What are gross motor skills?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC February 01, 2022

What are gross motor skills?

 Gross motor describes the activities and skills that involve large groups of muscles - the arms, legs, and trunk. This includes postural control and balance, locomotion (movement such as walking), overall coordination of the limbs and the trunk, strength and endurance, and even body awareness within the environment.

When we talk about gross motor skills, we focus on those areas of gross motor and development.

Let’s break each one down! 

Postural Control and Balance

We are most familiar with the term “balance,” but in therapy (such as occupational therapy), we often use postural control interchangeably with balance. Postural control can be defined as, “the act of maintaining, achieving, or restoring a state of balance during any posture or activity.” 

For our children, balance and postural control are developed as they begin navigating their environment through crawling, pulling to stand, and walking. Then, they begin to navigate a variety of surfaces and stairs, as well as begin to run and jump and climb. All of these activities develop their sense of balance (related directly to the vestibular system and the visual system) and postural control - including their ability to “catch” themselves before falling.

As adults, we utilize our sense of balance when walking through our environment, if we play sports - whether organized or with our family, children, and friends, and when participating in various forms of exercise, including weight lifting, yoga, and running. 

Locomotion

Locomotion is simply moving from one place to another. Children begin locomotion through rolling, then crawling, then cruising, and finally walking. This requires coordination of the arms, legs, trunk, and head as well as incorporating the visual sense to visually navigate the environment.

Other forms of locomotion include running, riding a bicycle, swimming, driving, riding a horse, and more. However, for the purposes of this article, we will focus on locomotion in the form of using one’s limbs (arms and/or legs). 

Coordination

When talking about motor coordination, we are talking about the ability to control and direct our gross motor movements in order to perform a desired action. This can involve just the arms - both right and left - or just the legs. This can involve both arms and legs. Typically, motor coordination always involves the trunk and head in some way. Additionally, motor coordination also involves balance and postural control, as well as strength, endurance, and body awareness. Some forms of motor coordination also involve locomotion! You can see how it’s all connected!

Coordination begins in infancy as babe begins to intentionally move arms and legs - they begin to intentionally roll and push up into a crawling position, then begin to actually crawl - thus coordinating both arms and legs together in an alternating pattern. Next comes learning to walk, which is also coordinated in an alternating pattern, as is running, walking up and down stairs, and riding a bicycle.

Gross motor skills

All childhood activities involve some form of gross motor coordination. Think about climbing up a ladder to get to the top of the slide, or climbing onto a swing and learning how to pump. Then there’s running and learning how to climb around playground equipment, riding a scooter or a bicycle, and then learning how to play specific sports such as soccer or baseball.

As adults, we may also participate in sports and climbing activities such as a rock climbing gym or simply chasing our children on the playground. Additionally, we must coordinate our gross motor movements to complete daily life tasks such as cooking, cleaning, and even driving. We are constantly coordinating our movements, typically without even thinking about it. 

Strength and Endurance

Gross motor skills require a certain amount of muscle strength and endurance to successfully move through various movement patterns. Muscle strength is simply the ability to exert a certain amount of force, while endurance is the ability to continue on with a specific activity.

Infants begin building gross motor strength and endurance almost immediately! When placed on their tummy, they begin to build the necessary strength throughout their neck and trunk in order to lift their head up independently. This progresses to building strength and endurance to push themselves up on their arms, roll, and move into a crawling position. You may notice a baby who is just learning the crawling position - they cannot initially hold it for very long, but the more they practice, the stronger they get (the more endurance they build)!

Children build strength and endurance with movement. The more active they are, the stronger they will be and the more endurance they will have (typically). This is the same with adults - the more active we are, the more likely we are to build strength and endurance for a variety of gross motor skills. 

