Q&A: Preeclampsia Baby Not Rolling Over
November 4, 2013Q&A: 17 Month Old Baby Not Walking
November 4, 2013My son is 5 months. I’m not concerned about his social interaction at all. He is a happy, “talkative,” and smiling baby. However, there are two things I’m concerned with regarding his motor skills.
1. Reaching for toys. Ethan met the guidelines for batting at toys but just now started to reach for them. When he does reach for them, he kind of just swipes both arms and hands inward towards the middle of his body. He is sometimes successful. Does this count as reaching? Should he have done this earlier? He has been putting his hands together and in his mouth since 3 months of age. When I put a toy in his hand, he will shake it and bring it to his mouth. I just don’t know what to look for with reaching and grabbing toys. He doesn’t grab the toys on his activity mat or in his exersaucer.
2. How long should he be bearing weight on his legs when placed on them? He’ll bear down for a split second and then bend them. He’ll then go up and down almost like he’s bouncing. Should he be standing for longer periods of time while supported?
From your description of your son it sounds like his fine motor/reaching skills are still within normal limits for a baby who is just about to turn 5 months old. From 3-5 months most babies are still batting at & reaching for toys on hanging gyms, while not necessarily always being able to grasp them with control. Babies from 3-5 months are typically able to grasp toys voluntarily when placed in or near their hand, instead of just reflexively. Babies of this age still tend to reach forward with both hands (bilateral reach) and as they get to about 6 months of age they begin to be able to grasp toys with one hand (unilateral reach) and begin to transfer toys hand to hand.
Babies from 3-5 months still do a lot of hand to mouth with or without a toy, which is age appropriate. By the time a baby is 6-7 months old they can typically reach with control from a variety of positions (belly, back, sitting, sidelying), but right now your son’s reaching may be more difficult in positions where he has less stability or support such as in his exersaucer or when on his belly. He may also still be using his fingers without his thumb to grasp, which is also ok for his age.
As far as standing, most babies by 5 months will briefly bear some weight on their legs and flex and extend their knees and by 6 months will bear weight for longer periods and bounce actively while requiring less support in this position. By the time a baby is 7-9 months they should be able to stand well with support against an object or with both hands held.
You can review our Gross Motor Development & Fine Motor Development sections at these links.
I wrote a few weeks ago about my son who shows no interest in reaching/grabbing for toys or anything. He is very social, “talkative,” full of smiles, and laughs. It almost seems like he is bored with the toys and wants to connect to the person/people instead. My pediatrician said that everything looks great and normal but seemed concerned when I brought this issue up. He doesn’t reach for his pacifier, my hair, or anything. She did say that it was very good that he is able to bring his hands together at his midline and put them in his mouth. She referred us to early intervention and we are just waiting on them to call and set up an appointment. I am literally going crazy with anxiety while we wait. My question to you is, what could this mean? Sensory disorder, developmental delay, autism? I know you can’t diagnose him without seeing and interacting with him, but I want to know if he is meeting every other milestone, what could no interesting in reaching or grabbing for things mean? What possibilities are we looking at? I’m just trying to prepare myself instead of drive myself crazy with anxiety.
I am sure it brings anxiety for you waiting for the early intervention team to show up to evaluate your son, but be assured that this is the best possible thing you can do at this point to allay your fears and help your son if he indeed needs help in any area of his development. Without knowing your son, I am still apt to say that he may just need a little more time to develop his reaching skills since he only just turned 5 months old on March 1. Most young babies still clearly prefer people and faces over toys and believe it or not that is a good thing. If he did not look at your face and did not show interest in people, I would be concerned. He may actually begin reaching for your face, hair or jewelry before he begins reaching for toys. When the team arrives to assess your son, they may have a developmental specialist or an OT and/or PT look at your son’s fine motor/reaching skills. At age 5 months, we are mostly looking at skills such as bringing his hand together at midline (which he is doing), bringing hands to mouth (which he is doing) and bringing hands to mouth with a toy, which I think you said he will do if you place the toy in his hand. I would also look for him to begin transferring a toy from hand to hand by the 6th month. His hands should also be open most of the time and if they are sometimes fisted, they should be very loosely fisted and not tight or with the thumb indwelling. Does he put his hands onto the bottle at all when you feed him? I would not expect him to hold it yet, but ideally he should be patting the bottle with one or both hands during feedings. Between 3-5 months babies are just developing tactile awareness in their hands and learning how to use their hands and fingers. The batting and swiping at toys comes way before the actual directed reach and clear grasp. The only other thing I would suggest is that if you haven’t done so, to have his vision screened since visual deficits can be one reason a baby will not reach for things. The OT and/or PT on the early intervention team will also assess his muscle tone and range of motion in his upper and lower extremities to make sure he is not too loose or too tight which can prevent a child from being able to move in a typical pattern. The team will only be able to tell you if he is showing a developmental delay in one of the areas of development (Gross Motor, Fine Motor, Cognitive, Self-Help, Social, Communication), they cannot make a specific diagnosis, but you can ask them about sensory issues if you are concerned about that.
You may want to try using wrist rattles, the little soft rattle toys that attach to a baby’s wrist with Velcro, this way the toy is on his one wrist and will encourage him to reach for it with his other hand and he will not drop it. Then switch it to the other wrist and do the same. Also you can massage his hands and fingers to improve his tactile awareness. If he is not reaching toward toys in his bouncy seat, try rolling up small receiving blankets or towels and placing them behind his shoulders to bring his shoulders forward which may help to bring his hand together and make it easier for him to reach toward the toys. You can also do this on the floor if he is lying under a baby gym. Also, since many rattles these days are heavy, we suggest using the connector rings that you use to hang toys on baby gyms, since these rings are small and light and the right size for a baby’s hands. Sometimes babies will hold or grasp a single connector ring before they are able to grasp a heavier, larger rattle. You can also use textured books with your son, opening his palm and guiding it across the page to feel the various textures or do this on the carpet or a pillow or blanket, helping him feel different textures. Best of luck with his upcoming evaluation and let us know what the team says. This link on our page talks a little bit about the process of early intervention and what to expect.