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signs my child will walk soon

When Will My Child Start Walking? 5 Signs That Your Child Will Be Walking Soon

All children develop and grow and their own rates. Current research gives a range where typically developing children achieve their gross motor milestones. But when the baby books and Pediatricians tell you that your baby will probably be walking independently somewhere between 10-15 months, with some children even walking at 18 months and still falling within normal ranges, parents want more answers. A great way to see if your child is on the right track is to check for these 5 signs that walking may be in their imminent future.

5 signs your child will be walking soon:

  1. Pull to Stand – When a child begins pulling up into standing using hands or stablesigns my child will walk furniture, he is strengthening his legs to prepare them for walking. The mature form of pulling to stand is to perform through a half-kneeling position.
  2. Cruising – Cruising is defined as walking while holding onto furniture. Cruising allows your child to practice weight shifting and forward progression in a safe environment.
  3. Crawling onto and over Furniture – As a child becomes stronger throughout his core and extremities, you may find him starting to climb onto furniture or crawl over obstacles. These are all signs that your child is developing the muscle strength and balance needed to walk independently.
  4. Walks with Push-Toy/Handheld Assistance – The added stability of walking while holding onto a push-toy or a parent’s hands helps children develop the confidence needed to take those first independent steps. Some children may use this as a crutch, so be sure to provide as little support as needed (2 handheld assistance>1 handheld assistance> holding onto sleeve of shirt>holding blanket between child and parent).
  5. Standing Independently – Children begin to let go of objects while standing when they feel confident and stable. The longer the child is able to stand, the greater his confidence is.  Bonus if the child is able to get into or out-of this position with control by himself.

If your child has not begun demonstrating the above skills by 12 months of age, he may benefit from a physical therapy evaluation.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

World Health Organization Development Study Results: Gross Motor Milestones In the First Year

 

The line between typical and atypical development can be a hazy one. There are standards that pediatricians, physical therapists, and developmental experts use to monitor growth and deviations from the norm, which allow us to recommend interventions when appropriate.  In 2006, the World Health Organization (WHO) released a whole new set of standards for evaluating and assessing the development of children from birth to 5 years.

What makes this new standard a great tool to monitor the change and growth of infants? This standard is based on data collected from healthy children, over multiple years, in six diverse geographic regions including Southeast and Southwest Asia, Europe, West Africa, North and South America. What is exciting about the new evaluation tool is that now, pediatric specialists have more than just reference curves for physical growth, but curves for motor development as well.

The six gross motor milestones WHO examined in babies were the following:

1.    Sitting without support
2.    Standing with assistance
3.    Hands-and-knees crawling
4.    Walking with assistance
5.    Standing alone
6.    Walking alone

The “windows of milestone achievement” were organized into percentile rankings which pediatricians and physical therapists can use, much like a growth chart.

Without delving too deep into statistics and calculations, the typical age range (in months) for each milestone is listed below:

1.    Sitting without support: 3.8 – 9.2 months
2.    Standing with assistance: 4.8 – 11.4 months
3.    Hands-and-knees crawling: 5.2 – 13.5 months
4.    Walking with assistance: 5.9 – 13.7 months
5.    Standing alone: 6.9 – 16.9 months
6.    Walking alone: 8.2 – 17.6 months

The average (mean) age for healthy children achieving each milestones is as follows:

1.    Sitting without support: 6 months (with 1.1 month standard deviation, SD)
2.    Standing with assistance: 7.6 months (with 1.4 month SD)
3.    Hands-and-knees crawling: 8.5 months (with 1.7 month SD)
4.    Walking with assistance: 9.2 months (with 1.5 month SD)
5.    Standing alone: 11 months (with 1.9 month SD)
6.    Walking alone: 12.1 months (with 1.8 month standard deviation)

(Click here to view this information in chart form from WHO.)

What is most interesting is that about 90% of the children studied met their milestones in a common sequence, and only 4% of the children skipped hands-and-knees crawling.  (Read here about the importance of crawling.)

As you read over these standards and timelines, remember that every baby develops differently from another. If you see your baby fall behind on any of the 6 gross motor milestones above, mention it to his pediatrician, and she will most likely recommend a physical therapist to help him along.



Reference:
WHO Multicentre Growth Reference Study Group.  WHO Motor Development Study: Windows of achievement for six gross motor development milestones. Acta Paediatrica, 2006; Suppl 450: 86-95.

The 411 on Infant Rolling

Around the 4th or 5th month of a baby’s development, he will roll over from being on his tummy to his back. This is often purely accidental; he does not have the ability to control his weight-shifting on his tummy and often tips over as a result.  Around the 5th or 6th month, a baby will have the abdominal strength to lift up his feet and roll over from his back to his tummy. Many of the kids I see are infants and toddlers who somehow missed this important step, or who didn’t start rolling until after the 9th month.  Many of the parents I talk to didn’t give this a second thought until they noticed delays in other skills later on in their children’s growth.

Why is rolling so important?

