April 10, 2023

How to Spot a Gross Motor Delay in Your Child

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When a child fails to meet their developmental milestones when it comes to big muscle groups, it can be cause for concern and an indication that your child may have a gross motor delay. Most kids develop these skills through usual play, like climbing around on pillows or passing and eventually throwing a ball. Balancing, crossing the midline (like doing a grapevine), and being able to jump on one leg are all activities that incorporate gross motor skills. But simple skills like sitting up with good posture, rolling over both directions, and being able to stand up without falling over, are also using gross motor skills.

How do you know if your child has a gross motor delay?

Children develop at their own pace. Some kids who never crawl walk early and never have issues with their gross motor skills. Some kids roll over later than others and some children take their first steps at ten months old in the bathtub (ahem, my child).

While a newborn can only do jerky movements and turn their head, between three to six months, babies should:

  • Roll from tummy to back
  • Sit with support
  • Lift their head and chest while lying on their tummy

As they progress with their sitting and rolling, by one year they should:

  • Crawl
  • Sit unsupported
  • Pull to standing

By fifteen months, babies should begin to walk. Older kids have a bit more variation in their development, but some signs there may be a gross motor delay in kids are:

  • General weakness or low muscle tone
  • Poor balance or frequent falls
  • Difficulty throwing or catching a ball
  • Needing support to sit or having poor sitting posture
  • Difficulty with jumping, skipping, or hopping

There are different kinds of gross motor delay. One is a difficulty with bilateral coordination, using the two sides of the body at once in a coordinated manner, like riding a bike. Another is a lack of core strength or postural endurance, and another is in upper limb coordination, such as hitting a baseball.

“Always talk to your pediatrician with any concerns you may have with your child’s growth and development as their expertise with differential diagnosis is important,” says Caitlin Sanschagrin, an occupational therapist and co-founder and owner of Bright SpOT Pediatric Therapy. They can make sure nothing else is causing the delay and reassure you if the delay is no cause for concern. Many delays go away on their own or with some targeted practice, and some are associated with other conditions such as dyspraxia, a common developmental coordination disorder.

How to help your child manage a gross motor delay

If you suspect or your pediatrician thinks your child has a gross motor delay, Sanschagrin suggests seeking free occupational or physical therapy services through your state’s early intervention program or your kid’s school. “You are always welcome to seek an individual, private therapy evaluation from an occupational or physical therapist,” she says. Always consult your insurance before beginning an evaluation process. Some insurance plans cover some or all evaluations, while others don’t. Many insurances cover occupational or physical therapy, but some limit the number or visits you can have in a calendar year.

You can also work on skills at home. Sanschagrin says, “Using play is the most effective modality for learning and developing gross motor skills.” Keeping it fun and engaging for your child will make it feel like a game. She suggests, “Parents can encourage their children to engage in physical activities that are appropriate for their age and developmental level. This may include activities such as tummy time, crawling, walking, running, jumping, and climbing.”

You may choose to make adjustments to your home in order to accommodate your child’s needs. “Parents should create a safe and stimulating environment that encourages their child’s exploration and movement,” Sanschagrin says. “This may include providing toys and equipment that support gross motor development, such as balls, climbing structures, and push toys.” Many families, in reaction to the pandemic, outfitted their garages, backyards, or basements with climbing walls, bounce houses, or other kids’ gym equipment. For families without the space or interest in converting their home into a play gym, making more frequent visits to indoor or outdoor playgrounds may suit a child who needs gross motor development.

How to talk to school about a gross motor delay

A child with a gross motor delay may appear klutzy or unathletic and it may be a good idea to give teachers or other school personnel a heads up to help them head off bullying or other discrimination. “Explain the situation,” Sanschagrin says. “Provide factual information about the child’s gross motor delay, including any relevant medical diagnoses or evaluations. Be clear about how the gross motor delay affects the child’s daily life and what specific challenges they may face.”

From there, develop a plan to address your child’s needs. Depending on your child’s diagnosis and your state’s particular laws, they may qualify for an Individualized Education Program (IEP) or 504 plan. In this meeting or in an informal meeting with your school, Sanschagrin says to “talk about the specific accommodations or modifications that your child may need to succeed. For example, your child may require extra time to move from one activity to another or a different seating arrangement to better support their posture.”

She says not to forget to share your child’s strengths. “While it is essential to discuss your child’s gross motor delay, it is also essential to highlight their strengths and abilities. Share what your child enjoys and excels at to help the teacher, parent, or friend understand that gross motor delay is just one aspect of your child’s development.” Many trained educators will have great ideas to help your child. “Emphasize that you are open to their suggestions and input and appreciate their collaboration,” Sanschagrin says.

Other conditions

Many children who have other conditions have gross motor delays. Children born prematurely, who have genetic conditions such as Down’s syndrome, nerve conditions such as cerebral palsy, or developmental diagnoses such as autism have gross motor delays. Some children with hypothyroidism also have gross motor delays.

However, if your child does not have a previously known condition, there may not be a cause for concern. Sanschagrin says, “Correlation does not equal causation by any means. I have seen many children that simply need a boost in their gross motor skills even though they excel verbally or cognitively.” No matter the reason for your child’s gross motor delay, addressing it early and with targeted interventions will help set them up to feel confident in their bodies as they grow.

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