In the previous article from this serie we focused mainly on how can the development of your child be disrupted by prematurely standing the child, or trying to speed up the maturation by sitting the child up. Ninth month, to which is this article dedicated is a month of big advances. Your child will learn how to sit in a straight position, kneeling, crawl on all fours and even trying to stand up.
In the ninth months comes a significant advancement. Your child will learn to sit straight, kneel, crawling on all fours and even trying to stand up. In a relatively short time 3 to 4 weeks will your child adopt many skills. It doesn’t matter in what order it will accomplish those skills, evaluation is again important, how well can the child perform single moves.
New position for playing
Your child should not be anymore in the position on the back or stomach, if it wants to play. The mental development is progressing very fast, which is a big motivation to reach for objects, which are placed on a chair or a lower table. Another big development of movement forward is caused by the fact, when the mother or any other close person goes further away too fast and too far. The effort is to get the toy, which the child sees but cannot reach , will motivate the child to find a solution, how to get to the destination as fast as possible without any excessive physical activity. Crawling is in this case for the child demotivating. It is too demanding and slow. The child has to find out how to move more fast and with less energy.
Position on all fours
The child can get into kneeling position on all fours in two ways:
1. From the so called tilted seat, when the child is leaning on the stretched hand, basically only the hand, one side of the pelvis and bending leg. The second leg will be freely placed in front of the body (as in 8th month). The child only has to stretch out for the toy, which is a little further from the body and slightly lifting the bottom from the ground, and getting that way on all four extremities.
If the child gets to the plank position, which was described in the 7 month, as a catapult, is a dead end for the child and a sign that it doesn’t involve the muscle chains on the trunk in the movement patterns.
2. The second option is that the child will rebound from the position on the stomach on both hands, stretching out the elbows and stepping forward with one leg and then with the second leg as well, to get into a kneeling position. And in order to be able to „step” towards the toy or any other goal, the child has to get into this kneeling position this way.
Creeping is science - immature crawling
Creeping is less energetically demanding and at the same time it is faster than crawling.
If the child is only beginning to creep, we talk about immature creeping. The child is switching legs and arms, but there is no coordination in between the single muscles of the trunk.
Signs of immature creeping which you can observe alone at home:
- Shoulders - inner rotation of the shoulders, when the child is rotating both hand and also fingers in a direction against itself
- Shoulder blades - the shoulder blades are sticking out forming small “wings”
- Trunk - the trunk is hanging down, and is slightly curved
- Head - head is dropping little bit down towards the ground, alternatively the cervical spine is significantly bending and the chin is pushed forward
- Pelvis - we can observe on the pelvis, how the child trying to step forward deflects to the side, the shins are directing outwardly and are slightly above the ground. The child is therefore resting only on the inner side of the knees.
Is there a reason for panic?
Such immature creeping can be tolerated by every child that is just trying to learn to creep. If takes up to several weeks later, it is very likely that the child had other coordination problems in the younger age (most likely since birth) and with increasing age and more difficult movement patterns it reveals coordination insufficiencies, which were earlier less obvious.
Mature creeping is following the immature creeping. It is about perfecting coordination of the immature creeping. Imperfections connected to immature creeping will disappear.
- Fingers - the child holds the finger in a hand directing forward and not rotating them inwardly.
- Shoulder blades - the shoulder blades are pressed to the back and held close to the spine.
- Trunk and head - the trunk and head are in one line without any curve.
- Knees and legs - knees are burdened in the middle and the shins of the child are kept in a straight line of the body.
Straight sitting posture
Sitting straight is often by mothers or grandmothers mistaken by passively placing the child into a sitting position. Relatives are then happy that a five months old baby is sitting, but no one evaluates whether the child managed to sit up alone or not, and to what extent is such violent sitting posture healthy for the child.
Be careful of premature sitting!
Very often the child is slouching back, head is pushed too forward and the small joints on the spine, ligaments and muscles in the area of the whole spine are overloaded. Usually the child is slightly turned to one side, which can by frequent repetitions performed by the parents or grandparents results in a scoliosis.
