Gross Motor Delay

Hi! Can I ask for activities for my client who still cannot crawl on all 4s at 1.6 y/o. She still cannot stand or walk but she can sit on the floor without support.

We do a lot of tummy time but she is still uncomfortable when put in this position. She attempts to crawl but she only uses one leg in crawling and the opposite leg is completely extended. I tried to facilitate alternating hip flexion motion and weight shifting activities. May I ask if I’m on the right track? No problem with muscle tone or there are no muscle tightness.

Thank you!

Any idea what’s causing the delay if there isn’t any tightness or weakness?

Is the baby able to maintain static quadruped? That’s probably where I would start-on the stability and making sure both sides of the body are developing equally. Lots of tall kneeling as well to strengthen the hips and core. And lots of crossing midline activities to build the right/left brain connections.

If baby can hold quadruped for a considerable amount of time as well as tall kneeling, I might have the baby try to push a diaper box to promote some knee walking and get both legs moving reciprocally and evenly. Perhaps isolating the extremities will help better determine what’s going on.

Does that sound like it may work for this baby?

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I had a little one who struggled with crawling and tummy time, we finally achieved creeping at 18 months and walking at 21/22. Some things we did that seemed to help….

side sitting
tall kneeling - at bench with UE support then at a mirror
transitions from sitting into quadruped
quadruped reaching - reaching with 1 UE for a toy
half kneeling at support surface
pull to stand through 1/2 kneel
modified quadruped - hands on uneven surfaces slightly raised, hands on Bosu ball
creeping up/down stairs - facilitated the movement for several sessions working on reciprocal pattern

Also if they are asymmetric there is likely some tightness/weakness… looking at static side sitting or if they always prefer to do tasks with one side can guide where you see that tightness.

Hope this helps :blush:

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The child still cannot maintain quadruped position but can maintain sitting on the floor without support. She inconsistently transitions from sitting to crawling. I did PROM to check if there is tightness but both legs can move to its full range. As for the weakness, probably there is weakness as the child prefers to put her weight on one side during tummy time.

Thank you for this! I will try to incorporate these activities in my treatment plan!

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