"Any concerns today?" I ask the father, warming up my stethoscope so my young patient Matthew isn't startled by the cold metal.
"No," Dad tells me, sliding a fleece off his son. "He's been pretty healthy. The only thing is, he's not showing too much interest in pulling himself up. He's 13 months old and still likes scooting around on his butt! I mean, I didn't start walking until later either, but his mom is worried."
One year marks the age when most parents of children who are not yet walking begin to worry. Kids with appropriate gross motor development can actually be later walkers. "Not all children walk in the first year," says Penny Glass, Ph.D., a developmental psychologist and director of the Child Development Program in the Division of Behavioral Medicine, Department of Psychiatry & Behavioral Sciences at Children's National Medical Center in Washington, D.C. "Most children walk or are trying to by 15 months, but 18 months can still be considered the upper limit of normal."
How can a parent differentiate between a late walker and a child with a gross motor delay? Dr. Glass says it is important to consider the infant's personality, strength, overall muscle tone, and interest. "If a child is not showing interest in motor activities, she may be having trouble with motor skills." In other words, a child who even attempts to pull up to a stand and try to walk is less likely to have a delay.
Look at overall muscle tone and quality of movement, Dr. Glass adds. Signs of gross motor delays will show up during infancy. In general, children should have good head control by about 4 months of age and remain upright when placed in a sitting position by about 7 or 8 months. Most babies start some form of crawling by 9 months. If children are meeting these milestones but are late to start walking, this is less concerning, Dr. Glass says.
It's also important to factor in your baby's personality or temperament. Some babies are curious watchers; others are more active, exploring their environment physically. Babies who have advanced social and engaging skills may be later walkers because they're more interested in watching the world around them and are more cautious in the realm of motor development.
What can parents do? "You can encourage walking skills by sitting down on the floor and letting your baby try to pull herself up to stand encircled by your arms for safety," Dr. Glass says. This is an opportunity for him to first practice holding on while standing to gain the balance needed to stand without support and later walk. Your admiration is a reward in itself for your child."
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