Early Childhood Intervention
This website is a place for families who are facing
challenges pertaining to their child's development and
growth.
It is a place to find answers and practical
suggestions. That's what Early Intervention Support is all
about.

Whether a family has a child with a challenging behavior,
a disability or developmental issue, childhood is short - it
should be savored and enjoyed.
Learn More:
Ask a Therapist

We understand developmental milestones and the challenges
of Special Needs children. We spend a great deal of time
with families understanding the inner workings of childhood
routines and interactions. Ask us about your child today!
Ask a Therapist
Motor Skills Concerns
Listed below are a few previous questions from our
Ask The Therapist
form relating to speech and language. You may also want to review:
My 17th month old was born at 36 weeks gestation. I think he has gross motor delays.
His language skills and fine motor skills are excellent but he has never crawled and
didn't walk (only cruised) until 16 months of age. He cannot get into a standing position
without assistance unless he can pull up and doesn't really bend over to pick up things
on the floor if he is walking. He will bend over and pick them up as long as he doesn't
have to bend too far. If the object is on the floor and he wants it, he will reach for it
and then sit down. I am wondering if he has a true developmental delay due to some organic
cause or if it is because his babysitter from the time he was able to sit up let him ride
on toys and in a walker. We did do some tummy time when he was small but he had horrible
reflux and would spit up excessively if he was on his tummy. He has had x rays of his hip
because he doesn't like to even get up on his knees; he just flops back down. I know I shouldn't
compare him to other children but it seems like kids his age are running circles around him.
I want to get early intervention and/or physical therapy if he needs it but everyone tells
me I am just worrying too much. We have no history of late walking or neuromuscular disorders
in our family but I worry about muscular dystrophy or other problems.
I would certainly suggest contacting your local early intervention provider for a physical
therapy evaluation for your son. It sounds like you have concerns about your son's gross motor
development, even if friends and family are telling you that you worry too much. As a Mom you
know your son the best, so the easiest way to resolve your concerns would be to have a team
evaluate your son and let you know if he indeed is showing a developmental delay in the gross
motor area or not. If he is, he can start receiving therapy now, rather than waiting. We, as
therapists would rather do an evaluation and say everything is fine then to have families wait
until their children are almost three years old and then finally get a referral and wonder why
the child was never referred for services earlier.
more »
« less
Tummy time is an important position in early infancy that has been shown to impact gross
motor skill development. You can read a
recent article about it on our website. Again, I
can't say for sure that lack of tummy time contributed at all to your son's lack of crawling, etc.
Walking at 16 months, although maybe later than some of his peers, is still considered
within average. However, since you mention that he cannot yet assume a standing position
without support and has trouble squatting down to pick things up, I am wondering if
perhaps he has low muscle tone? Children with low muscle tone often achieve motor
milestones later than average and in comparison to children with typical muscle tone,
may feel "floppy" when carried or held. Low muscle tone can be assessed by a physical
therapist or diagnosed by your son's pediatrician. I would also ask your pediatrician to
check your son's hips (this is usually done at well baby visits) to rule out any problems.
As therapists we do tell families to use play equipment like walkers, exersaucers &
bouncers in moderation, since these devices have been shown to not actually have any
benefit in helping children to walk and often instead of developing a child's quadriceps
muscles that they need for walking, they develop the calf muscles more and sometimes
lead to toe walking. But, having said that, it would be hard to say if spending time
in a walker on a ride on toy had any negative impact on your son's development.My recommendation
would be to definitely call your local early intervention provider so the team can tell you if
your son is demonstrating any developmental delays and if he is, he can begin physical therapy
to work on these skills. This is a link I found for
services in NC.
My daughter is 1 year, 4 months old. She is always bending her neck
to the side. When I correct her by lying her on the opposite side, she
keeps it straight for 2 weeks and bends it to the side I laid her on. I
dont know how to permantly correct this.
If your daughter has been bending her neck to the side since she was
an infant, she could possibly have a condition called Torticollis. We
cannot accurately say that this is what she has, but here is
a link on our web page describing this condition.
more »
« less
Torticollis should be diagnosed by your doctor and then a
pysiotherapist should provide stretching exercises during therapy and
can teach you some exercises you can also do at home. It is good that
you are trying to position her on the opposite side for sleeping. You
can also do things such as, positioning her chair during meals so that
she has to turn to her non-preferred side to look at you and interact
with you. Do the same if she is watching tv, etc. If you do not have a
pysiotherapist in your area, you can review these stretching exercises
for home use, but we strongly advise getting the advice of your child's
doctor in getting an accurate diagnosis and
seeking the
guidance of a physiotherapist in performing these stretches to
prevent injury.
My baby girl is 5 months. She can sit when put on a sitting
position, but when you want her to stand up and hold her, she'll use one
leg and cry. She hasn't put weight on her legs yet and when you put her
on her stomach, she cries but when she is lying, she kicks with her legs
and recognizes people and even cries for them. What could be the
problem?
Since your baby is only 5 months old, I don't necessarily think that
anything you mentioned would definitely indicate a problem, but if you
are concerned about her legs please do consult your baby's doctor. Many
babies do not begin to bear weight on their feet when held in a standing
position until they are between 6-9 months old. It is great that your
daughter is able to sit when placed in a sitting position. Since you
mentioned that your daughter will only place one leg down when held in a
standing position and will cry, you can ask your doctor to check her
hips to make sure she has no problems with her hips being out of place.
