What are the gross and fine motor milestones for a 4-year-old (four-year-old) child?

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From the Guidelines

By age 4, children should be able to climb stairs without support and skip on one foot as gross motor milestones, and draw a person with 6 parts, a simple cross, and button medium-sized buttons as fine motor milestones. According to the most recent and highest quality study available, 1, the expected gross and fine motor milestones for a 4-year-old child are:

  • Gross motor milestones:
    • Climbs stairs without support
    • Skips on one foot
  • Fine motor milestones:
    • Draws a person with 6 parts
    • Draws a simple cross
    • Buttons medium-sized buttons These milestones are essential indicators of a child's developmental progress and should be monitored by healthcare providers during routine check-ups. It is crucial to note that while these milestones serve as a general guideline, children may develop at slightly different rates, and some variation is considered normal. However, significant delays or concerns about a child's motor development should be discussed with a healthcare provider to determine if further evaluation is necessary, as suggested by the study 1. Healthcare providers should use standardized developmental tests and conduct thorough physical examinations to assess a child's motor skills and identify any potential issues early on, as outlined in the study 1.

From the Research

Gross Motor Milestones for a 4-year-old Child

  • At 4 years old, children typically achieve certain gross motor milestones, such as running, jumping, and kicking a ball 2
  • Gross motor development in children follows a predictable sequence as the central nervous system matures, allowing for the assessment of development and identification of motor delays through physical examination and screening with standardized tools 3
  • The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), is a standardized, norm-referenced measure used to assess fine and gross motor skills in children, including those aged 4-21 years 2

Fine Motor Milestones for a 4-year-old Child

  • Fine motor skills, such as manual coordination and fine manual control, are also assessed in children using tools like the BOT-2 2
  • At 4 years old, children typically demonstrate improved fine motor skills, such as drawing simple shapes and using scissors 4
  • The development of fine motor skills is an important aspect of overall child development, and delays or difficulties in this area can be identified through standardized assessments and evaluations 5

Assessment and Evaluation of Motor Milestones

  • Various assessment tools, such as the Bayley Scale of Infant and Toddler Development-III (Bayley-III), the Movement Assessment Battery for Children-2 (MABC-2), and the Test of Gross Motor Development-2 (TGMD-2), are used to evaluate gross motor skills in children 5
  • These assessment tools have varying levels of validity, reliability, and clinical utility, and are used to identify motor delays and difficulties in children 5
  • Early intervention and evaluation are crucial in addressing motor delays and difficulties in children, and can help improve overall developmental outcomes 3, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Review of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2).

Physical & occupational therapy in pediatrics, 2007

Research

The Developing Child.

Journal of the American Academy of Child and Adolescent Psychiatry, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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