Fine motor skills are the way that we use our fingers and hands to manipulate small objects. They are very important when we go to school and it’s time to work with pencils, crayons, and scissors. However, fine motor skills begin to develop long before school age. At around 3 months old, babies begin to use their hands to grasp objects and their arms to swipe. Between 9 and 12 months of age, most infants can pick up a small object with the thumb and index finger, which is called a pincer grasp.
At two years of age, a little one can color with whole arm movement and holds a crayon in a fisted position with the thumb facing upward. By age 4, most children can imitate a cross and trace a diamond and a triangle, and by age 5 they can hold a pencil with 3 fingers, which is called a tripod grasp. This is the optimal grasp to have when writing, although there are others that are acceptable. Hand dominance is typically established by this age as well.
Does your baby always turns her head to the right or left side? If so, you may want to ask your pediatrician if your child has a condition called congenital muscular torticollis (CMT). Torticollis means “twisted neck” and this condition is usually caused by tightness in one or more neck muscles. A baby with CMT often turns her head to one side with her chin pointed in the opposite direction. One shoulder is typically held in a higher position than the other. Infants with this condition are at an increased risk for developing flat spots on the head (positional plagiocephaly).
Infants are typically diagnosed with CMT sometime during the first two month of life. If not treated, CMT limits an infant’s ability to move her head freely to see and visually explore the environment, and CMT is often associated with delays in motor milestone development. Physical and occupational therapists treat torticollis through soft tissue mobilization and stretching. Educating parents about positioning and handling techniques is also an important aspect of treatment. For example, one position that therapists often recommend is holding baby in a sidle lying with the tight side of the neck down and baby’s head resting on the parent’s forearm. This gives the neck muscles a nice gentle stretch and allows the infant to visually explore the environment while remaining in close contact with the parent. For more information and a wonderful video series on infant development, please visit www.carolinakinderdevelopment.com.
Does your baby have a flat spot on the side or back of this head? The medical terms for these conditions are plagiocephaly and brachycephaly. Positional plagiocephaly means “oblique head.” When baby’s head is viewed from above, the shape of the head has a parallelogram appearance. This is caused by pressure that has occurred to one side of baby’s head. Positional brachycephaly happens when a baby has spent to much time positioned on his back, often lying against a plastic surface, such as a carseat. The pressure from prolonged positioning like this causes the back of the head to flatten unevenly, resulting in a short and wide head shape. The height of the back of the head may also be high.
Flat spots on the head occur because the skull bone of an infant is soft and flexible, allowing for the brain growth that happens early in life. When a baby stays one position for too long with her head resting against a firm surface, the pressure from that surface prevents the skull from developing into a normal shape.
In some cases, babies prefer sleeping or sitting with their head turned in one direction, because of tight muscles on one side of the neck. When a baby spends too much time with his head turned to one side, he can also develop acquired torticollis. In this condition, the neck muscles shorten on one side due to the position of the head. Baby’s neck turns in a twisted position and pulls his head to one side. His chin typically points to the other side. Torticollis contributes to flat head syndrome because baby’s head is typically turned in the same direction, and causes pressure against the side of the head. Acquired torticollis can be treated with stretching exercises from a physical or occupational therapist in conjunction with a home program carried out by the parents. If you suspect your infant has torticollis, consult with your pediatrician immediately. If your physician has ordered therapy for torticollis and you live in the Memphis, Tennessee area, feel free to contact me about torticollis therapy treatment.
For information about therapy services for an infant who has acquired torticollis, click HERE, then click on the contact tab in the upper right hand corner of the page.
This is a nice position for holding your baby, and it takes pressure off of the head.