It is good that she will kick both legs when she is lying on her back.
One thing I would encourage for your baby is more time on her stomach
(we call it "tummy time"), since this is the most important position for
her to be in during waking hours in order to strengthen her muscles that
she needs for the development of important motor milestones such as
rolling, independent sitting, crawling and later walking.
more »
« less
You can gradually ease her into more time on her stomach, by playing
with her as she lies on your chest facing you or getting down on the
floor on a blanket with her. Try to build up her ability to play in this
position for at least 5-10 minutes, 3-5 times per day. You can read a
few of our articles on our website which tell you why
tummy time is so important for young babies. And also check what is
typical for her
motor milestone development. Right now at age 5 months you want to
focus more on the tummy time, rolling actively in both directions
(stomach to back and back to stomach), as well as reaching for toys when
she is on her stomach by being able to hold her chest up, pushing up on
extended arms and reaching for a toy with one hand or the other. Here is
an excellent source of information on how to
encourage
tummy time during play, carrying, diapering, etc.
My daughter is 13 1/2 months old. She was born full term. She is not
bearing any weight on her feet. When we try to make her stand, she bends
her knees. She never crawled, never moved. Her mind is sharp, and our
family physician says everything with her is fine. I am extremely
worried if everything is fine, how come she don't bear weight? Is this
normal or should we do anything about this? I can't sleep properly
worrying about her.
I would not be concerned if your daughter was not walking yet at age
13 1/2 months, however, the fact that she is not bearing weight on her
feet when placed in standing, nor is she crawling or moving about in
some way at this age is somewhat concerning. Most babies are able to
bear weight on their feet between the ages of 6-9 months and will bounce
when their hands are held. I would definitely seek another medical
opinion, from perhaps an orthopedist to determine if there is an
underlying medical reason as to why she is not yet completing these
motor skills and make sure to have her hips checked.
more >
< less
I would also look into an early intervention evaluation from a
physical therapist in your area so that she can start receiving therapy
to help her progress in her motor skills. I was unable to locate a
specific resource for early intervention/pediatric physical therapy in
your area, however, perhaps if you contact someone at this website link
they can point you in the right direction for resources available to you
in the
Toronto area.
My daughter is five and her teacher is noticing that my daughter is
clumsier then the rest of the kids and she having a hard time holding on
to a pencil and stuff like that. I once saw her fall down with no real
cause. I'm taking her to the doctor on Friday. My daughter is adopted
and we don't have any medical information. We have had her since she was
two days old. I'm kind of worried thinking something could be wrong with
my daughter's growth. I'm not sure I have a question but what could be
wrong, or what could be causing her to be clumsy? She is my only child.
You are doing the right thing by first making an appointment with
your daughter's pediatrician to address your concerns. He should be able
to rule out any physical or medical reasons related to why she may be
falling so much and having difficulty with some fine motor tasks. You
may also want to seek an evaluation by a physical therapist and
occupational therapist through her school or a local clinic to rule out
any developmental or sensory issues as well. There is a diagnosis called
Dyspraxia which is a neurological condition that can result in
clumsiness. This link details some of the
symptoms of Dyspraxia.
more >
< less
You can ask you doctor about the possibility of this diagnosis on
Friday and see if he recommends any specific referrals or testing to
help get to the root of her problem.
My son will be 5 months old next week on March 1st. I'm not
concerned about his social interaction at all. He is a happy,
"talkative," and smiling baby. However, there are two things I'm
concerned with regarding his motor skills. 1. Reaching for toys. Ethan
met the guidelines for batting at toys but just now started to reach for
them. When he does reach for them, he kind of just swipes both arms and
hands inward towards the middle of his body. He is sometimes successful.
Does this count as reaching? Should he have done this earlier? He has
been putting his hands together and in his mouth since 3 months of age.
When I put a toy in his hand, he will shake it and bring it to his
mouth. I just don't know what to look for with reaching and grabbing
toys. He doesn't grab the toys on his activity mat or in his exersaucer.
2. How long should he be bearing weight on his legs when placed on them?
He'll bear down for a split second and then bend them. He'll then go up
and down almost like he's bouncing. Should he be standing for longer
periods of time while supported?
From your description of your son it sounds like his fine
motor/reaching skills are still within normal limits for a baby who is
just about to turn 5 months old. From 3-5 months most babies are still
batting at & reaching for toys on hanging gyms, while not necessarily
always being able to grasp them with control. Babies from 3-5 months are
typically able to grasp toys voluntarily when placed in or near their
hand, instead of just reflexively. Babies of this age still tend to
reach forward with both hands (bilateral reach) and as they get to about
6 months of age they begin to be able to grasp toys with one hand
(unilateral reach) and begin to transfer toys hand to hand.
more >
< less
Babies from 3-5 months still do a lot of hand to mouth with or
without a toy, which is age appropriate. By the time a baby is 6-7
months old they can typically reach with control from a variety of
positions (belly, back, sitting, sidelying), but right now your son's
reaching may be more difficult in positions where he has less stability
or support such as in his exersaucer or when on his belly. He may also
still be using his fingers without his thumb to grasp, which is also ok
for his age.
As far as standing, most babies by 5 months will briefly bear some
weight on their legs and flex and extend their knees and by 6 months
will bear weight for longer periods and bounce actively while requiring
less support in this position. By the time a baby is 7-9 months they
should be able to stand well with support against an object or with both
hands held.
