Developmental milestones

When one looks at motor skills development from a chiropractic point of view the subject of primitive reflexes springs straight to mind, as the two are linked in so many ways. Whilst it would be possible to write many an essay on this fascinating subject, I shall refrain and instead briefly discuss a couple of examples. I shall reference some great books at the end for those that wish to read further into the subject.

Tummy time

So let’s start at the beginning with some information on spinal development. When looking at an adult spine from the side there should be a series of curves that are essential as our shock absorption system. When a baby is born however, their little spine all curves in the same direction, therefore these reverse or ‘secondary’ curves need to develop. The way that this happens is when baby starts to lift their head unaided and then push themselves up on their arms whilst lying face down. These actions encourage the reverse curves in the cervical (neck) and lumbar (lower back) spines to develop. These curves should start to develop before your baby spends too much time upright. It is therefore important for motor development that your baby has regular tummy time. This doesn’t always have to be on the floor (they aren’t always that keen on lying facedown, but that is part of the point as it encourages them to lift their heads), it can be lying facedown on top or mum or dad. Tummy time can start from the word go, depending on how long your baby will tolerate. To give an idea though, research suggests that a 3-4 month old baby should be getting at least 20 minutes a day.

Crawling

One of the motor milestones that tummy time is essential for the correct development of is crawling. As most of you will know babies discover numerous methods of getting from A to B, including crawling, ‘commando crawling’, ‘bum- shuffling’ etc. An even, symmetrical crawl is important for the later development of your baby’s cross-body co-ordination, which in turn is essential for further skills such as running, sports and ball throwing. Whilst it is very difficult to teach your baby to crawl if they have decided to ‘bum-shuffle’ it is perfectly possible to simulate the movements with certain exercises/ activities to help your baby’s brain develop its communication between each hemisphere (side). Even if your child seems very keen to walk and starts to do so early, try to get him or her crawling if possible. Giving them a baby-walker too early can load the spine in a way that it is not yet ready for.

Reflexes

There are different types of reflex. You may well know of deep tendon reflexes (DTRs), which is when your leg flings out when your knee is tapped. Or spinal reflexes which are when you pull your hand away from a heat source before your brain has released you’re getting burnt. In a nutshell, a reflex is something that happens without your conscious thought.

A third type of reflex called a primitive reflex is what I want to briefly discuss here. These are the reflexes that are essential for baby during the birthing process and for survival in the early months. They should then disappear during early childhood (all at different times). A couple of examples include the Rooting and Sucking reflexes. These allow your baby to feed without effort in an efficient and relaxed fashion. Babies who do not have a strong sucking reflex find feeding more difficult and tiring and sometimes struggle to feed well at all. (If you have any concerns about your baby’s sucking or feeding speak to your health visitor or chiropractor.) Other examples of these reflexes include the Palmer reflex (babies have the ability to grip very strongly with their hands!) and the Moro/ Startle reflex. The final primitive reflex I wish to mention to you is called the Asymmetrical Tonic Neck Reflex (ATNR). This is where baby’s head turns one way, the arm and leg on that side will straighten. This helps baby down the birth canal. It also helps with early hand-eye co-ordination. It should start to disappear at 6 months of age. If this reflex does not disappear/ is retained, then problems arise with cross-body co-ordination, laterality/ side dominance and hand-writing. This is where the link between motor development and neurology gets interesting. Each reflex can have an effect on a different area of motor development if it is retained past its normal point of disappearance. Therefore it is a fine balance between different areas of neurology and learning new skills that allows your baby to develop at such an amazing pace – 65% of neurological development takes places in the first year of life.

Conclusion

Whilst the exact timing of many motor milestones can vary, meaning babies should not be compared too closely with their piers (i.e. the normal age range for walking is 10-18 months), it is important that they are met to allow neurological and motor development. This allows your baby to develop to his or her optimum potential.