When Should a Parent Refer a child to Physical Therapy

Birth to 2 months:

• Doesn’t lift head in prone position (while lying on their stomach)
• Does not turn head to one side in prone position
• Does not turn head to both sides in supine position (lying on back)

3 Months:

• Does not hold head up 90 degrees in prone (lying on stomach)
• Does not extend both legs or kick reciprocally
• Does not roll to back when placed on their side

4 Months:

• Does not place weight on forearms in prone position
• Does not rotate or extend head
• Is unable to grasp a rattle
• Cannot bring both hands together

5 Months:

• Does not roll over one way
• Does not hold head up when pulled to sitting
• Is unable to hold head steady in supported sitting position
• Does not bear weight on legs

6 Months:

• Is unable to keep head level with body when pulled to a sitting position
• Does not demonstrate balance reactions
• Cannot bear weight on hands in prone position
• Does not move head actively in supported sitting position

7 Months:

• Does not roll over either way
• Does not bear weight on legs
• Cannot lift head or assist when pulled to sitting position
• Demonstrates little balance reactions or protective extension of arms

8 Months:

• Does not roll over both ways
• Cannot sit with little or no support
• Does not hold weight on one hand while in the prone position
• Cannot bear weight on legs and bounce

10 Months:

• Cannot get to sitting position without assistance
• Does not assume crawling position (hand-knee position)
• Does not show interest/motivation to crawl
• Cannot sit on own without hand support

1 year:

• Does not pull to stand using furniture
• Cannot switch positions from sitting to prone
• Does not creep on hands and knees
• Cannot pivot while in sit position to retrieve toy
• Cannot pass an object from one hand to the other
• Cannot stand holding on to someone or something
• Cannot pick up small object

15 Months:

• Does not walk with one hand held
• Cannot stand alone well
• Does not demonstrate balance reaction while in the kneeling position
• Does not walk alone one to two steps
• Does not demonstrate motor planning by climbing on furniture
• Has a hard time picking up small objects

18 Months:

• Does not attempt to creep upstairs
• Does not walk without support
• Cannot throw ball
• Does not bend down to retrieve objects
• Does not demonstrate balance reaction in standing

24 Months:

• Does not run
• Cannot walk upstairs with one hand held
• Cannot carry large toy while walking
• Does not squat in play
• Cannot retrieve toy off of floor from standing position
• Does not climb onto furniture, turn and sit
• Cannot build tower of 6 blocks
• Does not use utensils well

30 Months:

• Does not jump in place with both feet
• Does not stand from sitting by rolling on side
• Cannot catch large ball
• Has difficulty with gait and balance
• Does not walk downstairs using rail for support
• Does not have wide range of movement
• Does not run and stop without holding
• Does not avoid objects when running

36 Months:

• Cannot kick stationary ball
• Is not able to stand on one foot for 2 seconds
• Cannot build tower of 9 blocks
• Cannot complete 5-6 piece puzzle
• Is not using utensils properly
• Does not attempt to ride tricycle
• Does not demonstrate grasp of crayon



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