You can review our
Gross Motor Development &
Fine Motor Development sections at these links:
I wrote a few weeks ago about my son who shows no interest in
reaching/grabbing for toys or anything. He is very social,
"talkative," full of smiles, and laughs. It almost seems like he is
bored with the toys and wants to connect to the person/people
instead. My pediatrician said that everything looks great and
normal but seemed concerned when I brought this issue up. He doesn't
reach for his pacifier, my hair, or anything. She did say that
it was very good that he is able to bring his hands together at
his midline and put them in his mouth. She referred us to early
intervention and we are just waiting on them to call and set up
an appointment. I am literally going crazy with anxiety while we
wait. My question to you is, what could this mean? Sensory disorder,
developmental delay, autism? I know you can't diagnose him
without seeing and interacting with him, but I want to know if
he is meeting every other milestone, what could no interesting in
reaching or grabbing for things mean? What possibilities are we
looking at? I'm just trying to prepare myself instead of drive
myself crazy with anxiety.
I am sure it brings anxiety for you waiting for the early
intervention team to show up to evaluate your son, but be
assured that this is the best possible thing you can do at this point to
allay your fears and help your son if he indeed needs help in
any area of his development. Without knowing your son, I am
still apt to say that he may just need a little more time to develop his
reaching skills since he only just turned 5 months old on March
1. Most young babies still clearly prefer people and faces over
toys and believe it or not that is a good thing. If he did not look at
your face and did not show interest in people, I would be
concerned. He may actually begin reaching for your face, hair or jewelry
before he begins reaching for toys. When the team arrives to
assess your son, they may have a developmental specialist or an
OT and/or PT look at your son's fine motor/reaching skills. At age 5
months, we are mostly looking at skills such as bringing his
hand together at midline (which he is doing), bringing hands to
mouth (which he is doing) and bringing hands to mouth with a toy, which
I think you said he will do if you place the toy in his hand. I
would also look for him to begin transferring a toy from hand to hand
by the 6th month. His hands should also be open most of the time
and if they are sometimes fisted, they should be very loosely
fisted and not tight or with the thumb indwelling. Does he put his hands
onto the bottle at all when you feed him? I would not expect him
to hold it yet, but ideally he should be patting the bottle with
one or both hands during feedings. Between 3-5 months babies are just
developing tactile awareness in their hands and learning how to
use their hands and fingers. The batting and swiping at toys
comes way before the actual directed reach and clear grasp. The only
other thing I would suggest is that if you haven't done so, to
have his vision screened since visual deficits can be one reason
a baby will not reach for things. The OT and/or PT on the early
intervention team will also assess his muscle tone and range of
motion in his upper and lower extremities to make sure he is not
too loose or too tight which can prevent a child from being able to move
in a typical pattern. The team will only be able to tell you if
he is showing a developmental delay in one of the areas of
development (Gross Motor, Fine Motor, Cognitive, Self-Help, Social,
Communication), they cannot make a specific diagnosis, but you
can ask them about sensory issues if you are concerned about that.
You may want to try using wrist rattles, the little soft rattle toys
that attach to a baby's wrist with Velcro, this way the toy is
on his one wrist and will encourage him to reach for it with his other
hand and he will not drop it. Then switch it to the other wrist
and do the same. Also you can massage his hands and fingers to
improve his tactile awareness. If he is not reaching toward toys in his
bouncy seat, try rolling up small receiving blankets or towels
and placing them behind his shoulders to bring his shoulders forward
which may help to bring his hand together and make it easier for
him to reach toward the toys. You can also do this on the floor
if he is lying under a baby gym. Also, since many rattles these days are
heavy, we suggest using the connector rings that you use to hang
toys on baby gyms, since these rings are small and light and the
right size for a baby's hands. Sometimes babies will hold or grasp a
single connector ring before they are able to grasp a heavier,
larger rattle. You can also use textured books with your son, opening
his palm and guiding it across the page to feel the various
textures or do this on the carpet or a pillow or blanket,
helping him feel different textures. Best of luck with his upcoming
evaluation and let us know what the team says. This link on our
page talks a little bit about the
process of early intervention and what to expect.
My daughter is 6 years old and in kindergarten. She was diagnosed
with low muscle tone around 3 years old. She is in Physical Therapy at
school for 2 years and her pt instructor said her progress is very slow
but there is some progress being made. She asked if my daughter had ever
seen a neurologist and she has not. Do you recommend low muscle tone
children see a neurologist? My pediatrician said she would refer us if I
wanted but really didn't see the need. (My pediatrician has also been
very "laid back" about my the low muscle tone and not done any further
test regarding it). So I guess my question is do you recommend a visit
to a neurologist and what types of test would they do?
I spoke with one of our physical therapists this morning and she told
me that is it never a bad idea to see a neurologist for a child with
motor problems/low muscle tone. A neurologist specializes in disorders
that involve the central nervous system (brain, spinal cord, nerves and
muscles) which can include, but are not limited to delayed motor
milestones, weakness, cerebral palsy, nerve muscle disorders and
coordination. A neurologist may be able to rule out if there is a
specific cause to your daughter's low muscle tone and delayed motor
milestones.
more >
< less
We are not sure what specific tests he might recommend for your
daughter, but it could possibly be an MRI. Our suggestion would be to
speak to your daughter's PT at school and she may be able to give you a
better idea of why she recommends it and what tests she thinks the
neurologist may perform. Seeing the neurologist can't hurt and it may
give you piece of mind in ruling out other concerns. There are many
children who have low muscle tone and no specific cause has been found,
however other children have low muscle tone due to a specific diagnosis.
