Abby Barnes, M.S., CCC-SLP
In the first year of a baby’s life, many parents watch for big new skills like sitting up and saying that first word. But there are a variety of other milestones to be looking for between birth and 12 months, related to fine motor skills, social skills, cognitive abilities, and more.
Occupational therapists (OTs) help babies and toddlers meet developmental milestones that set them up for strong physical, mental, and social growth throughout childhood. This guide explains the key areas of typical development in babies from birth to age 1, as well as what to do if your child needs help meeting these milestones.
Key takeaways
Occupational therapy can support children’s fine motor and visual skills, social and play skills, regulatory and sensory skills, and cognitive abilities.
There are a variety of milestones related to these developmental areas that babies typically reach in their first year.
Fine motor skills relate to using the small muscles in the hands and fingers to perform specific tasks.
Visual development refers to how babies look at things, then respond with their body to perform different motor tasks.
Cognitive skills refer to your child’s growing ability to think, learn, reason, and remember.
Regulatory and sensory development is how babies take in and respond to stimuli, such as what they feel, hear, or see.
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Occupational therapy can help with several areas of infant development:
Fine motor and visual motor skills
Social and play skills
Cognitive development
Regulatory and sensory organization
Fine motor and visual development is how babies use their hands and eyes together to interact with items and their environment. Examples can be holding a toy or reaching for a dangling object, like a baby toy.
Social and play skills are how babies learn to engage with others, such as through smiling or interacting with another person or playing with toys. This is an important piece of your baby’s overall development.
Cognitive growth includes problem-solving skills, attention, and cause-and-effect understanding. Cognitive skills help your baby learn new things as they grow.
Regulatory and sensory organization is how babies respond to sensory input like touch, sound, movement, or visual stimuli. It also includes how well they can soothe themselves when upset. Good regulatory skills can promote better sleep and wake cycles and contribute to playtime and feeding time.
See our other developmental milestone checklists for babies:
Watch for these milestones in your baby from birth to age 12 months to ensure their communication is on the right track.
Occupational therapy developmental milestones: 0-3 months
Fine motor and visual milestones at 0-3 months
For babies from birth to age 3 months, there are many fine motor and visual motor skills developing. You'll likely see your baby:
Open their hands briefly
Reflexively scratch or grab a blanket
Look at their hands
Blink suddenly at visual stimuli, such as when you hold a toy in front of them
Social and play milestones at 0-3 months
Social and play skills at this age are simple, but they’re still promoting big growth! When you lay your baby down and let them look at your face, it’s an exciting game for them. As they move through those early weeks, you’ll see them start to smile at you and seem happy to see you. They may also begin to imitate some movements and expressions.
Cognitive milestones at 0-3 months
Early cognitive growth is happening at this stage, too. You’ll likely see your baby watch a toy for a few seconds, or track you with their eyes as best they can while you move. These are great signs of cognitive development in the first three months of your baby’s life.
Regulatory and sensory milestones at 0-3 months
When it comes to regulatory and sensory development, watch for these milestones:
When there is a loud sound, your baby may cry, move, or open their eyes. This shows that they’re reacting to what they hear.
You will start to see your baby calm down when they’re spoken to or held. This helps them learn to calm and soothe, as well as develop strong attachment to their caregivers.
Occupational therapy developmental milestones: 3-6 months
As your baby gets closer to 6 months old, you’ll see them building on the milestones they developed in their newborn days.
Fine motor and visual milestones at 3-6 months
As fine motor and visual motor skills grow, your baby will begin to:
Hold toys more easily and even start to transfer them from hand to hand
Try to swipe at objects
Mouth their hands
Try to keep both hands on an item, such as their bottle
More smoothly move their head and eyes to track and watch smaller items, such as small toys
Social and play milestones at 3-6 months
At this stage, babies start to become their own little person learning to navigate their world. Laughing is one fun social milestone you’ll see in this stage. You never quite know what will give them their first giggle! Your baby will also reach for a toy, as if to communicate, “Hey, I want that!” They’re likely also interested in what they see in a mirror (although they don't realize it’s a reflection of them!).
What are the best toys for babies? Find out how to play with your 6-month-old using these fun toys and activities.
Regulatory and sensory milestones at 3-6 months
For regulatory and sensory organization, you should see them better self-soothe and stay calmer for longer stretches. Of course, babies get fussy, but at this age they’re typically better entertained by toys and people. This leads them to be more observant of their environment and (hopefully!) calmer than they were in the newborn days.
