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Creeps backwards down 3 Runs forwards 10 feet. Walks down 4 steps without Using 2 footed takeoff and Runs 15 yards in 6 seconds or
steps without support. support. landing, jumps forward 24 less.
Locomotion Walks sideways for 10 feet, inches.
Walks up 4 steps without leading with same foot. Walks backwards 10 feet Using 2 footed takeoff and
support. without heels touching toes. Jumps down from object 18 landing, jumps forward 26
Jumps forwards 4 inches inches high without inches.
Walks 10 feet quickly. without falling. Jumps up and touches line 2 assistance using 2 footed
inches above standing reach. takeoff and landing. Runs with arms moving back
Walks backwards 5 steps. Jumps down 1 step without and forth across body and
assistance. Jumps down from object 16 Using 2 footed takeoff and below waist, high knee and
inches high without landing, jumps over string 2 heel lift, trunk leaning forward.
Walks up 4 steps without assistance. inches off floor without
support from wall or rail. tripping.
Runs 30 feet.
With hands on hips and
without heels touching floor,
walks on tip-toes 8 feet on 4
inch line.
Stationary In kneeling position, maintains With hands on hips, stands on With hands on hips, stands on
balance while rotating head. 1 foot for 3 seconds. 1 foot for 5 seconds.
Throws 3 inch ball in any Kicks ball forward 3 feet. Presenting extended arms Catches 8 inch ball with arms Catches 8 inch ball with arms
direction by extending arm at directly in front, palms facing extended. extended.
Reflexes & shoulder or elbow. Throws small ball upwards or facing each other,
Object overhand/underhand 3 feet attempts to catch 8 inch ball.
Manipulation before it touches floor.
Initiates overhand throw,
moving arm upwards and
backwards – ball travels 7 feet
before touching floor.
With arms held overhead and without With arms held overhead, without Accurately imitates arm positions. Completes 5 sit-ups.
Stationary moving feet, stands on tiptoes. moving feet, and without swaying
more than 20 degrees, stands on tip With hands on hips and without Performs 8 push-ups.
With hands on hips and without toes. swaying more than 20 degrees,
swaying more than 20 degrees, stands on each foot for 10 seconds.
stands on 1 foot. With hands on hips and without
swaying more than 20 degrees, Completes 3 sit-ups.
stands on 1 foot, then stands on other
foot.
Using overhand toss, hits target from Using an overhead toss, hits target Using opposing arm and leg
Reflexes & 5 feet. from 12 feet. movements and initiating kick by
extending leg back with bent knee,
Object Using upper trunk rotation and moving Bounces small ball so it bounces once kicks ball si it travels 12 feet in air.
Manipulatio arms and legs in opposition, throws and then hits wall from 5 feet.
n small ball underhand 10 feet. Bounces and catches small ball on
With arms bent and using hands only, floor.
catches small ball thrown from 5 feet
away.
Fine Stage 1 Stage 2 Stage 3 Stage 4 Stage 5
Motor
Opens book. Turns 3 pages in book, 1 at Removes screw-on lid from Draws circle. Cuts paper into 2 pieces.
a time. bottle.
Visual-Motor Places pegs in pegboard. Laces 3 holes.
Places 3 shapes into Stacks 8 to 10 cubes.
Stirs spoon in cup. correct holes in board. Cuts within ½ inch of line
Cuts paper in 1 place. for entire length of a line.
Makes at least 1 scribble Stacks 4 to 6 cubes.
on paper more than 1 inch Draws horizontal line. Draws a cross.
long. Draws vertical line.
Bends paper, producing a Traces horizontal line.
Stacks 2 to 3 cubes. crease.
Unbuttons 3 buttons.