Before answering the question, let's sort out the terms that are often lumped together, which are not quite the same thing. Most often it looks like this crawling/crawling precedes quadrupling and prepares the baby's body for it. But beware: in some toddlers these stages are very short, in others they do not appear at all, and yet the child's development can proceed well.
What is crawling and quadruping?
Crawling This is usually the second form of „independent travel” on the floor after crawling. The child still moves close to the ground as in crawling but with the pelvis raised upwards. He rests on his knees and on his bent arms (on his elbows). This stage precedes the quadruped, which is the most advanced form of movement on 4 limbs. For the parents this is a great moment and a joy, but also a great challenge because the baby explores every nook and cranny of the house, sometimes at the speed of light
Quadrupling is the stage when the child supports himself on his hands and knees, lifts his torso above the floor and begins to move alternately (once right hand with left leg, once left hand with right leg). This requires more stability, coordination and body control. This movement skill develops coordination, balance and sensory integration, i.e. the cooperation of both hemispheres of the brain. Mostly appears between 7 and 10 months of age, usually after a period of rocking in supported kneeling, when the child can hold his or her weight stably on hands and knees.
And now for the most important thing: since some children quadriplegic, others crawl for a while, and still others try to stand up straight away - whether these stages are really necessary, or rather „very helpful”? About this further on.
Can a child skip the quadruped stage?
The answer used to be no. Many studies and experts in the past have recognised crawling as one of the most important stages of a child's motor and cognitive development. Dr Carla Hannaford, a neurophysiologist, even went so far as to say:
„We have known for years that children who do not pass the vitally important stage of crawling may later show learning difficulties” (Dr Carla Hannaford, Smart Moves).
And of course it is still a very important part of a child's development, whereas nowadays more and more children are missing out on this milestone. The American Academy of Pediatrics published new milestone guidelines for infants and toddlers in March 2022. Children who are not crawling do not have this stage recognised as a key milestone. Was this an oversight or an error? In the study, under the section „Milestones of motor development”, listed:
„Pulling up with arms straight in the tummy position” as a milestone at six months of age and then jumping to:
„Pulling up to a standing position” at 12 months of age (with a few milestones regarding sitting in between).
Crawling, as a milestone for children, is nowhere mentioned in the new guidelines. Should we continue to work on our children's crawling as an essential milestone? Or will future generations show that crawling does not necessarily guarantee a „smart and great at learning” child?
Why is foursquare so important?
The quadruped is an important, but at the same time very complex and demanding movement skill. What makes it difficult to master is the need to perform alternating movements, i.e. coordinated work of both sides of the body. This type of movement promotes bilateral integration and engage both hemispheres of the brain, supporting the development of coordination, movement planning and postural control. The motor experiences gained during quadrupeds can also be important for the further development of cognitive functions, such as concentration or action organisation, which support learning in the future.
At the same time, it is worth emphasising that the absence of a quadriplegic stage does not exclude the child's development. Many children who skip this stage reach their full school potential, especially if they have access to other forms of physical activity.
The quadruped also helps to develop visuo-spatial awareness, i.e. the ability to orient oneself in space, to judge distances and relationships between objects. These skills are important when learning to write and read, among other things.
„When a baby crawls and crawls from place to place, he learns spatial orientation, which helps him to understand what he sees and to explore the world. If a child does not have the experience of moving around on the floor (crawling and crawling) at a few months of age, he or she may later have difficulty judging distances and orienting in space” (Jean Ayres, Sensory integration and the child).
It is therefore important that all children have the opportunity to develop their motor skills. Regardless, whether the child is crawling or quadrupling, It is a good idea to give him access to a variety of activities: tummy play, free play on the floor, swings or toys that encourage movement.
Is it worth encouraging children to foursquare?
If the child shows a desire to crawl (quaddle), encourage it and give it every opportunity to do so in its environment. Don't give toys „under the nose” or at arm's length. Move the desired object away so that the child has to move to reach for it. Quaddling opens the door for children to explore their surroundings, which provides a range of sensations important for overall sensory development.
The most important and also the best thing parents can give their children is the „tools” for all types of movement. It is free activity (on the floor, on different surfaces, in different positions) that promotes motor development in the child and helps it to develop skills and integrate the senses, such as:
- primary senses (touch, smell, sight, hearing),
- vestibular system (balance and movement): rocking, swinging, rolling, changes of position,
- sight (pushing, pulling),
- touch (chewing, grasping, sucking).
