APPENDIX 6: Typical Development & Reflexes

The following is a guide reflecting typical development. Not all children will progress systematically though each age group.

Age Group

Progression of Liquid and Food

Oral Sensorimotor Function

Development Skill

Reflex

0 to 4 months

• thin liquid (e.g. breastmilk, formula)

• suckle on nipple
• forward-backward tongue movement
• adaptive oral reflexes e.g. rooting, sucking

• head control acquired

Rooting

(32-37 weeks gestation to 3-6 mos.)

Sucking

(18 weeks gestation to 4-5 mos.)

Tongue Protrusion (38-40 weeks gestation to 4-6

mos.)

Transverse Tongue (28 weeks gestation to 6-9 mos.)

Phasic bite

(28 weeks gestation to 9-12 mos.)

Gag

(26-27 weeks gestation and through life)

Cough

(35-40 weeks gestation and through life)

4 to 6 months

• thin purees (e.g. rice cereal, pureed fruits)

• suckle off spoon
• separation of tongue and jaw movements
• transition from reflexive suckle to suck (up-down) tongue pattern

• gross motor control of head and neck, trunk control
• sitting balance
• hands midline

7 to 8 months

• thick purees (e.g. pureed potato, rice, cereal, fruit)
• textured purees or soft mashed (e.g. banana, potato, pasta)

• some protective oral reflexes desensitized
• cup drinking
• vertical munching

• hand-to-mouth play
• reach, pincer grasp
• starts to assist with spoon- feeding

8 to 9 months

• bite and dissolve foods (e.g.  baby biscuits)
• soft finger foods – early chewing foods (e.g. pasta, soft fruit and vegetables, bread)
• hard munchables for exploration

• emerging lateral tongue movements
• unsustained bite pattern

• core stability developing

9 to 12 months

• hard finger foods (e.g. biscuits, par-cooked vegetables, fresh fruit)
• harder or chewy finger foods (breads, pasta, eggs, deli meats)

• cup drinking independent emerging rotary chewing
• graded bite through harder or chewy food

• refines pincer grasp - finger feeding
• grasps spoon with whole hand

12 to 18 months

• complete range of textures with some modification, including mixed texture (e.g. lasagna, minestrone)

• lateral tongue action established
• straw drinking

• increased independence for feeding
• scoops food, bring to mouth

18 to 24 months

• more chewable food (e.g. steak, raw vegetables, hard fruits)

• mature rotary chewing
• emerging or controlled sustained bite on hard foods

24 months and above

• complete range of textures or family foods

• ongoing refinements of oral skills
• controlled sustained bite

• total self-feeding, increased use of fork, cup drinking (open & straw), no spillage