our pediatric services
occupational, pelvic, physical and speech
At Heart and Sole Therapy, our mission is to empower children and their families by providing comprehensive, compassionate, and individualized pediatric therapy services with a collaborative team based approach. Through occupational therapy, pelvic floor therapy, physical therapy and speech therapy, we aim to foster each child’s unique strengths, promote functional independence, and support their developmental journey. We strive to enhance the quality of life of each child we serve through collaboration, innovation, and evidence-based practices, ensuring they can reach their full potential.
At Heart and Sole Therapy, our mission is to empower children and their families by providing comprehensive, compassionate, and individualized pediatric therapy services with a collaborative team based approach. Through occupational therapy, pelvic floor therapy, physical therapy and speech therapy, we aim to foster each child’s unique strengths, promote functional independence, and support their developmental journey. We strive to enhance the quality of life
of each child we serve through collaboration, innovation, and evidence-based practices, ensuring they can reach their full potential.
early identification and intervention
Pediatric therapists often identify developmental delays or challenges early on, which can lead to early intervention. This is critical because addressing issues at a young age can prevent more significant difficulties later in life.
Missing one or two abilities with developmental milestones should not cause alarm, as every child develops differently. However, if they are missing multiple abilities, be sure to talk with your healthcare provider. Do not be afraid to get a second opinion if you feel you are not being heard! You are your child’s first advocate.
our pediatric therapists
occupational, pelvic, physical and speech
Founder, Owner
Physical Therapist, Pelvic Floor Specialist
Dr. Courtney James
Occupational Therapist
Kelcy Ellis
Certified Occupational Therapist Assistant
Caitlin Moller
Speech Language Pathologist
Britta Dalbey
Occupational Therapist
Pelvic floor specialist
Dr. Meghan Marth
pediatric milestones
motor skills, language, social behavior, and cognition
Pediatric developmental milestones are key indicators of a child’s growth in areas such as motor skills, language, social behavior, and cognition. These milestones, which include activities like sitting up, crawling, walking, speaking first words, and using fine motor skills like grasping objects, provide a general framework for typical development. While children may reach these benchmarks at slightly different times, significant delays or deviations can be early signs of underlying challenges. Pediatric therapists—including occupational, physical, pelvic floor, and speech-language specialists—use these milestones to assess whether a child is progressing appropriately and to identify areas that may require support.
Pediatric developmental milestones are key indicators of a child’s growth in areas such as motor skills, language, social behavior, and cognition. These milestones, which include activities like sitting up, crawling, walking, speaking first words, and using fine motor skills like grasping objects, provide a general framework for typical development. While children may reach these benchmarks at slightly different times,
significant delays or deviations can be early signs of underlying challenges. Pediatric therapists—including occupational, physical, pelvic floor, and speech-language specialists—use these milestones to assess whether a child is progressing appropriately and to identify areas that may require support.
Physical Therapy Skills
- Turns head to each side when lying on back
- Holds head up when on stomach (prone)
- Kicks legs reciprocally
- Rolls side to back (supine)
Occupational Therapy Skills
- Looks at hands
- Blinks at sudden visual stimuli
- Tracks contrasting visual stimuli from side to midline
- Grasps rattle briefly
Speech Therapy Skills
- Begins to differentiate different cries
- Drinks from bottle or breast
- Alerts to sounds
- Smiles when you talk
If your baby is not meeting several of these milestones by 3 months, or if you notice muscle stiffness, floppiness, or difficulty feeding, talk to your child’s pediatrician. Referrals can be faxed to 855.702.2523.