The more safe opportunities a child has for exploration and movement, the easier it is to build a „base” for further skills. On the other hand, limiting spontaneous activity (little time on the floor, little free movement) can mean that some children need more support in areas such as coordination, stabilisation or concentration, and this can also be important for later learning.
What can I do to support the brain development of a child who is not quadriplegic?
Alternating movements are extremely important when it comes to a child's brain development. That is why exercises based on alternation will be particularly important with children who are not quadriplegic. It is crucial that these are crossed movements and that the head crosses the body axis during the exercise.
Examples are exercises for children in which the left side of the body meets the right, e.g.: the elbow of the right hand touches the knee of the left leg (and vice versa), the right hand touches the left elbow (and vice versa), the right hand touches the left ear (and vice versa), the right hand touches the left heel behind the back (and vice versa).
These exercises should be performed frequently, with a variable pace and a gradual increase in difficulty. Variety and an element of playfulness make children eager to practise and effects appear quickly.
Examples of alternate movement exercises and games:
- making „eagles” in a lying position on carpet, sand or grass,
- alternately touching the left ear with the right hand and the right ear with the left hand,
- Standing up paddles,
- alternating stretching of the right hand with the left leg and the left hand with the right leg,
- jumping from one leg to the other at different speeds (with alternating arm lifts),
- crossing straight arms in front of the chest,
- on all fours: straightening the right arm and left leg and left arm and right leg,
- right arm and left leg raise and left arm and right leg raise while lying on your back,
- touching the right elbow with the left hand and vice versa,
- touching the right knee with the left hand and vice versa.
Should you be worried if your child has missed the quadruped stage?
Both yes and no. Lack of quadrupedalisation can be a signal that it is worth looking more closely at the child's motor development. Especially if it is accompanied by other difficulties, e.g. poor stability, asymmetry of movement, reluctance to be active on the floor. In such situations, it is good for the „vigilance light to go on” and for development not to be left to chance alone.
On the other hand, many children, despite not being on all fours, develop correctly. Sometimes the child spends a lot of time in a quadriplegic or kneeling position, is able to alternately crawl or quickly moves to higher positions. The mere absence of the quadruped stage does not yet indicate a problem. The key point is not this, whether the child was quadriplegic, but how it copes with trafficThe baby's posture, whether he or she moves symmetrically, whether he or she can hold his or her body stably, what his or her coordination and posture look like during the next stages of development. This is why, in case of doubt, he can help us paediatric physiotherapist, who will assess the quality of movement and harmonious development.
When is paediatric physiotherapy needed?
If the difficulties are more complex and may affect the child's further development, the physiotherapist can suggest an appropriate form of therapy, such as the NDT-Bobath method or the Vojta method. These are approaches used with young children with disorders of motor development and - guided by an experienced therapist, in a form that is safe and adapted to the child - can produce very good results.
If the problem is complex and may interfere with the child's further development, it will be necessary to paediatric physiotherapy using the NDT-Bobath method or Vojta method. These are therapies dedicated to young children, which, combined with the therapist's experience and fun, give a very good results.
Sometimes, however, after a thorough examination, the specialist concludes that the lack of quadriplegia is not due to deficits in earlier stages of development. In such cases, a one-off consultation, instructions for daily play and exercise and periodic monitoring of development are often sufficient, without having to implement therapy.
Paediatric physiotherapist and lack of quadriplegia
The quadruped is beneficial for the development of the shoulder girdle, muscle strength, balance, coordination and alternation of movements, but it is worth remembering that these aspects can also be exercised through other activities.
It also happens that caregivers - unknowingly - limit the child's opportunity to learn to quaddle by frequent carrying in their arms or long stays in rockers, walkers or playpens. Fortunately, even if the child is not on all fours, all is not lost - the consultation with a paediatric physiotherapist and tailored exercises can effectively support the development of alternate movements.
Simple exercises woven into play can compensate for the no quadriplegia and ensure good integration of both hemispheres of the brain. Whichever way a child moves, the most important thing is to give them as many opportunities as possible to develop, supporting correct posture and full school potential.
Photo source: Freepik.com
Anna Bernaś
Paediatric physiotherapist