A healthy, typically developing infant is constantly moving. Like the rest of his body, his musculoskeletal and nervous systems are constantly maturing. As he gains strength in all his big muscle groups, he is also learning how to control his limbs. Motor control is an important aspect of a baby’s neuromuscular growth. Rolling encourages postural muscle recruitment (including the back extensors, hip flexor/extensors, the obliques, and the abdominals). The muscles need to be strong before a baby can learn to crawl, stand, or walk.

The segmental volitional rolling that babies learn to do also encourages trunk dissociation. Through rolling, they learn to separate the movement of their limbs from the movement of their head and trunk. Through these transitional positions, they learn to balance the muscles on the front of their body with the muscles on the back and sides. When they roll to one side of their body, they are elongating that side and contracting the other. It is through this unilateral segmented use that children develop their sequential motor skills – crawling, walking, and most other locomotion skills require the ability to separate one side from the other and separate limb movements from trunk movements.

How can parents help encourage rolling?

  1. Start early. This is similar advice I give to parents about increasing infant tummy time: get down on the floor and play with him. Encourage him and motivate him with toys, sounds, lights, and faces. Start as early as you can. Babies have certain built-in reflexes that help them roll to their side if they just turn their head (the neck-righting reflex).
  2. Ease in.  The more a baby rolls, the more input he receives from his environment to his big muscle groups. Our job is to introduce him to his environment and help him tolerate each new position. His own maturation process will take it from there. Play with him when he is on his tummy or back, then help him to his side and play with him there.
  3. Engage your child, step-by step. With your baby on his back, place a toy just out of reach. Help lift one of his legs and bend his hip to 90 degrees or higher. Slowly cross his leg over the other hip. Wait for him to turn his upper body and kick in his trunk muscles. Your pressure across his hips should be firm, but gentle.
  4. Practice. Practice. Practice. And repeat.

When should I seek a pediatric physical therapy evaluation?

What I often look for is initiation.  The lack of initiation by 6 months is a good indicator that your baby may need a little push from a pediatric physical therapist.  If your baby is not picking up his feet and rolling easily from side to side while on his back by 6 months, bring him in for an evaluation.

Why It’s Important NOT to Skip Crawling

Crawling is an important gross motor milestone for babies that are 8-10 months of age. It is at this time that your child is figuring out baby crawlinghow to get from one place to another independently. For some children, crawling is more difficult to learn and is, at times, delayed. This can often lead to a child skipping the crawling milestone and going straight into cruising and walking; however, this means that he or she may be missing out on some important benefits of the crawling stage.

Below are some of the reasons why a baby should NOT skip crawling:

  • Crawling helps strengthen the shoulders, back and core muscles, which are necessary for further gross motor development.
  • Crawling helps strengthen the tiny intrinsic muscles in the hand, facilitating development of the arches in the hands. These muscles are also important for emerging fine motor skills.
  • Crawling assists the child in learning bilateral coordination of his or her arms and legs.
  • Crawling also has a role in development of the visual-motor system as it requires scanning the environment with the eyes and moving the body in accordance.

A baby should be showing signs of emerging crawling skills by 8 months of age. This includes belly crawling (sometimes called “army crawling”) and pushing up onto their hands and knees and rocking. By 9 to 10 months of age, a baby should be crawling independently and using his or her arms and legs symmetrically. If you think your baby requires additional help in learning how to crawl, contact a Family Child Advocate to schedule an evaluation with a physical therapist.

Why It’s Important For A Baby Not To Skip Crawling | Pediatric Therapy TV

In today’s Webisode, a pediatric physical therapist shows how crawling is essential for an infant’s muscles and sensory input.

Read these useful tips on how to encourage your baby to crawl

In this video you will learn:

  • How crawling influences an infant’s muscles
  • What essential skills infants learn to master when crawling

Differences and Similarities Between Occupational and Physical Therapy | Pediatric Therapy Tv

In today’s Webisode, a pediatric occupational therapist explains ways to distinguish between occupational and physical therapy and how they are similar.

In this video you will learn:

  • To determine the differences between physical and occupational therapy
  • How the two disciplines are alike
  • What types of therapies are used for the different disciplines

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman, and I’m standing here with Lindsay Miller, a Pediatric
Occupational Therapist. Lindsay, people are often confused between physical
therapy and occupational therapy. Can you explain with the differences and
similarities are between OT and PT?

Lindsay: Sure. With occupational therapy, we usually work on independence
with self-care skills, and these are skills like dressing and bathing. We
also work a lot on fine motor skills as well. So that’s any sort of
movement using your hands and fingers like writing, coloring, using
scissors, using a fork and knife, those types of things. Traditionally,
physical therapists work on mobility, so that’s walking, running, jumping,
and other gross motor tasks that use the larger muscles of the body. In the
pediatric realm, occupational therapists also work on executive functioning
skills, so those are our thinking skills and our thinking processes, and we
also work on sensory processing as well, so that’s how children react
emotionally and behaviorally to their environment and their surroundings.
In the pediatric world, physical therapists also work a lot on mobility
again and also gross motor development. So that’s, can your child crawl and
can they get themself up into standing and those sorts of things.

