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Questions & Answers - Motor Concerns
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.
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.
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Questions & Answers - Motor Concerns
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