0-3 month milestone print out
Physical Therapy Skills
- Holds prone on forearms — lifts chest off surface
- Rolls prone to back (supine)
- Holds head in line with body during pull to sit
- Holds head steady in supported sitting
- Sits with slight support
- Bears some weight on legs
- Pushes up onto hands in prone
- Extends head, back, and hips when held in ventral suspension
- Rolls back (supine) to side
- Sits momentarily — may lean on hands
- Pivots in prone
- Actively moves head in supported sitting
Occupational Therapy Skills
- Brings hands to mouth
- Holds a toy when placed in hand
- Briefly keeps both hands on bottle
- While on back, clasps hands at midline
Speech Therapy Skills
- Begins to babble
- Giggles or laughs
- Responds to facial expressions
- Vocalizes different vowel sounds
- Produces “raspberries”
- Eats purees and meltable solids
3–6 month milestone
print out
Physical Therapy Skills
- Sits independently indefinitely — may use hands
- Bears almost all weight on legs
- Lifts head and assists when pulled to sit
- Rolls supine to prone
- Gets to sitting without assist
- Bears large fraction of weight on legs and bounces
- Stands, holding on
- Pulls to standing at furniture
- Crawls (belly crawls, typically backward and then forward)
- Assumes hands and knees
- Goes from sitting to prone (on belly)
Occupational Therapy Skills Cont.
- Shakes and bangs toys
- Uses raking grasp for cheerios
- Holds and drinks from bottle/sippy cup
- Uses arms for “So Big”, “Peek-a-Boo”, and “Pat-a-Cake”
- Purposeful grasp and release of objects onto containers
Occupational Therapy Skills
- Consistent, purposeful reach using vision to guide movement
- Transfers objects hand to hand
- Finger feeds large food like crackers
Speech Therapy Skills
- Looks at you when you call their name
- Babbles long string of sounds, such as “mamamama” or “bababa”
- Raises arms to be picked up
- Emerging phonemes including d, t, k, m, h, and n in babbling
- Babbles back and forth with caregiver in turn-taking conversational style
6–9 month milestone
print out
Physical Therapy Skills
- Lowers to sitting from furniture
- Creeps on hands and knees
- Stands momentarily
- Walks, holding furniture (cruising)
- Pivots in sitting (twists to pick up objects)
- Creeps on hands and feet
- Walks with 2 hands held
Occupational Therapy Skills
- Holds arms and legs out for dressing and undressing
- Claps hands together
- Bangs toys at midline
- Pincer grasp develops
Occupational Therapy Skills — Cont.
- Releases objects independently on a surface
- Begins stacking blocks, but may not balance
- Beginning use of utensils
Speech Therapy Skills
- Says one–two words (mama, dada, hi, bye)
- Points, waves and shows or gives objects
- Imitates and initiates gestures for social interactions and games (blowing bubbles or peek-a-boo)
- Responds to simple words/phrases like “go bye-bye” or “look at mommy”
9–12 month milestone
print out
Physical Therapy Skills
- Stands with feet flat for 3–5 seconds without support
- Assumes and maintains kneeling
- Walks with one hand held
- Stands alone well
- Walks alone 2–3 steps
- Walks backward
- Creeps upstairs
- Walks without support (13–15 months)
- Runs — hurried walk
- Walks upstairs with one hand held
Occupational Therapy Skills
- Self feeds with utensils
- Points with index finger
- Holds toys with one hand and manipulates with the other hand
- Scribbles on paper
- Stacks 2–3 blocks
- Dumps contents from a jar
- Tries to put on shoes
Occupational Therapy Skills — Cont.
