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In working with children of all ages, one key component is woven through the developmental process that can offer a good deal of information about the child's progression. Crawling. Arguably the most important developmental milestone, the act of crawling on all fours has a variety of benefits for the growing baby. If this skill is brief or skipped, it can lead to some predictable outcomes.

Let's first look at the act of crawling which typically occurs around 8 to 10 months old. When a baby is on all fours, she is getting weight bearing through her arms and legs. This physical property aids in the formation of the hip and shoulder joints in the manner of strength and structure. Weight bearing through the arms and legs also makes the bones stronger. For the hands, the arches are formed by the cupping motion on the floor and the intrinsic muscles are strengthened which later assists in fine motor skills like writing and manipulating small objects. The reciprocal motion of crawling- moving opposite arms and legs- forms connections in the brain which connects the left and right side of the body. This promotes overall coordination and balance, and is important later in learning reading, writing and math skills. Visually, the act of looking down and up while crawling develops near and far vision as well as peripheral vision. Crawling also aids in integrating reflexes. So as you can see, it is packed with benefits for a growing baby!

When a parent brings a toddler or school-age child to our clinic with concerns, one of the first things I ask is if he crawled and if so, for how long. Often the response I get is "he never crawled, just went straight to walking" or "he did crawl but very briefly" or "he scooted on his bottom instead of crawling on all fours." Certain childhood issues appear to be directly linked to not crawling on all fours during the developmental process. Some of the more frequent issues I see clinically coupled with a report of little to no crawling as a baby are: fine motor skills- manipulating buttons, snaps, tying shoes; handwriting- having messy, illegible handwriting, holding the pencil awkwardly- and showing significant hand fatigue in school; poor balance and coordination- tripping and falling often, not moving like other kids, difficulty keeping up with his peers, difficulty getting dressed; fidgeting in the classroom, can't sit still, on the go; toe walking; weak upper body strength and/or hip issues leading to walking with toes out as with bottom scooters. Babies who scoot on their bottom instead of crawling are also more likely to be delayed in learning to walk.

With the benefits of crawling so vast and the issues that arise from not crawling clinically significant, of all of the motor milestones to skip, please don't let your child skip this one! As a pediatric physical therapist, I would much rather a child crawl longer and be a bit later in walking than the reverse. "Should I knock her down and not let her walk if she starts to walk early?" (actual parent question). No need to do any knocking down, simply don't encourage early walking, rather promote crawling. It is not to say that every early walker or baby who crawled briefly will have issues but with the benefits of crawling so pronounced, it is definitely encouraged to give this milestone time to shine.

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