Children born prematurely tend to reach milestones a little later. Children that suffer from cerebral palsy and other medical disorders sometimes skip certain developmental milestones. Some of these milestones include rolling over as an infant, sitting up as an infant, crawling or walking, talking, potty training as a toddler, dressing as a toddler, or independent feeding.
Motor development is an important component of child development and involves underlying factors or processes influencing movement as well as movement itself .Motor development begins at conception , movement is first observed at birth with reflexive and random movements, which stimulate maturation of the central nervous system . The maturing nervous system permits increasingly greater voluntary control over movement during the first year of life. Movement itself causes feedback to and from the central nervous system , thus contributing to refinement of motor control . Fundamental movement pattern are basic stabilizing, locomotor , or manipulative movements and consist of an organized series of related movement. Fundamental locomotor pattern are gross motor movement that propel the body from one place to another . Skipping is most difficult of these fundamental locomotor patterns and is highly dependent on neurological maturation. This sequence begins with crawling and creeping during the first year of life, followed by walking , running , jumping, galloping, sliding, hopping, leaping, and finally skipping.
Skipping is a basic fundamental locomotor pattern that most children acquire between the age of five and seven , with more children able to skip with increasing age. Gutridge (1939) reported that 14% of 4 year old , 22% of 5 year old, and 90% of 6 year old could skip well , with a large variation in performance across the different age levels. There are three stages of skipping and the motor age in months accompanying the stages :
- shuffle 38 month
- skip on foot 43 month
- skip alternating feet 60 month
Skipping has been defined as a cross-extension movement of hopping, that is, a movement consisting of step hops alternating on each foot to move the body forward. Skipping has a double-task pattern each foot completes the step and hops before transferring weight to the other foot to complete the same task. This adds considerable complexity to the task. In addition, the arms move reflexively in opposition to the feet, and the movement is smooth and rhythmical. Skipping is a phenomenon that is something of a Gestalt experience because the whole is more than the sum of its parts. Something happens when the forward upward and side-to-side movement pattern is combined with the quick three-beat rhythm of the skip integration of the parts into a new unique mode of locomotion. Because skipping is comprised of step and hop it is assumed that the skills prerequisite to skipping will develop first. One prerequisite skill and component part of skipping is hopping; therefore, children should be able to hop a number of times on either foot before they alternate. Most children gallop and slide before they skip and often children who do not know how to skip will gallop when asked to skip. Other children may attempt a rudimentary type of skipping, a step hop movement on one foot, and walking on the other foot. If there is a delayed development of bilateral coordination would impede the child’s ability to skip
Are growth problems considered skipped developmental milestones?
Some physicians consider growth problems as part of disabilities associated with skipping developmental milestones. After all, sometimes infants develop disorders and disabilities due to low weight associated with the disease (problems such as spasticity in the digestive tract preventing natural digestion, problems with spastic movements,, and trouble swallowing or eating based on oral muscular disabilities). Because growth problems are in direct relation to disabilities, growth problems are sometimes considered skipped developmental milestones.
Occupational therapists focus on teaching so that infants and children can go on to experience a richer and more independent life. Sometimes they struggle with these milestones because they have an intellectual disability as a facet of cerebral palsy, and sometimes the nature of the cerebral palsy has limited their muscle movement and they don’t have control enough over their muscles to perform these tasks.
