Let’s talk about crawling! What is crawling? When should a child learn how to crawl? Why is crawling an important (maybe even vital!) developmental milestone?
What happens if a child skips the crawling phase? How can you encourage your young child to crawl? And how can you help your older child develop crawling skills if they skipped or struggled with crawling as an infant?
First, let’s break down what crawling actually is.
Crawling is a form of locomotion - it is a quadrupedal movement pattern. Quadrupedal is simply having four limbs (or feet). When we refer to quadrupedal for crawling, this means moving on hands and knees. Crawling allows an individual (typically an infant or young child) to move from one place to another.
While there have been some recent changes to the CDC Developmental Milestone checklist - in which they completely removed crawling as a developmental milestone - many professionals in the pediatric and healthcare fields still believe that crawling is an important, and perhaps vital, milestone for most children. That is the angle this article will focus on.
A quick note: There are some children who are unable to crawl due to underlying medical conditions. For the purpose of this article, we will focus on the children who have the physical capabilities to crawl.
Before an infant can crawl, he/she must first establish other gross motor skills. Crawling requires significant strength and stability throughout the cervical (neck), shoulder girdle, core/trunk, hips, and lower body musculature. Without proper muscle tone and strength, as well as joint stability, an infant will not have the physical strength necessary to hold him/herself up against gravity.
How is this muscle tone and strength developed?
Through other infant developmental milestones!
First, an infant will begin to develop cervical (neck) strength by developing the ability to hold his/her head up against gravity while being held and during tummy time. Once this is established, the infant will begin to prop him/herself up on forearms while in tummy time. Next, he/she will push up onto hands while in tummy time. And finally, the infant will be able to move into the pre-crawling position - on hands and knees.
These skills develop over time and with consistent practice. This is also why many professionals advocate for daily tummy time! Simultaneously, the infant will begin developing core strength and stability to sit upright and balance without tipping over and without external support.
Additionally, crawling requires bilateral coordination. This is the ability to coordinate both sides of the body and both upper and lower limbs in order to complete a task. Crawling requires the use of both arms and both legs. After the infant is able to successfully hold him/herself up against gravity in the pre-crawling position, he/she can begin to coordinate arms and legs to move forward. Just like building up the muscle tone and strength required for crawling, building the bilateral coordination for crawling takes time and consistent practice!
All of this development happens before the first birthday and although all infants develop at their own pace, but most professionals typically agree that an infant should master crawling before their first birthday!
Let’s briefly go over primitive reflexes, as primitive reflex integration is an important part of developmental milestones.
At birth, primitive reflexes are present to assist in survival - most develop in utero. These involuntary movement patterns are designed to keep the newborn alive and help with development throughout infancy. They are essentially the foundation for higher-level learning and development. The kicker here is that these primitive reflexes do not stay forever; they should integrate - go away - typically around 12 months of age, some closer to two or three years old.
When a primitive reflex integrates, it makes way for new, more mature movement patterns and higher-level learning to develop.
To be more scientific, when a new movement pattern is developed, it creates new neural pathways in the brain, thus prompting higher-level skill development. When talking specifically about crawling, new neural pathways are developed as the infant masters each developmental milestone - first gaining head control, then pushing up on arms while in tummy time, and moving into the pre-crawling position. However, these cannot be achieved without primitive reflex integration.
So what comes first, primitive reflex integration or developmental milestones?
That’s like asking, which came first - the chicken or the egg?
Primitive reflex integration is so entwined with developmental milestones that one cannot happen without the other.
For a more in-depth discussion on primitive reflex integration, check out our blog post, What are Primitive Reflexes?
As mentioned previously, the CDC recently removed crawling as a developmental milestone. However, we are going to dive into all of the reasons why crawling is typically necessary for development - and not just gross motor development, but also fine motor development, visual development, sensory processing, and social development!
We’ve already discussed the gross motor movements that are required to learn how to crawl - including the development of muscle tone, strength, and bilateral coordination. For a deep dive on gross motor skill development, check out our blog article, What are Gross Motor Skills?
Crawling truly is a building block for higher level gross motor skills. The development of bilateral coordination during crawling sets the stage for success with walking and running, riding a bicycle or a scooter, climbing equipment at the playground, various sports, and more!
