Q&A: 11 Month Old Not Crawling, Pulling Up or Standing

CME WebsitesChild Development, Infants 3 - 12 Months

blockquote_bgMy son just turned 11 months old. He is not crawling, pulling up, or standing. He does roll around the floor, and tries to “bounce” himself when on his stomach; and just recently, he does seem to be more interested in trying to pull himself up by latching his arms around my arm or body. He does not seem to know how to put his weight on his hands or legs. He is a large baby, over 95% in height and over 97% in head circumference; but only about 55% in weight. Could he just be top heavy and need more time to develop his muscles?
He didn’t truly sit up on his own until he was 8 months old and really only began sitting up for long periods of time and “catching” himself from falling over at 10 months, and he is just now starting to bend forward and lower himself onto the floor from a sitting position; so there is some progression in his development. Another concern is that he is very “into” and particular about his hands, i.e. moving them slowly in front of his face (although he is doing this less and less), doesn’t like for me to touch his hands, flaps his hands when excited or happy and still likes to lay on his back and put his hands and feet in the air (although again, doing this less and less).

Thanks for your question. I would advise contacting your local early intervention provider in order to have your son evaluated by a physical therapist as well as an occupational therapist if you continue to have concerns regarding his gross motor development, as well as his sensitivity related to his hands. Being a “large baby” could contribute to some difficulty in completing motor skills, and it sounds like he is moving along, just at a slower pace. By 11 months, hand watching behaviors should have disappeared since most children by now are far more interested in the toys they are holding than their hands themselves.

I am suggesting the OT evaluation since some children have sensory    issues which could be a reason your son does not like to bear weight on his hands and knees and does not like his hands to be touched. Does he have any sensitivity to his hands being messy when eating or his face being wiped, etc? Has your son ever had his vision evaluated? I would schedule a screening with your child’s doctor to rule out any problems related to his vision which could be another reason he is hand gazing. Vision problems can also contribute to delayed gross motor skills. You could also ask if your local early intervention program provides functional vision evaluations.

Having said all that, I would continue to encourage floor play as much as possible to increase his motor skills. Limit the use of walkers, bouncers, etc so he can practice important skills on the floor as much as possible. Crawling is a very important developmental milestone, and can be encouraged by placing your son over your leg on the floor, with his knees bent and hands bearing weight in front of him, rock him back and forth and sing simple songs to make it fun. You can also tape some large cans together or roll up several towels to make a roll and place him over this roll in a hand/knee position. Gently rock him back and forth so he is encouraged to bear weight on both hands and knees. Place a mirror in front of him and place toys to the left and right side, encouraging him to bear weight on one    hand while reaching for a toy with his other hand. You can also use a small playground or exercise ball and place him belly down on there and roll him back and forth bringing him forward to his hands and then back to his knees or feet.

Work on transitional positions, such as encouraging him to go from laying down to sitting by rotating his body, as well as going from sitting to hand knee. Place the roll to his left or right side (alternate) and help him rotate over into a hand-knee position. You can use a small box turned upside-down as a table, and place your son in a kneeling position beside the box for play to encourage weight bearing on his knees. Make sure his heels are under his bottom (don’t allow him to sit in a “W” position with his bottom on the floor between his legs) and help him pull up to a tall kneeling position. When he is able to tolerate tall kneeling, you can help him move one leg out into a half kneel position which he will need to pull up into standing. Sometimes furniture in the house is simply too high for little ones to pull up on, so use boxes, breakfast trays, lap desks, etc., whatever works best for your son’s height. Ideally when he pulls to stand the object you are using for a table should be about armpit height or a bit lower.