Screening for motor delays in infants and young children*

	The following motor skills should be observed in the young child at the specified visit. These skills are typically acquired at earlier ages, and their absence at these ages signifies delay. Loss of previously attained motor skills should also raise concern.
9-month visit	Rolls to both sides Sits well without support Demonstrates motor symmetry without established handedness Grasps and transfers objects from hand to hand
18-month visit	Sits, stands, and walks independently Grasps and manipulates small objects
30-month visit	Evaluate for subtle gross motor, fine motor, speech, and oral motor impairments Evaluate for loss of previously attained gross or fine motor skills
48-month visit	Evaluate coordination, fine motor, handwriting, gross motor, communication, and feeding abilities Address any preschool or child care staff concerns about motor development Evaluate for loss of previously attained gross or fine motor skills

* If screening reveals a neuromotor concern, the clinician should obtain an expanded history and perform a detailed neurologic examination. If abnormal tone is detected on physical examination, referral to early intervention and/or consultation with a pediatric neurologist may be warranted. Additional testing (eg, neuroimaging) may also be warranted. For additional information on the evaluation of children with abnormal motor development, refer to the UpToDate topic on evaluation and diagnosis of cerebral palsy.

Reference:

Noritz GH, Murphy NA, Neuromotor Screening Expert Panel. Motor delays: early identification and evaluation. Pediatrics 2013; 131:e2016.

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Screening for motor delays in infants and young children*