- Turns 2–3 pages of a thick book
- Attempts to pull socks and shoes off
- Pushes arms through sleeves / pushes legs through pants
- Holds and drinks through cup (with spilling)
- Displays discomfort with solid
- Opens mouth for teeth to be brushed
Speech Therapy Skills
- Looks around when asked “where” questions
- Follows simple directions (“give me the ball”, “hug the teddy bear”)
- Points to make requests, comment, or get information
- Shakes head for “yes” or “no”
- Understands and uses words for common objects, actions, and people
- Uses gestures like clapping, waving, high-fives
- Uses a combination of long strings of sounds, syllables, and real words with some inflection
- Identifies some body parts
12–18 month milestone
print out
Physical Therapy Skills
- Kicks ball forward
- Moves on ride-on toys (without pedals)
- Runs fairly well
- Climbs into and sits in adult chair
- Walks down stairs with one hand held
- Picks up toy from floor without falling
- Squats in play
- Walks upstairs alone, both feet on step
- Walks downstairs holding rail, both feet on step
Occupational Therapy Skills
- Pulls apart large pop beads
- Washes hands partially
- Removes loose fitting shoes
Speech Therapy Skills
- Uses and understands at least 50 different words/approximations
- Puts two or more words together (“more water”, “shoes on”)
- Follows two-step directions
- Uses pronouns (“me”, “mine”, and “you”)
- Uses words to ask for help
- Uses possessives (“mommy’s socks”)
18–24 month milestone
print out
Physical Therapy Skills
- Jumps 8–14 inches (24–30 months)
- Jumps from bottom step
- Catches large ball, using body to help
- Climbs well
- Walks downstairs alone, placing both feet on each step
- Walks upstairs with support, alternating feet
- Swings leg to kick a ball
- Runs easily
- Pedals tricycle (30–36 months)
- Runs well, stops without holding on, avoids obstacles
- Imitates one foot standing
- Walks backward 10 inches
- Walks a few steps on tiptoes
- Jumps sideways, backward, and over a small hurdle (2–8 inches)
2–2.5 yrs Occupational Therapy Skills
- Snips with scissors
- Imitates horizontal and vertical lines
- Strings 2–4 beads
- Helps pull up elastic waist pants
- Tries to put pants on
- Stacks 8–10 cubes
2.5–3 yrs Occupational Therapy Skills
- Able to distinguish between urination and bowel movements
- Assists with hand washing
- Pours liquid from one container to another
- Puts on front button shirt (without buttoning)
- Removes pull-over garment
- Puts on shoes (may be wrong feet)
- Copies a circle
- 3–4 piece block mimic
Speech Therapy Skills
- Uses multiple word combinations
- Says their name when asked
- Uses some plurals
- Uses “-ing” and “-ed” words
- Asks “why” and “how”
- Gives reasons for things and events
- Answers “what” questions
- Correctly produces /p, b, m, w, h, d, n/ in words
- Approximately 50% intelligible to strangers and 75% to familiar people
2–3 years milestone
print out
Physical Therapy Skills
- Gallops
- Hops on one foot
- Walks on a line
- Stands on one foot
- Jumps from 12 inches with feet together
- Walks up and down stairs alternating feet, without support
Occupational Therapy Skills
- Self feeds with utensils and open cup with little to no spillage
- Puts pants on
- Puts shoes and socks on
- Pulls down pants
- Unzips/zips non-separating zipper
- Buttons large buttons
- Holds cup with one hand
- Indicates needs for toileting
- Tries to wipe self following toileting
Occupational Therapy Skills Cont.
- Washes hands and face
- Able to cut paper into 2 pieces
- Strings small beads
- Thumb and finger grasp
Speech Therapy Skills
- Compares things with “bigger” and “shorter”
- Understands and uses location words like “inside, on” and “under”
- Correctly produces /t, k, g, f, y, -ing/
- Says all syllables in a word
- Says the sounds in all positions of words
- 90–100% intelligible to all
- Pretends to read and write, and can write some letters
3–4 years milestone
print out
Physical Therapy Skills
- Stands on one foot for 8–10 seconds
- Skips, alternating feet
- Throws a ball to a target
- Catches a ball with hands rather than using body to trap ball
- Hops 5 times on one foot
- Begins jumping rope
- Pumps a swing (with initial push)
- Walks balance beam forward and backward
- Completes a somersault
Occupational Therapy Skills
- Buckles
- Connects two-part zipper and zips up
- Knows front versus back of clothing
- Independent with Velcro fastening shoes
- Places shoes on correct feet
Speech Therapy Skills
- Produces grammatically correct sentences
- Retells stories with main characters, settings, and ideas
- Uses some irregular plurals (feet, men)
- Understands location words (behind, beside, between)
- Follows simple directions and rules to play games
