Published on October 23, 2017

6 Signs Your Child Might Need Physical Therapy

6 Signs Your Child Might Need Pediatric Physical Therapy

By Katie Powers, DPT, PCS, C/NDT, Pediatric Physical Therapist

As a new parent, we’re all so anxious for our babies to meet their next developmental milestone. When will he start rolling? When will she start walking? Unfortunately, it’s easy to compare your baby’s skills to other babies and start to worry that little Aiden isn’t crawling like his younger cousin.

Babies develop at different paces based on so many different factors. Just because one child learns to walk at 10 months and another at 13 months isn’t an indicator of any kind of medical issue, and won’t predict which baby is going to end up as a star athlete.

But there does come a time for concern, and that’s when you should speak up to your child’s doctor.  They can refer your child to be evaluated by a specially trained pediatric physical therapist. On that note, here are six warning signs to look out for:

1. Baby prefers to turn head only to one side

Babies have very little control of their heads and neck when they’re first born. It is easy for them to begin to rest their head in the same position all the time. This can lead to torticollis, a shortening of the sternocleidomastoid neck muscle.

This shortening causes a stiff neck, and the child begins to lose the ability to turn their head to both sides. If a baby only rests with their head in one position while they spend so much time on their back, it will lead to plagiocephaly, a flattening of the back of the head. These complications can be prevented with frequent position changes while baby is awake, sleeping on baby’s back, and lots of awake play time on their tummy.

2. Baby is not bearing weight on legs by 6 months

No, babies shouldn’t be standing on their own at the age of 6 months; they just need to be able to support some of their weight while you place them in standing. Babies who are unable to push through their legs in supported standing may have an issue with low muscle tone, hip alignment, or something more serious like a neurologic disorder.

3. Baby is not sitting by 8 months

We learn how to sit with lots and lots of practice with mom, dad, babysitter, etc. First, babies support their weight by propping themselves on their arms, and then progress to being able to sit while using their hands to play with toys. If a baby cannot maintain balance in a sitting position by 8 months of age, we begin to worry about poor core strength or a lack of postural reactions that we need to stay balanced.

4. Baby is not crawling by 12 months 

The brain of a baby is wired to explore. This allows them to navigate their surroundings, learn how to move efficiently, and discover new things. When a baby becomes mobile, their ability to explore drastically increases. Before you know it, that sweet little baby will be exploring the entire house!

With this internal drive to explore, we become concerned when a baby is not motivated to navigate their environment by the age of 12 months. I’m sure you have that friend who says, “My baby just skipped over crawling and went right to walking.” There are so many reasons to encourage crawling: hand eye coordination, fine motor skills, development of the spine and believe it or not, reading skills (just to name a few). Crawling plays a huge role in a child’s ability to run, skip, and much more as they grow up. A lack of crawling could be the result of issues with coordination, strength, or even vision.

5. Baby is not walking by 18 months

As you know, babies are changing and growing every single day. That time frame from when a baby is learning to crawl until they are learning to walk is filled with so many changes. Babies learn to crawl, pull to stand, cruise along furniture, stand on their own, and take those precious first few steps. Some babies learn to walk as early as 9 months and others as late as 18 months.

Babies will show smaller changes in development almost weekly. All of a sudden you realize your little one is walking along the couch and they only learned to pull up on the couch 2 weeks ago! Those little bodies need lots and lots of practice to master this walking skill. If a baby spends too much time in baby equipment (walker, exersaucer, jumparoo, etc.), they might not get the practice they need. A child that is not walking on their own by 18 months should be evaluated to see what is causing this delay.

6. Child only walks on tip toes for more than 6 months

So, your kiddo learned to take those exciting first steps! But, it’s only on their tip toes. There are several reasons why children walk on their toes, and toe walking can be a normal phase in development…as long as it is temporary.

If your child is standing and walking on their toes, a more supportive shoe might be necessary. If your child walks only on their tip toes for more than 6 months, an evaluation by a physical therapist might be necessary.

Now, we know that being a new parent comes with so many doubts and worries. Am I feeding her enough? Do I read to him enough? Did she have enough tummy time today? Take comfort in knowing that babies strive to learn and grow. And with your love and support, your baby will be leaving for college before you know it!

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6 Signs Your Child Might Need Pediatric Physical Therapy