Signs of Weakness by Age for Primary Care

Motor Development Milestones

This surveillance aid will facilitate the identification of motor weakness that presents between birth and five years of age. This aid is designed for children who were born on or after 38 weeks of gestation. If a child is born prior to 38 weeks of gestation, please use adjusted age for developmental milestones.

The assessment of milestones recommended in this aid is consistent with the Bright Futures Guidelines. The exception is rise to stand from floor, which is not included as a Bright Futures milestone but is a quick, easy, and important way to identify motor weakness.

During surveillance, recall the Clinical Pearl: Red flags for urgent referral include tongue fasciculation, loss of motor milestones, or CK greater than 3x normal.

Click the icons below to review the signs of weakness by age.

Download a pdf of the Surveillance and Referral Aid for Primary Care Providers. This Aid includes assessing weakness by age, clinical evaluation for muscle weakness, guidance on the use of CK testing, and the motor delay algorithm. These materials have been endorsed by the American Academy of Pediatrics.