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Your Baby’s First Year: Is It Developmental Delay?

As a parent or caregiver, you may be concerned if you notice that your child seems to be lagging behind the other children. During “mommy and me” classes, you may notice that your child sits in one place and isn’t moving around like the other children their age.

An HSS pediatric occupational therapist working with an infant.

Perhaps your child is not yet walking while other children the same age are already attempting to run. If you are concerned about your child’s development in relation to what children of the same age are doing, it may be worthwhile to make a visit to a pediatric therapist.

What is developmental delay?

A developmental delay is when a child has delays in gross motor skills, fine motor skills, language skills, cognition, or any combination of these. Children are expected to reach certain motor milestones by specific ages. Some children achieve skills quickly while other children take more time to achieve these skills.

What are the important baby milestones?

It is important to recognize that motor development is a continuous process and that many of these skills are achieved within a range and not necessarily at a discrete age. The following offers some key developmental milestones in relation to age in months during the first year of life:

  • Most children are able to lift and hold their heads up for brief periods of time while positioned on their tummies by two months of age.
  • By four months of age, most children can keep their head and shoulders up while propped on elbows and forearms when on their tummies. Also, around this time, babies are able to hold a small toy when placed in their hand. Babies begin rolling from their tummies to their backs around this time.
  • Most children are able to sit up without support by six months of age. Babies also begin rolling from their tummies to their backs around this time.
  • Around seven months of age, children begin to demonstrate more movement while on their tummies, pivoting in a circle. Babies also assume a hands and knees position around this time.
  • Most children begin crawling forward with their bellies in contact with the ground around eight months of age.
  • By nine months of age, children begin to pull up to a standing position by holding onto a nearby surface. Babies also begin crawling on hands and knees around this time.
  • Most children begin taking side steps or cruising in both directions with support around ten months of age.
  • By 11 months of change, children begin letting go of nearby surfaces while in standing for brief periods of time and also begin to take forward steps while someone holds their hands.
  • Many children begin walking without support around 12 months of age.

How can I help my baby’s development?

To encourage your child’s healthy development from birth to six months of age, our expert team of physical, occupational and speech therapists offer some helpful strategies:

  1. Provide many opportunities for your child to explore their environment. This can be achieved through floor time on a blanket or mat. A firm support surface provides important information to your baby as they learn how to move their bodies against gravity.
  2. Incorporate tummy time throughout the day. This position can be made easier by placing a small towel roll under your baby’s chest to assist them in lifting their head and shoulders. Tummy time is an essential ingredient for the development of future motor skills, such as standing and walking.
  3. Position your baby on their side during playtime. You can place a soft blanket roll at their back for support. This position encourages midline orientation of the arms and legs and can be used in addition to your baby lying on their back and tummy time. Around the age of three months, help your baby to bring their feet to their hands while positioned on their back. This movement encourages activity of the belly muscles and will prepare your baby for future activities, such as rolling.
  4. Around the age of three months, help your baby to bring their feet to their hands while positioned on their back. This movement encourages activity of the belly muscles and will prepare your baby for future activities, such as rolling.
  5. Encourage your baby to bring their hands to the middle of their bodies. Typical earlier movements of the arms and legs will appear more spontaneous while more coordinated movements of the limbs toward the midline will emerge around three to four months of age.
  6. At around the age of four months, you can begin to encourage rolling activities by placing a toy or a small mirror on each side of your baby, such that they reach to one side to get to the toy or to look in the mirror.
  7. Introduce toys which are soft and not too heavy, allowing your baby to manipulate the toys with their hands safely. You will soon realize that your baby explores many of their toys by placing them in their mouth. This is an important part of stimulating oral motor development.
  8. At around four to five months of age, you can begin to initiate sitting activities with your baby by providing support at their hips using your hands, legs, or a pillow. Placing toys and other objects of interest in more elevated locations will encourage a more upright position of your baby’s head and trunk.
  9. Even though your baby cannot talk just yet, communication is still happening. Interact with your baby through smiling, cooing, and vocal play.

What should I do if I think my child has developmental delay?

If you suspect that your child may have some developmental delays, the first step would be to discuss this with your pediatrician. Your pediatrician may refer you to a developmental pediatrician or pediatric neurologist to further evaluate the concerns you have regarding your child. Your doctor may then refer your child to therapy to address the delays and assist your child with achieving his or her motor milestones.

What does a pediatric therapist do?

Pediatric therapists work with the child and their family to help build needed skills. They have extensive knowledge on typical development and therefore, are experts in assessing babies and young children who may have some delays. There are three types of pediatric therapists:

  • Physical therapists (PTs) concentrate on gross motor skills or movement patterns involving large group muscles (such as crawling, running, jumping, etc.).
  • Occupational therapists (OTs) concentrate on fine motor skills, which involve smaller muscles (such as grasping, buttoning, handwriting, etc.). Additionally, OTs may address cognitive, visual-motor integration and visual perception impairments and delays.
  • Speech language pathologists focus on articulation, language, feeding, and oral-motor delays to enable infants to keep up with peers and interact/communicate with the world around them.


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