Body awareness

Simply put, body awareness is understanding where your body is in space and in relation to other objects/people within your environment. Another term for this is kinesthesia - “the awareness of the position and movement of body parts in relation to muscles and joints.” When talking about body awareness, we can even include the understanding of how your body feels - such as hunger, thirst, pain, etc. For the purposes of this article, we will stick with the initial definition of understanding where your body is in space!

Body awareness is directly related to our proprioceptive sense, which is the awareness of your body through receptors in your muscles and joints. While body awareness and proprioception may sound the same, we will talk about body awareness as it relates to gross motor skills - understanding how your body moves for specific tasks.

body awareness

Body awareness develops in infancy and in order to complete any gross motor activity with good balance and postural control, coordination, and force, one must have a good sense of body awareness. In order to successfully move through the environment and navigate obstacles, one must have a good sense of body awareness. Think about a child navigating the halls of a busy school - they need a good sense of body awareness in order to not constantly bump into their peers! The same goes for an adult at the grocery store or shopping mall!

Additionally, body awareness plays a huge role in coordination for childhood activities such as running, jumping, and climbing, as well as learning how to play various sports.

Why are gross motor skills so important?

Not only are gross motor skills important for overall success moving through the environment and interacting with others, but one study found that there is a positive association between gross motor skill development and cognitive development. Another study found a direct correlation between gross motor skills and social functioning skills - specifically in those with Autism. Although these and other studies are small, they indicate a positive association between gross motor skill development and overall cognitive and social development.

From a developmental perspective, gross motor skill development allows a child to interact with their environment and peers. It allows freedom to move and play. This provides opportunities for exploration, social interactions, and overall movement that is deemed good for overall health. While everyone is drastically different, some children may develop gross motor skills sooner than others or more coordination for specific tasks as compared to peers. Overall gross motor skill development should be considered imperative for overall development in our children.

What is the difference between gross motor and fine motor skills?

While gross motor skills are the movements and coordination of the large parts of the body - arms, legs, and trunk, fine motor skills are the movements and coordination of the small parts of the body - the hands and fingers specifically. From a developmental standpoint, fine motor skills cannot be well developed unless the gross motor skills are well developed first. Without good coordination, postural control, strength and endurance, fine motor tasks become more difficult.

Gross motor skill development

Let’s take a look at typical gross motor skill development, starting in infancy. This is a brief overview and is not comprehensive.

Infancy

By 2 months

  • Raises head independently
  • Moves arms and legs independently

By 5 months

  • Props self up on forearms (while laying on tummy)
  • May begin rolling from stomach to back
  • Brings hands to midline

6-9 months

  • Rolls both directions
  • Sits without support
  • Moves into crawling position and rocks back and forth
    • From there, may begin crawling forwards
  • Intentionally reaches for objects

By 12 months

  • Plays while sitting independently
  • Pulls self to stand and cruises along furniture
    • May begin taking independent steps

Toddlerhood

Between 1 - 2 years

  • Walks independently without support
    • May also begin walking backwards
  • Can crawl up and down stairs
    • Will also begin stepping up and down stairs, potentially without support by 24 months
  • Jumps in place without losing balance
  • Runs and can balance on 1 foot for short amount of time

Between 3 - 4 years

  • Successfully alternating feet on stairs
  • May begin riding a tricycle
  • Can jump and even hop on 1 foot without loss of balance
  • Able to walk sideways along a balance beam

Preschool

Between 4 - 6 years

  • Can run, hop, skip, and jump
  • Can throw, catch, and kick a ball
  • Can ride a bike with or without training wheels
  • Can begin learning to pump self on a swing

Elementary age and up

  • Able to participate in more complex sports
  • Able to participate in household chores that require more coordination

Delays in gross motor skills

When you take your child to the pediatrician for a regular checkup, the pediatrician will likely ask you questions about your child’s gross motor development. You may have a checklist to fill out and the pediatrician may ask to see your child complete certain tasks. If your child is showing delays in gross motor skill development, the pediatrician may provide you with suggestions and if the delays are significant, you may be referred to a Physical Therapist or an Occupational Therapist.

