Remember! If your baby spent a long time in neonatal, has had repeat admissions and/or was born prematurely then it is expected that physical development may happen at baby’s own pace. Prematurely born children should have physical development judged by corrected age until their second birthday.

Baby has difficulty learning to sit independently.

Sensory explanation: there can be a few different sensory explanations for this, including a combination of these. In order to sit independently, the vestibular and proprioceptive must be working efficiently and processing information correctly. Sitting involves normalised muscle tone, as well as activation and firing of the proper trunk and pelvic muscles; all which involve proprioceptive feedback. Balance and fine tuning of the vestibular system are also needed for independent sitting.

Ideas to help:

  • A physio or occupational therapists evaluation may be needed if there are concerns over muscle tone. Your GP, HV or paediatrician can discuss referrals if you are not already under the care of one.
  • Using a nursing pillow for assisted sitting on a flat and firm surface.
  • Provide regular doses of movement throughout the day.
  • Try a weighted lap pad or blanket across the hips to give the lower limbs proprioceptive feedback when practising sitting.
  • Use an exercise ball for interactive play; this can help develop trunk and pelvic strength.
  • Limit the time in car seats and similar and encourage plenty of floor and tummy time.

Baby is very slow to achieve gross motor milestones (e.g. rolling, crawling, walking).
Sensory explanation: all gross motor skills require the brain and body to be communicating efficiently and effectively. Even if one sensory system is not processing at the same pace as the others it can mean there is a delay in achieving motor skills as essentially the brain can become scrambled with too many signals to sort out and achieve.

Ideas to achieve:

  • A physiotherapist or occupational therapist is recommended to assess for any more complex neurological or muscular causes.
  • Focus on frequent doses of vestibular, proprioceptive and tactile based play. Lots of swinging and movement based play are helpful.
  • Think of quantity vs quality. Don’t rush crawling if rolling and sitting skills have not been refined and developed properly. The brain and nervous system and have a reason for the development sequence of skills.

Baby prefers to “W” sit.
Sensory explanation: W-sitting is when one sits on the floor with either leg splayed out behind to form a “W” shape rather than both legs to the centre or one side. It is strongly discouraged as it can cause problems with hip and knee joints. It also does not involve crossing midline and trunk rotation, which are crucial for brain development. Often a baby W-sits when she is seeking proprioception to the lower body or has poor trunk tone/poor pelvic stability.

Ideas to help:

  • Encourage side sitting, lying on tummy or long leg sitting, depending on the stage of the motor development.
  • Try and break this habit as soon as possible. Manually move legs if the child cannot isolate/coordinate their own movements.
  • Encourage lots of floor time and tummy time play. Rolling, crawling and scooting will develop the tone and stability needed.
  • Offer frequent and daily vestibular activities which require some trunk control. Swings or exercise balls can offer lots of fun before the little one has even realised they may be doing some work as well!
  • When using cues to encourage the child to switch from the W-position into a better position, keep it fun and light rather than telling off.

Avoids crawling on all fours and prefers scooting on bottom.
Sensory explanation: there can be many factors in this, some sensory and some more generally developmental. From a sensory standpoint, there are many systems working. The change in head position must be tolerated well by the vestibular system. Also the visual system may not tolerate or process this different position in prone; the sensitive palms of the hands may also be averse to being used along the floor which might prove a startling texture. From the developmental point of view, bilateral coordination (both sides of the body), shoulder stability, upper and lower body weight shifting, normalised trunk tone, body awareness and more are all things to consider that may be stopping the child from achieving or perfectly the crawling motion.

Ideas to help:

  • It is absolutely fine not to crawl; although mastering this has many benefits for brain development and being able to achieve subsequent skills.
  • Begin with working in prone (on tummy) over a roll or therapy ball, to support the trunk and take some weight off the arms/shoulders and knees/hips. Make it fun with plenty of encouragement and modelling the desired skills yourself.
  • Encourage lots of weight bearing with arms.
  • Try and determine if there is intolerance to movement or poor muscle tone/stability. If so, it is worth mentioning to a health professional to assess or monitor.
  • Encourage commando crawling as a starting point.
  • Offers lots of bouncing and swinging opportunities, plus lots of chances to statically assume the 4-point kneeling position, even if you have to help your child get into this. If they can achieve this position and maintain it, try it in a range of environments on different surfaces (advanced homework: on a trampoline with direct supervision) and with the encouragement of a favourite toy.

Lastly, an important consideration to a reluctance to perform certain fine or gross motor skills may be a reaction to environment or the feel of something. If a baby or child is averse or overwhelmed by some touch sensations, they will be reluctant or anxious about interacting with something. This can apply to handling objects and also surfaces to move across or through. if the environment is overwhelming generally, setting off one or more sensory triggers, then the child may also “freeze” and feel unable to either move or communicate. If you suspect this may be the case, get your Sherlock hat on and see if you can find out which are the offensive triggers! Finally, as a very last point, all children are different and reach different points at different times. If your little one is naturally shy or anxious, he or she may prefer to make these first connections alone away from both loved ones or a wider crowd.

 

WEBSITE DISCLAIMER AND RELEASE OF LIABILITY
The information within this section is provided as a resource tool for general advice and recommendations regarding sensory integration and sensory processing development. Sensory enriched activities are beneficial for all children. This website is in no way intended to replace medical intervention or individual therapy. Please consult with your child’s paediatrician therapist for a customized program. The activities suggested on this website require direct supervision. The information on this website is attributed to Angie Voss, OTR.