Updated CDC Developmental Milestones
For the first time in 20 years, the CDC has modified and updated its developmental milestones checklist. This checklist is typically used during a child’s regular well visits with their pediatrician to help identify developmental delays. The previous milestone checklist was based on the 50th percentile (when 50% of children were expected to achieve a milestone at a certain age). The new checklist is now based on when 75% or more of children are expected to achieve that milestone.
The Removal of Crawling and Why It Matters
I bring this up because, as part of the checklist revision, the motor skill of crawling has been eliminated. Along with this change, I’ve been asked by many families about the importance of crawling on hands and knees. This question often follows stories of children who never crawled and went straight to walking, or concerns about children who move in other ways, such as scooting on their bottoms or army crawling.
Is Skipping Crawling a Concern?
There is no conclusive evidence showing that skipping crawling negatively impacts development or overall function. However, this does not mean that crawling offers no benefits or that it doesn’t play an important developmental role. As a pediatric physical therapist for the past 20 years, I strive to help my patients achieve crawling on hands and knees—even if only for a short period of time. Here’s why:
Benefits of Crawling
- Promotes physical strength: Crawling strengthens the core (by lifting the tummy off the floor), shoulders (through weight-bearing on the arms and hands), and legs (through forward movement across the floor).
- Improves coordination: Crawling requires both sides of the body to work together, building the coordination needed for walking, running, climbing stairs, playing hopscotch, and using both hands for activities like cutting with scissors.
- Develops hand-eye coordination: This skill is essential for tying shoes, throwing or catching a ball, reading, and writing.
- Builds fine motor strength: Weight-bearing on the hands strengthens the small muscles necessary for writing and tying shoes.
- Supports binocular vision: As children look down at their hands while crawling and then up to see where they’re going, their eyes learn to adjust between near and far objects—an important skill for catching a ball or driving later in life.
- Encourages problem-solving: Crawling helps children learn to maneuver around objects, use trial and error, and plan paths to reach desired toys or goals.
How to Encourage Crawling
- Tummy time, tummy time, tummy time!
- During floor play, spread toys out of reach and encourage your child to crawl toward them.
- Use a tunnel or cardboard box to make crawling a fun activity.
- Get on your hands and knees and play “chase” by pretending to be an animal.
- Demonstrate crawling yourself, or have older siblings join in to model the behavior.
When to Seek Professional Guidance
As always, any questions or concerns about your child’s development should be discussed with your pediatrician, who may refer you to a pediatric physical, occupational, or speech therapist. If your child already has a PT, OT, or SLP, keep communication open and share any new or ongoing concerns. We are here to help both you and your child grow, develop, and achieve the highest level of functional independence possible.
