Toddler Gross Motor Skills Assessment

Child Name Date of Birth Assessment Date Assessor

Gross Motor Skills Checklist

Skill	Observed	Comments
Walks independently	YesNo
Runs	YesNo
Jumps with both feet	YesNo
Kicks a ball	YesNo
Climbs stairs (with/without help)	YesNo
Throws a ball	YesNo
Stands on one foot briefly	YesNo

Additional Notes