Feeling crushed by physio - she just wn't crawl

[Sleepstarved]

Our problems are pretty minor compared to most on here but I know some of you will understand.
DD is 15mo and has gross motor delay but no-one knows why.
Physio has said its a significant delay and her development is fragmented.
On paper she sounds ok, can roll, get up to sitting, sit unaided, get from sitting onto knees by pulling on furniture, commando crawl, cruise and walk holding two fingers.
Her problem is she can't crawl on all fours so can't really pull to standing. She also cannot stand unsupported although is getting there. She is incredibly cautious.
She is progressing but v slowly and physio says no point seeing her more than monthly.
Portage assessed her as borderline and is already talking about dropping her from weekly to fortnightly even though only seen her 3 times.
DD had some words, daddy, ca for cat, woof sometimes, spoon sometimes but that has all gone recently.
We have done everything we can think of to get her to crawl, she will go over cushions, legs ect but keeps sliding legs back so she is on belly. She has only recently restarted pushing up on straight arms (did I at 7mo but stopped).
At wits end. If only she'd get on to all fours the rest would soon follow.
Any ideas?

Sorry I know you're asking about crawling but if she's losing speech I'd pop her to your gp for a check up in general he may refer to a paed and will also check her ears at the same time

Thanks Chundle, she is already under a developmental paed so will mention it next week when we see her. One of DD's little friends did that too so wasn't too worried - I heard can happen at this age before word explosion at 18months.
Portage is waiting to hear her babble too, DD goes quiet around people assessing/making her do stuff until she knows them.

I agree re: losing words, I would see your GP. in terms of crawling my DD has physio and we were encouraged to hold her supported in the 4 point (hands and knees) crawling position for increasing lengths of time, distracting her with a toy to keep her there. She got it in the end and at 21 months is just starting to walk with a push along trolley. She is hypermobile though so we know why she is delayed with her gross motor skills. She also has global developmental delay and is 3 to 6 months behind her peers in all other areas, we don't know why that is, or if the diagnosis will be refined to something more specific in the future.

Ah that's good ages under a paed what does he make of her crawling? My dd wasn't a great crawler she preferred to knee walk as she didn't like the feeling of the carpet on her hands. At the child development centre we went to the staff there continually placed her in the all fours position and rocked her back and forth like that (put her legs between your ankles/legs so they don't move) my dd hated it but it got her used to the position. In the end my dd just got up and walked think she got sick of all the crawling stuff!
My dd lost a few words she had then didn't talk again for a while then dx with speech delay then suddenly about two months ago began to talk in very long sentences in the space of about two or three days

Don't lose hope! In our case DD crawled very suddenly at 15/16 months after having no mobility whatsoever. We got to the point where our physio said she probably was never going to crawl but just kept going with the 4 point position and one day she just got the gist of it.

It is great that she can cruise and is commando crawling and walking with support. Even if she doesn't crawl 'properly' at this stage and goes straight to walking it is something that can be introduced through therapy later to help build up muscles for fine motor skills etc.

You could try getting down with her and giving full physical support (she sounds anxious about falling) then moving rt arm, lt leg, lt arm, rt leg. Counting 1, 2 ,3 , 4 . To get a rhythm going. Crawling is good for development of all sorts of things so worth persevering but some children just are not keen, especially if they have weak arm and shoulders.

