The average age that an untreated baby with Down Syndrome starts creeping (crawling on hands and knees) is 17 months. Jett, who is treated, started army crawling (later referred to as "stomach crawling") at 10 months even though he had heart surgery at 6 months. He was creeping by 13 months (and pulling himself to stand at 14 months). You can get your baby to crawl much, much younger than that if you work on his muscle tone and do as much tummy time as possible, as soon as possible. I didn't do tummy time intensely until Jett was 3 months old. When we brought Jett home at birth, he was crawling on us immediately. But, I didn't realize that he would lose this ability as he gained weight if I didn't provide ample opportunity for crawling. And I also didn't realize how important it is for proper brain development.
Why is crawling important?
It helps your baby organize the wiring to his brain for higher level, cortical functions. Cross pattern activities help develop good communication between the right and left sides of the brain, which helps to avoid future problems of long-term memory, stuttering, etc. It also helps him feel and understand where his body is in space, as well as promotes good bladder and bowel control. Coordinated physical movement is dependent upon developing good tactility and corresponding good cross pattern movement.
-- Kay Ness, Jett's Neurodevelopmentalist
Down Syndrome: The Importance of Crawling on the Stomach
by Robert J. Doman, Jr. and Ellen R. Doman, National Association for Child Development
One of the areas of parental concern for the development of any baby is the area of mobility. Watching a baby learn to crawl, creep, stand and walk are thrilling to all parents. As a parent we can see our child learn to better explore their world and move from dependence to independence sometimes in the time span of the first year.
As a parent of a DS child, you may have a special concern about your child’s development of mobility. Cardiac conditions can slow down the emergence and development of mobility. The potential or reality of low muscle tone and poor tactility can also slow down development in this area drastically. Parents are often tempted to skip mobility developmental stages in an effort to reach the coveted skill of walking more rapidly. The consequences of this strategy can be very long lasting and impact other developmental areas as well.
Why stomach crawl? Crawling on your stomach on the floor in a cross pattern is hard work. Aside from people training in the military, few of us have spent any time past our first year of life utilizing this movement. What is to be gained by doing it, and why does your baby need this essential first form of locomotion? There are several reasons.
Your child’s eyes begin the work of learning to focus and converge together on near-point objects, a skill which is needed for everything from reading to depth perception. The tactile feedback given by the entire body moving against the friction of the floor teaches your child the location of the entire torso, arms and legs, and feet and hands.
Proprioception, knowing where your body is in space, is based on these early messages of tactile input on the floor and feeling every movement through the feedback of this contact. The child is learning that they have two legs, two arms, two feet and two hands because they can feel these parts moving against the floor. Crawling engages virtually all of the muscles of the body, from the arches of your feet to your abdominal and neck muscles, all of which are used in the process of moving your body forward across the floor. Arm, chest and back muscles are utilized in pulling the arms forward and then pulling the body forward. Quads, hips and hamstrings are worked during the leg movement. This is a workout!
Learning coordinated movement starts here with crawling on the floor. Whether the child picks up the cross pattern movement on their own or they learn it through parent assistance, this is the beginning of that very fundamental movement of a right arm and left leg, left arm and right leg-- the movement we use to walk and run, climb stairs and climb hills. When the child learns this by working on the belly crawl, they get all of that helpful tactile information through the limbs and through the torso, laying a strong foundation for more advanced forms of mobility.
They also develop a very critical physical piece through crawling-- muscle balance. The crawling movement is one of flexion and extension of the arms and legs, pushing and pulling using the flexor muscles, then the extensor muscles. One of the issues confronting many parents of children with Down Syndrome is that they are often advised that the child needs to begin developing trunk strength and tone through sitting because it is this lack of trunk strength and tone that creates the problem with crawling and walking. If sitting were the best thing for the development of the trunk, every adult would have strong backs and great abs. Sitting is not what develops the trunk; crawling and creeping is. The child should not sit independently until they can get themselves into that position independently, which is typically after they have learned to crawl on their tummy and creep on their hands and knees.
Another very significant aspect of crawling involves the integration of sensory input. Crawling provides the brain with what is quite possibly the best integrated sensory input that a child ever receives. This act of crawling sends simultaneous information to the brain from all of the tactile and proprioceptive receptors, the surface receptors, the deep receptors and the proprioceptive receptors in the joints. And not only is the brain receiving all of this input, it is receiving it through the simultaneous input from the movement of the right arm and left leg, and the left arm and right leg. This is very powerful sensory-integrating input.
Many children, when they start to move forward on the belly, have to learn where their pieces are before they can really start coordinating their movement. Many start by just pulling with both arms together or both legs together. These children are learning where their arm and legs are. Then with a little time and help they begin to alternate arms or legs, and sometimes they get the arm and leg moving on one side of the body, or leave out one leg.
As children go through these phases, they are getting more and more input, developing tactility, strength, tone, muscle balance, vestibular balance function, and proprioception. Furthermore the brain is learning to integrate all of this critical information. Given some time and some help, their brains and bodies can learn all of these critical developmental pieces and establish the foundation they need for all future physical and neurological function. It is also important to note that those children who find it the hardest to crawl need it the most, for they are the ones who really need to put all these pieces together properly.
