When I brought my third daughter, Josephine, to the pediatrician for her nine-month checkup, I reported that she had been sitting unassisted for nearly three months but that she was making no moves toward crawling. The doctor assured me that there was no cause for concern yet—babies all develop at different ages, and Josie’s muscle tone looked fine. Maybe she was just a late crawler. Some babies skip the crawling altogether and go right to walking. Perhaps, the doctor said, we had one of those babies!
And while I like and trust my pediatrician, I did not think we had one of those babies. My other daughters had crawled at almost exactly nine months, and for a few months before that they practiced getting themselves into crawling position, rocking back and forth on their knees, making concerted efforts to get at something out of their reach.
Josie wasn’t doing any of that. I had seen her roll a few times, but not very often, not very smoothly, and between you and me and the lamppost I think she was on a slight downhill when she did it. She wasn’t trying to pull herself up. She seemed, for lack of a better term, completely unmotivated. Or, to put it in a more positive light, she was content to sit and play with toys and watch what was going on around her. Happy, yes. Making all the requisite baby noises. Engaging with her sisters in an age-appropriate manner. But completely stationary.
A Mother’s Worry
“When do we worry?” I asked the doctor.
“If she gets to be a year and she’s not crawling or pulling up, then we might need some help,” she told me. Nine months turned to 10 and 10 to 11, and still nothing. I fretted. I researched. Despite my efforts not to, I felt embarrassed among friends whose younger babies were already sprinting, doing yoga, and walking the family dog. (“Really?” said the teenager at the gym daycare. “She’s 10 months old and can’t crawl?” I fumed through my workout.) My parental anxiety got the best of me and I blamed myself for dragging Josie around in her car seat while we kept up with her older sisters’ schedules. I asked my husband, for the forty-third time, if he was worried that our baby was a late crawler. (He said he wasn’t: “How many eight-year-olds do you know who don’t walk?” he asked.)
Eventually, I called the early intervention program in my state. They evaluated her, and determined that at nearly 12 months she was at about a seven-month level for gross motor skills; she qualified for services.
“Usually we look for crawling at eight to 10 months,” says Nancy Le Ray, a developmental specialist with the Thom Pentucket Area Early Intervention program based in West Newbury, Massachusetts, who worked with my daughter from March to October of 2008. There’s always a range,” she adds. “But a year is a definite marker.”
Le Ray began to work with Josie in our home once a week for an hour in March. When she came for our first session, I wasn’t sure if we would focus on crawling or walking. Part of me hoped we were going to skip the crawling part and that, in a few visits, Le Ray would somehow teach Josie how to walk, catching her up with her peers. But there was no doubt in Le Ray’s mind. We were going to do things right. This baby was going to crawl.
And so began my gross motor development education. Why was insisting on the crawling stage the right way to do things? “Walking is all the baby needs to be an adult,” says Le Ray. “But babies who don’t crawl have missed the whole piece of building upper body strength that comes from crawling.” Crawling allows babies to develop central core stability that’s important for activities later in life, from learning to write to playing sports—hockey, gymnastics—that require upper body strength. “Occupational therapists will say they can go into a roomful of kindergarteners and pick out which ones never crawled,” says Le Ray. That stability, she told me, moves from the central core through the shoulders and upper arms and into the lower arms and hands—from the center of the body out. In the beginning non-crawlers might have a little more trouble forming those first letters, but it’s also possible that later they’ll fatigue more easily than their peers when the little blue books come out at exam time. “If you miss that development you will see bits and pieces of it over the years,” says Le Ray.
In her work with Josie, Le Ray showed us how to help Josie feel comfortable and supported getting into a crawling position. She showed us how to encourage her to move toward an enticing object while we held her belly off the floor. We learned to turn her hips if she started to scoot forward on her bottom. Once she was ready to push herself into a standing position from a low stool or a lap, we worked on strengthening her leg muscles. We learned to toss her up in the air or “airplane” her through space so she’d feel comfortable when she wasn’t supported by the ground. By June, Josie had started crawling. By September she was walking holding onto our hands or onto furniture, and by October she was an official walker.
What Causes Motor Delay?
The first thing the early intervention team told me was that Josie’s motor delay was not my fault. I believed them (mostly) and I appreciate the level of reassurance they bring to their work, but the truth is that many babies today are crawling later than babies crawled a generation ago, and the way we care for our babies has something to do with that.
For one thing, the Back to Sleep campaign, which encourages caregivers to put babies to sleep on their backs to minimize risk for sudden infant death syndrome, or SIDS, means that babies are spending less time on their bellies, practicing the movements that lead to crawling. (Josie is a deep and committed sleeper, which is not something I’d like to change, but it did mean that she spent much of her infanthood lying motionless on her back, thumb in mouth.)
