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Giving your Children the Very Best

Motor Delays and Cerebral Palsy Motor Delays are defined as delays in use of the large muscle groups, including arms, legs and the spine. Motor delays are notices when the infant does not crawl on time or walk on time. There are signs before these major motor tasks happen that one might be alerted to if there exists a problems with motor development. Below is a time sequence of the motor development. Gross Motor Development

Action Age Holds head up 1 Month Rolls over from front to back 3-5 Months Rolls over from back to front 4-5 Months Sits with support 5 Months Sits without support 7 Months Pulls to stand 8-9 Months Walks along furniture 9-10 Months Walks alone 12 Months Runs 15 Months Walks up Stairs 21 Months Jumps in place 24 Months Walks down Stairs 36 Months

Fine Motor Development

Action Age Holds objects 1 Month Reaches for object 3 Months Transfers object from hand to hand 5 Months Grasps small object like raisin 6-8 Months Grasps with index finger and thumb 10 Months

Cerebral Palsy is a disorder caused by an injury in the motor area of the brain. Often it is unclear as to what caused this injury. Premature birth is responsible for some of the injuries to the brain, but most of the time we cannot say what caused the injuries. About 15-20% of babies with motor delays will develop cerebral palsy. Cerebral Palsy develops over the first 12-18 months of age. Most of the time, your doctor can tell by 6-9 months of age, if your baby has cerebral palsy. On occasion in milder forms it will not show until later.

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The incidence is about 2 cases of cerebral palsy in 1000 babies. Half of these babies would have been premature. The smaller and earlier the baby is born, the greater risk for the development of cerebral palsy. Other signs to watch for include having poor muscle tone or being floppy. As the baby gets 6 months of age their muscles will relax and become more coordinated, if they become stiff this would be another sign. Babies with cerebral palsy often do not feed easy or sleep well. Fussiness is another sign to watch for. If Your Baby is Premature

• All development tasks are delayed for premature babies. For every month premature your baby is, you get that many months extra to obtain the skill. In other words a baby 2 months early would not be expected to walk until 14 months.

• Follow closely your child’s development. • If you have concerns, consider having a developmental evaluation. • Some premature babies are eligible for developmental therapies even if there have been no

problems identified. Ask your pediatrician about this. If Your Baby Has Motor Delays

• Talk with your pediatrician; seek out consultation to verify that if in fact your baby is delayed. • A referral to the local development services coordinator will assist in getting services for your

child. • Developmental therapies often help allow your baby to make progress; these include

Occupational Therapy, Physical Therapy and Speech Therapy. • Sometimes scans (head ultrasound, CAT scan or head MRI) can assist one in knowing if there is a

brain injury that might lead to cerebral palsy. If Your Baby Has Cerebral Palsy

• Develop a relationship with your pediatrician as your baby will need ongoing services. • A referral to the local development services coordinator will assist in obtaining the services for

your baby. These will include physical therapy and possible speech and occupational therapies. • You will need assistance in obtaining equipment to assist you in dealing with a handicapped

child. Try to get your team in place including your pediatrician, therapists, teachers and family. • Never lose hope; many children with cerebral palsy develop in other areas including cognition.

Some will go through school and learn ways of managing their disabilities. Joseph C. Stegman, M.D. Maricela Dominguez Gulbronson, M.D. F.A.A.P. Mark C. Clayton, M.D. George W. Hatley, PA-C Angela Noone, CPNP 301 Medical Park Drive, St 202B, Concord, NC 28025 Phone: 704-403-2626 | Fax: 704-403-2699 | www.behavioralpeds.com