Is my baby delayed with their development?
It is a very common question parents ask when their baby has been referred for physiotherapy. Of course, there are many reasons that can cause a baby to have delays in their development. Before we tackle this big topic, let us first clarify the jargons and myths about baby development.
But what is childhood development?
4 Key Developmental Areas
These are: physical (gross and fine motor), language/communication, cognitive and social/emotional. Below I will briefly talk about what gross and fine motor development are.
Language/communication development is how a baby develops different ways to understand and communicate. Talking with spoken words is only part of the whole language/communication development.
Cognitive development is about how a baby thinks, problem solves, understands and explores their environment, which lays a foundation for acquiring future knowledge and solving problems.
In social/emotional development, a baby learns to understand who he/she is, how he/she feels about themselves and the world around them and what to expect when he/she interacts with people around them. It lays a foundation for future positive relationships with others and appropriate management and expression their own emotions.
Increasing evidence have shown that all 4 types of development interact with and enhance each other. For example, when a baby can sit on their own (gross motor development), being upright allows them to have more chances to interact with their mum and dad with eye contact and allows them to make sounds more easily than when lying on their back (language/communication development). The baby can also free their hands to play with their toys in sitting (fine motor development). Another example- when the baby starts to giggle to express their happiness when playing peek-a-boo with their parent, the baby learns that their parent would laugh and talk to them when they giggle (social/emotional development). This in turn encourages the baby to giggle more and look at their parent directly with good eye contact (language/communication development). This simple game also encourages the baby to use their hands to pull down the cloth that covers their face (fine motor development) and learns whenever the cloth comes down, they will see their mum’s face and if they giggle, their parent will laugh back (cognitive development). And you thought you were just playing silly games!
Gross Motor Development
This is a big word used by medical staff. It refers to development in movements involving large muscles such as rolling, sitting, crawling, walking, running or jumping.
It is used to distinguish from fine motor development, which refers to the use of smaller muscles especially in our hands in common activities such as writing, using a utensil like spoon or scissors or playing with Legos. sometimes gross motor development is interpreted as activities involving the legs and fine motor development as activities using the arms and hands because the big muscle are usually in our legs. This understanding may not be 100% correct because in order to carry out good fine motor activities with your hands, you do need strong muscles over your body and shoulders (those larger muscles) to stabilise yourself. Just think of those days when you have a very sore neck, it affects all your fine motor activities such as typing on your computer or using your smart phone. Our amazing body works as a synchronised system as a whole and therefore, it is difficult to chop and cut our body into different parts and look at them separately.
They happen over a long time frame and not at specific times. Like our height, weight and shoe size, they all vary but most of us fall within the average range, landing somewhere in the middle. This is why when you read books about baby development, the author gives a time range of when a baby would be expected to do certain things, e.g. a baby can keep their head in the middle when they are on their back around 3 months, or a baby commonly starts walking around 10 to 12 months etc. The timeline the author suggests in those baby books is the average time that most of the babies would achieve that developmental milestone but some babies may be faster or some may be slower. We cannot say if a baby sits on their own at 6 months old, they are better or stronger. Just like we cannot say an adult with a foot size of 12 is better than another adult with size 7. Therefore, it would be better that you take those timelines in the baby book as a reference to check your baby’s development but try not to be too bogged down by it. It is more important that your baby is steadily progressing towards each milestone than to achieve that milestone spot on at that time point.
It is also common for parents to think babies will first complete gross motor development before other types of development. All the 4 types of development discussed actually happen at the same time in the first few years after birth. Language/communication and social/emotional development will continue into their teens.
Usually it’s common for parents to think like this as the gross motor developments are very obvious e.g. when babies go from lying still on the sofa to nearly rolling off! We also notice that a baby may develop faster in one or two developmental areas and not much happens with the other developmental areas. Then the ‘quiet’ developmental area may come out next and the 2 previously dominant developmental areas quieten down. This is often why it is common for babies to be labelled as ‘walkers’ or ‘talkers’ as they are either learning to walk or talk. Patience is key, you should see your baby develop across all these developmental areas in a progressive manner over time.
Hopefully, you now have a better understanding of baby development. There are lots of things that impact developmental milestones, which I will talk about in my next blog.