Recognizing Early Motor Delays
A Comparison Examination of Six-Month-Old Infants
Typical Atypical
Able to symmetrically lift and
Shows improved ability to hold head
sustain upper and lower
and trunk in midline, but still without
extremities against gravity
adequate antigravity movement
Supine
Demonstrates increased
Has excessively abducted and
antigravity control of the muscles
externally rotated upper and lower
of the trunk and increased
extremities, with movement primarily
freedom of extremity movement
on the surface
Exhibits quick visual-motor
Appears visually interested in objects
response of looking, reaching,
but unable to reach and grasp
grasping and transferring objects
SIdelying
Rolls independently and easily Requires assistance from
from supine through sidelying examiner in rolling from
into prone in either direction supine to sidelying
Shows active head righting and Unbalanced neck, shoulder
upper extremity pushing against and back extension prevents
the surface to raise body while use of the arm to assist in the
reaching with the other hand rolling maneuver
Bears weight on extended arms Does not choose prone position
and forearms, with extension into for play due to decreased head,
the lumbar shoulder and trunk control
spine and lower extremities Has decreased upper extremity
Prone
Shows emerging upper extremity power, preventing weight shift
control in weight shifting for towards the pelvis necessary for
reaching, grasping and playing freedom in the upper extremities
Grasps toy towards thumb side Positions elbows behind
of palm shoulders, preventing head and
trunk lifting
Responds quickly and assists in Assists minimally in the pull to
Pull to Sit
the maneuver by actively flexing sit maneuver
neck and lifting head Demonstrates complete head
Also uses activity in the upper lag until the upright position
extremities and abdominals to assist Does not assist with upper
Shows good symmetry in the head, extremity pulling
neck and upper extremities
Recognizing Early Motor Delays
A Comparison Examination of Six-Month-Old Infants
Typical Atypical
Struggles to maintain head
upright and in midline; cannot
activate vision or explore because
Shows stable head and trunk
so much effort is required to
Sitting
control with active extension
remain upright
through the thoracic spine
Must be supported high up in the
Reaches with one arm at a time,
chest for stability
using a wide base of support in
Exhibits decreased trunk
the lower extremities
extension and freedom to reach
Horizontal Suspension
Demonstrates full, sustained Lifts head in midline and
extension in the neck and upper extends through the upper
thoracic spine, down through the thoracic spine only briefly
hips and legs Does not exhibit extension
through the spine and hips
Protective Extension
Easily and quickly brings
arms forward in a full protective Does not bring upper extremities
response when tipped toward forward to the surface in a
the surface protective response
Props immediately on one upper Displays inadequate antigravity
extremity when reaching for a toy neck and trunk strength to free
the arms to come forward
Exhibits immediate sustained
weight bearing on extended Fails to initiate or sustain active
Standing
lower extremities; turns head weight bearing when placed in
freely to look around supported standing
Keeps hips slightly flexed and Lacks necessary antigravity head
somewhat behind the shoulders and trunk control
Uses upper extremities to assist Unable to align head, trunk, hips,
in stabilizing the trunk knees and feet in the vertical
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