Some children move through this stage very quickly and move on to creeping on hands and knees. Some children take longer to learn this stage and may need a great deal of extra input to locate their limbs in order to be able to control those movements. This may take longer than parents expect, but is time well spent. Children moving from a good cross belly crawl to a good cross pattern creep on hands and knees are in good shape to move on to developing proper walking. Children moving from rolling to scooting to sitting to walking have not had the opportunity to learn where they are in space and how to move their limbs in an organized fashion, nor have they developed the proper muscle balance or strength. They potentially have not even learned how to focus on close objects or to use their eyes together for depth perception.
Short cuts and quick fixes will lead to later repercussions. Don’t take the chance. Try to do it correctly the first time and avoid thousands of hours of time in the future in physical and occupational therapy trying to overcome the problems that are often created by skipping this critical developmental activity.
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Creeping and Crawling Foundational to Child Brain Development
Stage II - Crawling
Children who are given abundant opportunity to learn to crawl in an infant track can enter stage II in the pons at 1 month of age, instead of 2 1/2 months, which is the norm. In stage I the newborn gained initial control of his limbs. In stage II he will master crawling. An infant enters stage II when he can crawl 2 or 3 feet non-stop in about 10 minutes. This makes him a beginning crawler.
It is wise to baby-proof your house before a child begins to crawl. You can make the environment safe by seeing that there are no uncovered electrical outlets. Remove cords and lamps and other items a baby could grab and pull over onto himself. See that furniture is stable and that there are no sharp edges or pointed corners. Also, check that there are no splinters on furniture or floors. Remove unsafe objects a baby could put in his mouth or choke on. And keep all poisons and toxic products well out of the baby’s range.
The more crawling a baby does the sooner the child will enter stage III of brain development and begin to creep. The best thing you can do when your baby is learning to crawl is to get down on the floor and provide love and encouragement. If you cheer the baby on and encourage him or her to crawl, your baby will make a greater effort. Your baby is delighted to have your attention, so always give him plenty of love and hugs whenever he crawls to you.
Another thing you can do to encourage crawling is to place toys and safe objects on the floor, out of the baby's reach but not out of his crawling range. Entice him to go after things. When he finally reaches an object let him enjoy it for a while. Immediately taking it away will frustrate and discourage him, which will dampen his eagerness to go after things for you. Dads are sometimes guilty of this. When the baby reaches the teddy bear, dad backs it up so that the baby has to go after it again. It's a fun game for dad but not too much fun for baby.
Your baby will learn to crawl like an expert in stage II if you continue to give him at abundant opportunity daily to master crawling in the track and on the floor. If you encourage him to crawl 15 times, each day, he will soon be crawling in a cross-pattern and will rapidly increase his capacity to 150 feet of crawling in a day. After so much crawling, the baby will then push himself up off the floor onto his hands and knees, which will mark his entry into stage III. This can happen sooner rather than later if you give your child abundant opportunity to crawl and plenty of encouragement to develop mobility.
Stage III – Creeping
After a baby has developed the cross-pattern and after much crawling, he will get up onto his hands and knees and begin to creep. Having mastered Stage II in the pons, he enters the midbrain area and Stage III of brain development. His infant days are just about over, so you can put away the track and save it for your next child. However, a baby will still be doing a lot of crawling in stage III, especially when he wants to get somewhere fast, but he will be working on learning to creep.
Now that the baby is starting to creep he will be everywhere he can get to in the house. To provide greater opportunity for creeping, just as you would do with a crawling baby, you get down on the floor with the baby and encourage him or her to creep. Creep beside the baby and cheer him on. Play games and have the baby go after you. Continue to use objects to entice the baby, and reward him with love.
In the midbrain area and Stage III of brain development the goal is for the baby to creep 400 yards in a day. (In Stage I, the medulla and cord stage of reflex response, the goal was for the infant to crawl 2 or 3 feet, nonstop, in ten minutes. The goal in Stage II in the pons was to reach 150 feet of crawling in a day.) How quickly your baby reaches mobility goals will entirely depend upon how much opportunity, how much love and encouragement you can provide.
The creeping baby definitely needs long pants and long-sleeved shirts. This goes for girls too. They shouldn't be wearing dresses; they get hung-up in the skirts. A creeping baby should wear socks, but not shoes. Thick rugs are best for learning to creep. Thick rugs are not as hard on elbows and knees. A kitchen floor is not where a beginning creeper does his best.
Your baby will still be crawling in stage III. He's not an expert creeper yet but, day by day, he will gradually do more creeping and less crawling until one day creeping will replace crawling entirely. You can then expect that his next accomplishment will be standing-up.
You help bring your baby to this point in Stage III of brain development by encouraging him or her to creep in many, many short creeping sessions. Doman says to get down on the floor 20 or 30 times a day with the baby and motivate him to creep. This seems like a lot, but the sessions are very brief at first. Then they gradually increase in length of time and decrease in number.
A baby remains in stage III until he is actually walking. One day after much creeping he will pull himself erect, and holding onto a piece of furniture he will stand. He will then pull himself up on every table and piece of furniture he can reach, and holding on to the edge he will walk its whole length. This is called cruising. His days in the midbrain are coming to an end. One day after much cruising, he will come to the end of the sofa and eye the chair and take his first independent steps, from the sofa to the chair. Now, the line is drawn. He has left stage III forever and has entered stage IV of brain development in the initial cortex. If you have given your child extraordinary opportunity to develop mobility from birth, walking can begin earlier as well.
Sources:
http://nacd.org/newsletter/1009_down_syndrome_crawling.php
http://www.internationalparentingassociation.org/BrainDevelopment/mobility3.html
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