A Therapists Guide to Fix the Developmental Delay of Baby Milestones

Posts Tagged ‘developmental milestones’

clubfoot in a childClubfoot can affect baby development and delay important developmental milestones.

Betsy Miller has written an informative book specifically for parents which explains clubfoot in easy to understand terms.  The book is quite in-depth and covers a wealth of information.  In it you will learn about clubfoot, the process of treating clubfoot -from initial diagnosis to ongoing at-home treatment – and even how to help your child cope with the diagnosis.  What I like about Betsy’s book is that she is extraordinarily thorough.  Knowing all current medical and treatment information removes the spectre of second-guessing.  Betsy talks about treatment for babies, treatment for older children, sleeping issues, coping with braces and more.  She also inserts individual success stories to make the book more personal.  This guide is a valuable tool for any parent who has a baby or child with clubfoot.

The following is a blurb based on Betsy’s book.


Clubfoot, also called talipes equinovarus (TEV) or congenital talipes equinovarus (CTEV), is a disorder that affects the foot and calf muscles.

The foot tilts sideways and turns inward, and the heel is up high. The foot stays in this position unless it is treated. With clubfoot, many small bones in the middle of the foot (tarsal bones) are in the wrong position. Clubfoot affects the tendons and ligaments in the foot and calf, as well as the calf muscle. Clubfoot can occur in both feet or in only one foot. In most cases, when clubfoot occurs, the reason is not known, though it does run in some families. Studies have reported the incidence of clubfoot as 1 in 800 or 1 in 1,000. It is more common in certain populations.

Clubfoot develops before a baby is born and can sometimes be seen in ultrasound during the mother’s pregnancy. A clubfoot … Read more

baby development exercise for milestonesIf I could offer one short statement which would provide the most help , it would be “trunk control is the key to good development”.

No matter what the underlying problem, if a child has good trunk control, other milestones are attained more easily. Handwriting is easier, walking is easier, dressing is easier, sitting at a desk is easier… everything is easier to learn when the trunk is stable.

Consider an analogy. Cook a noodle until it’s soft, and then try to stand it up. It will collapse in a pile. Even If you attached a strong base (like a plastic disc) to the noodle, it still will not stay up perpendicular to the surface. And so it’s the same with toddlers and children. It doesn’t matter if they have strong arms and legs. Without a strong core, the arms and legs can’t be controlled.

I am going to describe a wonderful exercise that you can do with your baby that will help strengthen her back very quickly.

It is quite easy to learn. This exercise can be performed with a 5 or 6 month old baby providing she has made progress through the early developmental milestones. She should be pivoting on the floor and able to keep her head off the surface. This is not good for babies who are medically compromised, have a feeding tube (NG tube) or who have spinal deformities or other back problems. It is intended for low tone infants who are basically in good health. I also want to caution parents if their baby has Down syndrome. Vertebrae can be unstable and this activity may not be appropriate. You can bring this post to your doctor and get medical clearance first. It is actually very good for babies with Down syndrome … Read more

baby development and learning to use a spoonGood child development is dependent on many factors. When a child meets her milestones and learns to be fully independent, she is able to interact with the world appropriately.

This should be the goal of all parents and educators. And with that in mind, it is vitally important to foster good self care skills in babies as soon as they start to demonstrate the necessary cognitive and physical skills.

Activities of daily living are referred to as ADL’s. These are the tasks we perform each day.

 Examples of ADL’s include feeding, toileting, dressing, bathing and grooming. Every child should learn to do these things independently. The groundwork for developing these skills starts as early as a few months. A baby is able to bring both hands to a bottle or breast by the time she is 4 months old.

Here is a list of expected skills and ages:

From 6 to 9 months

• Holds a bottle with both hands and uses a cup with assistance

• Tries to help with feeding

• Holds crackers or cookies and brings to mouth

• Plays with spoon

From 9 to 12 months

• Finger feeds soft foods

From 12 to 15 months

• Holds a cup using both hands and takes a few sips

• Puts spoon into food dish and attempts to get into mouth

From 15 to 18 months

• Drinks using a straw

• Uses spoon independently but still has some spillage

From 18 to 24 months

• Tries to feed herself without assistance

From 2 to 3 years

• Starts to use a fork by stabbing food

• Can use a spoon without spillage

By the time your child is 5, she should be able to feed herself independently.

If your baby or toddler isn’t meeting these … Read more

boy with good trunk controlI believe trunk control is the most important aspect of baby and child development. Without it, the ability to achieve milestones and the quality of developmental milestones is diminished.

 Short term, it can affect sitting independently, crawling and walking posture. Long term, it can impact handwriting, ability to sit and attend and contribute to poor coordination and poor precision movement.

