The Development of Balance

Balance development is a pivotal part of child development. Gross motor coordination, balance and motor planning are all part of the processes of acquiring these skills. Here, we cover balance development, strategies to support this skill, and specific balance activities.

Development of balance from infancy through preschoolers.

Balance Development

Acquiring or practicing balance can be seen in a toddler swaying step by step, a child pretending the sidewalk curb is an Olympic balance beam, or a teenager managing their new crutches.

Strong standing and walking balance equal safe mobility, which opens the door to so many wonderful new things; running, jumping, cartwheels, backflips…you get the picture.

Achieving physical balance plays an important role in the development of many different skills, some of which may surprise you!


Before officially diving into the development of balance, we first need to define and understand it. 

  • Balance – According to the Harvard Medical School, balance is the ability to distribute your weight in a way that lets you stand or move without falling, or recover if you trip. Good balance requires the coordination of several parts of the body: the central nervous system, inner ear, eyes, muscles, bones (Check out this list of bone names), and joints
  • Static Balance – maintaining body position during an unmoving task, such as sitting or standing
  • Dynamic Balance – the ability to remain standing and stable while performing movements or actions that require displacing or moving oneself

The various muscles of the body contract or relax in order to maintain the proper balance for our daily activities, as controlled by our balance center in the brain; the cerebellum

In addition to the cerebellum, the inner ear also sends signals to the brain, to give a status report on the environmental changes that affect balance. The inner ear is where the vestibular system is located.

Its’ fluid picks up on the motion and position of the head, constantly sending information back to the brain via the eighth cranial nerve. When there is a medical issue within the ear, such as an ear infection or torticollis, it may affect balance. This is generally in the form of dizziness or unsteadiness. 

The primary source of information for the following list of balance developmental milestones was primarily sourced here.

Information from different sources may vary slightly, largely due to the fact that developmental patterns fall into different ranges. For a general list of developmental milestones, refer to the CDC resource here.

For balance to occur, we need lower extremity strength integrated with other areas of development, including vision and processing of vestibular input.

Balance Development in the first year


  • The vestibular system is developed at five months pregnancy


  • Primitive reflexes (uncontrolled movement) lay the groundwork for future motor development
  • Tummy time develops vision and postural control required for optimal balance later on 


  • Rolling prone to supine (front to back), then supine to prone (back to front)
  • Supported sitting, then unsupported sitting


  • Picks up a dropped toy, may fall while reaching
  • Begins to army crawl, cruise crawl, or scoot
  • Holds majority of their own weight while standing supported
  • May squat up and down while standing 

10-12 MONTHS 

  • Pulls self up to stand, then stands unsupported
  • Manipulation of toys/ movement of arms while sitting unsupported 
  • Moves in and out of laying and seated positions with control
  • Cruises along furniture or walks supported

Development of Balance in Toddlers 

13-16 MONTHS

  • Walking unsupported, but may tumble easily
  • Crawls up and down furniture and stairs with support for safety
  • Begins to learn how to walk faster/run 

17-19 MONTHS

  • Is able to get onto small chairs without help
  • Walks up stairs while holding on with one hand
  • Runs stiffly and falls often
  • Can pick up objects while standing, without losing balance


  • Pulls off socks without losing balance
  • Runs with improved coordination
  • Can kick a ball without losing balance

Development of Balance in PReschoolers


  • Can briefly balance and hop on one foot
  • May walk upstairs with alternating feet (without holding the rail)
  • Able to pedal a tricycle


  • Hops on one foot without losing balance
  • Throws a ball overhand with coordination


  • Skips, jumps, gallops, and hops with good balance 
  • Stays balanced while standing on one foot with eyes closed 

The majority of our balance skills have developed by age 5, but will continue to fine-tune up until around age 12. Remember to keep in mind, these are averages for the typically developing child. 

Balance is required to do just about anything in daily life. 

Balance is needed to stand at the mirror while brushing teeth, get out of the car, and put on socks, to name just a few. Without the development of this balance skill, support aids (walkers, crutches, braces) may be necessary for safety and function.

Static Balance

Did you know that balance is also related to non-physical, or static tasks?

Research suggests that when balance is improved, so are attention and learning skills. Good balance helps children develop better reading, writing, and language skills, as well as improved concentration. 

One way balance is theorized to improve academic skills, is through increased body control, and knowing where the body is in space (proprioception). Having better body control and knowing how to coordinate movement in various environments is important.

Correct body awareness makes it easier to have a comfortable seated posture. Good balance also makes activities such as sitting still while moving the head to look up at the chalkboard, and then back down to write easier. 

Check out these Body Awareness Activities from the OT Toolbox.

Without proper body control, it is just that much more difficult to perform the tasks of a student: copying from the board, holding and reading long textbooks, carrying materials from space to space, and supporting an upright seated posture for many hours a day.  

How to Support Balance Development

Knowing the huge impact that balance has on the body, what can you do to improve it?

Check out this blog post on balance activities.

The OT Toolbox has great articles on gross motor skills, that will suit the needs of your children. Check these out and let us know your favorites!

If you love all of the great resources found above, consider becoming a member.

Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

Level 1 members gain instant access to all of the downloads available on the site, without enter your email each time PLUS exclusive new resources each month.

Level 2 members get access to all of our downloads, exclusive new resources each month, PLUS additional, premium content each month: therapy kits, screening tools, games, therapy packets, and much more. AND, level 2 members get ad-free content across the entire OT Toolbox website.

Join the Member’s Club today!

Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
background is in Human Development and Family Studies, and she is passionate about
providing individualized and meaningful treatment for each child and their family. Sydney is also
a children’s author and illustrator and is always working on new and exciting projects.

Development of balance