their neck, arms and legs
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Palmar Grasp Reflex: when an object is placed in the infant’s hand, the infant’s fingers will flex
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Plantar Grasp Reflex: when the ball of an infant’s foot is touched, the infant’s toes will flex and adduct
The following videos explain and demonstrate expected primitive reflexes of infants at 0-3 months.
Video 8-12. Primitive Reflexes
(Larsen & Stensaas, 2019a)
The above information has been adapted from ACECQA (2015); Larsen & Stensaas (2019a); and Pathways (2019a).