Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, June 20, 2011

Creepy Crawlies: Response to Jessica's Comment

On the comments for “Jean Talks!” post from several days ago, Jessica has asked an important question-- which I would answer right there if I could, but some glitch in this site seems to prevent me from doing that recently. (Help, blogspotters!). In brief, Jess is thinking about crawling because her baby is at about the age when it happens, and she wants to know what the story is, about advice that tells you you have to make your baby crawl-- even that you should move the furniture farther apart if a baby who hasn’t crawled yet wants to “cruise”.

As it happens, I was just looking up some material about this today. The first point I want to make about this is that nowadays most of the people who give this advice are chiropractors. See, for instance, http://unitedfamilychiropractic.com/pediatric-chiropractic/chiropractic-and-the-importance-of-crawling/. This chiropractor warns you that if your baby doesn’t crawl, he or she may not learn to read either.

This is pretty scary, but fortunately not true. If you doubt that, ask yourself if you’ve ever met a person with severe cerebral palsy who couldn’t have crawled, but who reads very well. Q.E.D.

The idea of the essential role of crawling in development seems to have been initiated by one Glenn Doman (not Dorman as the unitedfamily site says), a physical therapist who got his degree in 1940 and who in 1955 started the Institute for the Achievement of Human Potential, which still exists in the Philadelphia area. Doman opined, and he convinced many parents and teachers, that failure to crawl was problematic, and that many developmental disorders, from cerebral palsy to autism and severe brain injury, could be cured by a treatment he called “psychomotor patterning”. Patterning was a procedure in which five adults grasped a child’s head and limbs and moved them repeatedly in a pattern that imitated a reflexive movement of early infancy. (This procedure has twice been rejected as useless in position statements of the American Academy of Pediatrics.)

Why did Doman and his present-day chiropractic followers think this would work? As a first reason, they cite neuroplasticity-- the fact that the nervous system can continue to grow and develop long past infancy. Such a characteristic of the brain certainly exists, but it does not mean that any and all damage can be overcome, nor, certainly, does it mean that crawling movements would cause such recovery.

As a second reason, Doman and the gang repeated the mantra of the late 19th century, “Ontogeny recapitulates phylogeny”, or, the development of the individual repeats the development of the species. To a certain extent, this is true-- but it’s also irrelevant. What they really are saying is that they think ontogeny can recapitulate ontogeny, that a person whose development was interrupted or damaged can be made to go through the same developmental stages a second time and emerge healthy. That’s a lot different from anything about species development, and once again, what does it have to do with crawling?

The “cross-crawl” is an especially silly idea, because what true crawl would not be a cross-crawl, with right arm and left leg moving together and so on? It’s true that some animals “pace” by moving the two legs on the right together, and the two on the left together (I think tigers do this, and horses can be trained to do it). But imagine an infant doing a pace-crawl without falling over. As for some poorly-defined need to use the two sides of the body in “cross” fashion, we do this when we’re walking! One leg bears the weight while the other moves forward, and simultaneously older children and adults counter-rotate their shoulders to keep their balance, causing the left arm to swing forward with the right leg and so on.

There are a number of other issues about motor development, in addition to the Doman/chiropractor stuff. One is what Jessica said: babies will crawl or do whatever when they and the circumstances are ready for the action. If you have a very slippery floor, or a rough splintery one, they may skip the crawling part. In any case, they may only crawl briefly, then get themselves up (maybe because your furniture is a good size and shape to pull on), or for whatever reason they may figure crawling gets them where they want to go and stick with it for months.

However, if a baby gets to be 18 months old and shows no sign of standing, or if he or she crawls asymmetrically, using one leg much more than the other , or if only one hand is ever used in crawling or in reaching, those are all possible signs of developmental problems and should be carefully checked out (and in my opinion, not by a chiropractor).

Jessica also queried advice to put the baby on its stomach on a hard surface when he or she is awake. This is an interesting issue. If you are putting your baby to sleep on its back (and I’m afraid there is no really good reason to do that, no matter what you’re told-- but save that for another time), the order of motor development in the first months will be different than what it would be if the baby slept and spent most of its time on the tummy. Pushing up when in the prone position exercises neck and arm muscles and takes strong muscles to do well. If a baby doesn’t push up well because it hasn’t worked at doing it, getting up on all fours is not going to work too well either, and without all fours, crawling doesn’t happen. All those things will happen eventually, but unless the baby gets lots of tummy time, they won’t happen as early as they did before “Back to Sleep” came along. But… by age two years, no one will be able to tell the difference, so unless you’re worried when the baby doesn’t meet the milestones that are based on babies 20 years ago, there’s no real problem here.

7 comments:

  1. This is a great response, Jean! I feel better knowing that letting him do his own thing it on the up and up. Keep up the good work of refuting myths. It's not always popular but it is crucial!

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  2. have you tried logging out of blogger and unchecking the box that says "keep me logged in?" it worked for me.

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  3. Yow! That works, Sunday! Thank you-- Jean

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  4. Um, I'm afraid you're very mistaken about putting babies to sleep on their backs. It drastically reduces their risk of SIDS. What research have you seen that says otherwise?

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  5. The problem is not about research that says otherwise, but about the research that claims that sleeping supine is protective. The SIDS rates in the U.S. were on the way down before the "back-to-sleep" program was initiated and have continued on the same trajectory, suggesting that the operative factor is not sleeping position.

    In addition, U.S. statistics show that while SIDS deaths decreased, two other categories of infant deaths, accidental suffocation and strangulation in bed (ASSB), and "cause unknown/unspecified" increased. See Shapiro-Mendoza, C.K., Tomashek, K.M., Anderson, R.N., & Wingo,J. (2006). Recent national trends in sudden, unexpected infant deaths: More evidence supporting a change in classification or reporting. American Journal of Epidemiology, 162, 762-769.

    For further discussion of this, including data suggesting that pacifiers help prevent SIDS, read Claim 13 in my book Child Development: Myths & Misunderstandings (Sage, 2009).

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  6. Jean - I thought of you and this post today as I watched my son crawl across the living room for the first time. What an amazing thing, to watch a child figure out how to make it all work. And naturally, he figured out without any special help. :) Cheers!

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  7. Congratulations to both of you-- and welcome to the world of seeing-tiny-things-on-the-floor that you never saw before. You'll still be looking out for paper clips when this child goes to college!

    What I love is to see them begin to transfer their weight to one hand in order to reach for something without falling over.

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