Motor development delay

What is Motor Delay in children?

We speak of motor delay when a child acquires normal developmental milestones later than their peers of the same age.

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All children do not develop at the same rate. However, there are expected average ages for specific developmental milestones.

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Why is it important to treat Motor Delay in children?

• The first 12 months of a child's life: Acquiring the foundation for all future movements
• Crucial for the rest of their life, continuing into adulthood
• Motor development at 12 months has been shown to predict overall development at 4 years and older.
• In adulthood: it influences health and social participation (healthy lifestyle habits, self-esteem, avoiding chronic diseases, education, employment, etc.).

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What are the causes of motor delays?

This is a common condition with several possible causes.

• Contextual (most common): The child finds it difficult to lie on their stomach to play and spends a lot of time in static positions (swing, seat, car seat). Family or environmental conditions do not allow the child much free play on the floor.
• Musculoskeletal condition: (e.g., torticollis, clavicle fracture, hip dysplasia, etc.) limiting the child's normal play.
• Neurological condition: (use of suction cup, forceps, etc.) Low or high muscle tone due to damage to the child's neurological system.
• Other: (rare) global developmental delay, genetic conditions, pervasive developmental disorder.

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How to recognize a motor delay?

You can recognize a motor delay by observing your infant play.

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• At 2 months: Can they briefly lift their head when on their stomach? Can they turn their head to both sides? Do they turn their head in response to sounds they hear?
• At 4 months: Can they lift their head and chest, supported by their forearms, when lying on their stomach? Can they bring both hands together to touch objects at chest level when on their back? Can they keep their head stable when pulled to a sitting position?
• At 6 months: Have they started to roll from their back to their stomach? Can they pivot to the left and right when on their stomach? Are they trying to move on their stomach?
• Between 7 and 9 months: Can they alternate between sitting and lying on their stomach alone? Can they maintain a sitting position? Do they crawl on their stomach or on all fours?
• Between 10 and 12 months: Do they move on all fours? Do they change positions easily (sitting, all fours, standing while holding onto furniture)? Do they walk sideways while holding onto furniture (e.g., along the edge of the sofa)?

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If you do not observe these steps in your child, it could be a motor delay. Your physiotherapist can help you refine the assessment objectively.

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It is also possible that your child has atypical development. If you observe the following signs:

• Asymmetry: moves one side of their body more, makes certain movements to one side only.
• Very limp child, cannot hold their head and trunk when picked up, even after 3 months.
• Extended position, legs and back very stiff and hard to bend at all times.

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During the physiotherapy consultation, your physiotherapist will be able to assess and detect the serious causes of atypical development and will refer you to your doctor if further investigations are necessary.

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How is a motor delay diagnosed?

The diagnosis is made based on the child's birth history and observation of their spontaneous movements and postures. The observed postures are then compared to the expected norms for the age. We start talking about motor delay when the child is below the 25th percentile for their age group. We also assess their neurological and musculoskeletal systems, as well as their socio-emotional development.

Your doctor may recommend certain tests if the delay is significant.

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When should you consult a physiotherapist for a motor delay?

You should consult a physiotherapist AS SOON AS you notice the signs described above. The earlier your child receives care, the faster and more effective the intervention will be.

You do not need a prescription from your doctor or nurse to consult a physiotherapist.

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What physiotherapy treatments are available for a motor delay?

Your physiotherapist will conduct an assessment to determine:

• Lifestyle and positioning habits
• The presence or absence of weakness, tone disorders, associated torticollis, or any other pathology

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Based on the assessment results, your physiotherapist will:

• Will teach you how to place your baby on their stomach and in other play positions that promote their development.
• Provide you with advice to maximize your child's awake and play periods to stimulate their development (which toys to use, where to place them, how to position the baby, etc.)
• Give you specific exercises to target your child's difficulties

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What to do at home for a motor delay?

• Encourage free play on the floor on a play mat or foam mat.
• Minimize the time spent in car seats, bouncers, and jolly jumpers.
• Frequently place them on their stomach, for short periods if needed, for a total of 30-60 minutes per day.
• Frequently vary how you hold or place the child during awake periods, the textures in their environment, and the type of toy. Discovering new sensations promotes development.

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If you find it difficult to apply these tips, pediatric physiotherapists are there to help. We practice the exercises and positions with you so that you feel confident and comfortable applying them with your child.