Gross Motor Delay

[toobreathless]

Hi,

My DD is 7.5 months. My first child. We have been seen by Paeds since six weeks for failure to thrive. She has been diagnosed with CMP Allergy & is now gaining weight, albeit slowly. She remains small, 9th centile, 14 lb 12 at present.

At the last two appointments it has become apparent that her gross motor skills are delayed. She is not really rolling (has rolled once or twice front to back only), not sitting or crawling etc Her speech & language & fine motor skills are actually a bit ahead, at the level of an 9 month old approximately which is very positive.

Her Consultant, who is excellent has referred her for physio & is planning on reassessing in eight weeks.

I was wondering:

Is there is anything we can do to encourage her? We do 'tummy time' at present.

Are there any particular toys etc that might help her. She does not have walkers etc at present as I'm not sure they are a particularly good idea.

Are there any other services we would benefit from? What is portage, would this be good for us? We would be able to fund things ourselves if they might help.

Anything else we should be doing?

Thank you!

DD had gross motor difficulties and didn't sit until nearly 9 months (although over a year old when I finally took the cushion away!).

Tummy time will really help strengthen the muscles - is she ok in a Bumbo? We found short periods helped strengthen neck and upper body. We also did a lot of kneeling up - advised by physio as my DD has a weak trunk. Agree that walkers are generally not a good idea! Hopefully you'll get lots of useful, targeted exercises from physio..

Portage in our area depends on how many areas children are delayed in - if just motor issues you may not be offered it (as happened with my DD) - depends on local criteria?

Hi survivingsummer. Thanks for your post. We do have a Bumbo
(on loan) & she is fine in it though I worry about her posture so hadn't really been using it. Will try some short spells.

Can you explain kneeling up? Think I'm being a bit dense but struggling to visualise it.

Can I ask how your DD is now?

Floor time. Lots and lots and lots of floor time, DD used to have 4-5 hours on the floor every day, tummy time with a wedge or rolled up towel, books and rattly things in front of her to engage her. This will give her greater knowledge about her body, does she grab her feet and put them in her mouth? Does she clap? does she reach for objects?

Portage. Self refer. There is a portage website which should tell you if there is a group in your area, it's blocking brilliant but there is often a waiting list so the sooner you get on it the better.

Something else I have been told is that children are often walkers or talkers, DD had huge fine motor delays and still t some degree is speech delayed. But her physical control is good for a child brain damaged at birth and she crawled at 9.5 months and. Walked at 13.5 months. Badly admittedly and at 16 months she is still as doddery as they get but she is upright and bounces.

Doing a lot of cross body work can be great for increasing awareness, left hand to right foot or one arm up and one arm down, there is a song called open close them at yoga which I still do daily. When you get the number for physio badger them, and also if you are willing ring them and ask if they have an cancellations. We got ours at 17 weeks old and although they couldn't fit us in for regular sessions they gave us many ideas to keep going with at that initial session.

Also sitting on your lap on in you lap if you are cross legged helps them develop core stabilising skills while still having. The comfort of a soft landing

Hi toobreathless - literally get her into a kneeling position so legs under her body and either support her lightly or try to get her to self support for as long as possible. If you get lots of toys and things that will interest her she might be happier to stay there for longer!

DD is 4 now and still has some issues with her balance but doing really well considering! She walks and sort of runs and just a little unsteadier than her peers but she does have a brain injury which has made things a lot harder for her. Generally, low muscle tone (if this turns out to be the issue) improves by itself and children ultimately catch up with their peers!

Slow burner: hugely helpful thank you! She does put her feet in her mouth. She doesn't clap. She is able to pick things up, transfer between hands & almost has a pincer grip. Sorry to be a bit dense but what do you do with the wedge??

DD has a far bit of floor & tummy time but not 4-5 hours a day. I am going to aim at that! I will self refer to portage tomorrow.

Survivingsummer: glad to hear your DD is doing so well now.

Our problem is definately not low muscle tone our Consultant has said its normal & she appears very strong eg puts her feet flat on matat nappy changes & lifts her whole bottom off the mat then sways from side to side! The reason for her delay at present is a bit of a mystery.

If she's only 7.5 months, are you sure she counts as genuinely delayed in any gross motor skills????? I didn't think rolling was considered a milestone, as many children don't, and whilst 7.5 months is on the late end up being able to sit up, I wasn't under the impression it was that late. I knew quite a few utterly normal babies that didn't sit up until they were over 8 months old. As for crawling, plenty of normally developing babies don't do that until they are as old as a year... Isn't the mystery "delay" in the absence of any signs of low muscle tone (or hypermobility) probably more a case of your dd's consultant playing it incredibly safe because your dd is already in the system?

