Ask the Experts: Infant motor skills

This week’s Ask the Experts topic covers the oft-pondered question on many a parent’s mind: Is something wrong if my infant does not develop motor skills at the same pace as other children? Here to address the issue is Daniel Weissbluth, MD—a pediatrician in Chicago and a co-creator of the Weissbluth Method Infant Nap App and the Weissbluth Method Toddler Bedtime App. He writes with his father, Marc Weissbluth, on their blog, Weissbluth Method and recently edited his newest eBook: “Six Sleep Problems and Solutions” available at all eBook stores.

Motor development delay is a common concern for both parents and pediatricians. Naturally, parents tend to compare their child to their other children or those of friends. Pediatricians observe the infant in the office and ask questions to screen for developmental delay. Of course, the earlier a problem is detected, the earlier the parents and pediatricians (and physical therapists, if necessary) can begin treatment. Many general pediatricians simply ask, “Does your child roll over?” and other similar questions. Parents often are concerned if their child is not meeting the milestones, but it is completely normal for a child to be behind or ahead of other children.
Parents do not always realize that there is a developmental range for acquisition of motor, language, and social-emotional skills. To understand this range, one only has to look at the Denver Developmental Screen (initially developed in the 1960s) to understand that developmental skills occur in defined windows of time. Although the test has been criticized for not being sensitive enough to less severe problems or specific deficits, the results list the percentages of children meeting each milestone at a particular age.
Not only do children develop motor skills at different rates, some even develop their skills in different sequences. Motor skills generally progress from the center of the body outward and from the head downward. For example, when learning to walk, most infants slowly transfer responsibility for movement from their arms to their legs. However, some children skip certain stages of crawling, or never crawl at all, before they learn to walk. This is completely normal.
The most important points to remember are to be patient with motor development, continue discussing your concerns with your pediatrician and get an evaluation if necessary. Don’t worry if your child seems to be developing slower than others or slower than you would like—mostly likely, he or she is right on target.
References: Frankenburg, William K.; Dobbs, J.B. (1967). “The Denver Developmental Screening Test”. The Journal of Pediatrics 71 (71): 181–191
Largo, R.H, Molinari, M. Weber, L.C Pinto and G. Duc. (1985). “Early Development of Locomotion: Significance of Prematurity, Cerebral Palsy, and Sex” Developmental Medicine and Child Neurology. 27, 183-19