Assure the Best for your Baby ‛ s Physical Development TM
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Assurethe Bestfor your Baby ‛s
Physical Development
TM
Parents’ StoriesBirthAbby was born full term and had di�culty with feeding, low muscle tone and headcontrol. At our �rst visit with our family physician, she was diagnosed with a chromosomalabnormality and referred immediately for physical and speech therapy. Abby improveddramatically in her movement and speech skills. Now, at age 16, she is a happy, activeteenager. We are so grateful to our family physician for the early referral to pediatricphysical and speech therapy. James and Brenda A.
2-3 MonthsJe�rey was born at 42 weeks following an uneventful pregnancy. At three months, hecould not push up on his arms and had di�culty holding his head up when placed on histummy. We shared our concerns with our pediatrician who referred us to a developmental-behavioral pediatrician. Je�rey is now 10 months old and although he does not have ade�nite diagnosis, he can push up on his arms from tummy lying and get on his hands andknees. We know that he is getting the help he needs. Robert and Cindy P.
4-5 MonthsRachel was a breech baby and experiencedmeconium aspiration at birth. By age four monthsshe was not holding her head up or using her hands. Our pediatrician referred us to ourstate’s Early Intervention program so Rachel could learn better physical movement. Now atage four and a half, she is learning to walk, attends our neighborhood school and is maximizingher potential. Frank and Jenni S.
6-7 MonthsJason, who was eight weeks premature, was always di�cult to diaper. His legs were sti�and di�cult to get apart. At six months of age, he arched backward whenever we triedto place him in sitting. At eight months, he could still not sit by himself. Our pediatricianreferred him to an Early Intervention program that includes physical therapy. Jason is nowlearning to walk by himself. Larry and Pam R.
8-9 MonthsMatt, the second of twins, refused to be placed on his tummy. He also would not takeany weight on his feet, even at nine months of age, while his twin brother was walkingaround furniture in our living room. Our pediatrician referred us to a developmental-behavioral pediatrician and Early Intervention services. Matt began physical therapy atnine months of age. He took his �rst steps at �fteen months. He may no longer needtreatment by his second birthday. Mike and Terry S.
10-12 MonthsChristopher was born �ve weeks early and was in the hospital two weeks before cominghome. During his �rst year o� ife, we began to notice that he did not use his right handas often as his left. As he began to pull to stand, his right leg lagged behind. In standinghe leaned toward the left side and dragged the right leg when walking around furniture.At eleven months, our pediatrician prescribed physical and occupational therapy. Now,at three years of age, Christopher is walking. Bob and Sue D.
Typical Speech Development*
BY3MONTH
S Sucks and swallows wellduring feeding
Quiets or smiles in responseto sound or voice
Coos or vocalizes other than crying
Turns head toward direction of sound
Begins to use consonant soundsin babbling, e.g. “dada”
Uses babbling to get attention
Begins to eat cereals andpureed foods
Increases variety of sounds andsyllable combinations in babbling
Looks at familiar objects andpeople when named
Begins to eat junior andmashed table foods
Meaningfully uses “mama” or “dada”
Responds to simple commands, e.g.“come here”
Produces long strings of gibberish(jargoning) in social communication
Begins to use an open cup
Vocabulary consists of 5-10 words
Imitates new less familiar words
Understands 50 words
Increases variety of coarselychopped table foods
BY6MONTH
SBY
9MONTH
SBY
12MONTH
SBY
15MONTH
S
* Remember to correct your child’s age for prematurity.
Early Detectionis the BestPrevention!
ImportantParent Ideas:
Keep a notebookfor your concernsand observations.
Review this chartand check thesigns you seein your baby .**
Share yourconcerns, thischart and yournotebook withyour child’sdoctor or healthcare professional.