The whole skeletal and ligamentous system of the child is very soft and any inadequate pressure or movement can result in structural damages, and the pressure caused by the head involved on the upper part of the chest and internal organs has also bad effect on the development of the heart, lungs, livers and other internal organs.
Premature sitting can cause serious damage to the bones, muscles but also internal organs. Therefore give your child enough time, so that they would develop a correct straight sitting posture!
How to achieve the correct straight sitting posture?
How should the child manage to sit straight? The child can get to such position from a tilted sitting position. The child only has to transfer its weight from one side of the pelvis to the whole bottom. If it has a good muscle coordination on the front and back side of the trunk, if the activity of abdominal muscles and muscles on the back and nape are balanced. The child will then sit straight with upright spine without any deflections from the axis in the direct direction (leaning forward) or direction to the side (bowing).
- Legs - both legs are freely stretched in front of the body
- Shoulders - shoulders should be hanging freely down
- Neck - it should be obvious that the neck is long and straight without the head being pushed forward (pushed forward means that the ears are in front of the shoulders and the chin is pointing out)
- Head - if the child’s head is forward, because it looks on the toy, everything is of course in order.
Is there a reason for panic?
The starts of such straight sitting posture is of course accompanied by imperfections in form of curved back (the child is slouching the back), shoulders are too high by the ears, the child is unstable in a sitting position and has a tendency to fall down. But this „imperfection” of performance should be only short term (approximately first two weeks) and the child should quickly learn the correct body posture.
As soon as you will start to see that the child is able to sit in the straight posture and lift both arms above the horizontal line (stretching out hands to you, when elbows and wrists are above the shoulders), it is a good sign that your child will soon start to stand up next to the furniture.
Standing up by the furniture
Standing up next to the furniture can child achieve from the kneeling position, when it crawls to an object ( chair, couch, coffee table etc.). If the child is able to lift up one arm above 110 degrees in the shoulder joint, it will easily hold on to the edge of the object.
If the child stretches out even the second arm, and then steps forward with one leg (learning to pull up to the standing position, the child can step forward only with one leg, but shortly after the legs should be switched, so that the development would be symmetrical).
Grasping reflex is disappearing
In the ninth month fades away the last reaction of the so called primitive reflexes. Plantar grasping reflex also disappears, even though the child is learning to stand up and soon after it will learn to walk. If the reflex would remain, it would slow down or directly block this development.
What should the child be able to do in the ninth month?
In the ninth month the child should be able to use independently index finger on the hand. That way you can observe that the child is pointing a finger on a object or picture in a book. If the child points to a more distant object few meters ahead, the direction of the finger doesn’t have to respond with the direction of the given object. The child points up or to the side, even though it is looking forward. It is important for the development of the hand and gentle motor skill that the index finger is the only finger straight, meanwhile the rest of the fingers are closed in a fist.
This month will not be as important as the previous months. The child needs time for practicing and training the new abilities and get good at it. The whole 10th month will be about repeating the crawling, creeping, straight sitting posture and standing next to the furniture. New abilities are coordinately so difficult, that it can take also part of the 11th month, till the child decides to advance in further development.
If you have read this article but you still have doubts about the musculoskeletal development of your child, we recommend to contact a specialist for evaluating the psychomotor development of the baby and alternatively start with exercises (it can also in form of gentle stimulation) with the child. Timely started exercising can prevent formation of various smaller or more serious musculoskeletal problems.
Don’t try to speed up the development of the child!
Do not rush the development of your child and let it grow to each abilities alone without your help. The musculoskeletal system is maturing slowly and gradually, and only when the child starts to perform the activity without your help, it means that the system is strong enough to carry the child’s weight. If the child is prematurely seated, even though the child has not yet matured for that, it can quickly lead to damaged ligaments, but also bone structures. The result of our exorbitant effort to speed up the development of the child can be permanent damage of the child’s health.
Published in magazine Uzlíček, no: 8/2007
Author: Mgr. Iva Bílková, FYZIOklinika fyzioterapie Ltd, Prague, Czech Republic