My first dd never crawled (or rolled - at all) and went straight to walking at about 15 months. She doesnt' have any Special needs - it's just the way it is sometimes with children. She didn't have many words and didn't smile till she was 16 weeks, she was never intrested in toys or reached for them.... she caught up and is a lovely bubbly girl now who gets readers awards from the headteacher :)

Best of luck with your dd's progress - it sounds like she will do it in her own time x

Chundle The paed does not seem that bothered although agrees she is delayed in her gross motor.
DD has been seen by a neuro paed at GOSH who said there was nothing wrong and keeps asking how far behind is she really?
Spring and Sneeze We will try putting her on all fours but so far she has moaned and collapsed, putting her face on the floor.
She did tolerate it for longer last night though with a good toy as distraction.
Physio has said not to push her when she gets upset as she will just stop cooperating (must get that from me, hate being told what to do!)
I am a bit frustrated at the physio TBH as she says she has never seen anything like DD and doesn't know what else to suggest.
September Thank you, that has given me hope, the longer this goes on the more I think it must mean that she has SN. We have had to coax her to do everything, from propping on hands in sitting, to getting up and down from sitting ect standing and 'walking' holding our hands is all she has actively wanted to do.
Must go nap time

My dd never crawled either, she was a bum shuffler though, eventually stood at eighteen months and walked and ran within a week.She has no SN did her A levels and is working in a clerical job whilst she considers uni.
My ds didn't walk until 19 months, I never mentioned it to GP tbh but I am a lax mother he was offered exceptional funding for Cambridge university so definitely no SN there either.

She sounds a bit delayed on the gross motor front but I wouldnt call it a significant delay from what you have described. You say she commando crawls over obstacles so sounds as if she has good core strength. As someone ^ said, she may have weakness in her shoulder girdle which makes crawling uncomfortable for her.
She certainly warrants being closely observed over the coming 6 months by Paedx etc especially with her speech. But I wouldnt start diagnosing SN either until the picture is a bit clearer.

insanity wow, your children sound super bright, hopefully my DD will end up the same.
I do wonder about the whole thing of intelligence and physicality and if they are linked.
We often want our kids to be 'ahead' and think that is a sign of being bright but maybe that is not the case with physical milestones.
porridge we are not sure where the weakness is, she will now bear weight on straight arms as she crawls over cushions. Physio says she is floppy and has a weak core.
She has never felt like other babies when you pick her up, most feel really solid and dense but she has always felt a bit skinnier and squidgier.
I know I have to wait and see but the not knowing is just killing me.
I guess that is a good thing though because if it were something really bad it might be more obvious.

They were just laidback contented children tbh.Once they did walk though they were very adept it was almost as if they had got it sussed before trying to walk instead of trial and error first. My two who walked earliest although not early by most standards 15 and 16 months both have autism so you can never tell I suppose.

Sleepstarved - my DD has physical difficulties but is very bright (her teachers words not just mine!). It can be frustrating because people could (and do) assume they are linked but in many cases they are not. She has had to overcome things in a different way and so her problem solving skills are amazing even at age 5.

The 'not knowing' how things will turn out is the hardest thing

my DD didn't pull up or weight bear until she was 20 months, and she walked at exactly 2, so it could well happen sooner than you think - don't go worrying she will never walk.

Sleep, I taught dd2 to crawl using the stairs. I would put my knees each side of her to stabilise her lower legs and be right up behind her so that she couldn't topple backwards. And I would alternately move each leg and arm in a crawling pattern up to the next step, supporting her chest/ abdomen with the my other hand to prevent face planting

This was at about 15mos iirc. I would make her do this about 4 or 5 times a day.

IMHO, the stairs provided an 'easier' intro to crawling (which sounds a bit mad, but bear with me) due to the gradient - no huge weight bearing on the arms etc, and easier for kids with low trunk tone. Dd2 was dx with developmental delay at the time and had been having physio and SLT since birth. (she has cerebral palsy)

Dd2 wasn't pulling to stand or anything at this point though.

The physio thought I was completely stark staring bonkers. Or Attila the hun's long lost daughter. But she did learn to crawl. I think the repetitive movement helped not only with muscle memory, but also with making neuro links.

I have, of course, no idea whether it will work for dd, but they do sound very similar.

Make sure you are doing lots of exercises on the gym ball, and on a physio wedge if you have one. Really important to work on her core stability and tone.

Dd2 is hugely bright and has an iq higher than her consultant. she still has cp. intelligence has v little to do with disability.

