This site is intended for parents/carers of children who may display an unusual/atypical motor and/or cognitive development (or the lack of). The intent of this website is not to make a diagnosis but to encourage the parents/carers to promptly seek medical advice and/or referral to a relevant specialist.

How to track your child’s development

What can you do?

This section will provide you with information on what to look out for and some examples of atypical movement and behaviour your child may display. It is important to remember that each child develops at their own pace, so if they have not learned or mastered a skill yet, it does not mean they never will.

Head movement and control1-3

Lay your child flat and pull them gently by their arms to a sitting position.

TYPICAL Your child lifting their head along with their body or slightly behind.

ATYPICAL Your child no longer has control, and their head extends behind them.

Why this is important:

This test provides information relating to how your child’s muscles are developing. It could also provide an early insight into how your child’s brain is developing and could be linked to how your child may deal with emotions and behaviour in a given situation (known as self-regulation).

Balance and posture2,4

Hold your child upright around their trunk with their feet touching the floor.

TYPICAL If their legs stretch out to support themselves standing.

ATYPICAL Their legs do not allow them to balance or give way when trying to stand.

Why this is important:

Delays in postural control can be associated with your child’s muscles, strength and coordination not developing as they would. This can sometimes indicate neurodevelopmental delay and may cause issues with your child’s learning ability.

Crawling, walking and coordination2,3,5-9

If your child crawls, or bottom shuffles, put them in position and observe/record their movement – trying to get their attention, using a toy may help.

TYPICAL Your child moves as normal towards you or the toy.

ATYPICAL Your child tries but is no longer able to crawl or moves backwards. Your child can still crawl but is now swaying, leaning, or leaning more to one side whilst walking.

 

If your child has learnt to walk, watch them walking unaided and record their movement over time

TYPICAL Your child walks as normal and over time becomes more stable and confident walking unaided.

ATYPICAL Your child can still walk but is now swaying, limpling, or leaning more to one side whilst walking.

Why this is important:

The development of gross motor skills, such as crawling and walking are associated with the development of communication later in life. A regression (being unable to do these tasks when your child previously could) is an indication of neurodevelopmental delay, or an underlying developmental disease.

Fine motor skills2,3,5-8,10

Observing your child during mealtimes.

TYPICAL Your child picks up the food or tries to put the cutlery/cup in their mouth (even if they miss). They pick up food using their thumb and index finger.

ATYPICAL Your child has difficulty using cutlery and drinking from bottles or (sippy) cups. They are no longer able to grab food with their fingers and instead use the palm of their hand.

Why this is important:

A delay or loss of fine motor skills can indicate a range of underlying neurological disorders. Fine motor skills have also been found to predict social and cognitive ability in young children.

Your child’s behaviour2,3,5-8

Engage in an activity or play with a toy they like.

TYPICAL Shows interest, laughs and interacts with you.

ATYPICAL Does not pay attention or cries when you engage with them.

 

Chat with your child, call their name, smile, and try to make eye contact.

TYPICAL Your child responds, also smiles, and turns their head to make eye contact with you.

ATYPICAL Your child does not seem interested, cries, or does not follow your voice or face.

Why this is important:

A sudden lack of interest in things that were originally well liked by your child, or impaired focus, or being absent, can be signs of developmental delay, or regression.

Observe, document and share your concerns with your healthcare professional. If your child could do any of these actions previously, but are unable to do so now, please act urgently.

You can download some diaries to use as a tool to track your child’s development and capture any unusual signs of potential concern. We recommend that you make notes regularly and share them with your healthcare provider.

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      If your child seems to have lost skills they had previously mastered, or you are concerned about their development, you should share your documented observations with your healthcare professional urgently for further investigation.

      References

      1. Pineda RG, et al. Head Lag in Infancy: What Is It Telling Us? Am J Occup Ther 2016;70(1):1-8.
      2. Great Ormond Street Hospital. Brief Developmental Assessment (BDA). Accessed via https://www.gosh.nhs.uk/file/1841/download?token=oTvMwb9q on 26 July 2023.
      3. Healthier Together. Website accessed via https://www.what0-18.nhs.uk/ on 7 March 2023.
      4. Nickel LR, et al. Posture Development in Infants at Heightened vs. Low Risk for Autism Spectrum Disorders. Infancy 2013;18(5):639-661.
      5. Sun A. Lysosomal storage disease overview. Ann Transl Med 2018;6(24):476.
      6. Alenezi S, et al. Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study. Behav Sci (Basel) 2022;12(12):509.
      7. Reiss AL. Childhood developmental disorders: an academic and clinical convergence point for psychiatry, neurology, psychology and pediatrics. J Child Psychol Psychiatry 2009;50(1-2):87-98.
      8. Eichler F, et al. Understanding caregiver descriptions of initial signs and symptoms to improve diagnosis of metachromatic leukodystrophy. Orphanet J Rare Dis 2022;17:370.
      9. Valla L, et al. Motor skills and later communication development in early childhood: Results from a population-based study. Child Care Health Dev 2020;46(4):407-413.
      10. Burr P, Choudhurty P. Fine Motor Disability. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. 2022 Oct 10.
      11. Cleary MA, Green A. Developmental delay: when to suspect and how to investigate for an inborn error of metabolism. Arch Dis Child 2005;90(11):1128-32.

      IE-NoP-2400009, July 2024

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