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Questions & Answers - Developmental Concerns
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 doesn't bear weight? Is this
normal or should we do anything about this?
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. 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.
I would like to provide you with more input. She started sitting at 6
months, and we never ever provided her with support to sit. She decided
to sit and started sitting at 6 months without any support. She loves to
jump in her jolly jumper. She jumps very well without any help from us.
She is not crawling and not moving but tries very hard to reach her toys
while sitting and she manages to get her toys.
Her mind is very active
and she learns lots from others at her daycare. She follows others words
but does not following their walking. When I try to make her stand on my
lap, she stands for a second and then bends her knees. Sometimes she
jumps as she does in her jolly jumper(but never stands). She never liked
tummy time as well. Our physician checked her hips and spine and he said
nothing is wrong. She is now 13 1/2 months old and it is very
frustrating for me to see her not walking (always very hard for mother).
Is there any technique that I can use to encourage her to bear weight on
her legs?
Sorry for the delay in getting back to you with a second response. In
speaking with our physical therapist, we would again advise you to seek
the advice of a pediatric physiotherapist in Toronto so that he/she can
do a full motor assessment of your daughter. Perhaps she has hypotonia
or in other words, low muscle tone, which could be one reason she is not
yet crawling, pulling to stand on her own or walking. Low tone would
make it harder for her body to move against gravity to complete motor
movements. Also, the fact that she did not like tummy time and perhaps
did not spend much time in this position could mean that she simply did
not develop the core strength in those muscles which are needed to
perform more complex motor movements and she could need some
strengthening in this area. Without being able to see your daughter for
a "hands on" evaluation, we cannot unfortunately pinpoint any exact
reason as to why she is not crawling/walking yet. And, she could also
just need more time since some children do not learn to walk until
around age 16-18 months and can still be considered within average, even
though late in achieving this skill. There are children who never crawl
and who go straight to walking, however, from a a therapy standpoint
crawling is a very important skill that we do not like children to skip
over because it can sometimes leads to later difficulties with sensory
issues (from not bearing weight on hands and knees) and even some
research has shown later difficulty with reading/writing/visual
convergence due to not learning to use arms/ legs independent of one
another at this early stage.
You can do some simple things such as bounce your daughter on a large
exercise ball, shift her weight on the ball from side to side and back
to front while holding her as low as possible at the hips so that she is
doing most of the work to "right" her body in space when her weight is
shifted. This can help with strengthening. You can use a smaller ball
and place her on her tummy and roll it forward and encourage her to
place her hands on the floor and bear weight and then roll it back and
encourage her to bear weight on her feet or her knees. You can place her
in a hand-knee position over your leg and use your hand/body to keep her
in a 4 point position and encourage her to play while bearing weight and
reaching in this position. Use a small box or tray table and place her
in a kneeling position (make sure her bottom doesn't drop between her
feet, her bottom should sit back on the back of her heels if she is not
in a tall kneeling position), entice her to come up to tall kneel to
play with toys or reach for things. Sit her on a small stool or box so
that her feet touch the floor in a flat position, hold her hands and
practice coming from sit to stand and back to sit. Use music and singing
and mirrors and bubbles and things to make all this fun and not work for
her.
I would limit the use of her jumper, baby walkers or exersaucers
right now since she needs as much floor time to practice and develop
these skills on her own as possible. Many baby items such as walkers,
jumpers and exersaucers have been studied and shown to not actually
improve a child's ability to walk, and on the contrary may develop the
calf muscles more than the quad muscles (needed for walking) or even
lead to later toe walking due to the way a child pushes off in these
types of seats. They also inhibit a child's ability to see their feet
while moving and some sling seats hold the child's hips in a position
that is not ideal. Another study from Children's Hospital of San Diego
cited that "The exercise your baby gets in a jumper does not promote the
development of trunk and leg control or the balance needed for walking.
Additionally, it may limit time your baby spends on his tummy developing
the valuable skills for crawling." Again, we advise seeking the advice
of a
pediatric
physiotherapist, as well as keeping in close contact with your
child's pediatrician to monitor the
development of her
motor skills.
Back to: Therapist
Questions & Answers - Developmental Concerns