“And babies’ development overall is changing because of the equipment we have,” says Le Ray. Exersaucers, portable car seats, bouncy chairs: All these modern conveniences are wonderful in their own way—try grocery shopping with an infant in your arms—but they do mean that babies are spending more time being supported by equipment rather than developing muscles to support themselves. “We always say, ‘Carry the baby, don’t carry the carrier,'” says Le Ray. “As you’re holding the baby they’re engaging all those muscles.'”
In Josie’s case, it was most likely a combination of temperament and lifestyle that led to her gross motor delay. I’m sure I spent less time putting her on her belly and engaging her in games or conversation to keep her interested because I had less time to spend than I had with the other two. She definitely spent a lot of time being shuttled from here to there in her car seat. And when she was sitting, she was engaged enough with her surroundings that it didn’t frustrate her not to be moving. She didn’t squeak a lot, so she got very little oil. Which brings me to the good part.
Because of all the time she spent sitting and observing, Josie developed killer fine motor skills. When she did start walking (at the ripe old age of 19 months), she was developed enough in other areas to use her newfound mobility to explore with caution and curiosity rather than hurl herself down the stairs or into the fireplace. She understood—and could repeat—the words no, stop, and hot long before she needed to. Her language development and social skills tested above age level both at her initial early intervention assessment and at the assessment the early intervention team performed six months into the work. And, now that we’re through with her therapy, I can admit that a few extra months of not having to worry about a moving baby and two other children of preschool age was a bit of a blessing.
Preventing and Treating Gross Motor Delay
I’m grateful to the early intervention program in my state for their assistance and education. Here are some pointers distilled from my experience:
Use equipment judiciously. If you’re the parent of a young baby, think about the amount of time your child spends in bouncy chairs or car seats instead of in situations where she can begin to develop good core strength. Don’t be a nut about it, but take Baby out of the car seat when it’s practical and reasonable. And most occupational therapists would prefer if an Exersaucer never made it onto your wish list. “Babies shouldn’t be spending a lot of time in equipment that puts them in positions they’re not ready to be in,” says Le Ray.
If there’s really nothing to worry about, don’t worry. “There are a lot of different ways to be not crawling,” says Le Ray. “If a baby is on his belly pushing up and doing things toward crawling I would be less concerned.” If you observe progression in your baby’s activities, chances are things are right on track.
But if you are worried, look into it. “Any time you don’t see change week by week—if they seem stuck—then I would make that call,” says Le Ray. “Or if they’re developing patterns outside the norm [scooting on their bottoms, for example] you should call.” Early intervention services vary from state to state, but a little Googling will likely give you the information you need about your state, or your pediatrician’s office will be able to refer you to the right person. “Parents shouldn’t hesitate to call because they’re afraid of what they’re going to hear,” says Le Ray.
Part of what I liked about my early intervention experience is that it gave me a complete overview of Josie’s development. You may have gross motor concerns but come out reassured about the social or fine motor development. If there really is no problem, they’ll tell you that, and that assessment will mean a lot more coming from a team of experts than from your mother, your neighbor, or the well-meaning clerk at the grocery store.
If your baby didn’t crawl, don’t freak out—get down on the floor. Some babies, it’s true, do stand up and walk at a very young age, and you can’t exactly knock them down like a bowling pin. “But even if babies don’t need the crawling to get them walking they need it as a foundation for later,” says Le Ray. “There’s nothing wrong with a child who can walk doing crawling activities.” Play games that involve getting down on the floor. Create obstacle courses with low stools or giant pillows. Encourage siblings, if there are any, to play on the floor with the youngest child.
If older children who didn’t crawl start to exhibit signs of upper body or core weakness—trouble with writing, working with scissors, sports that require upper body strength—and you’re concerned, bring your concerns to the attention of the school, your doctor, or an outside occupational therapist. “Some schools will remediate with occupational therapy,” says Le Ray. “They’ll put children through ‘crawling exercises’ in the guise of sports games.”
The advice we most often receive as parents is not to lose sleep over things we can’t control. In many situations that’s true, and the fear of falling into the hyper-parenting trap means that parents of this generation are often torn between wanting the best for their child and wanting to retain a modicum of sanity in the most bewildering job there is. But in this case I’m glad I followed through. The six months of early intervention services Josie received helped her to develop the right muscles in the right order and put her on path toward sound physical development. And the minute Nancy showed up at our door and told me everything was going to be fine was the minute I stopped worrying.