--</>
My child just had her nine month check-up. My husband and I have
been concerned as her gross motor skills are developing slowly. I had
preeclampsia during pregnancy and spent the last two months on my side.
My doctors kept her in my womb until she had neutral blood flow. At that
point, they decided it was time for me to have her via c-section. She
was born 6 weeks and one day early. She weighed 3 lbs. 5 oz. Because of
her prematurity, we have been monitoring her gross motor development
based on what her due date would have been if she was full term. Even
given this though, she is developing slowly. She did not require any
oxygen when she was born nor were there any complications other than
what one might see in a normal preemie. For the last 2 months, she will
roll from her back part way onto her stomach (will not remove the arm
under her), and she tends to sleep like this. She will not roll over all
the way from back to stomach. She will not even really attempt to roll
over from stomach to back. It is as if she does not recognize that she
can use her arms when she is on her stomach. While she has been able to
hold her head steady for a couple of months, she is not making much
progress on sitting up without support. If she is leaning against
something, she can balance for a few minutes or longer depending, but
she does not sit up on her own without support. She mostly just seems
very content to lay on her back and play. We have tried to work with her
both on her stomach and back but have made little progress. Her doctor
did not have many recommendations although her did recognize that her
gross motor skill development is delayed. My questions regarding this
are: Should we be concerned and seek other opinions? If so, do you have
a recommendation as to whom? (i.e., help me grow, another specialist,
etc.) Are there more things that we should be doing as parents to
facilitate gross motor skill development?
I would recommend contacting your local early intervention provider
for a physical therapy evaluation for your daughter. From your
description of your daughter's motor skills, it sounds as if your
daughter would definitely qualify and benefit from physical therapy
services to help her continue to progress with rolling, sitting and
crawling. Since she was a preemie, it is certainly fine to keep in mind
that she may need an extra month or two to develop skills similar to her
same age peers, however, by 9 months she should be rolling in both
directions and starting to sit on her own. Continue to give your
daughter as much play time as possible on her belly on the floor and
encourage her to roll to secure toys that are placed just out of her
reach. You can help her if her arm continues to get stuck as you
mentioned. If you place her on a small blanket and tip the blanket
upwards while she is on it, it will give her some extra momentum to
roll. You can also place her over your lower leg, tucking her knees
under her, to get her used to weight bearing on her knees and encourage
her to place her hands on the floor over your leg to bear weight in this
position (a skill she will need for crawling).
more >
< less
You can use a boppy pillow or a pile of regular pillows around her on
the floor to encourage her to practice independent sitting. Place toys
to her left and right sides and not always directly in front of her to
encourage her to pivot and reach for things when she is on her belly and
while sitting. After each diaper change you can work on helping her into
a natural sitting position by (instead of just picking her straight up)
by rolling her to her side, and placing on of your hands on her hip and
your other hand on her opposite shoulder and rotating her up into a
sitting position. This will help her to learn to achieve a sitting
position on her own, and as she gets stronger she should be placing her
hand on the floor and helping push herself upwards. You can also sit her
on an exercise ball and gently bounce her, tipping her gently from side
to side and encouraging her to "right" her body back into midline. This
may help increase her core strength needed for more complex motor
skills. You can lie her on her belly on a small playground ball and roll
her forward encouraging her to place her hands on the floor and then
rolling her back again into her knees. Limit her time spent in bouncy
seats, exer-saucers, walkers, etc. A physical therapist will be able to
give you many more suggestions on how to work on her motor skills during
playtime. You can consult with your local Help Me Grow program, seek out
a private physical therapist through your insurance or this is a link to
early intervention services in your area: Clark County Board of MR &
Developmental Disabilities: Early Intervention Services 2430 Van Buren
Avenue, Springfield, OH 45505-2555 Phone: (937) 328-2680.
My son is seven months old. He rolls over, can lift his head and
seems to have pretty good control. He cannot sit by himself, but can sit
supported. I am concerned because when I am holding him he won't put any
weight down on his feet on my legs. I see other children younger than
him bouncing up and down. He is barely pushing down on his feet. Should
I be concerned?
Even though you see babies younger than your son bearing weight and
bouncing, most children are able to bear weight on their feet somewhere
between 7-9 months of age, so your son may just need a bit more time to
complete this skill. Since he is actively rolling and lifting his head,
as well as sitting with support those skills sound within normal limits.
Since crawling comes before walking, you can practice skills such as
placing your son over a roll made of blankets or your lower leg and work
on weight bearing on his hands and knees first, gently rocking him back
and forth to encourage weight shifting. Place toys to the left and right
sides to encourage him to lift one arm and bear weight on the other
hand. To work on weight bearing on his feet you can sit him straddling
your lower leg or thigh so his feet rest flat on the floor and rock back
and forth encouraging him to bear weight gently on one foot then the
other, and as he gets stronger encouraging him to pull up into a
standing position.
more >
< less
You can also sit him on your lap facing away from you, and sing a
song, as you rock him side to side and gently apply some downward
pressure to his knees (make sure his bare feet are flat on the floor
under his knees-he should always be placed so his body is in alignment).
