Home Visitor's Online Handbook

Perceptual, Motor, and Physical Development

Toddler boy throwing a ballHow do perceptual, motor, and physical development goals relate to school readiness? The environment of a healthy womb and healthy habits established in the first five years of life lay a strong foundation for the physical and mental well-being needed for school success. The strength, balance, and coordination developing in the bodies of young children will grow into physical skills that allow them to pay attention; participate in games, active play, and sports; and use tools such as pencils, crayons, markers, and paint brushes. The ELOF provides a detailed progression of the knowledge and skills a child achieves in this domain.

Young children depend completely on adults to provide good nutrition, well-child care, health, and oral health care. Every day, parents establish the rudiments of healthy living—simple things like hand-washing, covering coughs and sneezes, and tooth-brushing—that will help keep them free from illness and able to attend school regularly. Proper nutrition supports brain development, growth, and health. The progression of large muscle development is generally predictable but only occurs when there is opportunity and encouragement for movement. Each new posture requires new learning about balance and brings new perceptions of the world. The sitting baby sees the world differently from the crawling baby. The walking baby needs to relearn all he knew about depth perception as a crawler. In turn, as the child perceives more of the world, she is motivated to gain a greater variety of movements. More movement builds strength, flexibility, and endurance.

Teacher cutting paper with a childFine motor development (e.g., development of the small muscles in the face) is the foundation for communication through facial expression. Fine motor development also provides our unique ability to use our fingers. It doesn't look like much in early infancy when babies who are just able to grasp a rattle can't even figure out how to release it. However, by age 3, they are using markers and paintbrushes, dressing themselves, using manipulative toys, and putting together puzzles. They are well on their way to having hands that build, write, turn pages, and create masterpieces.

How To

You support parents in protecting their child's health and safety and developing healthy habits by:

  • Providing information on well-child and immunization schedules
  • Teaching songs that help parents and children time how long to wash their hands or brush their teeth
  • Prompting parents to establish a routine to help their child wash hands after outdoor play, before eating, and after toileting
  • Knowing how to access resources in your community to promote safety, such as free outlet covers or car seats
  • Having community partners who can help the family find a medical or dental home
  • Being respectful of parents' beliefs and values concerning health
  • Modeling healthy behaviors
  • Using motivational interviewing to discuss topics
  • Introducing health literacy
  • Talking about healthy nutrition and the value of physical activity
  • Sharing information about the effects of secondhand smoke on children's health
  • Maintaining a safe environment in their home

You support parents in promoting their child's physical development by:

  • Using and discussing home safety checklists and tools
  • Helping parents have realistic expectations of large motor developmental milestones
  • Using the home environment to provide interesting physical challenges, such as putting a firm sofa pillow on the ground for an infant to crawl over
  • Encouraging parents to take the child outdoors to play
  • Finding objects in the home that can be thrown (e.g., a ball made from crumpled paper and taped into a ball shape)
  • Figuring out safe ways to hang toys for reaching infants
  • Encouraging active, developmentally appropriate play with their child
  • Talking with parents about their feelings and beliefs; for example:
    • Should girls be active?
    • Should boys do artwork?
    • Is it safe to play outdoors?
    • Are they in a hurry to have their child walk or run?
    • Do they prefer a child who can sit quietly?
  • Suggesting strategies for providing guidance to toddlers who want to climb on tables or other surfaces unacceptable to parents

You can support parents' promotion of fine motor development by:

  • Bringing recipes for play dough so their child can build hand strength by making the dough and forming small items using their fingers
  • Using sidewalks or outside walls for broad strokes with water-filled brushes; moving to paper and markers as the child gains more finger control
  • Using writing utensils and manipulative toys
  • Singing songs with hand movements, such as "The Itsy Bitsy Spider" and "Twinkle, Twinkle, Little Star"
  • Playing the "thank-you game," where the child hands you an object, you take it and say thank you, and then hand it back to the child
    • This grab-and-release activity not only supports fine muscle development but also helps reinforce the pleasure of taking turns

This information in this list was adapted in part from News You Can Use: Foundations of School Readiness: Physical Development and Health.

