News Flash

By Tara Liddle and Catherine Andrasko

The CDC, along with the American Academy of Pediatrics, has updated its developmental milestones for the first time since 2004. 

Yes, the milestone guidelines needed an update!

As two pediatric specialists, we are glad to see changes. However, we are not happy with the omittance of certain developmental milestones. 

The CDC states changes have been made based on ‘societal changes’ and parents to “learn the signs and act early” rather than wait for delays. 

Prior guidelines were based on what 50% of children were expected to achieve by certain ages. The new guidelines are revised based on what 75% of children can be expected to accomplish by certain ages; this makes it more challenging to take a “wait and see” approach when a child is not achieving certain milestones. 

When babies have floor time to move, they will typically crawl. When they don’t, there is generally a reason. Some possible reasons a baby may not crawl are weakness or sensory issues. A parent may see compensations such as an asymmetrical crawl, belly crawling, or scooting on their buttocks. 

As therapists, we see more infants ‘skipping’ the crawling phase and moving directly to walking. One explanation may reflect how parents are playing with their babies. 

I recently conducted a small survey of 19 pediatricians, 68 physical therapists, and 33 parents. The main finding is that parents place their infants in exersauers or jumpers between the ages of 2-4 months, while pediatricians only begin discussing walker/exersauser use at the 5 to 7 months visit. By that time, infants are used to being upright. 

It is much easier to be upright in a supported device than working and using your muscles. 

So why is crawling so important?

Crawling builds strength, improves gross motor and fine motor skills, enhances range of motion of the hip joints, improves posture, spatial cognition, and object permanence. Crawling builds depth perception, brain activity, and bilateral coordination. It also enhances higher-level skills that will develop later. 

Yes, a baby will walk and talk without crawling, but there is a risk of weakness, spatial difficulties, and challenges with more advanced skills later in the developmental process. Occupational therapists and physical therapists continue to document seeing preschoolers who have not crawled. The children often present with messier handwriting, difficulties using utensils, decreased shoulder stability, weaker core strength, and challenges with more advanced milestones such as running, jumping, hopping, and ball throwing. 

So please, do not give up on the crawl, and crawl before you walk!

Crawl Baby Crawl!!!!