This may sound like hyperbole, but it happens to be true. If you stop and think about how the body functions and how we manage to perform our activities of daily living, you will start to understand how important it is to stay erect from our hips to our neck. That section of the body is the trunk. Stability at the trunk allows us to use our hands for all kinds of activities. It allows us to stay in our seats without falling over. It keeps our body aligned during walking, running, jumping and skipping.

During the natural course of development, most babies acquire good trunk control because of weight bearing and anti-gravity movement.

Babies who have low tone, joint laxity, or other developmental problems are at risk for not developing good trunk control. Babies with Down syndrome, cerebral palsy, torticollis, Spina bifida and more benefit tremendously when therapy exercises are devoted to strengthening the trunk.

I have been getting quite a few emails lately from caregivers who are concerned that their baby is not crawling properly, or can’t sustain independent sitting. In response, I have described for them specific exercises which will help them achieve good trunk control.

Today I am going to describe one of these exercises. It is fairly easy to learn, but might take a few attempts to get the proper hand position and to keep the baby stabilized. This exercise can be … Read more

Baby and child development red flags

Tuesday, March 8, 2011@ 5:30 PM

Do you look at your baby and notice that she isn’t doing the same things as other babies her age?

 And are you afraid that something is wrong, but are afraid to give voice to your concerns? I can tell you that it is often difficult to predict which delays are significant and which ones will resolve when given time. I know firsthand as a mom that you don’t want to be an alarmist, and that you also don’t want to neglect something important. Making good decisions as a parent isn’t easy. That’s why I am going to describe some things that are potential red flags. These are the signals that might indicate the need for therapy or other intervention.

In previous articles, I have discussed reflexes and muscle tone issues.

Today I am going to expand on those and describe problems that can be easily observed. Please realize that if your baby presents with any of these problems, it does not mean that you need to rush out for an evaluation. But it does mean that it warrants your attention.

Gross and Fine Motor:

Muscles that are either too stiff or too floppy can be signs of an underlying problem. When muscles are too stiff, the baby moves awkwardly. As they get older, the stiffness interferes with the quality of their movement. Floppy tone is an issue when the baby has difficulties with head control, crawling and standing with good posture. Floppy (low tone) can interfere with all skills which require muscle control. Take note if your baby strongly favors movement on side over the other, or appears to be very clumsy. If your baby tends to keep her hands open and doesn’t fist her hands, it can indicate possible neuromuscular problems. Likewise, she should bend her knees and … Read more

erb's palsy and baby development delaysAside from torticollis, I think Erb’s palsy was one of the most frequently occurring diagnoses in my practice.

Statistics claim that more than 5000 babies are born each year with Erb’s palsy. It is typically a result of a difficult birth (dystocia) whereby the infant’s shoulder gets stuck during delivery. The problem can manifest with a very large baby or very small mom. The result is that the brachial plexus, which is a network of nerves, gets stretched and/or torn. The nerves of the brachial plexus stem from the neck and upper back and pass through the armpit to the arm. They are responsible for providing function to the muscles and sensation to the skin of the entire arm and upper back/shoulder. 

Depending on the severity of the injury, surgery may be required. If the nerves are torn and can be repaired surgically, the doctor may decide to operate prior to the baby getting therapy, or the doctor may wait and see how much progress is made with manual treatment. Some cases resolve themselves without residual problems within a year. In my experience, all cases of Erb’s palsy require occupational therapy, and usually physical therapy as well.

When a baby does not have full function in both arms, development is delayed.

 Because of the nerve injury, there is paralysis of some muscles. The baby can’t prop, push off the surface with both arms, crawl on all fours or pull to stand. I have explained in other posts how delayed physical development impacts learning. With Erb’s palsy, delayed gross and fine motor skills means that the baby isn’t playing with toys or moving around and exploring the environment. Consequently, all developmental progress is adversely affected. Even if the baby receives immediate surgery, recovery time causes development and milestone delays. … Read more

Amazing help for pregnant moms

Thursday, January 6, 2011@ 3:43 PM

Teext4baby mobile service for healthy baby developmentThe goal of occupational therapy is to preserve or restore function for optimal performance during activities of daily living.Pediatric O.T.’s focus is on helping babies reach their developmental milestones.

The best gift to an occupational therapist is patient discharge. Although pediatric O.T. s might lose work, an even better gift than discharge is the gift of babies born healthy.

Last February, Text4baby, a mobile phone based health initiative was launched. It was designed to help underserved pregnant women so that they could receive up-to-date health information to guide them through their pregnancy.

 The intention is to provide pertinent prenatal care on a regular basis in order to get mothers-to-be to eat well and help them to avoid drugs and alcohol, among other things. Hopefully, this guidance will result in healthier births and lower infant mortality rates.

