Cephalocaudal Development

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In developmental psychology, many principles and theories describe the universal process of how humans grow and develop biologically and psychologically. Within these spheres, there are many more areas of development addressed by psychology, and they can be studied independently but should be seen as part of a whole. Cephalocaudal development is one such area.

Cephalocaudal development, or the cephalocaudal principle or trend, is a term used to describe the universal "head-to-toe" direction of humans' growth and functional motor development. It is most obviously observed in infants' spatial proportions change, continuing to adulthood.

People develop at different rates, as impacted by internal and external factors such as genetics or cultural influences, to name a few. As such, the cephalocaudal trend, universal or general, is explained by categorizing its stages into time ranges, i.e., months and years. Despite individual differences, cephalocaudal development is orderly and cohesive.

A Broad Explanation Of Cephalocaudal Development

Cephalocaudal development is used to explain the head-to-toe trend of physical and motor development in humans. The prefix "cephalo" originates from Ancient Greek and means "head". The word "cauda" is derived from Latin and means "tail", so the term cephalocaudal means from head to tail (or, in our case, to the furthest extremity from our head – our toes).

The human head - more specifically, the brain - is our main neural area. It is a control center that sends and receives messages along its long axis, the spine, to the other areas of the body via a complex nervous system. Before the use of our extremities can be mastered and refined, there needs to be growth, development, and strengthening of our control center and everything that supports it.

When Does Cephalocaudal Development Begin?

Cephalocaudal growth starts in utero, as early as the embryonic stage. The brain and spinal cord start to develop 22 days after conception, indicating the start of cephalocaudal development. While in utero, the structures of the embryo (and later, fetus) that are nearest the head will develop before those closer to the feet. 

When Does Cephalocaudal Development End?

The human body does not stop growing and regenerating new cells during a lifetime; it is only when we die that we stop "growing". Physically, cephalocaudal growth appears to be complete by the time we reach adulthood, when our head is spatially proportionate to the rest of our adult body compared to the head-body ratio of infants.

Based on our physical growth and functional development, we start to mature. That means we can acquire new abilities, using our existing cephalocaudal development as a foundation to grow and hone new skills. Essentially, cephalocaudal development doesn't stop until we die or stop maturing.

What Is Needed For Healthy Cephalocaudal Development?

Cephalocaudal development not only refers to the physical growth and changing proportions of humans. It also refers to the development of the nervous system that sends messages from the brain, down the spine, to the other parts of the body. These are messages of growth, movement, muscle memory, sensations, and so much more.

A healthy mother during pregnancy is a good starting point for healthy cephalocaudal development in an infant. Healthy nutrition, appropriate stimulation, exercise, and care all contribute to healthy myelination, which is the formation of the fatty myelin sheath around the nerves so they can function effectively. Myelination is essential for cephalocaudal development to occur.

What Can Negatively Impact Cephalocaudal Development?

Issues that can negatively impact cephalocaudal development can occur during pregnancy, birthing mishaps (such as oxygen deprivation or damage to the newborn), or after birth (e.g., severe illness or neglect. Despite the cephalocaudal trend being universal, an infant that is malnourished, abused, neglected, or suffers from a severe infection might lag in their development.

Cerebral Palsy

Children with cerebral palsy might exhibit a delay in their cephalocaudal growth and development due to the lesions on their brains. Children who risk developing cerebral palsy are those born prematurely, those with very low birth weight, the conception of two or more fetuses, or mothers that have been exposed to infections or toxins during pregnancy.

Complicated births, where a child's brain is injured or starved of oxygen, can also lead to cerebral palsy. Individuals with cerebral palsy may become wheelchair users, while others need minimal to no specialized care in later years. Many of the indications of cerebral palsy can be attributed to hindered cephalocaudal development due to neural damage in the brain. They include:

  • Affected ability to move, maintain balance, and posture,
  • Difficulties with muscle tone,
  • Difficulties with coordination,
  • Difficulties with movement, and
  • Difficulties with speech.


The cause of autism is unknown, but its prevalence is ever-increasing, and specialists have been researching it for years. Not every infant or child on the autistic spectrum will show delays in cephalocaudal development, but some might, depending on the processing issue they experience.

