National Survey of Pediatric Experts Indicates Increase in Infant Delays.
CHICAGO -- A new survey of more than 400 pediatric physical, occupational and speech therapists confirms what early childhood medical professionals have been observing for years: two-thirds of therapists reported seeing a rise in Early Motor Delays in infants in the past six years, and those who saw an increase said that lack of tummy time while awake is the number-one contributor to the escalation in cases. An Early Motor Delay occurs when a child isn't able to meet critical physical milestones in the first months and years of life, which can later affect a child's ability to learn basic skills such as chewing, grasping, crawling, standing and walking. Tummy time - supervised awake time babies spend on their stomachs - can help prevent Early Motor Delays.
The survey was conducted by Pathways Awareness, a national not-for-profit that educates parents and medical professionals about the benefits of early intervention for children who show development delays. With assistance from the Neuro-Developmental Treatment Association (NDTA) and the Pediatric Section of the American Physical Therapy Association (APTA), more than 400 occupational, speech and physical therapists who regularly work with pediatric clients and who average more than 20 years of experience participated in the survey.
"This survey quantifies the observations that my colleagues and I have been discussing for years," said Gay Girolami, physical therapist and member of the Pathways Awareness Medical Round Table. "We noticed that not only were we seeing more children coming to therapy with Early Motor Delays, but that these delays were clearly related to the fact that they were spending too much time on their backs. The next step is to educate parents and medical professionals about the easy ways they can introduce tummy time to newborns."
Backsleeping, "Container" Lifestyle May Contribute
The vast majority of babies now sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS). Back-sleeping, coupled with more awake time in "containers" like car seats, bouncers and strollers, add up to so much back time that babies aren't able to develop their neck and back muscles, contributing to the increase in Early Motor Delays.
Each year more than 400,000 children in the U.S. are at risk for an Early Motor Delay, and actual incidences are one in 40, a 150 percent increase from 25 years ago, a rate even higher than incidences of other accelerating conditions like autism.(1) While previous studies have linked lack of tummy time to Early Motor Delays,(2) the survey by Pathways does not definitively identify lack of tummy time as the cause of the increase in Early Motor Delays. Rather, the survey quantifies experienced observations by qualified professionals, which may serve as a hypothesis for a future scientifically controlled study on the rate of increase and causes of Early Motor Delays. In addition to back-sleeping and lack of tummy time, the increase may also be caused by factors such as a higher survival rate of preterm babies, increased numbers of twins and triplets (who may be crowded in the uterus) and increased survival of children with cardiac, neurological and genetic disorders.
Survey Methodology and Results
The Web-based survey was conducted between February and May 2008 by Pathways Awareness. Respondents were 409 highly qualified physical and occupational therapists who belong to APTA or NDTA, who work with pediatric clients on a regular basis and who average more than 20 years of experience. All results reported are significant at the 95 percent confidence level.
* Two-thirds of therapists (66 percent) reported that they had observed an increase in Early Motor Delays in babies under six months in the past several years.
* Of therapists noting an increase in Early Motor Delays, the vast majority named lack of tummy time while awake as the number-one reason for the increase in Early Motor Delays (84 percent), followed by the increase in premature births (59 percent) and back sleeping (54 percent).
* Nearly two-thirds (61 percent) of all respondents thought that Early Motor Delays could be caused or exacerbated by back sleeping, and 77 percent had observed Early Motor Delay cases that could be attributed to babies spending extensive time on their backs while they were awake (in car seats, bouncers, etc.)
* Therapists observed that most parents have little or no understanding of tummy time (70 percent).
* The majority of therapists who observed an increase in Early Motor Delays noticed this phenomenon starting within the past six years: most observed an increase starting 4-6 years ago (44 percent) followed by 0-3 years ago (34 percent).
What Parents Can Do
New parents are concerned with the basics: sleeping, eating, changing and nurturing. However, a few simple "moves" - even just holding and soothing the baby in a different position - can help infants get used to tummy time. Pathways Awareness developed "Five Moves for Baby's First Workout," a guide that includes photos, tips and suggestions for integrating tummy time into an infant's day. Pathways recommends babies start with tummy time for just a few minutes - even just a few seconds - per day, eventually building up to an hour a day, in spurts throughout the day, by three months. Parents can visit www.pathwaysawareness.org for more information.
If parents have concerns about their child's development, visuals, including a growth and development chart and more information about developmental warning signs, are also available on the Pathways Web site, www.pathwaysawareness.org and by calling Pathways' "parent answered" help line, 1-800-955-CHILD (2445). The development chart has been endorsed by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners.
About Pathways Awareness
Established in 1988, Pathways Awareness is a national, non-profit organization dedicated to raising awareness about the benefits of detecting Early Motor Delays and encouraging physical therapy in very young children. Pathways' critical infant milestones literature has been recognized and endorsed by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners as the definitive resource concerning Early Motor Delays. For more information, visit www.pathwaysawareness.org.
About the Neuro-Developmental Treatment Association (NDTA)
The Neuro-Developmental Treatment Association (NDTA[TM]) is an international, non-profit organization of occupational therapists, physical therapists and speech-language pathologists who practice Neuro-Developmental Treatment (NDT), a comprehensive and highly individualized therapy approach in which therapists use ongoing assessments to address motor difficulties in both adults and children who have neurological challenges (e.g. cerebral palsy, stroke, head injury) which impact development. NDTA offers continuing education to the health professionals, educational services to the community, and supports clinical research and client and family advocacy. Visit www.ndta.org.
About the American Physical Therapy Association
The American Physical Therapy Association (www.apta.org) is a national organization representing physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can access "Find a PT" to find a physical therapist in their area, as well as physical therapy news and information at www.apta.org/consumer.
(1) Statistics compiled by the Pathways Awareness Medical Round Table from a variety of sources, including the March of Dimes, Pediatrics Annual Summary of Vital Statistics, and the Centers for Disease Control and Prevention
(2) Influence of supine sleep positioning on early motor milestone acquisition. Dev Med Child Neurol. 2005; 47(6):370-6; discussion 364 (ISSN: 0012-1622)
Survey data and graphics available