In the previous articles from this serie we introduced you to all the abilities according to which we evaluate the correctness of the psychomotor development of the child. Gradually we went through the periods from birth till 4th month of the child's life. Today we will focus on how you can check the correct development of your children between the 5th and 6th month, and according to which signals you will find out that something is not right.
Whether the child will be rotating after 5 months depends from big part whether it is able to grasp and reach for objects across the middle line (for example left arm is grasping a toy offered from the right side).
What should the baby be able to do while laying on the back?
The child should be able to keep its body in a straight line without problems.
That means that the head, trunk and legs are in one straight line. This ability was developed from the 3 month of life. But if you observe in the 5th month persisting asymmetry in how the child keeps the axis straight (the child is not able to place its head, neck, trunk and legs into a straight line, meanwhile the axis of the shoulders and pelvis is in a right angle to the longitudinal axis), you should pay attention!
Another typical point after reaching 5th month is that the child is able to lift up its legs to such a height where it can reach on its calves, ankles, alternatively toes on the feet.
So the baby is able to sufficiently involve the abdominal muscles and lift up the bottom from the ground. The child should during this „heavy” exercise keep the body in symmetrical position.
1.signal of incorrect development
If the child can stay in the symmetrical position, however it often returns back to asymmetrical position, you should contact neurologist, pediatrician or directly a specialized physiotherapist. After talking to one of the specialists, correction of the body posture should be started by using ideal rehabilitating methods.
Babies sometimes also like to play with their own feet. They are watching their feet with enthusiasm how they move and touch each other.
While laying on the back, five months old babies like to play with their hands without any problems.
The child is consciously playing with the hands, observing them, and if it has a toy, it should be able to hand the toy from one hand to another without the toy falling.
By five months old toddlers we can observe how they start to rotate.
Big motivation for the child is to reach for a toy, which is on the side (for example on the left). The child should start to reach for a toy with a right hand, pulling the legs towards the belly, left hand should be placed in a right angle to the body, and turning trunk to the left side. The child cannot turn further coordinately, therefore they often fall back on the back.
What should the child be able to do while laying on the stomach?
The child will continue to „exercise” the achieved abilities. It will be more and more leaning against one hand, resting on the elbow and forearm, and using the second arm for grasping toys. The child should be able to switch the supported arm, right and left and the opposite leg.
2. Signal of incorrect development
If you observe by your child, that it prefers to lean for example only on the left forearm and right knee, using only right arm for grasping objects, you should pay attention. If the child doesn’t switch sides till two weeks, it can be a signal of incorrect psychomotor development of your child.
Sixth month is crucial period for the development of the child. During this month the baby starts to rotate from position on the back to the position on the side and till the 6th month the child should be able to rotate from back to stomach. The whole act is very difficult, and therefore for a perfect training of the full rotation will the child need approximately month and a half.
Because the child can reaches across the middle line, it leads to gradual rotation of single segments of the spine. The child will start to rotate also the pelvis and involve external oblique muscles, so that it could rotate to the side and stomach. For rotating to the stomach, the child has to learn how to spread both legs.
Up till now, both legs were activated when the child pulled them simultaneously towards the belly, but now it has to bend one leg and stretch the other so that it could rotate on the belly. At the same time the child has to differ both hands. The upper hand has to reach for the toy, meanwhile the other hand will support the trunk and help in the full rotation of the body.
What should the child be able to do while lying on the back?
While lying on the back the child should be able to reach for hands, tapping them, begging to observe and touch the feet and single toes.
Coordination of the eye-hand-leg is by a 6 months old child very favorite game of children.
The child is grasping for the toy with the whole hand, basically with the open hand.
The child is able to pull big toe as much as possible from other toes and stretch out the remaining four toes. In the beginning the child held the toy from the pinky finger side of the hand and afterwards holding it with the whole hand.
If you hand the toy to the child directly from the middle line, above the face or chest, it will not be able to decide with what hand to reach for the toy.
This hesitance is manifesting when the child waves with both hands, opening mouth, kicking with the legs, as if it would want to hold the toy with the whole body.
Even eyes have their own muscles, their movement coordination had to mature with time.
Some babies are after birth slightly squinting. This squinting was physiological (that is normal given to the age of the child) till the 6th month. However now all the eye muscles should be sufficiently coordinated by the head nerves, so the child should not squint.
3. Signal of incorrect development
If you observe even after 6 months that the child still has asymmetrical eye movement, then definitely search out pediatric ophthalmologist.
What should the baby be able to do while lying on the stomach?
There is a big advancement in this age while laying on the stomach. The child is able to lean on both elbows and stretched hands, meanwhile resting on the palms of the hands. It got therefore to the „second floor”, from where the child has yet again better sight in its environment. Child can even in this position relieve one hand to reach for the toy. If the child is able to reach for a toy, it will get into the position, leaning against the elbow and forearm and at the same time resting on one knee.
It is also characteristic for this time period to „swim”, someone knows the term „airplane”. It is similar to when the child lays on the back and it is not able to decide, with which hand it will reach for the toy, it is same while laying on the stomach when the child sees the toy, but cannot reach it, it will start to kick with legs, bend in the back, drool, opening mouth and waving with hands. The child cannot yet crawl, and it has no clue what to do in order to reach for the toy. Therefore this is the only possible spontaneous manifestation.
If you perform the so called traction test by a 6 months old baby, that is when the baby is lying on the back, and you hold the child by the hands and you pull it to a sitting position, the child should alone roll into a “ball”. The chin will be tucked towards the chest, and the child will pull itself with the hands, pulling the shoulder blades together and feet towards the belly.
Published in magazine Uzlíček, no: 6/2007
Author: Mgr. Iva Bílková, FYZIOklinika fyzioterapie Ltd, Prague, Czech Republic