Almost every childhood play activity requires the use of both sides of the body and coordination of the arms and legs.
Fine motor describes the activities and skills that involve the small muscles of the hands and fingers, and indirectly, the muscles and coordination of the wrists and forearms. It’s important to note that for good fine motor skill development, we must also have good gross motor skill development and stability in the upper body and trunk. For a deep dive on fine motor development, check out our blog article, What are Fine Motor Skills?
When an infant is participating in simple play tasks, they begin to learn that they can reach for objects and begin to manipulate or move those objects with their hands. As the palmar grasp reflex is integrated, the infant begins to intentionally open and close both hands which in turn allows him/her to hold and let go of objects. Simultaneously, the infant is developing his/her gross motor skills and is beginning to push up on their arms while in tummy time, thus putting weight through their forearms, wrists, and hands.
While in this weight-bearing position, muscles are being developed in the palms of the hands - as long as the palms are flat on the ground and the fingers are spread. Next, the infant moves into the pre-crawling position, thus putting even more weight into the arms and hands, thus continuing to build those tiny hand muscles! This muscle development sets the stage for future fine motor development!
Once the infant is crawling, they are continually applying weight to both hands. Instead of the weight-bearing being static (not moving), now the weight-bearing is dynamic as the infant moves across the ground! This dynamic weight-bearing helps to develop even more hand musculature that is necessary for refined fine motor skills later in life.
When we talk about visual development and visual perception, we are not talking about visual acuity (which is how sharp one’s vision is). Instead, we are talking about what happens when you see something in your environment and how your brain processes and interprets it, as well as what action is then taken. For example, if your friend throws a ball to you, your eyes see the moving ball, your brain processes and interprets that the ball is moving towards you, and you react by reaching up with one or both hands to catch it.
At birth, an infant’s vision is not fully developed. He/she can only see a couple of inches in front of them. Within a couple of weeks, the infant can begin to see patterns however they may appear to go cross eyed - this is very normal and in fact, this is how the eye muscles begin to strengthen. By around 2 months, the infant may begin visually tracking objects nearby and by around 3 months, he/she may begin reaching for objects (the beginning of visual motor development, or hand-eye coordination).
By the time the infant is beginning to crawl (between 6-9 months old), they will begin to visually process more of their environment including space and depth. This continues to develop visual motor skills as well as various parts of visual perception (specifically visual spatial relations). Some research suggests that children who skipped crawling or who participated in minimal crawling may not learn how to use their eyes together as well as children who master crawling before walking.
To learn more about the visual system, check out our article What is the Visual System?
Sensory processing is the way in which we process and understand sensory information. This includes touch (tactile), sight (vision), smell (olfactory), taste (gustatory), hearing (auditory), vestibular (movement and balance), proprioception (position of body), and interoception (internal state of the body).
Let’s quickly go over what sensory processing looks like.
Everyone is born with all 8 senses. These senses develop through infancy and childhood. When an individual is able to successfully process sensory input, they are able to provide adaptive responses to sensory input. For example - tolerating clothing without a big reaction; eating a variety of foods; holding a conversation with a friend in a busy environment; locating a pen in the messy junk drawer; safely navigating the environment without bumping into objects.
However, if an individual does not successfully process sensory input, adverse reactions can occur and challenges will arise during daily life tasks. For example, not tolerating certain types of clothing due to seams or tags; limited food rapport due to difficulty with food textures; inability to hold a conversation in a noisy room; inability to locate a pen in the messy junk drawer; appearing clumsy to the point of always bumping into objects in the environment.
So how does this relate to crawling?
When an infant begins to develop the necessary skills to hold their head up, to roll, and to begin crawling, their sensory system is also developing. Their vestibular system is learning how to process movement and balance during rolling and sitting activities. Their proprioceptive system is learning where different body parts are and how to move them for controlled tasks. Their tactile system is learning how to process different textures on the floor. Their visual system is learning how to process and interpret their environment.
Specifically, when an infant begins to crawl, they are receiving proprioceptive feedback through their arms and legs. This helps to develop a better understanding of where they are in space and how to move and navigate their environment (in coordination with their visual system!). Additionally, as they move through their environment they are getting vestibular input and developing the necessary musculature to maintain balance. And finally, they are receiving lots of tactile input to their hands and knees and legs and feet which helps to better understand different textures.