Not crawling can have follow on issues later with some retained reflexes and stuff, but if she just skips crawling and goes straight to walking, it isn't too much of an issue. If she does have low core tone and this is the reason for not crawling, it will be more complex and can have implications for fine motor and self help/ writing etc. so really important to focus on core now.

I'm with madwoman. My DS (who also has CP) can climb up and down stairs. He can't walk yet but stairs are easier for him. Worth a try perhaps? I would also take her swimming if you can, it's great for core strength and you hold on to her so weightbearing isn't an issue, but also fun.

Thanks madwoman I have tried the stairs but she gets upset even at the first one. She likes to be able to push back into sitting when she feels unsafe, even with me there, and she hasn't got room to do that on a stair.
Physio suggested trying on bigger foam ones at gym (DD does a 'class' once a week which is great for core and confidence).
I will keep trying her periodically.
there onthestair DD does a swimming class too. She has been going from three months and loves it.
CP was suggested at 7 months but been discounted by paeds x 2 and physio, she just doesn't display the symptoms apparently.
Her fine motor seem fine, she can feed herself single sugar puffs, blueberries ect. Portage said that was fine but I know what you mean about crawling being important.
I can't think why she won't do it when can commando over stuff so well. I just had her rolling over an inflatable barrel and 'walking' her hands out on floor and coming back again....

I used to put favourite toys on the next step up, or one of the flashy pound shop toys there to distract whinging.

Dd2 used to feel perfectly safe, as her body was pretty much completely touching mine the whole time, from the way I was supporting her - and tbh I ignored the upset stuff and tried to distract. Loads of tinies don't like physio, but sometimes it's a necessary evil. You could try with putting her favourite snack on the 'to reach to' step as well. Choc buttons? (or sugar puffs, lol)

The fine motor sounds v promising, anyway. Maybe she is just one of those kids who don't crawl. We knew dd2 was going to need a lot of help, so it was more important to do the Attila the Hun school of parenting thang. We were told she wouldn't be able to walk or talk, originally. It was bloody hard work, but she can do both, and tbh she doesn't remember the early physio at all. She's 8 now. We spent about five years doing the wheelbarrow thing, on and off, and she finally got rid of her walking frame at the end of yr r.

I should probably add - I was a lot harder on her than the paed or physio. They were quite content to just let her go at her own pace, but I could see that she could achieve more, with a bit more work, iykwim. I do see quite a lot of pessimism, and don't think parents should automatically accept a gloomy outlook for their child... That said, I don't think that applies in your case!

madwoman the physio has never mentioned doing gym ball exercises. I even asked her about it as I know a ball is recommended for adult core but she just shrugged and said we could give it a go.
The only time she has mentioned a gym ball is to get her to weight bear on her arms by rolling over it until her hands hit the ground.
And that was only when I pushed and pushed her about not weight bearing on straight arms and how could DD possibly crawl if she doesn't.
Physio was more concerned with getting her cruising.
Now physio says she is not impressed with her cruising (having been v impressed last time with it ) because she is not getting up there herself.
Feels like the goalposts keep moving.

Phaps ask paed re hypermobility as often hypermobile children are late crawlers, or never crawl, or bottom shuffle. My two children and I are hypermobile - your daughter sounds similar to my son who crawled at 18 mths, and walked at 24 mths with physio input, working on learning to roll, sit, sit to stand, kneel, stand, cruise, and walk. Orthotics boots really helped in giving support to stay standing and to take steps, and still give us all support when needed eg uneven ground. Hypermobile shoulders, elbows, wrists made it tricky to give enough strength to support ourselves in crawling. Www.hypermobility.org - good advice here. Maybe worth applying for DLA re the amount of time you spend doing physio. all your help with physio at home is very much worth the time and effort, and your physical strength. I was later with my milestones as I didn't have physio, and physio would have helped me learn how to walk properly.

