Our pediatrician referred us to physical therapy for our 9 month old daughters gross motor development. Our daughter is 9 months and 1 week and she has just begun army crawling. At her 9 month appointment last week she was only rolling to get where she wanted to go. So she has gained the secondary skill of using her arms and legs to go forward instead of sideways, to get to new places. The pediatrician was also concerned because she is not pulling herself to stand or cruising along the furniture when she is in a standing position. We have our eval appointment tomorrow and I’ll happily take any suggestions from the physical therapist. But, I am curious if this is premature of our pediatrician? This is our first child, and I stay home with her so her needs for mobility might be less, I suppose. But I do provide her ample floor and tummy time. Just curious on opinions about this. Has she missed her milestone or…?
Each milestone has a range, so even if most babies start crawling or pulling to stand between 8-9 months, others don’t begin till closer to 10 months**. When I evaluate babies, I try to look at overall development and see if baby is progressing steadily. If I see a steady progression, I am more comfortable with giving baby time to develop these skills through play and exploration on the floor.
Keep in mind that babies also need sufficient core and arm/leg strength to crawl on all fours and to pull to stand. If the evaluating PT feels your daughter lacks the strength to reach those milestones then you’ll have a better sense if this is really necessary.
Here are some of our Instagram posts that you might find helpful:
This is helpful for strengthening the core and balance reactions:
This post can help you see how to help your daughter get on all fours to practice quadruped crawling instead of commando crawling.
Hi! Pedi PT here—I actually think you have a great pediatrician! The old school way of thinking is to watch and wait but with the new research on the benefits of early intervention, the best approach is to be as proactive as possible. There’s a lot that happens between the 9 and 12 month appointments and I’m thankful the doc referred you just to be on the safe side! That being said, it sounds like your little one is progressing now but I would still recommend you get an evaluation knowing that the intervention period will likely be short! The hope is that the PT sessions place your babe in the normal range rather than at the tail end of each milestone! Hope that helps and hope you have a great PT who can give you some things to work on at home to keep baby moving and groovin!
Pedi PT and mom of 2!! From a PT perspective, I would evaluate her on a more holistic scale. Strength, trunk stability and control, integration of her primitive reflexes, balance between R and L sides while army crawling, ability to come to midline and cross with each side, obtaining sitting independently, then consider past developmental history. If she is on the tail end of development with each milestone and is just one that needs a little extra time, then time is what I would give her if all of the above mentioned checked out just fine. However, if there are delays and/ or limitations in other areas not just crawling then I do believe it would be worth at least an evaluation and consultation with PT to get suggestions on things you can work on with your daughter to help her progress.
From a mommy perspective, my oldest son (even having a Pedi PT as a mom) did not start crawling until 10 months without any other delays or limitations! I was on the verge of taking him to another PT to see if I was just being biased because he was my own and not wanting to see any problems or if he was just testing my patience. Now I know he was just testing me since that is kinda his personality!
The best advice is to ALWAYS trust your mommy instincts! Never doubt your ability to know when something isn’t right!
And the above responses are spot on! Milestones have a range for a reason, all kids are different and props to your pedi for being proactive! I hope others will jump on board with that thinking!
Hope this helped and please reach out if you have more questions, I would love to help!
Hi! I’m a pediPT and a mom if a new little one! Congrats on your little one developing the army crawling! I do agree with the movement mama that I think it’s great your pediatrician is being proactive rather than waiting to see. The PT eval will be great to see if there is any weakness that could be getting in the way and potentially give you some pointers for some purposeful play. I think it’s great you are providing ample floor time! All in all a PT evaluation will only provide you good information that can let you decide the best way to proceed based on your instincts! And keep encouraging the exploration with the army crawling! More exploration leads to more desire to move which promotes motor skill development! You’re doing a great job!
Hi there! Roulla here, pediatric PT and mom. I absolutely agree with the ladies above that your pediatrician is fabulous and very proactive in sending you for an evaluation. Gross motor milestone ages are in ranges because babies develop at different rates. As long as your little one is progressing through their milestones, don’t worry if it is at the end or beginning of that age expected range. Your PT will be able to better help determine if there is any weakness that you can work on and help improve so that your little one continues to achieve their milestones.
Thank you all, I felt much more informed going into her appointment today. She’s not crossing midline on her left sides, and she did a leg stiffening thing she does when frustrated that concerned her. Her body sits at the 21st percentile for height and weight but her head at the 97th. So, the physical therapist suggest that she has some adaptive skills due to her head size. She thinks a small dose of physical therapy will do her good. I appreciate all the information that I was able to digest before the appointment.
So glad this group was able to help prepare you and help you feel more comfortable about the evaluation!
Hi there! I’m a pediatric PT in NJ and a mom of 3! I think your pediatrician is being proactive, something we don’t see as often as we like!
Considering you don’t go back to the ped until 1 year, I think it’s a great idea!
Physical therapy for this age group is. Lot of fun, and it sounds like your baby will breeze through rapidly since baby has already shown signs of improvement. I would love to see your baby getting up onto all 4s and crawling which will really address any weaknesses and help them figure out the rest! Lastly I want to say that Therapy for kids shouldn’t be something you are afraid of, or have anxiety about- a good PT will give you lots of tips and fun things to do with your baby that will stay with you long past the therapy appointments. You’re a great mama, I can already tell! Good luck!! Xoxo
The physical therapist suggested that she didn’t easily cross the midline with her left side but easily crosses the midline with right and then passes to the left hand. I’ve done some looking up of the crossing the midline milestone. I am wondering if she should be passing the midline with both sides equally well, as if reflexive, at this point (9 months)? I’m really excited to work with her gross motor development and get all the tips and tricks I can get to get her making quick gains.
Ideally she should be crossing midline you both sides at this point. If she has created some strategies based on the above things you were mentioning that may be why she’s only doing it to one side but you want to see it to both sides. I’m glad your PT appointment went well and hopefully they will have lots of ideas for you to incorporate into play at home!