Friday, April 17, 2015

Tummy Time and Developmental Delays

I have a love hate relationship with the ASQ.

Actually that's not totally true.

It's mostly a hate-hate relationship.

I mean, logically I get why it's important.

I get why the kids' pediatricians office has us fill them out.  I know that the checklist is useful in identifying developmental problems.

But that doesn't mean I look forward to it.  Checking "not yet" over and over again gets depressing really, really fast.

It's the opposite of the twice a year therapy evaluations where we look at how far Mae has come and all the things she can do and is working to do.  It can feel like a giant list of can'ts.

Still, when James' ASQ arrived for his six month well baby check I wasn't worried.

At least I wasn't worried until I found myself scrolling along on Facebook and started to notice that all the babies that were born after he was born here doing things that he isn't even near doing.

Then I went back to the mantle and found the envelope with that Ages and Stages Questionnaire in it and ripped it open and ran my finger down the list.  Yes, yes, yes, sometimes, yes.

Then I got to gross motor skills.  Yes.  Sometimes. Not yet. Not yet. Not yet.  Not yet.

He was already having quite a bit of tummy time but suddenly James found himself in baby boot camp.

What kid, you think ten tummy time sessions in one day is enough?  Push that little chest up off the ground or roll over and we'll talk about taking a break.

After two weeks of super extra tummy times I spoke with two of our OTs, beginning the conversations with the question: "If there were a six month old that got almost all "not yets" on the ASQ do you think the doctor would hold off and see how things go, or do you think they'll order testing right away?"

After answering a few more questions on what's going on, the general consensus is that physical therapy is very likely to be ordered right away.

Thankfully we already have quite a few supports in place, so today at a Early On activity I was able to ask even more questions and when Patch has his Early On appointment next week I'll ask about setting up an eval (James also has his pediatricians' appointment next week), because he's not rolling all the way over on his own, or pushing his chest up off the floor or putting any weight on his legs (they're seriously like jelly when I try to get him to stand).

He's social and friendly and smiley and happy.  He's just also kind of floppy (enough so that I've started to think of him as "Floppy Baby" instead of "Grumpy Baby.").

I'm not worried at this point.  If there's one thing I've learned in the last year and a half it's that early intervention can be huge and we're certainly catching on that there may be red flags early this time.

So now to gear up for another week of appointments and days of Super Tummy Time for the tiniest member of the family.


  1. Mine wasn't doing what was supposed to be happening so I simply shifted from the current mode of tummy time and everything else on the back to: all day tummy time. After all, I am right here with the child the entire time, and when my oldest was born they were still saying to put the baby on his tummy to sleep and only a very few early voices for on the back sleeping were being heard back then, so while I insist on nighttime on the back, I am allowing a lot more on the stomach short naps to increase how much she experiences tummy work (I also wake her to feed her on schedule since she isn't the most reliable about remembering to ask to eat). The result was all the gross motor the kid was behind on was caught up a huge amount, and the child who could barely lift her head now pushes up with her arms and lifts her head, rolls over from tummy to back-- but still cannot back up once her head is against the side of the playyard. I think some of our kids need a lot more tummy time than others. Of course, there are still a few things this one is not yet doing, and nothing where she is ahead of schedule. Still I was very surprised to realize how many hours she had to be on her tummy to make any progress at all. Even so, the kid is behind a bit but the change to all day tummy time has speeding things up, and I hate those charts too.

    My kids up until the youngest have been a month or two ahead on some things, a month or two behind on some things, and with a few things months ahead, o behind on the charts, and hardly ever actually ON the schedule and my first actually gross motor skilled child is amazingly clumsy with fine motor, enough that I am getting a bit concerned but may not be behind except by comparison to all his siblings who were very early in fine motor skills...and then the baby, who has been behind fairly consistently but not quite far enough to trigger concern in the pediatrician.

    My biggest concern has always been that my kids get comfortable with or without me so very early that I wonder if we missed a bonding step. Up until number 5 I never did have a baby get so bonded that my being gone bothered them. OR I was so reliable they took me for granted from birth (unlikely). This one actually wants me preferentially and that has been fun-- I finally have a child who fits the descriptions of properly bonded. Now if only the charts didn't make me so nervous about all the things she does poorly or not quite yet....but as I said, she has needed a LOT of tummy time to make progress at all.

  2. I wouldn't want to discourage any necessary tests but my oldest would probably have qualified for "floppy baby". He took forever to hold his head up alone and didn't walk alone until 16 months. He also had fine motor issues and was never really what you'd call a "rough and tumble" type. However on the strengths; early speech and great vocab and social skills. And today he works as a cook. With sharp knives! And he still has all his fingers! LOL I would do all the tummy time stuff and any other gentle exercises/head start type stuff that is suggested. Any type of early stimulation helps guild a baby towards being on track as opposed to the whole "wait and see" approaches that may be losing valuable developmental time. (can you hear the mom whose kid had developmental issues here??) But even if James has any kind of issues; doing all that stuff is super helpful and won't hurt at any rate.

  3. Our #5 was a floppy baby and I wish someone (me? ped?) would have caught it earlier. He was finally 13 months when we did all the tests and started Early Intervention. He is 22 months now and moving about like a champ, but it was a scary time testing for cp, md, sma etc. I don't know if more tummy time would have worked for my guy, but I wish I had thought to do more of it. Maybe we could have been spared some of the anxiety.

  4. When we had custody of my nephew, he was delayed. He was born addicted to meth. I know it is a different story. But he was exactly what you describe FLOPPY at 6 months. But by a year, with Occupational therapies, he was an entirely different child. When his parents got him back, he had way more Yes' than No's.
    Hugs and prayers.
    Sure are beautiful kiddos.

  5. Totally out of the ordinary here too, but my son has had two open heart surgeries, two general surgeries on his colon, and countless other procedures during the first 15 months of his little life. He had NO tummy time until shortly after the last cardiac surgery and he was nearly 11 months and didn't even roll until then. To say we had no anxiety about what the rest of his life/developments would look like would be a flat out lie. Today he is 18 months old, and just starting to pull up and cruise around holding onto things. He had a PT evaluation today and where he is obviously delayed (about the ability of a 12 month old), from all that he went through, he's on the right track. I guess what I'm trying to say is that the charts are guidelines. Sheesh, my son would be considered "failure to thrive" according to his growth chart. If you saw the way he gets around with his 6 other siblings, you would outright laugh. He may be "failure to thrive" on the charts but he's one tough little dude and is doing big things -- HUGE things, considering we didn't know if he'd be making any of these milestones. Kids are so amazing. Prayers for you that all progresses well.


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