Some of the similarities are that occupational and physical therapy both
can look at muscle strength, flexibility, range of motion, and muscle tone,
but the biggest difference is really how we look at those things and in
what context. So occupational therapists look at those muscle strength and
flexibility and those types of things and how they affect functioning and
daily life whereas physical therapists look at those things and how it
affects mobility and gross motor skills. So overall, there is some overlap
between occupational and physical therapy, but the biggest difference is
really how they look at it in terms of functioning.

Robyn: All right. Thank you so much, Lindsay, and thank you to our viewers.
And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

Stability Ball Exercises

The stability ball is a simple and easy piece of equipment to work into everyday exercise for your child, ranging from infant to teenager.  Stability balls can be bought at most sports stores, cost only about 20 dollars, and last for years.

Below are some fun activities to follow along with your kiddos to see improvements in core strength, posture, and shoulder stability:

Age: Infant

  • Simply sitting your 2+ month old infant in supported sitting on the stability ball will help his posture.
  • Placing your 2-8 month old on their tummy on the ball. TLittle girl rolling on a balance ballhis is a bit more challenging then pure tummy time as they have to push up through their arms on a cushy surface, helping build strong back and shoulder muscles.
  • At 4+ months, you can lean the ball/baby to the left side and watch your infant “right” their body up toward the middle. Practice to both sides. This will help their muscles on the sides of their trunk that are important for crawling.

Age: 1 year-5 years

  • Bouncing your child up and down gently on a ball will help both their core strength and vestibular system.
  • Bouncing the ball back and forth by lifting it above your head while keeping your and your child’s tummy muscles tight helps build great core and shoulder strength.
  • 3+ years, have your child practice dribbling the ball for increased hand-eye coordination and motor planning.

Age: 5 years +

  • Sit-ups:With either
    • your child’s hips and knees at a 90 degree angle from each other or
    • holding your child’s feet down, practice crunches to build abdominal strength.
  • Push-ups: With feet on floor and child in a plank position, they can practice push-ups with their hands on the ball. An adult may need to hold the ball stable so it doesn’t move.
  • Practicing chest passes (like in basketball) is great for chest strength, motor planning and overall stability.

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Encouraging Crawling in Babies

There is nothing as heart warming as watching your child crawl across the room to try to pull your grandparents wedding china onto the floor.

baby crawling

Crawling is an important form of movement for infants.  It helps to build a stronger core and begins to introduce weight through the bones of the upper leg to increase bone density.  Crawling is singular in its ability to promote strength and stability of the shoulder and the surrounding muscles (which become important postural muscles once the child is standing) using the child’s own weight.  From a visual standpoint, they begin to hone their ability to maintain a smooth visual field while the head is in motion as well as work on their objects per minutes. Reciprocal crawling also develops the ability to coordinate their right and left sides (bilateral integration).

It is typical for babies to progress from scooting backwards on their belly, “swimming ” (where arms and legs are both moving up off the floor), belly crawling (“army/military crawling”), and then reciprocally crawling on hands and knees.  This sequence cannot begin if they are never on their tummies to play, so the foundation is tons and tons and tons of tummy time.

Attempting to change the movement habits that you little one has, or challenging them to build new habits is not easy.  Yeah, very not easy.  I would encourage you to understand their frustration, empathize with them, but stay the course.  Remind yourself of your own tears every time you try to give up coffee.  Remember how tough it was to begin something you wanted to challenge yourself with, but how rewarding it was when you accomplished your goal.  So there may be some tears (some from the baby), but there should also be plenty of cheers and hugs and kisses.

Try these activities at home to encourage crawling:

1. Strong foundations – Tummy time, tummy time, tummy time. I know I said this above, but it is worth  repeating.
2. Get down and get busy – Lay, roll, and crawl around with your child.  You can make a lot of eye contact, and if you are on the floor your face can still be seen if they need to put their head down to rest, so they may enjoy being on their tummy longer.
3. Get low – If laying next to them is not enough, lay on your back, and place your child on your chest.  This is great for bonding and
4. Born free– Take them out of the exerscaucer or bouncy seat – When children do not have to move to get a toy or look at something new they won’t, which leads me to……
5. Move a toy just out of their reach – Yes, I said that you needed to be mean, and this may lead to screaming. They may just surprise you and themselves by moving towards it.
6. Try a different toy- perhaps with lights and/or music.
7. Try using your phone to motivate them -I have seen this work, just don’t let them put it in their mouth.  Ew!
8. Try changing what they are wearing- Layers of clothing can impede sensory input and get in the way of movement.
9. You are the local expert – If these things do not work, you know what motivates your child, mix it up, and then let me know, I’m running out of ideas.
10. Tummy time -which means getting them out of the bouncy chair/bumbo seat.  Learn more about the importance of Tummy Time from this 2 minute video