** It is okay to checkboxes in both theareas of “TypicalDevelopment” and“Signs to Watch for.”
is a 501(c)(3) Not-For-Pro�t Public Foundation
www.pathwaysawareness.org
While lying on their tummy…Pushes up on arms
Lifts and holds head up
Uses hands to supportsel� n sitting
Rolls from backto tummy
While standing withsupport, accepts entireweight with legs
Sits and reaches fortoys without falling
Moves from tummyor back into sitting
Creeps on hands andknees with alternate armand leg movement
Pulls to stand andcruises along furniture
Stands alone and takesseveral independentsteps
Walks independentlyand seldom falls
Squats to pick up toy
While lying on their back…Visually tracks a moving toy fromside to side
Attempts to reach for a rattle heldabove their chest
Keeps head in the middle to watchfaces or toys
Reaches for a nearby toy whileon their tummy
While lying on their back…Transfers a toy from one handto the otherReaches both hands to play with feet
In a high chair, holds and drinksfrom a bottle
Explores and examines an objectusing both hands
Turns several pages of a chunky(board) book at once
In simple play imitates others
Finger feeds self
Releases objects into a containerwith a large openingUses thumb and pointer �ngerto pick up tiny objects
Stacks two objects or blocks
Helps with getting undressed
Holds and drinks from a cup
Typical Physical Development*Typical Play Development*
* Remember to correct your child’s age for prematurity.
Di�culty lifting head
Sti�egs with little orno movement
Pushes back with head
Keeps hands �sted andlacks arm movement
Rounded back
Unable to lift head up
Poor head control
Di�cult to bring arms forwardto reach out
Arches back and sti�ens legs
Uses one handpredominately
Rounded back
Poor use of armsin sitting
Di�culty getting to standbecause of sti�egs andpointed toes
Only uses arms to pullup to standing
Sits with weightto one side
Strongly �exed orsti�y extended arms
Needs to use hand tomaintain sitting
Unable to take steps independently
Poor standing balance, falls frequently
Walks on toes
Di�culty crawling
Uses only one side of body to move
Arms heldback
Sti�egs
Inabilityto straightenback
Cannot takeweight on legs
Signs to Watch for in Physical Development*
* Remember to correct your child’s age for prematurity.
Pathways AwarenessMedical Round TableCo-ChairmenH. Garry Gardner, M.D., FAAPJohn F. Sarwark, M.D., FAAP, FAACPDM, FAAOS
CommitteeSuzann K. Campbell, P.T., PhD., FAPTA, FAACPDMRonald Espinal, M.D., FAAPDeborah Gaebler-Spira, M.D., FAAP, FAACPDMGay Girolami, P.T., M.S., FAACPDMKaren R. Judy, M.D.Fredric Leary, Jr., M.D., FAAFP, MBAAmy Becker Manion, RN, MSN, CPNPMichael E. Msall, M.D., FAAP, FAACPDMMichael N. Nelson, Ph.D.Russell G. Robertson, M.D.Katie Silverman, Ph.D.Lori Walsh, M.D.Rosemary White-Traut, Ph.D., RN, FAANNina Aliprandi, ParentMargaret C. Daley, President EmeritusShirley Welsh Ryan
Questions? Please call our “parent-answered” toll-free number, or email us.We will send you more information andrefer you to therapists in your area.
This message endorsed by the American Academy of Pediatrics, the NationalAssociation of Pediatric Nurse Practitioners, the Section on Pediatrics of the AmericanPhysical Therapy Association and American College of Osteopathic Pediatricians.
COPY FREELY, DO NOT CHANGE, MUST ACKNOWLEDGE PATHWAYS AWARENESS.© Copyright 2010
What Every ParentShould KnowIt is important for you totrack your child’s physicaland speech development.Our unique chart allows youto do just that. Remember totrust your instincts . You knowyour child best. If you feel yourbaby is developing at a di�erentpace, seek help. All childrencan learn. Early detection isthe BEST prevention.
About Pathways AwarenessEstablished in 1988, PathwaysAwareness is a national programof the Pathways Foundation,a 501 (c) (3) Not-For-Pro�tPublic Foundation. Pathwaysis dedicated to raising aware-ness about the gift of earlydetection and the bene�t ofearly therapy for infants andchildren with early motordelays to assure their best.Our activities are based uponthe Pathways AwarenessMedical Round Table , leadingphysicians, clinicians, nursepractitioners, and lay advisors.
1-800-955-CHILD (2445)TTY 800-326-8154email: [email protected]
is a 501(c) (3) Not-For-Profit Public Foundation
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