Experience It

This is a very short clip of a baby just learning to walk. Notice that, although Perpetual, Motor, and Physical Development is the primary domain observed, multiple infant/toddler ELOF domains are in play at once. Even though you can't see the person behind the camera, they play a large role in the baby's reaction.


Describe the developmental domains observed in this scene.

Answers may include:

  • Perpetual, Motor, and Physical Development
    • Walking
    • Pushing the chair
    • Stooping and standing
  • Social and Emotional Development
    • Smiling
    • Vocalizing
  • Language and Literacy
    • Vocalizations
  • Approaches to Learning
    • Persistence
    • Initiation

What could you plan with parents to do at the next home visit based on your observations?

Answers may include:

  • Find other stable objects the child could use to support pre-walking behavior
  • Hold the child's hands and go for a walk in the home or outside
  • Check around the home to see if the family has objects the child could push
  • Examine the home for safety issues that a newly mobile child may encounter

How do you observe with parents to help them notice all of the domains of development occurring in their child?

Answers may include:

  • Individual reflection

In this video clip, the home visitor works with Elinor and her mother on several aspects of their interests. One of  the mother's goals for Elinor is to learn scientific principles. The home visitor has followed up on Elinor's interest in fish and on her mother's goal by bringing magnetic fishing poles to go "fishing" with the child and her mother. Notice that during this brief interaction, the various domains for school readiness are constantly evident throughout.


Describe the school readiness domains you observe in this scene.

Answers may include:

  • Social and Emotional Development
    • Mother and child smile at each other frequently
    • They are face to face throughout the experience
    • Mother imitates child's motion and words, tapping her head and saying her word for "oops"
    • Mother shows pleasure at Elinor's activities and words
  • Perceptual, Motor, and Physical Development
    • Holding the fishing pole
    • Eye-hand Coordination
      • Picking up the "fish" with the poles
    • Fine Motor
      • Placing the fish on the magnets
    • Gross Motor
      • Elinor sits, then stands, as she does the activity
  • Language and Literacy
    • "Swing, swing."
    • "Fish swim."
    • Many words in her home language
    • Mother repeats what Elinor says
  • Cognition
    • Discussion and observation of properties of magnets
  • Approaches to Learning
    • Problem-solving around how to put fish on poles
    • Self-regulation and persistence around frustration at not achieving her goal of keeping the fish on the pole

How does the mother enhance the child's experience by her observations and comments?

Answers may include:

  • She calls the child's attention to the characteristics of the magnets (e.g., how they pick up the fish, etc.).
  • She repeats and talks about what the child is saying (e.g., "Fish swim, but Elinor's swing;" the equivalent of "oops" in her home language and tapping her head).
  • She talks with the child in both English and her home language about the fishing activity.
  • She engages the child in the activity by showing interest and playing the game herself.
  • She faces the child throughout the activity, even though the child is physically closer to the home visitor.

Is there anything else you would like to know about this family before planning future experiences with the parents?

Answers may include:

  • You may want to know more about their country of origin and background to integrate learning experiences appropriate to language and culture.

What could the home visitor suggest to the parent as they plan for next time to expand on the child's learning about magnets? Are there materials in the home that can be used to do that? As the home visitor plans experiences with the mother about magnets, how might she assure that all of the domains of development are addressed?

Answers may include:

  • Individual reflections

Learn More

Check out these News You Can Use e-newsletters for more information about encouraging young children's physical, motor, and perceptual development. Each shows how the information can be used in daily practice.

Explore the different definitions of play and why it is so important. Play benefits every aspect of child development as infants and toddlers explore their world and their bodies, while also learning about and mastering relationships and social skills. This is useful information for home visitors, program staff, caregivers, and others serving infants and toddlers through Early Head Start and Migrant and Seasonal Head Start programs.

Take It Outside
Discover ideas about how to create outdoor spaces that are engaging for infants, toddlers, and their families. Early Head Start teachers and home visitors may use this resource to set up spaces for families using community resources such as parks, gardens, and nearby schools.