The reasons for gross motor skill delays are vast and differ person to person. Oftentimes there is a direct cause, such as Cerebral Palsy or trauma. Other times, there seems to be no direct or known cause.

Red flags

If your child is not meeting expected developmental milestones, that can be a red flag that something is “off.” While children develop at different rates, developmental milestones should be kept in mind when watching your child develop. If a developmental milestone is completely skipped, such as crawling, that can be a red flag that they may lack the necessary coordination or strength. If your child does not pull to stand within the expected time frame, that can be a red flag that they may lack the necessary strength or postural control.

Always talk with your child’s pediatrician if you have concerns with gross motor skill development. 

Activities to promote gross motor development -from an Occupational Therapy Assistant’s perspective

There are a variety of professions that address gross motor skill delays, including physical therapy and occupational therapy. For this article, we are looking at gross motor skills from an occupational therapy standpoint.

Gross motor skills affect daily life tasks. That’s where occupational therapy comes into play! It’s always best to receive in-person services, however there are some activities you can do at home to help your child improve their gross motor skills!

Postural Control and Balance

In occupational therapy, we often use balance beams or other balance items to address postural control and balance. Swings and obstacle courses are also used frequently. These are three ways you can promote postural control and balance at home!

  • Balance items - set up a balance beam or other balance items (you can even use pillows!) for your child to walk along. Increase the challenge by placing toys or other objects on the floor next to the beam and have your child pick them up without losing their balance. Provide assistance as necessary while working up to less and less assistance each time.
  • Swings - open swings, such as a platform or regular playground swing, are perfect for addressing postural control. These swings require the child to activate their core muscles which plays an important role in balance. You can add different activities to the swing such as throwing and catching objects.
  • Obstacle course - set up a simple obstacle course in your home with regular household objects! Create a tunnel by placing a blanket over two chairs; create a crash pad using cushions and pillows; add a balance component by setting up several pillows to walk across. The possibilities are endless!

Locomotion

In occupational therapy, locomotion is typically addressed through other means such as balance beams and obstacle courses (while simultaneously addressing other areas!). Walking along balance objects or crawling through obstacle courses all address locomotion skills. 

Coordination

Coordination is addressed in occupational therapy through a variety of activities including obstacle courses, climbing, and ball skills tasks. At home, there are a few specific activities that can be completed to address coordination of the arms and the legs!

  • Jumping jacks - this elementary P.E. activity is perfect for promoting coordination of the arms and the legs. If your elementary school age child struggles with jumping jacks, break up the movements to address each step.
    • Start with standing with feet together and arms at sides.
    • Move both arms up over the head.
    • Then, jump feet apart.
    • Move back to the starting position by jumping feet together, then moving arms back down.
    • As your child improves with these steps, start to put them together to complete a full jumping jack.
  • Animal walks - similar to crawling on hands and knees, animal walks are a great way to address coordination skills. Try bear walks (on hands and feet), crab walks (on hands and feet with the belly on top; the opposite of the bear walk), and wheelbarrow walks (the child has their hands on the ground to “walk” while you hold their feet).
  • Scooter board - you can find a scooter board online or at a store for fairly cheap. Then, you can have your child move around on the scooter board in a variety of ways to address coordination skills.
    • Laying on stomach, using arms to propel self forward.
    • Sitting and using legs to propel self forward.

Build an Obstacle Course in 5 Easy Steps!

 

    Strength and Endurance

    Strength and endurance is often addressed indirectly in occupational therapy through other activities such as obstacle courses. Depending on the child’s age and abilities, strength and endurance can be addressed through specific exercise type activities. At home, addressing strength and endurance can be as simple as going for a walk or completing household chores. All of the activities previously mentioned can also be used to improve your child’s overall strength and endurance.