Cognitive milestones at 3-6 months
Babies at this stage have growing curiosity that helps them observe and learn about the things around them. They show cognitive thinking in several ways:
Looking at their hands curiously
Struggling to get objects that are out of reach
Understanding more about cause and effect—for example, this toy makes a noise when I touch it, or Dad picks up that toy when I drop it!
Occupational therapy developmental milestones: 6-9 months
Fine motor and visual milestones at 6-9 months
By ages 6 to 9 months, you’ll start seeing:
A pincer grasp, where the thumb is pressed to the index finger. This allows the child to pick up something small, such as small bites of food.
Your baby beginning to finger-feed themselves
Your baby rotating their wrist while holding a toy
Social and play milestones at 6-9 months
This brings us to social and play development. You’ll start to see your baby do things like:
Shake a rattle
Pick up items and drop them purposely, such as picking up blocks and dropping them in a bucket
What are the best activities for babies? Find out how to support your 9-month-old’s development using these fun activities.
Regulatory and sensory milestones at 6-9 months
Your baby is learning to organize the sensations they take in. They are learning to:
Tolerate new textures of food, such as purees and softer foods
Pull themselves to stand up
Tolerate new sensations under their feet as they practice standing—their body has to learn how to make sense of and respond to this
Cognitive milestones at 6-9 months
You’ll start to see your baby understanding more overall. One fun task is to watch them look for objects that have fallen out of sight. So if you show them a teddy bear and put it behind your back, they will look at you as if to say, “Where did that go?” Your baby likely will enjoy dropping, rolling, or throwing objects to find out how they behave. It’s their way of figuring out how the world works!
Occupational therapy developmental milestones: 9-12 months
As your child approaches their first birthday, the skills keep multiplying!
Fine motor and visual milestones at 9-12 months
You should see these skills in your baby:
They’ll handle items with their fingers more often, as opposed to using the palm of their hand.
Dressing will become a little easier, as your baby may hold their arm or leg out to help you get their clothes on.
Their pincer grasp will be more refined.
Social and play milestones at 9-12 months
As you play with your baby, you’ll notice them:
Using more gestures like waving
Bringing both hands together to clap purposefully
Imitating your actions while playing
Preferring certain toys
Starting to get good at stacking one block on another
These milestones bring a whole new level of fun to playtime!
Regulatory and sensory milestones at 9-12 months
In sensory development, your baby will likely start to enjoy activities like spinning or swinging. So you may have lots of playtime on the swings soon!
Cognitive milestones at 9-12 months
Cognitively, you’ll likely start seeing your baby do the following:
Respond to their name
Look at an item pictured in a book when it’s named
Begin to turn cardboard pages in a book
Bang or use two objects together while playing
Begin to use objects correctly, such as “talking” on a pretend phone
Keep your 1-year-old entertained with these fun indoor activities. Plus, tips for promoting your toddler’s speech and language while you play.
What if your baby isn’t meeting developmental milestones?
If you’re noticing that your child is missing some of these milestones, talk with your pediatrician or an occupational therapist. Infants’ brains grow quickly, and the sooner you can support them in all areas of development, the sooner you’ll start to see new skills develop.
Here at Expressable, we provide personalized, virtual occupational therapy designed to fit your child’s needs. Reach out to us to schedule an OT evaluation and get your questions answered.
Frequently asked questions (FAQs)
Developmental milestones are the expected skills that children meet at different ages. Every child is unique in their development. However, there is a general timeline and progression that OTs look for as children grow and develop.
You should see your baby mouthing their hands or trying to swipe at objects between 3 and 6 months. Watch for them to use their fingers more, such as for feeding themselves, around 6-9 months. At 9-12 months, babies are typically handling things with their fingers more accurately.
Babies start developing social skills as soon as they’re born! Simple things like looking at a person who speaks to them is part of social development. As babies grow, these social skills become more noticeable, such as smiling, trying to imitate your expression, or using gestures like waving.
Early on, around 0-3 months, you should see babies blink a lot when shown an object. They are better able to track items with their eyes by 3-6 months. Also look for milestones such as the ability to grab items, which demonstrates that their visual motor skills are growing.
Watching people and items like toys; looking for hidden objects, such as a toy hidden behind your back; responding to their name; and looking at a book shown to them are all cognitive milestones to watch for in your baby’s first year.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