You could also sit him on a small ball, small enough so his feet are
flat on the floor when seated and do the same exercises, supporting him
at the trunk/hips as needed. I would also mention your concerns to your
pediatrician at his next well baby visit. Depending on the advice of
your pediatrician, if you are still concerned about his motor skills and
your son is not bearing weight and starting to bounce by around 9-10
months of age you may wish to have a physical therapy evaluation through
your local Early Intervention provider:
http://health.state.ga.us/programs/bcw/
My Son is 14 months and 2 two weeks and he doesn't walk yet; he
doesn't even try can he get some help.
Let me first say that since your son is only 14 months old, he is
still well within typical development, even though he is not yet
walking by himself. You may read that babies typically walk at 12
months, but walking anywhere between 9-18 months can all be
considered within average development. You didn't mention if your son
was pulling to stand or cruising along furniture, but if he is,
then he is well on his way to independent walking.
more >
< less
You may want to refer to this recent "Ask A Therapist" question (I
copied and pasted it below), which details some ways to work on
independent walking skills (http://www.earlyinterventionsupport.com/commonquestions/asktherapist-development.aspx):
My daughter is 19 month old. She is not walking independently. She
is mostly walking by kneeling down but a couple times I have seen
her take a few steps but still reluctant to walk independently;
otherwise she holds my finger and walks. Hip x-rays were taken.
All seems fine according to her pediatrician. Otherwise, her
vocabulary is great. She knows a lot of words. Her memory is also
great! Please let me know what might be the reason.
Most children walk by age 18 months, but there are still plenty of
children who are late walkers who for some reason don't begin to
fully walk independently until closer to age two. Some of these
children are knee walkers or very fast crawlers and for them it seems
like "why walk when I can get there faster this way.
Some of these children are carried a lot by caregivers. I am glad
you checked with your pediatrician first and had your daughter's
hips checked. If she is walking with one hand held, that is a good
sign that she will soon take off on her own, she may just need to
gain that extra confidence to let go of your hand. I would
recommend carrying her as little as possible when at home and
encouraging her to walk pushing toys or holding your one finger as
you mentioned. You can also have her walk behind a large ball
(like an exercise ball) pushing it across the floor. You can try
little tricks like dressing her in overalls, so that you can hang
onto the back straps of the overalls while she walks (since you'll
be behind her, she won't notice as much when you are holding on or
letting go) and much like riding a bike "let go" when you feel she
has her balance so that hopefully she will take a few steps on her
own. Some parents even attach an extra little strap to the back of
the overalls so they don't have to bend down as far while their
child is practicing walking. You can also have her stand with her
back to a couch so she has her balance and then give her a small
ball or stuffed toy to hold so that she has to use both hands to
carry it and encourage her to come show the toy to you.
I would also suggest not using walkers or exersaucers with her
right now, or if you do, limit it to very short time periods since
she needs to develop strength and balance on her own. You can play
squatting games with her to help strengthen her quadriceps muscles
which she needs for walking, have her hold your hands and squat down
and then pop back up. If you continue to have concerns and your
daughter is not progressing with independent walking within the next
month I would suggest calling your local early intervention
provider for a physical therapy evaluation to rule out that any
other factors (such as low muscle tone) are contributing to her
inability to walk on her own.
Also check out our link for Gross Motor Skill Development for ages
9-12 months, as this section would also apply to a 14 month old
child:
http://www.earlyinterventionsupport.com/development/grossmotor/9-12months.aspx
If you continue to have concerns, or your son is not yet pulling
to stand, cruising along furniture or walking with both hands
held, you may want to contact your local early intervention
provider for a physical therapy evaluation. This is a local link I
found for your area:
http://www.southbaymentalhealth.com/families.html
My granddaughter is 19 months old and does not walk. She walks
holding on with one finger but will not let go. Do you feel there can
be a problem? The doctor does not find anything wrong.
Thanks for your patience in waiting for an answer from us over the
holidays. I am glad that you first checked with your pediatrician
and that he/she feels there is nothing medically wrong with your
granddaughter. If you continue to have concerns you can always
call for a physical therapy evaluation through your local early
intervention provider. This is a link to some services in your area:
http://www.bcckids.org/
more >
< less
I have copied and pasted below the answer to a similar question to
yours which we just answered on our website in recent weeks (http://www.earlyinterventionsupport.com/commonquestions/asktherapist-development.aspx
3rd question/answer on the page).
Most children walk by age 18 months, but there are still plenty of
children who are late walkers who for some reason don't begin to
fully walk independently until closer to age two. Some of these
children are knee walkers or very fast crawlers and for them it seems
like "why walk when I can get there faster this way?". Some of
these children are carried a lot by caregivers. I am glad you
checked with your pediatrician first and had your daughter's hips
checked. If she is walking with one hand held, that is a good sign
that she will soon take off on her own, she may just need to gain
that extra confidence to let go of your hand. I would recommend
carrying her as little as possible when at home and encouraging
her to walk pushing toys or holding your one finger as you
mentioned. You can also have her walk behind a large ball (like an
exercise ball) pushing it across the floor. You can try little
tricks like dressing her in overalls, so that you can hang onto
the back straps of the overalls while she walks (since you'll be
behind her, she won't notice as much when you are holding on or
letting go) and much like riding a bike "let go" when you feel she
has her balance so that hopefully she will take a few steps on her
own.
