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Newborn and Infant Care

Develop stages for 10 month old

09/14/2006

Question:

My question is what should a child be doing at the age of 10 months? my grandaughter is 10 months and is not pulling herself up nor is she crawling ..when you try to stand her up she holds her legs up and will not stand..We are concern with this also she has not cut a tooth yet...do you feel there might be something we should be looking into?

Answer:

The answer to whether or not there is a problem depends, in part, on whether your grandchild was a preterm infant or not. If she came early, you and her parents should subtract the number of weeks she came early from her chronological age, because developmentally, she truly is younger than her chronological age, so less mature behaviors are expectable. For example. If she was born 8 weeks early, she is actually 8 months old in her development, not 10 months old. This should be done for the first 2 years of life.

That being said, all children develop on their own schedule and there is increasing variability among infants in skill levels in body movement and language, with increasing age. Part of that variability is the result of genetic inheritance and part of it is environment and experience. So, if your granddaughter has a parent who matured later in gross motor skills such as crawling and tooth cutting, she may have inherited those same developmental patterns.

Pediatric dentists tend not to worry about teeth appearing until the child is 12 months old. Then if there are no teeth, they X-ray the gums to see if teeth are present. Sometimes they cut the gums to hasten tooth eruption.

If your granddaughter was a full term, healthy baby with no problems at birth, then it is somewhat more worrisome that she is not wanting to bear weight on her legs, which is a requirement for pulling to stand and moving around holding on to furniture (cruising). Crawling usually does precede standing. However, some children do not crawl, which used to be considered a normal variant. Now we know that these children are very likely to later have difficulty with reading and writing. In fact, one treatment used by occupational therapists is to have the older child learn to crawl. Walking may occur as late as 17 months of age and still be considered normal. For certain, she should be able to sit without support by 8-10 months of age. So if she still needs help with sitting steadily on her own, the likelihood of a problem is greater.

In summary, I would say that if the little girl is preterm, she is more likely to be developing appropriately. If she was full term and healthy at birth, then her developmental progress is somewhat slow and should be evaluated, especially if she is behind in language skills as well as gross motor development or sleeps more than 16 hours total per day. The baby's doctor can do this or her parents can request an evaluation by the Help Me Grow program in Ohio. This is free and can be arranged by contacting the Help Me Grow office in your granddaughter's county of residence. They are listed on the website at www.ohiohelpmegrow.org. If a problem is identified, they can help guide her parents in locating the professionals she needs for early intervention.

Other resources her parents may find helpful are Penelope Leach's wonderful book "Your Baby & Child from Birth to Age Five" published by Knopf and a real bargain at $20. The Healthy Start, Grow Smart booklets are available for download at http://www.ed.gov/parents/earlychild/ready/healthystart/index.html or ordered by calling 202-205-8113. These free resources offer parents a month-by-month guide to their growing infant in the first year of life and suggested activities to support mastering new skills.

She is a lucky baby to have caring grandparents! I hope this information is helpful.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University