1 |
Enjoys being held/realigns |
0 or 1 |
2 |
Rotates head |
0 or 1 |
3 |
Moves arms and legs vigorously |
0 or 1 |
4 |
Holds head steady while held upright |
0 or 1 |
5 |
Supports self on forearms while positioned on belly |
0 or 1 |
6 |
Sits with support and with head steady |
0 or 1 |
7 |
Rolls over (belly to back) |
0 or 1 |
8 |
Holds on to examiner’s fingers and pulls self from lying on back to sitting position |
0 or 1 |
9 |
Shifts weight to one side while reaching for toy |
0 or 1 |
10 |
Stands with hands held and bounces |
0 or 1 |
11 |
Sits alone with arms not used for support |
0 or 1 |
12 |
Pulls self to stand |
0 or 1 |
13 |
Gets from sitting to hands and knees |
0 or 1 |
|
Fine Motor Items |
|
Item |
Description |
Scoring |
|
1 |
Arms held close to body with hands fisted |
0 or 1 |
2 |
Reflexively grasps a ring |
0 or 1 |
3 |
Brings fist to mouth |
0 or 1 |
4 |
Brings hands together at midline |
0 or 1 |
5 |
Hands held open with fingers extended |
0 or 1 |
6 |
Nonreflexive grasping of a small peg using ulnar palmar grasp |
0 or 1 |
7 |
Reach for and grasp a block using radial-palmar grasp |
0 or 1 |
8 |
As child plays with blocks, s/he transfers, bangs, and/or drops a block (at least 2 behaviors must be observed) |
0 or 1 |
9 |
Reach for and grasp a block using radial-digital grasp |
0 or 1 |
10 |
Pick up small object using partial or refined pincer grasp |
0–2 |
11 |
Bangs blocks together in a horizontal movement at midline |
0 or 1 |
12 |
Takes blocks out or puts them in a container |
0–3 |
13 |
Uses two hands together to manipulate an object |
0 or 1 |