I have a few concerns about my 5 1/2-month-old daughter. She has
strong neck control and holds her head very steady. However, when
on her stomach, she won't push up hardly at all. She lifts her
head, but never uses her arms to push up. She also really doesn't
try to roll at all. If you leave her on her belly long enough, she
will just lay her arms back and lay down. Also, she won't bear any
weight on her legs when I put her feet against a hard surface (or
my lap). I remember my older daughter doing all of these things by
now. Can you tell me if I should be concerned?
Depending on where you look for a developmental milestone chart
you will see
varying age levels listed for the motor skills you mentioned.
Most charts differ by a few months. Also, it's always natural to
compare when you have another child who may have completed these
motor tasks at a different pace.
more >
< less
Having said that, as therapists we look for babies to be pushing
up on extended forearms on their bellies by around 5-6 months,
rolling smoothly with coordination in both directions within the 6-9
month old period (you may read that most babies are rolling in
both directions by 5 months, but many babies still do this purely
by accident and not purposely at this age), and fully bearing
weight on feet and bouncing in a standing position by around 7-9
months (many babies are just starting to bear weight on their feet
around 5 months of age). All babies develop at their own pace. I
would encourage you to mention these concerns to your pediatrician
at your next well baby visit so he can observe your daughter. Red
flags would be if you feel your baby's muscle tone feels too
floppy or too stiff, or if she prefers one side of her body over
her other (such as keeping her head turned to one side frequently
or rolling to only one side). It is great that you are doing tummy
time with her, since this is indeed the most important time for
her to develop and practice the skills you mentioned. It sounds
like she has nice head control and neck strength, so maybe she
needs to develop more trunk/core strength. You can encourage her
to play with her feet when on her back, tucking a blanket roll
under her hips to help her raise her feet and place rattle socks
on her feet to entice her. You can encourage her to push up on
extended forearms by rolling up a small blanket and placing it
under her armpits so that her chest is now lifted and it makes it a
bit easier for her to place her forearms/hands on the floor.
Lay on the floor in front of her and entice her to push upwards
with mirrors and toys to reach toward. You can also place her on her
tummy over the lower part of your leg, knees bent under her in a
sort of kneeling position so her chest rests on your leg and
encourage her to put her hands down on the floor to bear weight on
them. You can facilitate rolling during play with her, gently
guiding her at the hip and opposite shoulder or simply tip the
blanket by lifting a corner to help her get the momentum to roll
over. You can let her play in a side-lying position (left and
right sides) and then practice rolling side to back or side to
tummy. You can sit her on your lower leg, straddling your leg, and
gently lift her up and down to encourage weight bearing on her
feet. Also while in a sitting position with her feet touching the
floor you can very gently apply pressure to her knees so that her
feet feel the pressure of the floor beneath her. Since babies
learn new skills almost daily during these early months you may
want to give her another month to practice. However, if you are
very concerned right now, or if your pediatrician has concerns or
if you do not see anymore progress with these skills by 6-6.5
months I would call your local early intervention provider to have
a free physical therapy evaluation completed to rule out any
concerns. Your local early intervention provider is: Montgomery
County Infants and Toddlers Program Administrative Office 51 Monroe
Street, Suite 1700 Rockville, MD 20850 Phone: 240 777-3997 Program
Director: Ronnie Biemans
http://www.montgomeryschoolsmd.org/departments/infantstoddlers/
My daughter is 19 month old. She is not walking independently.
She is mostly walking by kneeling down but a couple times I have seen
her take a few steps but still reluctant to walk independently;
otherwise she holds my finger and walks. Hip x-rays were taken. All
seems fine according to her pediatrician. Otherwise, her
vocabulary is great. She knows a lot of words. Her memory is also
great! Please let me know what might be the reason.
Most children walk by age 18 months, but there are still plenty of
children who are late walkers who for some reason don't begin to
fully walk independently until closer to age two. Some of these
children are knee walkers or very fast crawlers and for them it seems
like "why walk when I can get there faster this way?".
more >
< less
Some of these children are carried a lot by caregivers. I am glad
you checked with your pediatrician first and had your daughter's
hips checked. If she is walking with one hand held, that is a good
sign that she will soon take off on her own, she may just need to
gain that extra confidence to let go of your hand. I would
recommend carrying her as little as possible when at home and
encouraging her to walk pushing toys or holding your one finger as
you mentioned. You can also have her walk behind a large ball
(like an exercise ball) pushing it across the floor. You can try
little tricks like dressing her in overalls, so that you can hang
onto the back straps of the overalls while she walks (since you'll
be behind her, she won't notice as much when you are holding on or
letting go) and much like riding a bike "let go" when you feel she
has her balance so that hopefully she will take a few steps on her
own. Some parents even attach an extra little strap to the back of
the overalls so they don't have to bend down as far while their
child is practicing walking. You can also have her stand with her
back to a couch so she has her balance and then give her a small
ball or stuffed toy to hold so that she has to use both hands to
carry it and encourage her to come show the toy to you.
I would also suggest not using walkers or exersaucers with her
right now, or if you do, limit it to very short time periods since
she needs to develop strength and balance on her own. You can play
squatting games with her to help strengthen her quadriceps muscles
which she needs for walking, have her hold your hands and squat down
and then pop back up. If you continue to have concerns and your
daughter is not progressing with independent walking within the next
month I would suggest calling your local early intervention
provider for a physical therapy evaluation to rule out that any
other factors (such as low muscle tone) are contributing to her
inability to walk on her own. This is a link to a provider in your
area:
http://www.iceckids.org/html/icechome.htm
My son is 12-1/2 months old, started to roll over at 7 months,
crawling well at 10 months. But he is not interested in bearing
weight or pulling to stand. He stands very well (with minimal support
on his knees) and walks with knees with pushing toys. If I make
him stand, he usually bends his knees at 90 degree and won't
attempt to stand. He was born at term. How can I make him pull up
and bear weight?
