As part of our series on early intervention, we look at Motor Developmental Delay, also referred to as delay in a child’s movement and muscle coordination. Find out how you can detect this...
By Dr Arpan Kumar and Dr Pooja Sharma
In our series on developmental delays, we have previously looked at cognitive delay or delay in thinking and understanding. Here, we examine movement and muscle coordination in children. If you’ve been following our series, you’d know that a developmental delay is indicated when a child has not reached particular milestones within the expected time period. At the same time, we also need to consider that children don’t develop skills on a strict timetable.
For example, some babies start walking when they are just nine months old while others don’t take their first steps until 15 months. In both cases, the babies are still within the range of typical development. Plus, minor differences related to a child performing a skill aren't usually a cause for concern. A developmental delay is only when it is more than just being ‘slower to develop’ or ‘a little behind’. Such a delay is shown by a child who is lagging beyond the developmental range or is continually behind his peers.
In simple terms, motor development is the development of movement. The ability to move is essential to human development. Motor skills are necessary for everyday activities like sitting, walking, running, climbing stairs, picking up objects, using cups, knives and forks, pouring drinks, dressing, holding and using pencils, pens, scissors and using keyboards. Motor development is the evolution of motor changes across the lifespan.
Motor development can be divided into two parts:
Gross motor development: This involves the development of the large muscles in the child’s body. These muscles allow your child to roll, sit, crawl, stand, walk and run, and perform day-to-day activities.
Fine motor development: This involves the small muscles of the body, especially in the hand. These muscles allow your child to hold bottles, toothbrushes, crayons and pencils. They also help your child to manipulate toys, button shirts, eat food, etc.
Motor development also involves:
Did you know?
The typical development of a child’s motor skills usually follows a predictable order or sequence.
Take note when your child is continually behind in motor skills when compared to other children her age. For example, a baby who isn’t rolling over by four months may be just a little behind in that one skill. But if she is also not able to hold her head up and push up when lying on her tummy, she’s behind in more than one motor skill. That’s a sign of a developmental delay.
We cannot tell why exactly a developmental delay occurs. It could be due to:
A developmental delay can also be a symptom of other underlying medical conditions, including:
In each of these conditions, the severity of the problem may vary from one child to another.
All children develop at different rates and in slightly different ways. Differences in development may be related to personality, temperament, experiences or even, cultural aspects. Some children are born with special needs that can impact their health, growth and development. Other children may not show developmental deficits, delays, or differences, until later in their childhood.
It is important for a parent to know the early warning signs regarding motor skills so a child can get the necessary support and help early. Early intervention also helps parents understand the types of services and support that will meet the child’s needs. The sooner a concern is identified, the better. The child and the family can then receive individualised developmental support and guidance, specifically around building up the child’s motor skills.
Symptoms by age:
If there are concerns regarding your child's development, talk to your paediatrician to direct you to an appropriate therapist, who will first make an assessment. This is done to understand the child’s issues after which, you will be suggested appropriate therapy. In case of fine and gross motor development, a child will usually benefit from an assessment made by an occupational therapist (OT) and/or a physiotherapist (PT) specialising in paediatrics. Ideally, a child should start therapy as early as possible. This therapy will help a baby develop from a very early age, by placing her in beneficial positions and helping her to move.
For children with motor delay, both physiotherapists and occupational therapists have important roles to play. Together, they can help a child reach his potential. While there is some overlap in what these two fields offer, a coordinated programme that uses the knowledge and training of each professional, can help children with motor skill development and life skills. Both physiotherapists (PT) and occupational therapists (OT) have important roles to play
The first session with a therapist will be an assessment session. The general components of evaluation will include:
Note: Physiotherapists often work with children who have difficulty with mobility and stability from birth to age 3, but services can extend beyond this point, if needed.
Whilst all children develop skills at their own pace, you can assist your child’s development. It is important to understand from your child’s therapist how you can support your child at home. Here are some ways to do so:
Note: There is no need for expensive toys. The most interesting objects for a baby or toddler to play with are often just furniture and boxes to pull up on and stand, cushions to fall on, containers and a spoon to bang and make sounds. Give older children time outside where they can run and jump.
Your child’s development can be effectively improved with timely intervention and a supportive home environment. The key is to act early. Always keep track of your child’s developmental milestones and talk to your doctor about them during your routine visits.
We hope you found this article useful. You can look forward to more informative articles, as we plan to cover other areas of child developmental delays.
Dr Arpan Kumar is Director and Senior OT while Dr Pooja Sharma is an OT at OT4Kids, NEW DELHI
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