Posts

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.

Using the Fall Season to Work on your child’s Developmental Skills!

The weather is changing and children are back to school.  The Fall season provides opportunities for many activities to address your child’s occupational therapy needs.Children playing with autumn leaves

The activities listed below work on a variety of developmental skills and are appropriate for children of all ages:

  1. Rake leaves- provides heavy work and builds strength and endurance
  2. Carve pumpkins- addresses hand strength and fine motor skills
  3. Roll in a pile of leaves- provides heavy work and vestibular input
  4. Fall cooking and baking- decorate cupcakes or bake an apple pie by stirring the batter or placing sprinkles on the frosting. These activities work the small muscles of the hands and enhance fine motor precision.
  5. Leaf rubbing (place a leaf under a piece of paper, rub a crayon over the leaf until the image appears on the paper)- addresses visual skills and fine motor skills

Your children and whole family will be eager to engage in these fun Fall activities!

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

Developing Hand-Eye Coordination

Hand-eye coordination is the synchronization of eye and hand movements. It involves proprioception (knowing where your body is in space) combined with processing visual input. Any task that requires the coordination of vision and hand movements involves hand-eye coordination. Examples of hand-eye coordination include grasping objects, catching and throwing a ball, playing an instrument while reading music, reading and writing, or playing a video game.

Hand-Eye Coordination in Infants

There are many ways to encourage development of hand-eye coordination in a child. Just like any other skill, the more time spent doing activities that involve hand-eye coordination, the easier the skill will become. In infants, reaching and playing with objects and toys are great ways to foster development of hand-eye coordination. As they get older and are able to sit independently, you can play with balls, encouraging the baby to roll and corral them. Playing with blocks and other toys that involve putting something in or taking something out are also great ways for an infant to develop this skill.

Hand-Eye Coordination in Toddlers

With toddlers, continue to play with various sized and textured balls to develop hand-eye coordination. By the age of three, a toddler should be able to “fling” a ball forwards and catch a ball against their chest. To help develop his aim, you can practice tossing balls into hula-hoops or targets on a wall (start with big targets and get smaller as the child progresses and gets older). To practice catching with only the hands, start with bigger and softer balls (like koosh balls or bean bags). Progress to smaller and harder balls (like a tennis ball) as the child gets older.

Hand-Eye Coordination in 4 Year Olds and Older

Coloring and creating crafts is another fun and great way to develop hand-eye coordination. Some fun crafts to do include stringing beads or macaroni, finger painting, or playing with play-dough. When a child is four years or older, games that involve slight hand movements can also further facilitate growth in this area. Examples of these games are Jenga, Honey-Bee Tree, or Topple (all available at any toy store). Complex puzzles, Legos, or building blocks are other great hand-eye coordination activities.

Children who have poor hand-eye coordination often refuse or choose not to participate in activities that involve this skill. The activities mentioned above can be very beneficial in assisting these children in improving their hand-eye coordination. Some children struggle immensely with every-day activities due to poor coordination skills. These children may require extra assistance from an occupational therapist or a physical therapist.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

4 Steps To Get Your Baby Rolling

As a pediatric physical therapist, I am often asked “how can I get my child to walk,” “how can I get my child to crawl,” and other such questions. I like to use the same principles that would motivate me, or other adults I know.baby rolling

A) Encourage an older child to perform something that is beneficial but difficult by letting her know the alternative is something that is (while still beneficial) either more difficult or outright unpleasant.

B) Observe what the child likes (like a specific toy, not like oxygen) and then remove that item a small distance away from her, and return the object (remember toy, NOT oxygen) when she performs the task that you would like him to perform.

Encouraging A Baby To Roll:

Rolling. I would like to use the words supine (lying on one’s back) and prone (lying on one’s tummy). You can toss these words out at your next pediatrician appointment and impress the doctor. (I think most pediatricians have a deal where you get an extra lollipop if you correctly use medical jargon in a sentence.) Rolling
from back to side typically occurs at about 3 months, with rolling from tummy to back (prone to supine) and from back to tummy (supine to prone) at 4 and 5 months respectively.

4 Steps To Encourage A Baby To Roll:

  1. Break it down. Play with your infant while she is on her tummy, play with her while she is on her back, and play with her while she is laying on her side to make sure she is comfortable in each position.
  2. How can I get my child comfortable laying on her side?  You can place your infant on her side with both arms in front of her and then stabilize her at her hips. Use a toy that she can hold and chew and shake. By supporting at her hips, you promote stabilization through her core.
  3. Work the transitions. Let’s use rolling supine to prone over her right side (see above for definitions) as our example. Using a toy that she can reach for and is interested in reaching for (refer to tip “B” above as needed)…
    1. Brush the toy against her left hand to encourage her to reach with that hand and move the toy so she begins to reach to the right, across her body.
    2. With your hand on her left hip, gently bend her hips to 90 degrees and slowly and gently roll her towards her right.
    3. Move very slowly and allow the child to lead the movement.
  4. Repetition is the key. Repetition is the key. Repetition is the key.  I don’t believe I need to expound upon this point further.

Rolling is a wonderful early milestone for your child. It is one of the first locomotor movements she may learn. If your child is not initiating rolling on her own by the age of 6 months, ask your pediatrician for a referral for a gross motor evaluation by a pediatric physical therapist.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!