Just like with primitive reflexes, sensory processing is connected to all aspects of infant development.
What comes first - developmental milestones, primitive reflexes, or sensory processing? Again, they are all so entwined that they are nearly impossible to separate when talking about child development!
Finally, let’s talk a little bit about social development and how it relates to crawling. First, what is social development?
Social development refers to how a child learns to interact with others. This includes play skills and communication skills, as well as the development of emotional regulation. This happens throughout infancy, toddlerhood, and later childhood. Social development requires interactions with peers as well as adults. It also requires some type of language development (whether that be verbal or by some other means such as a picture exchange system or sign language) as well as locomotion abilities (whether that be crawling, walking, or using an assistive device).
One study from 2020 discussed the importance of motor skill acquisition in relation to language and communication, emotional expression and regulation. But let’s dive a little bit deeper and talk about how everything we’ve already gone over is connected, which then also connects to social development.
First, there are primitive reflexes which studies have shown lay the foundation for higher level learning - which includes social and emotional learning skills. Next, there are gross motor, fine motor, and visual skills which are all required (at some level) for participation in childhood occupations such as playing on the playground and playing sports. Then there is overall sensory processing which provides opportunities to successfully participate in daily life tasks including play and social activities.
Let’s assume that we agree on one thing - crawling is a necessary part of development (for those children that have the physical capabilities to do so) for all of the reasons discussed above. Because we agree on that point, now let’s dive into the ways in which we can help our children master crawling!
The easiest way to help your infant develop the skills necessary for crawling is to complete tummy time every day. This starts the day the infant is born - simply laying your infant on your chest in an inclined position puts them in tummy time position. Completing tummy time daily, when your infant is happy and awake, will set them up for crawling.
Once your infant gains head control, you can begin placing toys and high-contrast colored books near them to look at while in tummy time. As your infant begins reaching for these objects, place them close enough for success. As your infant begins pushing themselves up on their arms and hands, move those objects a bit farther away to encourage him/her to attempt to move forward.
Another way to make tummy time fun (once your infant has gained head control) is to complete tummy time over a round or peanut therapy ball. Place a mirror in front to make it even more engaging. You can also place toys in front for your infant to reach for while moving on the therapy ball.
As your infant begins to push up into the pre-crawling position (on hands and knees), make sure they are rocking back and forth. You can help facilitate this by providing support at his/her hips and gently rocking them. This can be fun to complete in front of a mirror and maybe with some fun music! Additionally, place those toys just outside of reach to encourage your infant to begin attempting to move forward.
Once your child has begun crawling, provide as many opportunities to crawl as possible! Use pop up tents or build a tent using chairs and blankets. Set up simple obstacle courses that include crawling to preferred toys. Try crawling on different surfaces - grass, dirt, carpet, hard floor, etc. Try crawling up and down slight inclines. Be sure to encourage your child to complete crawling on open hands and knees.
Once your toddler has begun walking, it can be challenging to convince them to crawl again. This is where creativity takes hold! Set up tunnels with their favorite toys on either end. Push a noisy ball through the tunnel. Set up more challenging inclines to crawl up with their favorite toy at the top.
A simple obstacle course with a tunnel, an incline, and a cause-and-effect toy can be a great activity for your toddler. They may only complete it once and that’s ok! The more you complete simple 2-3 step activities like this, the more they will enjoy and learn how to sequence them.
Don’t fret! There are plenty of crawling opportunities for older children as well! Just like in toddlerhood, older children can benefit greatly from obstacle courses (see our video below!). However, older children can complete more complex obstacle courses! Just make sure you include a crawling component - with a larger tunnel, with crawling over bean bags or pillows, or with a crawling challenge such as crawling with a bean bag on his/her back.
Some other ideas for older children who skipped crawling:
The key here is to remember why crawling is so important - it helps develop all of the necessary skills that your child will need later in life. From primitive reflex integration to sensory processing, crawling is a foundation for higher level skill development. Additionally, all children develop at their own pace! However, if you are concerned with your child’s development, chat with your pediatrician. A physical therapist or an occupational therapist can help in many areas of child development.
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