Let’s Talk Dates

As a PT I have access to several sources that help me log your child's gross motor skills. We use some of these tools to help insurance companies decide if treatment is necessary. We use them to help us determine goals for therapy. We use these measurement tools to help explain what is going on to you, the parents.

First I want to assure you that none of these tools is meant to be taken as an exact science. They are guidelines with many things to be considered. The first is what is called adjusted gross age. This is your child's age if they were born prematurely or any time over 2 weeks before their due date. Full term pregnancy is 40 weeks. For example: If your child was born 4 weeks early/or at 36 weeks then they get an adjustment of 4 weeks subtracted from their age when I am determining what gross motor skills they should be doing. Math is not my best subject but there are websites with calculators that can help you determine adjusted age if your baby was premature. If your baby was born full term then their age is calculated based on their birthdate - business as usual.

Gross motor skills ideally develop in a certain order, but skills can develop in what I call a scattered pattern. This means that some skills are on time and others are not. Each skill develops over a certain period of time - not all at once on a child's monthly birthday. There are many many skills developing throughout the first 0-36 months. More than just rolling, sitting, crawling and walking. These skills take different amounts of time to emerge and perfect. Many things can affect skill development including torticollis, muscle tone, complications at birth, size, amount of practice/exposure to skills, amount of floor time, and so much more. PTs take these things into consideration when determining if there really is an issue.

So now lets get to the dates.

• 0-3 months - Baby is working on head control

• 2-6 months - Baby is working on rolling both directions

• 5-9 months - Baby is working on sitting and getting into sitting

• 6-10 months - Baby is working on getting into quadruped and pulling to stand at stable surfaces

• 9-11 months - Baby is working on crawling on all 4s

• 11-18 months - Baby is working on cruising and then walking

These are the most common skills but remember there are many other intermediate skills that are developing that help babies meet the above skills. Some examples are bearing weight on legs, pivoting in a circle on belly, exhibiting balance reactions, stands momentarily.

In my personal opinion there are some dates that I use to determine if treatment is necessary. Those are poor head control when being held or in prone at 2-4 months. If you feel your baby can't hold their head up its best to seek a PT evaluation. Baby will have significant difficulty progressing without head control.

If your baby is not showing any signs of rolling by 4 months you may need some assistance. 4 months is the age that babies start to roll over and can start sleeping on their belly. They also start developing arm strength through tummy time that helps them roll and begin to be more mobile.

If your baby is not transitioning from sit to prone or hands and knees by 7-8 months either because they can't sit or because they sit but don't move, it might be time to seek help. Transitional movements - ie. changing positions - are the beginnings of mobility. They are important in helping baby observe there environment. They require good trunk control/use .of abdominals. They also require your baby to use his vestibular system which is how we tolerate movement and find our balance.

If your baby is not crawling by `10-11 months... you guessed it - a PT eval may help. I've written an entire blog on the importance of crawling so I won't bore you again.

Lastly - if your baby is not close to walking by 15 months, please see a PT for help.

There are many places to check on when gross motor skills should be developing. Pathways.org is a great website to consult. Feel free to contact me if you are having difficulty determining if your baby is meeting all their skills. These websites are helpful but often without education in some of the more minor skills its hard to determine what the problem is and how to help. Pediatric PTs are here to help you through the first few years and demystify gross motor skills.