Friday, August 12, 2022

Parents, educators and physicians are concerned that more and more children seem to be requiring therapy than ever. While it may be difficult to determine statistically the number of children receiving therapy versus five or 10 years ago, it seems safe to say that it is more common for children to receive therapeutic intervention today than it was even 10 or 15 years ago. We believe that there are several different preventable factors that can contribute to children’s development.

About a month ago, an adorable little boy went for an occupational therapy evaluation. He is 4 years old and having difficulties with fine and gross motor development, as well as sitting for circle time in class. After a hands-on assessment and an extensive conversation with his mom it was quickly discovered that this little boy, let’s call him “Dave”, commando crawled low on his belly for several weeks before finally pushing up onto his hands and knees. Dave was able to crawl on all fours for a few weeks before awkwardly pulling himself up to stand. Commando crawling—and many other atypical forms of crawling—look adorable and can entertain adults, but  it can adversely affect development. Once walking, Dave’s gait pattern remained awkward, he was described as clumsy and unaware of his environment and he often fell backward without catching himself. He hardly ever sat to play.

This scenario plays out on a regular basis at our center as well as for developmental therapists across the country. While there are many theories on the reasons that may be affecting children’s sensorimotor development, one cause that seems to have had a significant affect on children’s development and is also one of the most controversial is crawling. Crawling on hands and knees is an important developmental milestone in that it helps to develop bilateral coordination, upper extremity strength and visual perceptual skills (both of which are contributors to successful prewriting skills), gross motor coordination, and so much more.

In 1994, the National Institute of Child Health and Human Development followed the American Academy of Pediatrics (AAP) recommendations and adopted the Back to Sleep Campaign to address the significant concerns of Sudden Infant Death Syndrome, also known as SIDS. This campaign was recently renamed “Safe to Sleep” and includes specific suggestions for parents including putting babies to sleep on their backs; removing stuffed animals, pillows, fluffy bumpers and quilts from cribs; and ceasing smoking around babies. Since the introduction of these guidelines, SIDS rates have declined by nearly 50% according to the National Institute of Health.

Any of us born before the 1990’s would have slept on our stomachs soundly and peacefully. The general timeframe for rolling over from our belly to our back would have been around 3-4 months of age and back to front shortly thereafter. Since babies were on their bellies most of the time, they were content in that position and happy enough to push up onto their hands to see the world and be a part of what was going on around them. The next logical stage was crawling so that babies could get from point A to point B.

Today’s newborn spends the majority of time on his/her back or is in a car seat, swing, bouncer, exersaucer or stroller. We are seeing more babies with flattened heads and delayed motor milestones. And, when unaddressed, this shows up in the quality of many other developmental milestones. So here are our recommendations:

For the safety of your newborn, she should definitely continue to sleep on her back.

Tummy Time means that your newborn should be playing, or lying, on his belly during much of waking time. Of course, your baby should be supervised in ANY position. This awake time on the belly should begin from birth so that your baby never has to adjust to being in this position.

Limit use of paraphernalia meaning, your baby should be playing on her stomach or back on the floor or crib rather than a swing, bouncer or car seat as much as possible. Do not use an exersaucer until your child is able to support herself.

Wait for your child to reach motor milestones, don’t make him crazy standing him up at 4 months on your lap or sitting him on the floor propped all around at 5 months. When his muscles are ready he will do these things himself.

Next issue,  we will discuss technology and its impact on childhood sensorimotor development.

Alyssa and Aviva operate Kids Therapy Place and  can be reached at: (201) 525-0050 or kidstplace_yahoo.com

By Alyssa Colton and Aviva Lipner

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