Developmental Milestones in Infants
This is the term used to describe the sequence of motor skills acquisition in each child as they learn to move their body against gravity. This is a very general reference and there is a wide age range within each milestone which is considered normal. Development is multifactorial and so does not always follow the same path. For example cultural differences can make a difference. In some countries it is not normal to leave babies on the floor to play which can lessen the likelihood of a baby rolling and crawling. In the long term this is unlikely to make any difference to the child’s ability to walk or run.
Variation in the sequence of acquisition of skills and a delay in the age that a baby acquires a motor skill does not necessarily imply that something is wrong.Below is a timeline for the main milestones a baby will acquire between 3 months and 18 months.
- Fidgety movements of neck, trunk, and limbs in all directions
- Established head control in sitting
- Good head lift when lying on tummy
- Bringing hands to midline
- Sitting with minimal support
- Directional control when reaching
- Rolling from front to back
- Rolling from back to front
- Sitting without support
- Standing with assistance
- Standing alone
- Walking with assistance
- Walking alone
Physiotherapists are experts in normal movement. If there is suspected abnormal movement or development, a baby can be assessed to see whether there is an underlying problem. Often it is a case of just reassuring the parents that there is nothing wrong. If there is considered to be developmental delay, milestones can be facilitated through specific activities and play. A program can be formulated for parents and caregivers to ensure that the baby is reaching his or her potential as far as good, normal, sequential movement. A child may need to be referred on for further investigation in some cases.
Torticollis is a condition which is found in babies usually up to 12 months, where their head is held to one side. As well, they are inclined not to turn their head to the opposite side. The problem is due to a shortening of the sternocleidomastoid muscle and is usually congenital, that is, present at birth. This muscle can feel tight and there may be a small lump present as well. Due to the head being held to one side and spending long periods of time on their back, the baby will often develop a flat spot on their head, termed positional plagiocephaly.
Physiotherapy for this condition involves some gentle stretching of the tight muscle and frequent positioning of the head to facilitate movement towards the opposite side. The mother can be shown how to achieve this with activities which promote the baby turning the head towards the desired side as well as some stretching. Such activities and stretches can be done frequently during the day as part of daily routine such as playtime, dressing, feeding and as part of their interaction with other family members. Tummy time should take place frequently during the day as it encourages normal use of neck muscles against gravity and takes pressure off the “flat spot”.
The problem can clear up within weeks when a suitable home programme is put in place.
knowledge … self-management … prevention