When we think about preparing children for school, we often focus on cognitive skills like reading readiness, attention span and the ability to follow instructions. But what many parents don’t realize is that the foundation for those skills is often laid much earlier—within the first year of life—through physical milestones like rolling and crawling.

As a pediatric physical therapist, I’ve worked with many school-aged children who struggle with things like sitting upright for long periods, handwriting, jumping and keeping up on the playground. More often than not, when we trace back their developmental history, we find that they skipped, or struggled through, some of those key early motor milestones.

The Role of Early Movement in Long-Term Development

Early movement is about much more than just mobility. It plays a foundational role in how a baby’s brain and body develop—building strength, coordination and body awareness, while also supporting sensory integration and visual development. Each milestone in the first year— tummy time, rolling, crawling and beyond—contributes to a child’s long-term growth.

For example, rolling isn’t just a transitional skill. It helps babies learn how to shift their weight, rotate through their core, and experience different head and body positions. These movements stimulate the vestibular system (which helps with balance), support muscle tone development and encourage crossing midline—important for riding a bike, participating in sports and reading and writing later on.

Crawling is a milestone often mistaken as optional, but it’s essential for both the brain and body. Crawling strengthens the shoulders, core and hips, integrates primitive reflexes and builds bilateral coordination. These are all critical for future tasks like climbing stairs, opening a water bottle, buttoning a shirt, swinging on monkey bars, holding a pencil, reading, writing and executive functioning.

When babies skip or rush through these early milestones, it can lead to subtle challenges later on such as poor posture, difficulty focusing or struggles with gross and fine motor skills. That’s why the first year is so important: It’s not just about when milestones happen, but how they happen—and whether they’re giving the brain and body what they need to grow.

Is ‘Wait and See’ the Right Approach?

When parents raise concerns that their baby isn’t keeping up with same-age peers, siblings or daycare friends, they’re often told to “wait and see” because “not all babies do things at the same time.” And while that’s absolutely true, it’s only part of the picture.

What really matters is whether a baby is showing steady progress toward the next stage. For example, crawling typically emerges between 7 and 10 months. So while some babies crawl at 7 months and others closer to 10, we should see signs in the months leading up to it that the body is preparing. These “mini milestones” include pushing up on straight arms during tummy time, pivoting in circles, tucking knees under the hips, and rocking on all fours.

If those signs aren’t developing and baby isn’t showing interest in movement or exploration, it’s a good time to get a professional opinion. We don’t want to simply wait until 10 months (or beyond) and hope things come together. Early support can prevent small challenges from becoming bigger issues later on.

What to Watch For

Trust your instincts if something feels off. Here are subtle signs that may warrant a physical therapy consultation:

Asymmetry: Favoring one side when reaching, rolling, or crawling.

Stalled progress: Limited ability to reach, rotate, or bear weight through arms or legs.

Low motivation: Content to stay still, showing lack of interest in moving toward toys.

Early Help Is Empowering—Not Alarming

Seeking support early on doesn’t mean something is wrong. In fact, it often means giving your baby the opportunity to move more freely, explore with confidence, and build a strong foundation for the future. Just like a school-age child might benefit from a tutor to support a learning gap, a baby may benefit from physical therapy to strengthen the building blocks of development.

Parents often worry about overreacting—but in my experience, the earlier we offer guidance, the more naturally and easily a baby’s development can get back on track.

You Know Your Baby Best

At the end of the day, if something feels off, trust your instincts. You don’t need to wait for a major delay or a formal diagnosis to reach out for help. Sometimes, just a few targeted exercises can make a meaningful difference.

Early development lays the foundation for everything that follows—academic readiness, motor coordination, independence and confidence. And while it might not look like much in the moment, those early movement milestones are doing far more than getting your baby from place to place. They’re helping to build the strong, capable body and mind that will carry them through childhood and beyond.

Dr. Allison Mell, PT, DPT, is a pediatric physical therapist and founder of Tots On Target. She supports families through her popular Instagram account, @totsontarget, and The Tot Spot—an online membership offering milestone courses, live Q&A Zoom calls, and ongoing guidance to help babies reach their milestones. Learn more at www.totsontarget.com.