Huh, weird physio. Get a gym ball. If she has any core weakness you really need to be working on that, whatever the physio says. We used to sit dd2 on it and steady her using thighs and pelvis, and then roll it gently so that she had to use her sitting balance and core to stay upright.

Do you do reaching exercises out of range in long sitting? Both sides? All around? Does she reach equally with both hands, or favour one hand for reaching and grasping? High/ low reaching? Rolling balls to and fro in long sitting? Play row row row the boat? (wheelbarrow stuff good too) lying down 'grand old duke of York', using a dollar store sparkly baton held in both hands? So you don't march but move the baton up and down - over head to the floor and down to legs, with straight arms if poss? Bent too? This will also give the shoulders a good stretch, and might give you clues if that's an issue.

Does she have any kneeling balance? you can do reaching exercises at the kneel as well as long sitting... She might be past the physio wedge stage, tbh.

Sometimes it's tricky - if there is no underlying problem and she's just not going to be a crawler, then you might be fine just waiting and seeing, but if there is the chance of something or other - particularly low tone or muscle tone difficulties, then really the earlier the intervention the better... And most of the physio type stuff can be made into fun games.

I would personally probably veer towards playing lots of physio type games - if only because she seems to have piqued the interest of a lot of professionals (kids don't end up with portage and seeing a GOSH neuro paed without some sort of reason... The thing with developmental delay is that kids do sometimes catch up - hence developmental 'delay', but sometimes the don't. And some kids only catch up because of the early intervention...). I do feel for the Paeds and therapists, as I do believe it is pretty much impossible to forecast which kid is which. So I would err on the side of caution and implement therapy, rather than taking the chance that it will all sort itself out.

And the sorts of games / physio I'm talking about are great fun to do with nt kids as well, and will do no harm if they are unnecessary. Both siblings used to do dd2's exercises, too (with the exception of the gym ball and the stairs lol) just because they wanted to - as they were fun. and big kids doing them meant dd2 was more likely to be compliant!

You say she pushes back into sitting from all fours, so I assumes she can do 'bunny position' with extended arms but minimal weight through them?

I have read up on normal infant physical development and when babies first move into taking weight through their arms their shoulders do something called 'winging' - looks like the scapula (shoulder blades) are poking out their upper backs. When this happens it means the shoulder girdle is not yet strong enough to comfortably take the weight. As development and strength build the winging stops. If you can find a way to see if this is occurring when dd weight bears on extended arms you will know that she is still at an early stage and this needs working on. If it does not occur there could be other causes, such as just not liking it!

Re sitting on the physio ball. We sing 'when I was 1 I ate a bun the day I went to sea, I jumped aboard a pirate shop and the captain said to me....we're going this way, that way, forwards and backwards over the deep blue sea etc (5 verses!). Obviously moving left right etc etc. it's always a fun game and brilliant for core strength.

Can't figure how to do smileys on iPad. . Did I find it???

Yea!

practically she has been checked for hypermobility as there is a bit in our family but the answer was 'a bit' but hard to tell at his age. Her hands and fingers are but ankles do not roll in or out when standing.
madwoman you are a mine of information! Physio not said about gym ball, no mention of long reaching (not now she can get up and down from sitting to lying, it was mostly to get her to prop and maybe go onto all fours) and never heard of doing Grand old Duke lying down but makes sense that would work.
The physio has been focused on teaching her to do what she can't, not strength building IUSWIM.
We have seen neuro paed cos I have some clout with medical profs through my job, it was a second opinion, not cos of suspicions on their part.
Stairs caused major trauma BTW so not ready for that yet, completely collapsed, then threw herself backwards -the works. No Atilla for me, phew.
Sneeze she can't really do a bunny position, it's more like she comes up onto knees and pushes one hip down at same time, but she can weight bear on arms over a cushion so will check her shoulders then - had not heard that so thanks!