Early Motor Development
The Occupational Therapist at Quickstepz Paediatric Therapy has extensive experience in working with babies and toddlers who have delays in developing their motor skills. Some babies are slower in reaching their milestones or they will perform these motor skills in an odd or awkward manner (for example, bottom shuffling instead of crawling). Some babies resist or have difficulty tolerating tummy time, or perhaps are not sitting by 8-9 months or standing by 12 months. This can be caused by a number of reasons. Once these are identified, parents are then coached in ways to support their babies’ motor development.
Many babies and toddlers with motor delays have low muscle tone. Muscle tone is the amount of tension (or resistance to movement) in muscles. Our muscle tone helps us to hold our bodies upright when we are sitting and standing. Changes in muscle tone are what enable us to move. Muscle tone also contributes to the control, speed and amount of movement we can achieve. Low muscle tone is used to describe muscles that are floppy, which is also known as hypotonia. Children with low muscle tone may need to put in more effort to get their muscles moving properly when they are doing an activity.
They may also have difficulty maintaining good posture when sitting or standing. Many children with low muscle tone have delays in their gross motor development (e.g. rolling, sitting, walking). If your baby/ toddler has low muscle tone, they may:
- seem limp when you lift them
- have increased flexibility in their joints
- have poor posture
- get tired easily (have low endurance) because of the extra effort they have to put in to activate their muscles or maintain their posture
- not have much strength in their muscles
- have delays in reaching gross motor milestones, such as rolling, sitting, crawling or walking.
Early intervention is intended for infants and toddlers who have developmental delays or are considered high risk due to prematurity, environmental (e.g extended NICU stay, or trauma) or biological factors (e.g hypotonia/hypertonia). Early intervention should start as soon as possible to obtain the best results for the child and family. Therapy is a play-based intervention in order to create a highly motivating learning scenario. The OT has highly developed hands on skills, combined with a big dash of fun, creativity and playfulness, to develop individualised therapy programs for each of the children. The therapist then collaborates with the child’s family, other health professionals and teachers or educators.
Being able to move well and engage in a range of movement activities allows babies and toddlers to explore their bodies and how they work, as well as their environment and all the things in their world – being able to move easily and successfully is essential for learning and growing.
Comprehensive play-based assessment is used to identify areas where a child needs to improve.
Therapy sessions then aim to:
- Improve muscle strength
- Achieve physical milestones
- Develop a more coordinated pattern of movement
- Develop motor planning skills
- Provide ideas for how to implement these strategies at home
Encouraging optimal early motor development is very important as it forms the foundations for later development. Symmetrical crawling on hands and knees is important to assist in developing a child’s pelvic, shoulder, trunk and wrist stability. Developing this stability is important for a child’s postural control, as well as the development of fine and gross motor skills. The opposite arm and leg motion used in the crawling action helps a child to integrate the brain hemispheres, thereby promoting better coordination of the two sides of their body and other skills.
Here are some general indicators that an infant may benefit from an OT evaluation:
- Easily startled
- Poor muscle tone: floppy or stiff
- Difficult to console, unusually fussy, suffers from colic.
- Had invasive medical procedures at birth or in early months (e.g. feeding tube, oxygen tube, surgeries)
- Slow to roll over, creep, sit or stand. Lack of rotation in movement
- Limited or no babbling
- Difficulty maintaining eye contact
- Frequent fisting of hands after six months
- Limited exploration of environment
- Dislikes baths, lotion, getting dressed and undressed, nappy changes
- Becomes tense when held, dislikes being cuddled.
- Takes an extended period to finish bottle/breastfeed or fatigues after a short period, needing frequent feedings
- Sleep difficulties
- Difficulty tolerating new food textures (from 6 months)
- Sensitive to bright light, noises, smells, and/or visual stimuli (cries, turns away, falls asleep)
- Needs to be held for extensive periods of time
- Plays alone for long periods of time without seeking out caregiver, not needing much external stimuli to keep them content
- Avoids lying on stomach, gets upset when placed on stomach
- Has difficulty conforming to your body when being held
