Ep 14 - Why Crawling Matters More Than You Think: The Neurodevelopmental Case for Not Skipping Motor Milestones

 

ABOUT THIS EPISODE

In 2022, the CDC and the American Academy of Pediatrics revised their developmental milestone guidelines and removed crawling. The rationale was that many children develop normally without crawling, so it should no longer be considered a required milestone. I want to address this decision directly: I believe it is the wrong call, and the neurodevelopmental research tells a much more complex story than the policy implies.

Crawling is not simply a form of locomotion that some children skip on their way to walking. It is a full-body neurological integration event. During cross-pattern crawling, both brain hemispheres are activated simultaneously and in coordination. Corpus callosum connectivity is being built. Bilateral integration is practised. The visual system is trained for convergence at near-point focus. The vestibular system is challenged in a specific way that builds postural stability. Primitive reflexes are being inhibited by the movement patterns crawling requires. All of this happens in a specific window that does not fully reopen.

Children who skip crawling or crawl for only a brief period do not uniformly develop problems. But the research shows that motor delays in the first year predict learning and attention difficulties at school age with a consistency that is not coincidental. The children who go on to have reading difficulties, attention problems, and poor handwriting frequently share movement histories that include skipped or atypical crawling. This is not correlation. There is a mechanism, and it runs through the primitive reflex integration and hemisphere connectivity that crawling uniquely provides.

My position on developmental milestones is this: the bar should be raised, not lowered. The appropriate response to a child who is not crawling is not to remove crawling from the checklist. It is to ask why the child is not crawling, evaluate the factors that might be interfering, and provide support to achieve the milestone. I have seen this make a profound difference in the developmental trajectories of hundreds of children in my clinical career.

 

WHAT YOU WILL TAKE AWAY

  • Crawling is a neurological integration event, not just a locomotion stage. Cross-pattern crawling activates both brain hemispheres simultaneously, builds corpus callosum connectivity, and integrates primitive reflexes in a way that is not replicated by other movements.
  • The CDC's 2022 removal of crawling from developmental milestones is clinically concerning. Absence of a milestone in a proportion of children who develop normally does not mean the milestone does not matter. It means we need to understand better why some children are not achieving it.
  • Motor delays in infancy predict learning and attention difficulties at school age. This is not coincidence. There is a direct mechanistic relationship through primitive reflex integration and hemisphere connectivity.
  • The goal is optimal development, not minimum acceptable development. Parents should be asking not "is my child within normal range?" but "is my child achieving optimal milestones, and if not, what is in the way?"
  • Most children who are not crawling can be supported to crawl. Clinical evaluation of the factors interfering with crawling — spinal restrictions, retained reflexes, low muscle tone — can identify what needs addressing, often with excellent outcomes.

 

EPISODE TIMESTAMPS

00:00 — The CDC 2022 decision to remove crawling from developmental milestones

04:00 — What executive function is and why it matters for school readiness

07:00 — What actually happens neurologically during cross-pattern crawling

13:00 — The research linking motor development to learning and attention outcomes

19:00 — Why removing the milestone is the wrong response to the right observation

24:00 — What to do if your child is not crawling or skipped it

Reference List for books and articles https://www.dropbox.com/scl/fi/yz5etz7yv4n7tj1jn9tre/Crawling_Reference_List.pdf?rlkey=zvm2ay5p9pzhrova2z5bgido5&st=2gl1x99f&dl=0

Why Crawling is so important handout; https://www.dropbox.com/scl/fi/uvtg011jx3isdg1uu8wb7/Crawling_Patient_Handout.docx?rlkey=9dh45w27z9dksvf6fxj1a2gox&st=cppx90j4&dl=0

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MUSIC

Original music composed by Philippe Custeau

This podcast is for educational purposes only and does not constitute medical or professional advice. Always consult a qualified healthcare provider with questions about your child's health and development.