As parents, we are thrilled when our infant starts rolling, sitting up on his own, crawling and then, walking. These are stages of developmental milestones. We also use these stages to monitor a child’s progress.

All child care books mention an approximate level of months when these milestones should be reached.

Most people are aware that a child should be able to walk by 1 to 1 and a half years. Any milestones not being reached at appropriate times usually cause parents to become concerned.

Muscle Tone and Its Various Types

All these milestones are achieved through a complex process of fine-tuning muscle tone within the child’s body. Muscle tone is the state of continuous but passive contraction of the muscles all over the body.

It sounds confusing but simply put, if you bend your elbow, the bending motion should be smooth and effortless. If it is not, then there may be an issue with muscle tone. If the movement is tight and jerky, then it is classified as an increased tone.

On the other hand, if the bending overshoots and my arm flops beyond its intended destination, then it is classified as a decreased tone.

What controls muscle tone?

Muscle tone is controlled by various factors within the body. The nervous system plays a major role in muscle strength and tension playing supporting roles. All these factors hold true for infants who are trying to achieve their milestones.

For the infant to be able to crawl forward successfully, he needs to build good muscle tone within his arms, hands, neck, and butt muscles. He is able to do that if he has rolled; held his head straight and sat up independently prior to crawling.

All these milestones have to be achieved for a reason, they are building a foundation of strength that results in all the major milestones. To be able to get up and stand, the infant should have crawled successfully for some period of time.

Muscle tone problems with normal children

Even children with normal histories should be observed for tonal problems within their milestones. Many infants miss one or two milestones in their developmental period and still walk at 12 months. Technically, they would have achieved their milestones, but they still may have some aberrations with their tone.

This may not be evident until later on in life when they try to participate in other sporting activities. E.g. many infants do not crawl at all and instead they sit and move forward. I have noted these children to often have poor core strength later on in life which can increase their risk of injury from different causes.

The purpose of crawling is to develop a good tone within the core muscles and make the back and abdominal region stronger. Aberrant milestones should always be noted and the child should be taught the proper way to achieve the milestone whenever possible. It is not hard to correct when caught early on.

Muscle tone in delayed children

Many children are classified as delayed in their milestones. That simply means that they have not met their monthly goals as per the norm. There could be a plethora of reasons behind the delay. It could be related to birth problems, intra-uterine problems during pregnancy, genetic issues, etc.

Early Intervention is Key

Whatever be the reason for the delay, the important point to remember, is that the human brain is very pliable and “plastic” from birth till about 3 years of age. This then is the crucial time during which we can make neural changes within the brain and encourage the nerves and muscles to grow, develop, and build proper connections to the human body.

Therefore, this is the period when maximum changes can be made to achieve milestones through tonal modifications. This period is called the “Early Intervention” phase and Physical therapy done during this time, is called Early Intervention Therapy.

What Prevents Early Intervention Therapy From Occurring?

Early intervention therapy cannot occur when delayed milestones have not been diagnosed in a timely manner. The most common stop, therefore, is the late diagnosis of delayed milestones.

Most children are diagnosed at the age of two or older. Parents, and unfortunately some pediatricians, tend to lessen the importance of milestones. This gives them false hope that their child does not really have a problem.

Others ignore the situation, while still other parents simply may have poor observation skills that lead to a loss of early intervention. I have noted parents telling me that their child smiles and responds to the conversation so they do not feel there is a problem, despite the fact that the child is not sitting at 2 yrs of age, as an example.

Others tell me that their baby was very gentle and quiet, did not cry at all, and slept most of the time when the facts were that the child may be suffering from the low tone, floppy muscles, and fatigue. I don’t fault parents for this – not at all. They are not doctors. But early intervention succeeds only in the case of timely diagnosis and therefore I feel it incumbent upon me to educate parents, soon-to-be parents, and grandparents.

Knowledge is power. Let us be informed so that these wonderful children can get the care they need.

How is Early Intervention Performed?

The first step is to be very observant of your infant. As a parent, get pro-active with the child’s growth. If you are observing that your child is doing something out of the norm, get it checked out. Time is of the essence in the early intervention protocol. Get a detailed pediatric evaluation from an experienced Physical therapist. The Physical therapist will let you know if there are any tonal problems with the child, and if so, develop a treatment plan of care with specific goals. The physical therapy program I utilize is primarily geared to achieve the necessary milestones in a timely fashion with the result of proper, symmetrical muscle function. I use various neurological techniques that help to facilitate normal tone and nerve function in the young brain. These techniques create proper pathways in the brain, and, with constant repetition, help to solidify normal movement patterns. Muscle tone problems in young children and infants can be easily treated if caught early on. Please let me know if you have any questions or you would like a child to be evaluated.