Monday, December 22, 2014

Skip Crawling? A TEAM PT offers a follow-up

credit: envato
Dear Melissa,
My 8-month-old baby girl is starting to pull up on furniture! I really think she is just going to skip crawling and move right on to walking!  

So, your baby is pulling up on furniture, but never really went through the crawling phase? My response to this question last week prompted some wonderful discussions with members of Children's Therapy TEAM's Physical Therapy Department. One of our veteran Physical Therapists, Christina Ruby, has shared a treasure trove of knowledge with me. Her advice is, "Do not panic!"

First, Christina set me straight on the definition of crawling: 
  • Crawling is when a baby is in locomotion with her tummy and legs on the ground while using her elbows and forearms to help push her body along. This is also commonly called “Army Crawling". 
  • Creeping is the formal term for when children are in locomotion with their hands and knees on the ground and their belly lifted off of the ground. 
Creeping is actually the movement pattern I am discussing here. From this point forward in this post, I will properly refer to the type of locomotion in question as “creeping”. Christina suggests that even if children appear to be skipping the creeping phase, they can still practice the skills gained from creeping. Parents can provide frequent opportunities for their child to pull up, get back down, move to another piece of furniture, then pull up there. All of this up and down from hands and knees (creeping position) to standing will provide practice with trunk strength and control. It also helps with coordinating the right and left sides of the body. And for my two cents, even if a child is pulling up, it is still not too late to practice creeping! 

As I noted last week, creeping helps with visual development, sensory input, strength and coordination of the entire arm, and later, handwriting skills (Skip crawling and walk...Is it a good idea?). These are all things that OT tends to focus on. But, creeping helps out with so much more! Christina has offered insight based on her expertise as a Pediatric PT.

Core Strength Development
When a baby creeps with her belly off of the ground, it forces her back and abdominal muscles to work together to provide a stable foundation for the arms and legs to move. This sets up the foundation for proper posture, trunk strength, and balance later in life.

Coordinate all four extremities in a reciprocal manner 
When creeping, each arm and each leg moves at it’s own pace in a coordinated manner.  This coordination of right and left sides of the body as well as the upper and lower halves of the body takes a lot of work! This ability to coordinate all four quadrants sets the child up for successful movement patterns as they age. 

Weight shift from right to left
As we walk, we shift our weight from the right foot to the left foot and back to the right.  Same with creeping: right, left, right, left. Creeping is an important developmental milestone needed for walking.

Coordinated hip/knee/ankle/foot movements 
It is almost impossible to walk with our hips, knees, and ankles in a fixed position. We need to move! Creeping provides that rhythmical coordination of the hip/knee/ankle/foot. Practice makes perfect! As a child practices typical creeping patterns, this sets her up for success for when she takes those coveted first steps.  

Trunk rotation 
As a baby creeps, she naturally creeps for a bit, then sits to rest and look around before taking off creeping again. Every time she transitions from the creeping position on her hands and knees, to sitting, and back to hands and knees, it involves trunk rotation. As she matures, this will allow the child to not only have better balance as she is walking, but also give her the ability to reach and move in all planes, not just in a straight forward and back motion. 


Who knew creeping could do all that? Wow! Thank you Christina for sharing.

As always, I would love to hear about your experiences. 
You can both share and submit questions to share@childrenstherapyteam.com

Resources
Six Reasons Why Crawling Is Important, Joanna Bounds, Kids Spot
Effects of Sleep Position on Infant Motor Development, Davis, Moon, Sachs, Ottolini, American Academy of Pediatrics (1998)
Crawling, an OT's Perspective, Melissa Foster, Children's Therapy TEAM Blog (2014)
Tummy Time for Babies, Melissa Foster, Children's Therapy TEAM Blog (2014)
Downs Syndrome, The Importance of Crawling on the Stomach, Robert Doman, Ellen Doman, National Association for Child Development Volume 22, Number 12 (2009)