ps physio is absolutely fantastic. No amout of floor and tummy time did anything to help ds (who has a connective tissue disorder and an apparent inability to work gross motor things out for himself!). However, within a couple of weeks of physio, from the age of 15 months, ds1 could roll over and get himself to sitting (two things he hadn't achieved by himself and his parents certainly couldn't work out how to teach him!). He was also taught how to crawl. He was walking by 23 months, despite starting physio at 15 months unable to get from lying to sitting (could sit for a bit if put in that position from about 7.5-8 months), sitting to standing, unable to roll over, unable to crawl.... You are very lucky that you have been referred when your dd is so young.

ds was referred at 7 months, but was delayed in all areas, when a schedule of growing skills was done he was at the level of a 1 month old in most areas. He started sitting at a year, rolled last month (he is 17 months), Until he was a year old he showed little interest in toys and was either carried or just lay down. He has global developmental delay and issues with muscle tone and swallowing so gets a lot of input and lots of testing to try and find a reason for his delays and other issues. The physio we have been shown has been mostly based around positions for play, using my body to support his, and now a standing frame to encourage core strength. You can self refer for portage, but in most areas there is a long waiting list, we had to wait 5 or 6 months, and require quite a high level of support.

Your dd sounds like she is within normal range developmentally (I think as far as sitting goes 8 months is the normal range) and the fact that she will be getting physio is amazing!

Walkers aren't a good idea, our physio says they are very bad for hip development.

Most of the games we played at this age were lying on his back holding his feet and rolling him from side to side to encourage rolling - but your dd has shown the ability to roll and the fact she holds her feet is great.

As far as sitting goes we just had to support ds until he developed the strength and confidence to sit on his own.

Most of ds's therapy is based around play as this is the best way to encourage all areas really.

It really does sound as though your dd is doing great, and it is lovely that she has good speech and language. Good luck.

Physio was great for our DS - and I'm sure they will have lots of good ideas for you to do at home, which your DD will just think of as playing.
Good advice given above, and even silly things like putting a favourite toy just out of reach will help!

Also her weight is about the same as dd1's was when she was 8 months, she was 91st centile when born, fell to 50th and then hovered between 2nd and 9th centile until she was a year when she went up to the 25th, there were never any concerns about her weight although she was weaned early because she would hardly have any milk and screamed a lot when feeding!

I understand that your dd has a cmp allergy, but it does sound as though you have a very attentive consultant!

DS2 and DS3 have gross motor delays and hypotonia. DS2 has hypermobility as well. It was different for us as DS2 in particular was a lot more delayed than your DD at that age but we did some things that might help your DD as well. We used to put toys on the coffee table and hold him under his bum so he was standing. We put him on the floor and waved toys at him just out of his reach. We took him on the huge slide at soft play so he could experience what other toddlers his age could do. I looked really daft taking my 14lb 1 year old who looked about 3 months on a slide but he loved it. I did a lot of things like that and recently I took him round an adventure playground, carrying him over the bits he couldn't do because he wanted to do what the other children were doing.

Anything up to 9 months for sitting is completely normal. DS2 was sitting at 16 months and DS3 is 10 months and not sitting yet. It looks like you have an attentive consultant which is lovely in some ways because you are getting lots of support but I find it does make parents panic. DS3 was in the system and getting physio a lot quicker than DS2 because he had an older brother with similar issues and I have to remind myself that he isn't that bad really.

Ok, couldn't post again last night as my phone died but another trick to help rolling is to lie you little one on the floor and you kneel at her feet. Take her absolute favourite toy and place it at 45 degrees from her shoulder at about arms reach on her left side for example, encourage her to reach for it with the opposite arm, so her right arm, and as she does so lightly lift her right leg to bring her halfway and her own body weight should do the rest.

I have to say thought that I think your paed is erring on the side of caution, my niece is 7 months and not able to sit unsupported, roll or crawl and it not considered delayed at all. She is quite chatty though.

Thank you all for your very reassuring replies. I agree that our Paeds is probably just being cautious but we are happy that we are getting help early, in case she were to fall further behind.

We have been practising today. The kneeling went well. I have been putting her on the floor on her tummy, this is ok for about a minute then she gets bored of holding her head up & puts it down on the floor.

The fact that she holds her head up for that long, when on her tummy is great. Have you tried rolling up a towel (like a sausage roll) and putting it under her chest, then extending her arms out over it, like the 'bolster time' bit on this page? We also did a lot of ds lying on his tummy on my tummy, so he could see my face.

Just out of interest, has your ds had a Schedule of Growing Skills done by the hv or paed? Ds had one done when he was 7 months old, and has just had another one at 17 months. It might be interesting for you to see where your dd is at, developmentally. They look at all areas, gross and fine motor skills, speech and language, social and interactive. I would be surprised, from what you have said about your (lovely sounding!) dd, if she was behind at all.

Hazeyjane:

Thank you for your support, you (& all the other posters) have helped me feel so much better. Love your name (& the song) DD is actually Hazel Jane!

No we have not had a schedule of growing skills. I have been googling like mad but can't actually find one online.

When I said DD could hold her head off the floor for a minute I was exaggerating its more like 15 seconds in reality. We tried with a rolled up towel as you suggested & she was much more tolerant of this!

Hope your son is doing ok.