Gross Motor Delay

Gross motor delay is when a child is not rolling, crawling, walking, or doing other gross motor activities when the child is at the right age to do those things. Gross motor activities are big movements that use the arms, legs, and torso (middle of the body). Fine motor activities are small movements like holding a crayon or picking up small objects. Children can have a delay in gross motor skills, fine motor skills, or both.

Children grow and develop on their own schedules. Some children walk as early as 9 months while others start walking after their first birthday. Many children with a gross motor delay are able to do the activity at some point, but just do it later than most children their age.

In some cases, the gross motor delay is a sign of a more serious problem. Your child’s pediatrician will help you understand if a child’s gross motor delay is something to worry about. It’s important to take your child to the pediatrician for all of the child’s checkups so the pediatrician can find any problems as soon as possible.

A child with a gross motor delay is not doing the movements and activities children that age usually do. Below is a list of gross motor activities and the age a child usually does them:

• 2 months: Lifts head and chest while on their stomach
• 4 months: Rolls over from stomach to back; props up on their wrists and elbows while on their stomach
• 6 months: Rolls over from back to stomach; sits without help
• 9 months: Pulls up to stand; goes from lying down to sitting up; crawls
• 12 months: Walks and stands without help
• 15 months: Walks backwards; runs
• 18 months: Walks up stairs while holding an adult’s hand
• 2 years: Scoots on a toy or bike with no pedals; jumps
• 3 years: Climbs on and off furniture; pedals
• 4 years: Climbs stairs without help; skips

Many children are normal and healthy even if they don’t follow this schedule. Your pediatrician will check your child’s muscles and watch your child move to see if there is a problem. The pediatrician will also ask you questions about what you notice your child doing or not doing at home.

Take your child to all checkups so the pediatrician can make sure your child is growing normally.

Call the pediatrician right away if your child can no longer move or do things that you have seen the child do before.

Some children just reach gross motor milestones later, and there is no problem. When gross motor delay is due to a medical problem, it can have several causes:

• Premature birth, which can cause muscles to develop more slowly
• Genetic disorder such as Down’s Syndrome
• Neuromuscular (nerve and muscle) disorder such as muscular dystrophy or cerebral palsy
• A developmental problem such as autism
• Hypothyroidism, usually in older children

To test for a gross motor delay, the pediatrician will watch your child move and, depending on the child’s age, ask the child to do certain movements. The pediatrician will also check the child’s muscles.

If the pediatrician thinks there may be a problem, the pediatrician will have your child get other tests. The test depend on the suspected problem, but may be an MRI or a blood test to check for genetic disorders, cerebral palsy, or thyroid problems.

Some gross motor delays resolve on their own. The child simply does the activity later than other children. The pediatrician may also recommend physical therapy or exercises to help the child develop strength and coordination.

If another problem is causing the delay, the pediatrician will likely refer the child to see a pediatric specialist—for example, a pediatric neurologist. Treatment will depend on the cause of the delay.

Gross motor delays have so many causes, both known and unknown, so it is difficult to prevent them. It is always helpful to give your child opportunities to practice motor skills. Encourage children to try the skills when they are old enough to do so. Give children the opportunity to play and move, and try new skills with your help.

• Healthychildren.org

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This medical information is provided by Intermountain Healthcare. It has not been developed to replace medical advice provided by your health care provider.