The developmental impact of crawling WHAT IS CRAWLING

The developmental impact of crawling

WHAT IS CRAWLING? Motor milestones: § Quadruped: 7 months § Crawling/creeping: 7 -10 months Creeping vs. Crawling Creeping 9, 10

More than just a form of mobility! WHY IS CRAWLING IMPORTANT? 1. Balance 2. Strength 3. Vision 4. Body awareness 5. Mobility 6. Motor planning 7. Upper Extremity Development 8. Tongue/Jaw 3, 9, 10 lateralization

BALANCE Protective Extension Rocking, rotating, reaching Righting reactions Proprioception, vision, & vestibular system

BALANCE REACTIONS 3, 10

STRENGTHENING Role of reflexes Proximal strengthening Scapular strengthening Co-contraction of antigravity flexors and extensors

STRENGTH 3, 9, 10

VISION Binocular vision Depth perception Hand eye coordination Pic 1 Scanning the environment 1, 2, 3, 5

BODY AWARENESS Weight bearing through the joints Tactile awareness Pic 2 1, 2

MOTOR PLANNING Right and left hemispheres working together All four lobes of the brain Graded control Dissociation of movement 9, 10 Pic 3

MOBILITY Exploration Decision making Movement out of personal space 3, 7, 9, 10

UPPER EXTREMITIES Joint control: shoulder, elbow, forearm, hand Arches of hand Motoric separation Hand strength/tone Bilateral coordination § Reach and play with toy Pic 4 Pic 5 3, 9, 10

TONGUE AND JAW DISSOCIATION Dissociation of tongue and jaw for chewing and speech Hips and the jaw Speech generation during physical activity 5, 6, 8 Pic 6

WHAT HAPPENS IF THEY DON’T CRAWL? Maybe nothing Likely Something

EXAMPLE Mr. and Mrs. Smith are concerned about their 7 y. o. daughter’s difficulties with: § Handwriting § Unclear speech § General clumsiness—she runs into the walls, avoids participating in sports and often loses her balance. § Weakness “She’s just kind of awkward. ” Maybe she didn’t crawl!

DID ALL OF YOUR PATIENTS CRAWL AS INFANTS?

INTERVENTION IDEAS Reteach crawling Play games in quad Vision Flashlight tag Strength Wall push Scavenger ups hunt Card game in prone prop Ball push ups Flashlight tag Global Blue swing Balance Prone in net swing Proprioception Crashing Play games in frog prone/prone prop Leap Trampoline UE weight bearing/ Proprioception Prone in net swing Quad on trampoline Push ups (wall, ball) Playing in quad Retrieving game pieces in quad Speech Transitioning in and out of quad Stability ball work Scapular strengthening Visual game while: Quad on platform swing Lateral/forward reach on barrel swing Trampoline Hippotherapy Treatment on a swing Pelvic motion on a stability ball

REFERENCES 1. Characterizing crawling behaviors in 7 to 14 month-old typically developing infants and their relation to visual proprioception. Pediatric physical therapy. 2012; 24(1): 94. 2. Clearfield MW. The role of crawling and walking experience in infant spatial memory. J Exp Child Psychol. 2004; 89(3): 214 -241. doi: 10. 1016/j. jecp. 2004. 07. 003. 3. De Jager M. Understanding developmental milestone: Get moving. Natural Medicine. 2010(61): 29. 4. Dworkin-Mc. Daniel N. Tiny feet, big job. AM BABY (PRENATAL ED). 2007; 69(4): 24. 5. Mc. Ewan MH, Dihoff RE, Brosvic GM. Early infant crawling experience is reflected in later motor skill development. Percept Mot Skills. 1991; 72(1): 75 -79.

REFERENCES 6. Ozonoff S. Gross motor development, movement abnormalities, and early identification of autism. J Autism Dev Disord. 2008; 38(4): 644. 7. Porretto D. Go, baby, go! AM BABY (PRENATAL ED). 2003; 65(1): 47. : Crawling gives baby a taste of independence and a new view of the world. American baby. 2006; 68(12): 58. 8. Matson JL, Mahan S, Kozlowski AM, Shoemaker M. Developmental milestones in toddlers with autistic disorder, pervasive developmental disorder-not otherwise specified and atypical development. Dev Neurorehabil. 2010; 13(4): 239 -247. doi: 10. 3109/17518423. 2010. 481299. 9. Campbell SK, Palisano RJ, Orlin MN. Physical Therapy for Children, 4 t h Edition. Elsevier Saunders, St. Louis, 2012. 10. Ollendick K. Reflexes, reactions, and postural control: birth-1 year of age. Powerpoint Lecture presented in Bondurant Hall, UNC-Chapel Hill. January 2012

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