Signing up is easy. All a pregnant woman needs to do is text the word BABY (BEBE for Spanish) to 511411. All registration requires is a zip code and a due date. Subsequently, she will receive three messages per week. The content will be specific to the baby’s gestational age (how many weeks pregnant). Messages may cover prenatal care topics, recommendations to keep medical appointments, and reminders regarding the importance of avoiding drugs, tobacco and alcohol. All aspects of maternal care, prenatal care and preparation for childbirth are discussed and texted at the relevant time. The service is one way, so it is not possible to text back. However, some messages include resource information and phone numbers to call to get additional help.

Once the mom gives birth and advises the service of the birth, succeeding messages will pertain to the care of the newborn.

The mom can continue getting messages for the baby’s first year. She can terminate the service at any … Read more

Baby development and milestones 0 to 3 months

Wednesday, January 5, 2011@ 5:08 PM

baby development and milestonesIt may not seem that much happens during the first stage of baby development other than crying, sleeping or eating, but quite a bit is actually going on.

A newborn starts developing new skills as soon as they start life outside the womb. The newborn organizes and regulates sensory information. She begins to problem solve and discover cause and effect. She learns spatial relationships, and begins to understand language. Motor skills which are governed by gravity begin to emerge.

Below is some specific information about baby development from birth until about three months.

 These are things to look for so that you can be sure your child is on target developmentally.

Sensory organization and self-regulation: She will respond to sounds and can listen to voices for a short time. She should contour her body to yours when held and cuddled (arching away is a potential problem). She should enjoy being touched as well. She should show an active interest in her surroundings, including people and objects. She should calm when she is held.

Awareness of sounds: She should respond to sounds such as voices and other noise and use her eyes to search for the origin of the sound.

Speech development: Initially her cry should be monotonous and one breath long. As she develops, she will make sounds to indicate comfort. Her cries will start to change in order to indicate her needs. She may cry louder or longer depending on the reason.

Motor development milestones: Head control will start to improve. Initially she will only hold her head resting to one side. By the age of two months, she should be able to lift her head off the surface briefly when she is placed on her tummy on the floor. By 3 months, she should be able to … Read more

Our physical senses play an important role in our lives – the sound of a baby’s laugh, the taste of chocolate on the tongue, the sight of a loved one’s smile, the caress of a gentle breeze.

 So I think it comes as a surprise that a child who has never experienced one of these senses would reject the opportunity if available.

Many years ago, I treated a little boy with Down syndrome who was born premature and without hearing. He was the firstborn of a young couple who were determined that he would be like any other child. Their ambition for him was astounding considering that not only was he deaf but with moderate to severe cognitive impairment. Physically he presented with profound low tone and joint hyper-mobility. The therapy team had quite a challenge.

Urged on by the parents, the therapists on his team were dedicated to helping this boy reach his developmental milestones as close to “on time” as possible. He learned to stand and walk and ride a tricycle. When he was about two, his mom took him to see a highly regarded speech therapist so that he could learn lip reading and sign language. Because of the hearing impairment, he did not speak. At about the same time, his mom explored the possibility of getting a cochlear implant. She was determined that he should speak and hear. Her argument was that he had enough of a challenge having Down syndrome, without having the added burden of deafness.

I remember clearly something this mom told me after she consulted with a specialist. The surgeon told her that deaf children do not always accept hearing.

The doctor told her a story about two sisters who were both deaf. Their parents chose to get the implants for … Read more

holding up head is hard for a big babyI was recently contacted by a mom who wanted to know how to get her baby to stay in the propped position. It seems that he could hold the prop position briefly, but very quickly his head dropped down to the floor. The mom’s observation was that he had a very big head. In fact, she said his head circumference was in the 98th percentile.

Believe it or not, a big head can cause big developmental delays.

Other potential delay causes include very big babies, cute fat babies and low tone babies. While none of these issues are considered to be a disorder, they can be very problematic to the developing baby. The goal is to have your baby accomplish her developmental milestones within the normal time frame. If you have read my other posts, then you understand that delays can mean that your baby does not realize her potential.

Here is the reason why the above problems can cause developmental delays. Everything we do relies on body mechanics and gravity.

In reality, it all boils down to physics. So when a baby’s head is very big, the weight of her head relative to her developmental progress is disproportionate. Her neck and other muscles cannot hold the head up against gravity. The same problem applies to heavy babies or very large babies. Their weight exceeds their developmental ability. If the child is low tone, then she doesn’t have sufficient strength to move up into gravity and skills don’t emerge on time. The problem snowballs because the older the baby gets, the bigger or heavier she gets as well. When the initial milestones are missed, the subsequent ones are harder and harder to achieve. Progress slows and eventually the baby is substantially delayed. Is there anything actually wrong with these … Read more