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Red Flags in Gross Motor development from 0-5 years old

Red Flags in Gross Motor development from 0-5 years

Development of gross motor skills in children follows a similar pattern. For instance, a child should be able to roll by 6 months and walk independently by 18 months. If parents notice that their child is still not reaching the appropriate milestone, it is a warning sign, or red flag, and the child should be brought to medical attention. The delay in milestone may signify something ominous and bringing the child to medical attention early ensures no child gets left behind.

Early intervention for children is essential once a condition is suspected or diagnosed. The child’s brain is still developing hence it is the best time to teach a skill or to change a behavior. Late diagnosis or parents’ denial in a condition may result in late intervention, which will prevent the child from reaching his/her maximum potential due to a smaller window to teach skills or create changes.

The table below shows the red flags, or warning signs of delayed gross motor development, with reference to the Queensland Government Early Intervention Referral Guide for Children 0-5 Years. If your child shows any signs of delayed stated in the table, it is highly recommended to bring your child to medical attention or to paediatric physiotherapist where a full gross motor developmental assessment can be carry out.

Age Red Flags Red Flags at any age
6 months
  • Not rolling
  • Not holding head and shoulders up when on their tummy
  • Not achieving indicated developmental milestones
  • Strong parental concerns
  • Significant loss of skills
  • Lack of response to sound or visual stimuli
  • Poor interaction with adults or other children
  • Difference between right and left sides of body in strength, movement or tone
  • Loose and floppy movements (low tone) or stiff and tense (high tone)

 

9 months
  • Not sitting without support
  • Not moving eg creeping or crawling motion
  • Does not take weight well on legs when held by an adult
12 months
  • Not crawling or bottom shuffling
  • Not pulling to stand
  • Not standing holding on to furniture
18 months
  • Not attempting to walk without support
  • Not standing alone
2 years
  • Unable to run
  • Unable to use stair holding on
  • Unable to throw a ball
3 years
  • Not running well
  • Cannot walk up and down stairs
  • Cannot kick a ball
  • Cannot jump with 2 feet together
4 years
  • Cannot pedal a tricycle
  • Cannot catch, throw or kick a ball
  • Cannot balance well standing on 1 leg
5 years
  • Awkward when walking, running, climbing stairs
  • Ball skills are very different from peers
  • Unable to hop 5 times on each foot
Disclaimer: The information and advice contained in or made available through this website is for educational purposes only and is not intended to replace the services of a health professional or to be a substitute for medical advice of physicians.
Reference:

1. Queensland Health,  Queensland Government Early Intervention Referral Guide for Children 0-5 Years, http://www.health.qld.gov.au

Cerebral Palsy

What is cerebral palsy?

Cerebral palsy is a brain disorder that happens in infancy or early childhood. Cerebral palsy is non contagious (does not spread to other people) and non progressive (does not worsen over time).

What are the different types of cerebral palsy?

The traditional classification of cerebral palsy is according to the type of muscle impairment and the number of limbs involved.

Classification according to muscle impairment:

(1) Spastic

  • most common type of cerebral palsy
  • reduced ability to stretch muscle
  • usually due to damaged motor cortex of the brain

(2) Ataxic

  • presented as increase tremors and/or low muscle tone
  • caused by damage to cerebellum, hind brain that controls coordination

(3) Athetoid

  • presented with mixed muscle tone
  • caused by damage to the corpus striatum

Classification according to number of limbs involved:

(1) Monoplegia: only 1 limb involved

(2) Hemiplegia: one entire side of body affected

(3) Triplegia: 3 limbs involved

(4) Diplegia: predominantly lower limbs involved

(5) Quadriplegia: all 4 limbs involved

Hence, for instance, if a child has increase muscle tone in all 4 limbs, he/she will be classified as a spastic quadriplegia.

 

What causes cerebral palsy?

There are numerous risk factors that are related to cerebral palsy. Below is a summary some of the risk factors:

  • Low birth weight
  • Preterm
  • Postterm
  • Asphyxia during delivery (lack of oxygen)
  • congential malformation
  • congential or perinatal infection
  • Intrauterine growth retardation
  • Viral Infection (TORCH – Toxoplasmosis, Rubella, Cytomegalovirus and Herpes simplex virus)
  • Multiple pregnancies
  • Injury to the brain in first year of life
    • cerebral infection
    • acquired brain injury
    • infantile spasm
Disclaimer: The information and advice contained in or made available through this website is for educational purposes only and is not intended to replace the services of a health professional/physiotherapist or to be a substitute for medical advice of physicians.
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