    If your child displays low muscle tone (also known as hypotonia and not to be confused with low muscle strength), they will likely need to exert more energy and effort than a child with “typical” muscle tone. This can be seen as poor strength and endurance and can be addressed through in-person occupational and/or physical therapy.

    Body awareness

    Body awareness is another gross motor skill that is oftentimes addressed indirectly in occupational therapy through all of the previously mentioned activities. There are some really great activities that specifically address body awareness that you can complete at home!

    • Simon Says - this is a great activity to help improve body awareness! Take turns being Simon Says to make it more engaging. Try simple commands to start, such as “Simon says lift your arms in the air.” As your child improves and as they get older, you can incorporate left vs right components as well. Try making it even more difficult by providing multi-step directions, such as “Simon says lift your left leg in the air and wave your right hand.”
    • Proprioception and tactile based activities - body awareness is directly related to the proprioceptive and tactile systems, so anytime you can complete activities that address these two areas, you will also be working on body awareness!
      • Heavy work to the muscles will address the proprioceptive sense - animal walks, pushing / pulling such as tug-of-war, etc.
      • Messy play and sensory bins are great ways to work on the tactile system. Try completing them blindfolded!
    • Twister - this classic game is a great way to address body awareness, just by simply playing! Not only will your child be required to plan their movements, but they will also have to navigate moving around others who are also playing!

    Final thoughts

    Gross motor skills are essential to completing daily life tasks, especially for our children! Children need to move and run and jump in order to learn about their bodies and develop skills necessary for tasks later in life. If you notice that your child is showing signs of gross motor skill delays, talk to your pediatrician while also completing the activities mentioned above!


    Check out our podcasts full of helpful info about gross motor skills!

    #44 - Tummy Time + Crawling

    #7 - What is the Proprioceptive Sense?

    #85 - Creating Your Own Sensory Motor Experience

    #165 - A Deeper Look at Sensory Milestones and Red Flags

    #5 - Favorite Products for Infant and Toddler Development

    #10 - Using Sports to Connect Children with Disabilities with Gabriel

    #108 - Muscle Tone vs. Muscle Strength

    #83 - Pediatric Physical Therapy with Emily

    #37 - Motor Planning and Praxis Abilities


    And don't miss our Gross Motor Skills Activity Course to learn more ways to help your child with Gross Motor Skill development!

    Resources:

    https://www.understood.org/articles/en/coordination-and-motor-skills-what-to-expect-at-different-ages?_sp=5a4d65f8-add7-47d2-b5be-8dc957e69c15.1639519717358

    https://therapiesforkids.com.au/gross-motor-milestones/

    Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
    Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

    Rachel Harrington, COTA/L, AC and Jessica Hill, COTA/L both Certified Occupational Therapy Assistants (COTA). They have been working with children for over 6 years in outpatient settings. Rachel and Jessica specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Rachel and Jessica are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Rachel and Jessica, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


    Leave a comment

    Comments will be approved before showing up.


    Also in Special Needs

    Motor Planning and Praxis blog post
    What is Motor Planning and Praxis?

    by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC May 13, 2022

    What is motor planning and praxis? Well from the moment you wake up to the moment you go to bed, you are constantly motor planning your movements. Read our article to learn more about motor planning and praxis, challenges with praxis and ways to help support a child who has challenges with praxis and motor planning skills.
    Read More
    What is multisensory processing blog post
    What is multisensory processing?

    by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC May 11, 2022

    Multi-sensory processing is when more than one sense takes in information at the same time. Check out this article to learn all about multisensory processing, challenges that can occur, and ways to help!
    Read More
    Crawling Blog Post
    Why Crawling is a Milestone Your Baby Should Meet

    by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC April 28, 2022

    Recently the CDC Developmental Milestone checklist was updated to remove crawling as a necessary milestone. We think crawling is an important milestone your baby should meet! Read our article to learn why crawling is the foundation for higher level skill development and learn ways you can help your baby master crawling.
    Read More