- Locates the front of a book and its title
- Recognizes at least 10 letters and can write their own name
- Emulates reading and writing from left to right
- Blends word parts (cup+cake), begins to identify some rhyming words
- Speech is 100% intelligible and they produce most consonants, except for possibly “th” and “r”
4–5 years milestone
print out
5–6 yrs Physical Therapy Skills
- Completes a somersault
- Stands on one foot 10 seconds
- Catches a small ball using hands only
- Jumps over an object, landing with feet together
- Walks on a line
6–8 yrs Physical Therapy Skills
- Runs smoothly with arms opposing legs and legs close together
- Uses step and throw in opposition to throw a ball to a target
- Walks backward heel-toe
- Walks balance beam
- Uses jump rope
- Catches a small ball with hands only
- Rides a bike without training wheels
- Skips well
- Jumps a hurdle landing with 2 feet together
- Kicks a soccer ball with fair control and accuracy
Occupational Therapy Skills
- Dresses without help or supervision
- Ties shoes
- Buttons small buttons
- Completes all toileting and hygiene tasks
- Writes name from memory
- Copies all letters and numbers
- Uses scissors to cut out simple shapes
Speech Therapy Skills
- Produces various speech sounds correctly, including those that typically emerge in the preschool years (e.g., /s/, /z/, /ch/, /j/, /r/, /th/, /sp/, /st/, /bl/, /cr/)
- Signs of stuttering or other fluency difficulties
- Produces words and phrases
- Speech is 100% intelligible and they produce most consonants
- Follows simple directions and rules to play games
- Produces grammatically correct sentences
- Ability to communicate their thoughts
- May have difficulty in finding the right words to express themselves
- Has the child had a hearing test
5–8 years milestone
print out
During your child’s regular well-child check ups with the pediatrician, the provider will ask the parent about the child’s milestones and observe the child play and talk during the exam. However, parents know their child best and should bring up any concerns, such as missing milestones or a loss of skills. These checklists can help with consistency if your child sees more than one provider, clinic, health system or if you move. They also help pediatricians identify and refer children with developmental delays.
what to do with our milestone checklist?
we are here to support
schedule an appointment
pediatric milestones
what resources are needed for you to feel confident as a child advocate?
Whether a family chooses our clinic for extra support or would like to explore their options, we believe parents and professionals should have all the tools they need. You can access our milestone checklists online at any time, feel more confident in recognizing issues and advocating for your child or students, which leads to more appropriate and timely referrals.
Our Mission
Our mission at Heart & Sole Therapy is to provide a safe space for women, men and children to feel heard and seen. We are devoted to enhancing each individual's quality of life and ensuring that your needs are being addressed.
what our clients are saying?
Britta Dalbey connected so well with my daughter and helped to evaluate her speech needs and develop and implement a treatment plan. I knew I wanted her to help with my son when we discovered he needed help with speech as well. She proved just as invaluable with him. We saw excellent results and my kids always looked forward to visits with Britta.
k. smith, review on facebook
We had Courtney for our son’s PT and she was phenomenal!! She went above and beyond explaining things for us. Answered every one of my worried texts. We saw improvement every single week with her exercises. I highly recommend her!!
s. zenter, review on facebook
We have been seeing Courtney for 3.5 years! We absolutely love her! We are so excited for her to open her own practice!
B. mccracken, review on facebook
Kelcy has helped my youngest son so much. She is so creative in getting him to engage with her and always has new ideas. I can’t recommend her enough. And to top it off she is so kind and understanding of the difficulties that can come with parenting! She is amazing!
k. meyer, review on facebook
Britta is an amazing speech therapist. She worked so hard with our son, and he loved every minute of it! Could not recommend her more highly.
b. brindle, review on facebook
Courtney is amazing! She is very understanding, listens, asks questions, and really gets up in your business, which is a good thing if you want a strong, respectable, and straight forward therapist. I felt extremely comfortable when telling her all about myself. She does not make you feel embarrassed or self-conscious at all. I would recommend. . .
c. cervantez, review on facebook
