THREE- TO FOUR- MONTH TYPICAL DEVELOPMENT CHECKLIST (©Diane Bahr) Place a check mark next to the characteristics you see in your three- to four-month-old baby
Open checklist as PDF
|
Typical 3- to 4- Month-Old Baby |
YES | NO | ||
| MOUTH/FEEDING DEVELOPMENT | ||||
| Anterior tongue & Babkin reflexes seem to fade (3-4 months) | ||||
| Locates the breast nipple frequently without rooting reflex (3-6 months) | ||||
| Controls gag reflex during mouthing & feeding experiences (4-6 months) | ||||
| Has closed mouth & easy nose breathing during sleep & when mouth is inactive/empty | ||||
| Rests tongue in the roof of the closed mouth to help maintain the broad palate shape | ||||
| Is free of tethered oral tissues (tongue, lip, and/or cheek tie) | ||||
| Has good suck-swallow-breathe coordination (3-4 months) | ||||
| Sequences 20 or more sucks without a pause (different in breastfeeding than bottle feeding) | ||||
| May cough or choke occasionally (3-4 months) | ||||
| Recognizes the bottle (3- 4 months) | ||||
| Pats bottle or breast with hand(s) at 3 to 4 months | ||||
| Takes sips from an open cup held by the parent or care provider (4-6 months) | ||||
| Uses increased lip control & movement (4-6 months) | ||||
| Begins using jaw, lip, cheek, & tongue muscles independently | ||||
| Uses mostly generalized mouthing to explore appropriate toys & fingers | ||||
| Brings an appropriate object to mouth around 4 months | ||||
|
BODY DEVELOPMENT (Typical 3- to 4- Month-Old Baby) |
||||
|
When on the Stomach (Typical 3-Month-Old) |
||||
| Rests arms symmetrically around the head | ||||
| Lifts the head in the middle (midline) at 45- to 90- degree angles without bobbing | ||||
| Shifts body weight from side-to-side as head moves to left or right & may roll to the side | ||||
| Visually tracks an object horizontally across 180 degrees while looking upward | ||||
| Props & bears weight on forearms with elbows in line with or in front of the shoulders (crucial for shoulder development) | ||||
| Lifts the chest & lowers the hips | ||||
| May make finger scratching movements or swimming motion with body & legs when seeing a toy | ||||
| Lowers head & shoulders when raising the hips (weight is shifted forward & minimal kicking occurs) | ||||
|
When on the Stomach (Typical 4-Month-Old) |
||||
| The flexion/bending part of the tonic labyrinthine reflex seems to disappear (become integrated by the brain) | ||||
| Controls head/neck, spine, hips, & shoulders to lift head 90-degrees, lift chest, arch lower back, & place weight on the forearms | ||||
| Has front-to-back body movement, & pivots extended/stretched body to place weight on forearms | ||||
| Maintains propped/lifted body position when head/neck are bent downward (flexed) contributing to abdominal muscle & rib cage development, as well as hip stability | ||||
| Rolls from stomach to side with weight shift | ||||
| Has increasing eye muscle control related to head control; visual attention leads head & eye movements | ||||
| Alternates between extending & bending legs to develop hip, leg, knee, & ankle muscles | ||||
|
When Lying on Each Side of the Body (Typical 4-Month-Old) |
||||
| The flexion/bending part of the tonic labyrinthine reflex seems to disappear (become integrated by the brain) around 4 months | ||||
| Demonstrates a good balance of bending & extending body when lying on each side (significant developmental milestone) | ||||
| Develops rib cage shaping/contouring by bearing/supporting body weight against gravity along with the pull/action of the oblique abdominal muscles | ||||
| Develops side bending with new head positions | ||||
|
When on the Back (Typical 3-Month-Old) |
||||
| Moro/Startle reflex begins to disappear (become integrated by the brain) between 3 & 6 months | ||||
| Has head close to or in midline (middle of body), & begins to tuck chin toward chest & look downward | ||||
| Rotates head from side-to-side while lengthening back of neck; may turn body onto side | ||||
| Looks at a toy in midline/middle with increasing attention, & may swipe at it | ||||
| Visually follows a toy/face horizontally from side-to-side | ||||
| Typically has hands open with wrists & fingers spread | ||||
| Shows increase in hands & eyes working together (eye-hand coordination) | ||||
| Demonstrates increase in moving just enough for an activity (grading) & moving one body part separate from another (dissociation) | ||||
| Brings hands to the body in an increasingly coordinated manner, & begins to gain control over palmer grasp reflex | ||||
| Uses hands with increasing intention to explore own mouth, body, clothing, & care-providers (body awareness/touch experiences) | ||||
| Often has feet together for body awareness/touch experience (frog-legged position) | ||||
| Stretches hip, leg, knee, & ankle muscles when moving legs | ||||
|
When on the Back (Typical 4-Month-Old) |
||||
| Moro/Startle reflex seems to disappear (become integrated by the brain) between 3 & 6 months | ||||
| The flexion/bending part of the tonic labyrinthine reflex seems to disappear (become integrated by the brain) around 4 months | ||||
| The asymmetric tonic neck reflex seems to disappear (become integrated by the brain) between 4 & 6 months | ||||
| Moves trunk/core as a unit in slight bending & extending/stretching related to abdominal & hip movements (lowers spine & lifts hips) | ||||
| Maintains head in midline/middle with tucked chin & elongated neck; neck & shoulder stability needed for tongue & jaw development/movement | ||||
| Looks downward when lowers chin | ||||
| Moves head toward side of sound and/or visual stimulation | ||||
| Body follows head movement to roll body to the side | ||||
| Follows & fixes eyes on objects without head movement | ||||
| Moves arms & legs actively, symmetrically, & in synchrony | ||||
| Brings hands to middle of body & other body parts developing body awareness, hand use, & beginning eye-hand coordination for reaching & grasping | ||||
| Reaches toward toys, & holds lightweight toys placed in hands | ||||
| Bang, shakes, & brings appropriate toys to mouth with hands | ||||
| Mouths appropriate toys discriminating shape, size, & texture (typifies/assists mouth & tongue sensation/awareness used in future feeding, eating, drinking, and speech) | ||||
| Kicks legs with increasing coordination stretching hip, leg, knee, ankle, & toe muscles | ||||
| Shifts weight to side when foot placed on opposite knee, & can roll to side with flexion/bending | ||||
| Foot-on-foot play & pushing with the feet increases body awareness |
Primary References
•Bahr, D. (2018). Feed your baby and toddler right: Early eating and drinking skills encourage the best development. Arlington, TX: Future Horizons.
•Bahr, D. C., & Hillis, A. E. (2001). Neurological and anatomical bases. In D. C. Bahr Oral motor assessment and treatment: Ages and stages (pp. 1-41). USA: Pearson College Division.
•Bly, L. (1994). Motor skills acquisition in the first year: An illustrated guide to normal development. USA: Psychological Corp.
•Feldenkrais, M. (1972). Awareness through movement (Vol. 1977). New York: Harper and Row.
•Morris, S. E., & Klein, M. D. (2000). Pre-Feeding skills: A comprehensive resource for mealtime development. (2nd ed.)
. San Antonio, TX: Therapy Skill Builders.
•Neuro Restart (2019). Primitive reflexes. Retrieved from http://www.neurorestart.co.uk/primitive-reflexes/
•Vulpe, S. G. (1994). Vulpe assessment battery-revised: Developmental assessment, performance analysis, individualized programming for the atypical child. East Aurora, NY: Slosson Educational Publications.