It sounds like your son may just need some extra time to get used
to weight bearing on his feet and develop more strength for
standing, especially if he only began rolling actively at 7 months
and crawling at 10 months. I would, however, check with his
pediatrician first to make sure there is no physical reason why he
would refuse to bear weight on his feet (the doctor may check his
hips).
more >
< less
Once this is ruled out I would practice using a therapy ball or
large playground ball that is big enough that your son can stand in
front of it at about chest height. Make a game of singing and
rolling him forward with his belly on the ball and then back onto
his feet. Row, row, row your boat is a great song for that
activity. He may even enjoy just standing beside the big ball and
patting it as a game.
Since he already enjoys kneeling and playing in this position, you
can help him to assume a 1/2 kneel position by helping him shift
his weight and bringing one foot forward, which will be the
position he eventually use to pull to stand on his own. Often you
can tempt babies to try to pull to stand by placing some of their
favorite toys just out of reach on a low table or couch...if he
gets to his knees, push the toys a bit farther out of reach and
help him assume the 1/2 kneel and boost him upwards so he can
reach the toys. Make a game out of it and practice it several
times a day.
You can also sit him on your leg, with one of his legs on either
side of yours and raise him up and down encouraging him to press
his feet on the floor and stand as you raise him up with support.
Bouncing in this position can help him increase the strength in
his quad muscles that he needs for walking. Do not wear shoes on
him, he needs to feel the floor under his feet to develop these
skills. Since he is already pushing toys by knee walking, he will
probably soon begin to pull himself up on his own.
All babies develop at their own pace, but generally we look for
children to walk independently by around age 15-16 months, so your
son still has plenty of time for practicing these needed skills. If
you continue to have concerns and your son is still not weight
bearing on his feet within the next month I would recommend calling
your local early intervention provider to request a physical
therapy evaluation.
My son just turned 11 months old. He is not crawling, pulling up,
or standing. He does roll around the floor, and tries to "bounce"
himself when on his stomach; and just recently, he does seem to be
more interested in trying to pull himself up by latching his arms
around my arm or body. He does not seem to know how to put his
weight on his hands or legs. He is a large baby, over 95% in
height and over 97% in head circumference; but only about 55% in
weight. Could he just be top heavy and need more time to develop
his muscles?
He didn't truly sit up on his own until he was 8 months old and
really only began sitting up for long periods of time and
"catching" himself from falling over at 10 months, and he is just
now starting to bend forward and lower himself onto the floor from
a sitting position; so there is some progression in his
development. Another concern is that he is very "into" and
particular about his hands, i.e. moving them slowly in front of
his face (although he is doing this less and less), doesn't like
for me to touch his hands, flaps his hands when excited or happy
and still likes to lay on his back and put his hands and feet in
the air (although again, doing this less and less).
Thanks for your question. I would advise contacting your local
early intervention provider in order to have your son evaluated by a
physical therapist as well as an occupational therapist if you
continue to have concerns regarding his gross motor development, as
well as his sensitivity related to his hands. Being a "large baby"
could contribute to some difficulty in completing motor skills,
and it sounds like he is moving along, just at a slower pace. By
11 months, hand watching behaviors should have disappeared since
most children by now are far more interested in the toys they are
holding than their hands themselves.
more �
� less
I am suggesting the OT evaluation since some children have sensory
issues which could be a reason your son does not like to bear
weight on his hands and knees and does not like his hands to be
touched. Does he have any sensitivity to his hands being messy
when eating or his face being wiped, etc? Has your son ever had
his vision evaluated? I would schedule a screening with your
child's doctor to rule out any problems related to his vision
which could be another reason he is hand gazing. Vision problems
can also contribute to delayed gross motor skills. You could also
ask if your local early intervention program provides functional
vision evaluations.
Having said all that, I would continue to encourage floor play as
much as possible to increase his motor skills. Limit the use of
walkers, bouncers, etc so he can practice important skills on the
floor as much as possible. Crawling is a very important developmental
milestone, and can be encouraged by placing your son over your leg
on the floor, with his knees bent and hands bearing weight in
front of him, rock him back and forth and sing simple songs to
make it fun. You can also tape some large cans together or roll up
several towels to make a roll and place him over this roll in a
hand/knee position. Gently rock him back and forth so he is
encouraged to bear weight on both hands and knees. Place a mirror
in front of him and place toys to the left and right side,
encouraging him to bear weight on one hand while reaching for a
toy with his other hand. You can also use a small playground or
exercise ball and place him belly down on there and roll him back
and forth bringing him forward to his hands and then back to his
knees or feet.
