In a recent study published in Pediatrics this week, the American Academy of Pediatrics outlines specific recommendations for pediatricians on detecting and evaluating gross and fine motor delays in infants and toddlers. Gross motor development refers to your child’s larger muscle groups like their neck, trunk, and legs, and skills like sitting and walking. Fine motor development refers to your small muscle groups in your hands and fingers, and refers to your child’s hand-eye coordination and various hand strength and coordination like scribbling or puzzles. Earlier identification of delays in a child’s motor skills allows families to receive treatment and care for many delays that go unnoticed until the older toddler or preschool age years. There is a very wide range for what is typical in a young child’s motor development skills, and often developmental delays are not detected until much later. In a report from 2010, it was shown that pediatricians also varied widely in their confidence, ability and methods to detect motor delays in infants and toddlers.
Now, in your well child visits at 9, 18, 30 and 48 months old, pediatricians may ask you more questions about what motor milestones your child is working on, how they are moving and what concerns you may have. They may want to actually watch how your child is rolling over, crawling, walking, running or climbing stairs. Your child may be asked to hold a crayon or stack some blocks. Your pediatrician may have you fill out a longer questionnaire looking at your child’s overall development. They also may want to feel your child’s muscles and gauge if they have low muscle tone (loose and floppy) or high muscle tone (tight and rigid). If you or your doctor is worried about your child’s motor development or muscle tone, they may look at her expanded history, conduct some further tests and most importantly, refer your child to early intervention services for a more complete evaluation by a physical therapist and assessment team. In conclusion, the report outlines the importance of referring families to the early intervention program in their area, while at the same time pursuing any diagnostic tests that may provide information for why these delays may be happening.
For more information about the early intervention programs in your area and the initial evaluation process, please read this blog about common parent questions about the EI process.