Movin’ On Up
One of the main goals in development is to move up against gravity from floor activities such as rolling, crawling and sitting to become a stander and walker. This includes going from belly to hands and knees, getting to a support to pull up to kneeling, and finally coming to stand. For some babies this may happen quickly and for others, especially those with low muscle tone, these stages may take longer to move through. But the exciting thing is you will really get to witness each element that goes into creating the entire movement plan as your little one works through each stage.
There are many ways to help motivate a baby who wants to push up and move off of their belly. An excellent toy that will prove itself useful over and over is an activity table with legs that are easily removable. This toy will be helpful when in belly time, hands and knees, kneeling and while pulling to stand, even while learning to cruise. Who doesn’t love a toy that is usable throughout so many stages!? It easily earns its place on my list of favorite toys! With the legs off the baby needs to press up high onto their arms to see the engaging surface. In order to access the buttons and spin features they will need to shift into one arm and reach (mimicking the move needed to start crawling). Playing in hands and knees and alternating which arm they play with allows practice shifting side to side which is a skill vital for crawling. When your baby is ready for a new challenge, insert 2 legs back into the table you now have a slanted surface which begs to be played at in kneeling. Now we are halfway to standing!
Once the baby is comfortable transitioning from hands and knees to kneeling and playing in kneeling it is time for all 4 legs to go back on the table. The table is a wonderful height for the baby to hold on and pull up to stand. Standing at the table they can play with one hand and support themselves with the other. They can also play with both hands and use their chest or belly against the table for balance.
Another fun setup for playing in kneeling and transitioning to stand is at the couch, especially if the cushions can come off. With the cushions removed the surface of the sofa is typically an ideal height to play at and come to stand at. The bottom step of your flight of stairs is another unique play space for kneeling that is often off limits to a new crawler. Novel toys and play spaces are very motivating for the development and practice of new skills.
Cruising from side to side is an important skill that helps set the foundation for pelvic control and stability which is required for independent walking. Using your couch or coffee table you can place desirable toys at one end, just out of reach of your new stander. This will encourage them to problem solve how to move, reaching and stepping, to get to the toy. As your child experiences success in this new skill you can build on the distance by placing the toy farther out of reach. Eventually, over time, you’ll be ready to place the toy on another adjacent piece of furniture so the child can start to experiment with cruising between 2 different surfaces. You may notice during this time of cruising that your child is starting to get braver, letting go with both hands at once, practicing standing without support. You may also notice that they have difficulty figuring out the movement plan needed to cruise sideways. Both of these scenarios, and everything in between is a normal progression of learning a new motor skill. The best advice I can give to parents who are working with their child in this, and any motor skill stage, is be patient. There is so much brain development that happens during the trial and error phase of life when learning new skills. If we rush the process, smooth everything out of the way and manually do the skill for the child they lose out on creating the pathways of figuring out the skill on their own. The gift of time is so important for individuals learning new skills. Along with patience, create lots of opportunities to practice. Practice makes progress! When your child is working on a new skill it is vital to think about setting up play opportunities throughout the day so they can attempt the pull to stand and cruise in a variety of locations and with a variety of objects of support. Don’t view it as “PT practice time” rather a way of life to incorporate into your day and your child’s day. You can support your child as they journey from views on the floor to views upright! And don’t lose hope – they will move through each stage and make progress in their own time!
Colleen Weitekamp, MSPT
Board Certified Pediatric Clinical Specialist