Child Development Concerns

Back to:  Therapist Questions & Answers - Developmental Concerns

I am a school nurse working with 0-5 year olds. Which types of crawling are considered abnormal?

A typical crawling pattern would be considered crawling on hands and knees symmetrically. Most children crawl between the ages of around 6-10 months. Most children progress from belly crawling/combat crawling to hand/knee crawling. Crawling is a very important motor milestone that should not be skipped. Some children deviate from the typical crawling pattern in a variety of ways, and it doesn't always indicate that anything wrong, but can be a red flag for developmental delay or even a diagnosis. One major red flag to look for in crawling patterns would be asymmetry, for example a child who uses one side of their body unequally to the other ( for example, right arm and right leg pulls body forward, while left arm and leg lag). Some children "bear crawl" on hands and feet, not letting the knees touch the floor, and while this looks unusual, it is not always abnormal. Some children will "crab crawl" on one knee, while keeping the other knee bent and the foot flat on the floor to propel themselves.

Some children scoot on their bottoms, propelling themselves with their hands instead of crawling. Some children will roll to get where they want instead of crawling. Children with low or high muscle tone can find crawling difficult to master, and also babies who did not spend time on their tummy's or have weak core strength and or poor head/neck control or tight hip flexors can find crawling difficult. Also, children with sensory concerns may dislike crawling, not being able to tolerate the feel of carpeting on their knees or hands as they weight bear. The best suggestion is to have a a child evaluated by an early intervention physical therapist before age one if there are any concerns about a child's crawling pattern or lack of crawling.

Back to:  Therapist Questions & Answers - Developmental Concerns