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Motor Milestones

Why Are So Many Children Meeting Milestones Late?

Dr. Allison Mell, DPT
December 29, 2022
Why Are So Many Children Meeting Milestones Late?


Many babies these days are rolling, crawling, and walking, and jumping later than what the checklists and books tell us. What is going on? Is there something in the water? Is there a secret we are missing? Is this another consequence of the COVID-19 era on babies?

Why does it seem like the measuring stick is moving backwards and it’s taking longer to check off those developmental milestones that we’re expecting to see a bit earlier. And why are some milestones all of a sudden “disappearing” from medical guidelines? Why are teachers reporting that more and more kids are starting school without the foundational skills needed to hold pencils, cut out shapes, and sit properly? Are babies and little kids THAT different from how they used to be? Are we raising a new generation of developmentally “behind” children?

Some of you might be reading this and thinking, my child met all the milestones early! All my nieces and nephews met milestones early – you must be making this up or exaggerating just how many kids are developmentally behind.

While it is true that many babies and children are still following the typical progression of skills and starting of preschool with a BANG, it’s  many- but certainly not most. The range of normal has widened, the expectations have loosened, and instead of stopping to ask why or what should be changed, the medical community has been changing the standards to accommodate the shifts we are seeing.

Not sure if your child is meeting milestones within the typical time frames? Download my FREE Baby Milestone Checklist and/or my 1-6 Year Old Milestone Checklist.

SO WHAT HAS CHANGED?

It started with the Back to Sleep Campaign, launched in the mid 90s, which advocated for babies to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS). This very important change has decreased the number of SIDS deaths, which is incredible and a wonderful change because life is certainly the most important thing.

However, as with all good things, there are some drawbacks. Because babies are now spending much more time on their backs (they do sleep a hell of a lot!), they are not getting as much belly down time (tummy time) as they once were when the standard practice was to place babies on their tummies for sleep. How does this affect our babies, you ask?

  • Strength– Tummy down positioning helps build strong back, neck, shoulder, arm, and hand muscles. Babies now get a fraction of the time to build up strength and endurance for these body parts, which could affect their progression towards milestones reliant on that strength.
  • Body Awareness– In prone (tummy down), babies have full contact with the surface below them, giving them lots of proprioceptive input to help them learn where their bodies are in space. When on his back, baby’s face, hands, arms, and toes are not getting that same input. In order to reach their milestones, babies need lots of proprioceptive input to help their brains learn where each body part is. This, again, is part of the foundational process needed to reach first year milestones and beyond.

Today, we are also seeing Baby Product Overuse– The baby item market is now filled with car seats that become strollers, strollers that become car seats, portable swings, stationary swings, bouncy seats that rotate baby, and all types of loungers. Babies are spending more time than ever in some sort of “container”, allowing for much less opportunity to stretch and move to learn new motor patterns and integrate primitive reflexes.

Another big change with this generation is Screen Time. I get it-my kids watch tons of screens too (so do I-I run an Instagram account!), but it is affecting the skills they are building. Even educational apps don’t encourage manual dexterity, hand strengthening, and hand-eye coordination like Mancala, Othello, and Checkers. Sitting and coloring on a screen with a finger is not the same qualitatively as coloring with a crayon. Gross motor skills are certainly lacking as kids are spending a lot less time running, climbing, and swinging- avatars have taken over those jobs. The pull of screens gets us all, and our children’s development is suffering from the repercussions of it too.

So now what? What are you supposed to do if your baby is not crawling by 10 months, or walking by 16 months or writing with a mature pencil grasp by kindergarten?How do you help your child who is struggling with the gross and fine motor skills necessary to enter into the school years?

I’VE GOT YOU! IT’S NEVER TOO LATE TO WORK ON MISSED OR LATE SKILLS.

Babies: Prioritize tons and tons of open play floor time because playing in ALL positions is necessary to develop the foundational strength, vestibular and proprioceptive systems needed for all future milestones. Babies need lots of tummy time, back play, and sidelying play to build up all their muscle groups.  

Toddlers: Offer lots of opportunities to play outside in nature, set up obstacle courses, head to the playground, or throw some couch cushions all over your floor for your toddler to run across. Playing on uneven surfaces and challenging their bodies to move in all different ways will help them continue to progress in their gross motor, fine motor, and sensory development.

Preschool/kindergarten: Most of us can’t eliminate screens- and screens can be so good! But as we started this off, with all good comes another side that might be, well not so good. Try to set aside 10-15 minutes every other day designated for fine motor activities like color-by-numbers with broken crayons, board games, cutting shapes, and beading necklaces. On the alternate days of the week, use this time slot for gross motor activities like yoga, playing tag, kicking or throwing balls, animal walking, and obstacle courses. It may just look like play, but these activities are serious workouts and will help build the strength and coordination needed for those important school-based skills.

I know that childhood development can be a stressful topic at times. Are my kids meeting milestones, am I doing all that I can to help them? Where should they be at each age? These are questions we all have asked, which is why I created the Tots on Target Membership. This membership was launched for parents who want reliable information and to ask their questions to a professional they trust (that's me!). Inside the membership, you will also have access to a ton of resources like a rolling and crawling course, activities for kids birth to 6, my Strengthening Through Play course, printable worksheets to advance fine motor skills, and weekly group zoom calls with me! This is truly a place that encompasses all things child development.

Dr. Allison Mell is the founder of Tots on Target and a physical therapist based out of New Jersey.

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