Is Your Child A Late Bloomer?

By Magdalena Oledzka, PT

His sister was crawling by this age—why isn’t he?

We get questions like this all the time. We all need to remember that every child is unique, and they have their own internal timeline for development and achieving milestones. Keep in mind that these same differences exist among siblings.  While some children crawl by eight months, others don’t get going until 10 or 11 months. Still others never crawl and they go straight to walking. If your child is not crawling by 11 months, it would be a good idea to ask your pediatrician about what you’re noticing. There might be some weakness that is preventing the child from crawling.

When should my child be able to wave?

Waving typically happens between eight to 11 months of age. It is a good indicator of cognitive skill, since it is a form of social interaction. Parents will notice precursors to waving, such as the baby smiling in recognition when they walk into a room. If the baby does not make direct eye contact, or isn’t playing with age-appropriate toys, (at eight months they should be interested in “cause and effect” toys, in which an action by the baby, such as pushing a button, prompts a reaction in the toy) then the child should be evaluated by a pediatrician.

What is the normal timeline for a baby to start sitting up?

Between five and six months of age, babies will do what we call “tripod sitting,” where they use their hands placed on the floor in front of them for balance. At six months, they should be able to use their hands for play while sitting, as long as they are placed in that position. Babies should be able to sit by themselves by eight to nine months.

My baby was premature. Will he/she still hit the same development milestones as a baby that was brought to term?

There are more premature babies out there than one would think, and this is often the cause behind delayed development. We consider preemies to be babies born before 37 weeks gestational age. In this case, we adjust their age based on how early they were born. If they spend time in neonatal intensive care, they’re going to develop more slowly compared to their peers. Usually preemies will need extra time to catch up—until about two years of age.

What are some of the other physical development milestones that we hit later on in life?

By two to three years of age, children can usually jump, run, and climb stairs without holding a rail. As they get older, they are able to skip, kick a moving ball, and jump over hurdles. If your child is between ages three and four years and he isn’t able to jump forward on both feet, walk backwards easily, walk upstairs alternating feet with no use of handrail, or jump down from a 12 inch high chair or a stool, they should be evaluated by a physical therapist. In this situation, a physical therapist would evaluate your child’s muscle strength and range of motion and assess their functional abilities and areas of difficulty using a standardized assessment test.

What do occupational therapists typically treat?

Pediatric occupational therapists work with children of all ages. They work with babies and toddlers who have difficulty with age-appropriate fine motor skills such as grasping a rattle, playing with cause-and-effect toys, and building a tower from blocks. They also work with preschoolers and school-aged children on skills needed at school such as tracing shapes, drawing, writing, or cutting with scissors. They help children overcome hurdles at school by working on improving attention span and other skills that are needed in an academic environment. Occupational therapists help children learn fine motor skills needed for daily activities such as feeding, dressing and grooming; for example, they will work on holding utensils to eat, buttoning a shirt or jacket, tying shoe laces, washing hands and brushing teeth. Occupational therapists also work on sensory motor integration and sensory processing issues to help children who are having difficulty organizing and interpreting sensory input.

About The Author:

Magdalena Oledzka, PT, MBA, PCS is a pediatric physical therapist and pediatric rehabilitation section manager at the CA Technologies Rehabilitation Center at Hospital for Special Surgery in New York.