For example, an infant that is highly tactile-defensive will not like to be touched or cuddled and may not like the feeling of textures against their skin. They might not want to crawl or touch things as a result and be "difficult babies" that cry a lot when touched. The combination of less touch and fewer attempts to move may cause a cephalocaudal or neural delay in motor functioning.

Injury Due To Accident, Abuse, Or Neglect

An infant that has experienced an injury to the head or spine in its developing stages is likely to have hampered cephalocaudal development. Injury can occur in utero or when the infant is born and can result from an accident, abuse, or neglect.

Examples of accidents in utero would be if the mother was involved in a severe car accident and was not wearing a safety belt, or she was a victim of a shooting. Accidents out of the womb could include someone holding a baby in a car instead of securing it in a car seat or if a baby was dropped and hit its head, causing brain or spinal damage.

A baby's brain and spine can be injured through abuse in utero and after birth, affecting cephalocaudal development. An unborn child can suffer physical injury if its mother is being beaten. Some unwanted infants become injured when they have been dumped after birth, and some awful people abuse infants, too.

Cephalocaudal injuries from neglect include not securing a baby on a changing mat and allowing it to fall, not treating illness or attending to medical needs, or severe infant neglect where the baby is not fed or nurtured properly. Infant neglect can cause hampered cephalocaudal development that might result in permanent brain damage.

It must be mentioned that the rate of cephalocaudal development is not an indicator of a child's intelligence. Although a general trend, it is just that – general. There will be children who develop faster or slower than the norm, depending on factors that are specific to each child.

The Cephalocaudal Trend in Biological Development

As mentioned, the cephalocaudal trend is mostly observed in what we can see – the physical changes in the spatial proportions of an infant through to adulthood, as well as the gross motor skills, accompanying these changes. An infant must master its head and upper limbs before it can master its lower limbs.

Physical Development According To The Cephalocaudal Trend

Perhaps the most obvious physical change we can see from infancy to adulthood is the gradual change in the head size in proportion to the rest of the body. Below is a table to show you the proportional changes of the head to the rest of the body during the first 25 years of human life.

AgeHead Size In Proportion To The Rest Of The Body
Prenatal – 3 months in uteroOne-half (1/2)
NewbornOne quarter (1/4)
Two yearsOne-fifth (1/5)
Six yearsOne-sixth (1/6)
Twelve yearsOne-seventh (1/7)
Twenty-five yearsOne-eighth (1/8)

As the child grows and gains muscular strength and neural memory, the rest of the body starts to grow proportionately faster than the head. The torso, arms, and legs start to lengthen, gain strength, and increase in functionality from the head down. As an infant grows, a universal pattern of functional gross motor development is explained by the cephalocaudal trend.

Functional Motor Development According To The Cephalocaudal Trend

In the human brain, the motor cortex is responsible for controlling conscious motor movements of the rest of the body. The motor cortex is a neuron strip located at the top of the brain and extends from ear to ear. As motor skills are acquired, they become foundations for other, more complex motor skills.

Myelination plays a big part in explaining cephalocaudal development, as it is effectively the growth, development, strengthening, and protection of the nervous system that is vital in controlling the body's motor functions. Myelination does not happen all at once in the body. It gradually progresses from the head down the spine as an infant grows, triggering the baby's milestones.

A baby needs to be able to stabilize its head before learning to stabilize and control other parts of its body. Gross motor skills are developed through a sequence of maturation that requires certain milestones to be completed for the next milestones to occur. Skipping a milestone (e.g., crawling) could cause developmental delays later.

Below is a table of the gross motor milestones of children in the order in which they generally occur. Factors such as illness, genetics, disability, quality of care and stimulation, or cultural influences can impact how and when an infant reaches these milestones. Note how the milestones develop in the direction of head to toe.