Work on transitional positions, such as encouraging him to go from
laying down to sitting by rotating his body, as well as going from
sitting to hand knee. Place the roll to his left or right side
(alternate) and help him rotate over into a hand-knee position. You
can use a small box turned upside-down as a table, and place your
son in a kneeling position beside the box for play to encourage
weight bearing on his knees. Make sure his heels are under his
bottom (don't allow him to sit in a "W" position with his bottom
on the floor between his legs) and help him pull up to a tall
kneeling position. When he is able to tolerate tall kneeling, you
can help him move one leg out into a half kneel position which he
will need to pull up into standing. Sometimes furniture in the
house is simply too high for little ones to pull up on, so use
boxes, breakfast trays, lap desks etc, whatever works best for
your son's height. Ideally when he pulls to stand the object you
are using for a table should be about armpit height or a bit
lower.
My daughter is a little over 4 months of age and can hold her head
up and stays on her elbows while on her stomach. How do I encourage her
to bear more weight on her arms? She just does not seem interested in
going any higher than that. Is it too early to expect her to be doing
this?
Since your daughter is only a little over 4 months old, it sounds as
if her motor skills are within normal limits for her age if she is able
to left her head and turn it from side to side, as well as bear weight
on her forearms while on her tummy.
more � � less
Tummy time is the most important position for developing later
motor skills. Typically between 4-5 months is when most babies do
begin to push up a bit on extended arms lifting their chests off the
floor. To encourage these skills lots of tummy time is important
throughout your daughter's waking hours. You can roll up a small
towel or receiving blanket under your daughter's armpits to raise
her up a bit and encourage the weight bearing on her extended arms
that you are looking for. You can also use a small soft wedge of
foam for this same effect.
Always supervise tummy time play for young infants. Get down on
your baby's level on the floor and face her so that she has the
extra motivation to raise her head and look around and push upwards.
You can also use a mirror & raise it up in front of her to encourage
her to lift her head and chest. When using toys as a motivator,
don't always put them directly in front of her, but to each side as
well, moving toys farther away or holding them up higher to the
left, right and center so she must look up to catch sight of them.
Placing toys to the side encourages a baby to shift her weight and
enhances her range of motion. To strengthen her neck, back and trunk
muscles you can also carry her belly down in a sort of "football
hold" by sliding your hand between her legs and under her tummy, you
can support her head and neck with your other hand if needed and
carry her close to your body for support.
Lying on your back with your baby on your stomach is another nice
way to do tummy time without really thinking about it, she will want
to look up to see your face as you talk/sing to her. You can also
lie on your back with your knees bent, feet on floor and place your
baby on your knees/lower legs facing you...hold her hands and
encourage her to look up at you in this position. Daily tummy time
is the best way to continue to strengthen all the muscles she will
need for later more complex motor skills. If your daughter does not
begin to bear weight on her hands and push up by 6 months you may
want to seek a physical therapy evaluation through your local
early intervention provider.
My almost-11-month-old son still crawls with his belly on the floor.
He can get up on all fours when he is still, but doesn't move forward or
backward in that position. Also, though he can sit perfectly without
support, he has not yet figured out how to get himself into a sitting
position. He is able to pull to standing on his own and can get anywhere
he wishes in a room. Are crawling on hands and knees, tummy off the
floor, and getting himself to sit major milestones he is missing? Or is
it okay at this point?
It sounds as though your son has accomplished some very nice gross
motor skills. I wouldn't panic at all. What I would do, though, is
continue to put him on the floor on his belly and encourage him to get
up on all fours.
more >
< less
Once he is on all fours, I would use a toy that motivates him and
encourage him to move toward it. Also, each time you change his diaper,
roll him to his side and encourage him to push himself up into the
sitting position. Try hard not to put him on the floor to play in a
sitting position; instead, put him on his belly or back so he has to
either work on crawling or getting to sit on his own. If you do these
few things, he should accomplish moving to sit and crawling in no time.
If he still doesn't seem to be gaining these skills, you can always
discuss your concerns with your pediatrician.
My 10 1/2 month old son almost always stands on his tip-toes. He can
not stand without support yet but when we hold him in a standing
position or when he is in his exersaucer, he is on his toes. I have
tried to manipulate his feet to a flat position but he rarely does it or
only stands flat for a few seconds. Should I be concerned?
While it's not entirely uncommon for kids to be on their toes when
first standing and walking it can interfere with balance and make it
difficult to stand on their own and take steps. First off I would
recommend limiting time in the exersaucer for only those times when you
need him to be in a safe place such as when you are cooking, etc. If you
have a pack and play that may be a better option instead of the
exersaucer as he can still play in standing and also has the opportunity
to cruise and move around some while contained.
more >
< less
If you choose to keep the exersaucer adjust it so that his feet can
be flat. Often kids will stand or jump on their toes when in exersaucers
causing their calf muscles to get tight and making it hard for them to
stand on flat feet. Without seeing your child I can not be sure exactly
why he is standing on his toes but I would suspect tight calves.
You can stretch his calf muscles by laying or sitting him on the
floor or in your lap using toys to distract him-hold his knee straight
with one hand and with the other bring "toes to nose." Stop and hold
when you feel resistance. Try to hold at least 10 seconds, but if he
tolerates it you can hold longer. Do not bounce his foot or push into
the resistance. Be sure to keep his knee straight. Repeat (as tolerated)
at least 3-5 times per foot and try to do this several times per day
such as after diaper changes. After bath is also a great time to stretch
as the warm water will help to loosen the muscles. Continue to
reposition his feet so that they are flat when he is playing in
standing. If the above suggestions do not seem to make an improvement in
the next couple weeks then I would recommend looking into early
intervention services in your area to get a physical therapy evaluation.
Return to Top
|