Since a newborn has no control of its neck, anyone holding the baby must support its head until it is strong enough to do so independently.
Baby lifts his head while lying on his stomach.Myelination is moving down the neck and shoulders, allowing the baby more control and increased strength in these parts.
Baby can roll over from his tummy to his back or back to his tummy.Rolling over becomes possible when the baby has control of his shoulders.
Baby can push himself up using his arms, raising himself from the floor a bit.The torso and arms have gained strength, but the baby's legs are still flat on the floor.
The baby can start to sit.   This milestone occurs at roughly six months of age.As myelination travels down the spine, the baby gains control of his back and hips and can sit with support initially. He will be able to sit independently and reach around for objects near him.
Baby starts to crawl at around nine months old.With control of the upper legs (thighs), the baby can start to pull his legs underneath him. He might crawl backward, initially, because his arms have more control than his legs, but he will start to crawl forward.
The baby can pull himself up to a standing position.Control and strength are improving in the lower legs due to myelination.
Baby starts to walk, usually around 12 months old.Myelination has reached the feet, and there is increased control for walking. Babies will initially walk with their feet wide apart and their hands raised to help them with balance, but as the control of their feet and toes improves, they will walk more like adults.

Caregivers are encouraged to instill a love for movement and exercise in children (it need not be excessive) as it certainly plays a role in healthy biological and psychological development. It is advisable to steer away from too much screen time as it does not encourage motor development on the whole.

The Cephalocaudal Trend in Psychological Development

As the child grows physically and develops motor functioning as per the cephalocaudal trend, psychological growth will also occur. Psychological growth includes mental, social, emotional, cognitive, and sensory-motor development. The spheres of psychological development can be impacted by the child's biological development and vice versa.

Below are explanations of how the different spheres of psychological growth affect and are affected by physical and functional cephalocaudal development.

Mental development refers to our ability to observe, attend, perceive, remember, imagine, think, solve problems and grow our intelligence and language skills. These abilities align with our physical and functional cephalocaudal development, helping them develop and mature. For example, you don't need to relearn how to walk; you build onto what you have learnt.

Social development refers to how we interact and grow on different levels, including family (parents and siblings), friends, cultural and religious groups, etc. Humans are inherently social beings, and we learn to move by observing what others do and wanting to be a part of what they do. It is in this way that our motor skills are encouraged to develop.

Emotional development is when a child acquires the ability to experience, understand, express, and manage their emotions in the different spheres of their life, e.g., socio-emotional development. Healthy cephalocaudal development lends itself to healthy emotional development. If a child can move around and play, they are more likely to interact and grow emotionally.

Cognitive development focuses on the ability to process information, conceptualize, and perceive, using the mental skills at our disposal. A cephalocaudal developmental delay or injury might affect a person's cognitive development, but certainly not always.

As biological changes and capabilities occur, changes in the brain and nervous system lead to a state of learning and maturation. The psychological changes and maturation linked to the biological changes of cephalocaudal development allow a growing individual to do more complex functions as they can master developmental milestones.

Along with biological and psychological development and maturation comes readiness. An example of readiness is that a two-month-old child cannot be expected to write sentences with a pencil, as he will have not yet mastered the motor functioning of his arms, nor has his brain developed or matured enough to do this task. However, a school-going child should display readiness for this task.

Another example would be of speaking. A four-month-old child will not be able to communicate using coherent language as the infant's mind has not matured enough to talk. This ability comes around two years old and is due to maturation in the brain and interaction with others.

Infants rely heavily on capable caregivers for their survival. A child with healthy nutrition, care, proper stimulation and motivation, sufficient exercise, and opportunities is more likely to achieve developmental milestones than one without. If there has been a physical delay in a child's cephalocaudal development for some reason, it could affect the child psychologically.

Consider an infant just left in a crib with no stimulating toys and minimal interaction for its first year. The infant is likely to reach developmental milestones much later as there has been little stimulation or interaction to motivate it. The nature of caregiving will also have a psychological effect on the child, causing potential learning and emotional difficulties later in life.


Cephalocaudal development explains the head-to-toe trend of growth and maturation of humans as their nervous system develops. Cephalocaudal development focuses primarily on the spatial, physical, and motor development of infants through to adulthood but also impacts the psychological aspects of a growing child and adult.


Motor Development


Prenatal Development









https://www.sagepub.com/sites/default/files/upm-binaries/57592_Chapter_6_Levine_Sample.pdf https://www.sutori.com/en/item/cephalocaudal-and-proximodistal-patterns-of-growth-and-infancy-in-childhood-th

Reference this article:

Practical Psychology. (2022, August). Cephalocaudal Development. Retrieved from https://practicalpie.com/cephalocaudal-development/.

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