Motor development assessment after 9 months
It’s very different, especially if you’re using the Alberta scale.
I’m going to give you 3 tips that will boost your evaluation.
Sometimes in pediatrics, we differentiate between babies and children.
Obviously, different anatomy, different cognition, or different challenges for neurodevelopment. This differentiation is natural and educational.
But there are other differences that are more subtle.
Even babies themselves can be very different from one another.
And whoever sees it, gets it. Just like that.
What does a premature baby, a full-term newborn, a 5-month-old and a 9-month-old have in common?
Only one thing…
They’re all called “baby”.
But beyond that, they are completely different,
Especially in their sensorimotor functions and cortical aspects.
Even in their motor and postural patterns, or in their psychosocial profile.
But in all of them, the physio must do a precise and thorough motor and postural assessment.
The functional diagnosis and clinical decision-making largely depend on it.
Of course, this assessment should be complemented by cortical and/or cognitive aspects such as visual attention, motivation, or auditory function.
Let me include the latter under cortical. Neuromusculoskeletal assessment also needs to be included here. Neck, head, or hips. Of course.
But let’s focus on the postural motor aspect.
Let me explain.
A baby under 9 months is on autopilot, meaning they should respond almost instinctively with a postural or reaching response. For example, if you place an object in their field, a 4–5-month-old should quickly reach for it—that’s ideal. If they’re 6–7 months, they should roll to prone almost immediately, like a cat, as soon as you place them in supine.
A 9-month-old won’t. It doesn’t work like that. They might take their time — or they might not. It depends.
It may take a while before they decide to grab an object or roll over. As if they were thinking about it. But this is physiological. You can’t interpret this delay as a deficit. And be careful when using the Alberta scale not to score that wait time as a motor item. You’ll wreck the scale results.
- Better if you step away
If you want to assess motor and postural development with or without the Alberta scale—step back first. Do it around 7 months. Especially if you want to observe spontaneous motor behavior.
At this age, you’re already a stranger to the baby (if they’re healthy, of course—if they’re not, they might come to you as if you were family. A bad prognosis). And it’s great that you’re a stranger, it’s a strong cognitive sign.
By keeping your distance, the baby won’t feel inhibited and will show you their full range of motor skills. If you get too close, you become a threat and they may hold back from showing you what they can do.
- You need to test more manual and cognitive aspects
Let me explain.
Manual function really takes off here. Both the pincer grasp between index finger and thumb to pick up a colored thread, and gestures like waving goodbye or pointing are advanced manual functions. Especially the latter.
So complement your postural and motor assessment with manual, manipulative, communicative, and simply cognitive aspects.
In the Denver screening you have some great items you can use. However, the gross motor section is not that good for babies in the Denver.
Above all, admire how the brain takes off after 9 months. It’s something incredible that reveals the miracle of the human being.
Let me explain.
A baby under 9 months is on autopilot, meaning they should respond almost instinctively with a postural or reaching response. For example, if you place an object in their field, a 4–5-month-old should quickly reach for it—that’s ideal. If they’re 6–7 months, they should roll to prone almost immediately, like a cat, as soon as you place them in supine.
A 9-month-old won’t. It doesn’t work like that. They might take their time — or they might not. It depends.
It may take a while before they decide to grab an object or roll over. As if they were thinking about it. But this is physiological. You can’t interpret this delay as a deficit. And be careful when using the Alberta scale not to score that wait time as a motor item. You’ll wreck the scale results.
- Better if you step away
If you want to assess motor and postural development with or without the Alberta scale—step back first. Do it around 7 months. Especially if you want to observe spontaneous motor behavior.
At this age, you’re already a stranger to the baby (if they’re healthy, of course—if they’re not, they might come to you as if you were family. A bad prognosis). And it’s great that you’re a stranger, it’s a strong cognitive sign.
By keeping your distance, the baby won’t feel inhibited and will show you their full range of motor skills. If you get too close, you become a threat and they may hold back from showing you what they can do.
- You need to test more manual and cognitive aspects
Let me explain.
Manual function really takes off here. Both the pincer grasp between index finger and thumb to pick up a colored thread, and gestures like waving goodbye or pointing are advanced manual functions. Especially the latter.
So complement your postural and motor assessment with manual, manipulative, communicative, and simply cognitive aspects.
In the Denver screening you have some great items you can use. However, the gross motor section is not that good for babies in the Denver.
Above all, admire how the brain takes off after 9 months. It’s something incredible that reveals the miracle of the human being.
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Here you can go for a more clinical assessment or use a scale like the Alberta Infant Motor Scale. This is one of my favorites, as you know. It has many advantages. That’s why TMPI has a very practical and useful online training on this scale. It’s available here. Although most of you have already taken this training, it’s hard to miss. Anyway, moving on. Other scales are also great for motor-postural assessment. Like the Infant Motor Profile, among others. If you’re using the Alberta scale or doing a clinical assessment of spontaneous motor behavior, there are several points to keep in mind:
- The baby may take a long time to activate motor patterns.
Let me explain.
A baby under 9 months is on autopilot, meaning they should respond almost instinctively with a postural or reaching response. For example, if you place an object in their field, a 4–5-month-old should quickly reach for it—that’s ideal. If they’re 6–7 months, they should roll to prone almost immediately, like a cat, as soon as you place them in supine.
A 9-month-old won’t. It doesn’t work like that. They might take their time — or they might not. It depends.
It may take a while before they decide to grab an object or roll over. As if they were thinking about it. But this is physiological. You can’t interpret this delay as a deficit. And be careful when using the Alberta scale not to score that wait time as a motor item. You’ll wreck the scale results.
- Better if you step away
If you want to assess motor and postural development with or without the Alberta scale—step back first. Do it around 7 months. Especially if you want to observe spontaneous motor behavior.
At this age, you’re already a stranger to the baby (if they’re healthy, of course—if they’re not, they might come to you as if you were family. A bad prognosis). And it’s great that you’re a stranger, it’s a strong cognitive sign.
By keeping your distance, the baby won’t feel inhibited and will show you their full range of motor skills. If you get too close, you become a threat and they may hold back from showing you what they can do.
- You need to test more manual and cognitive aspects
Let me explain.
Manual function really takes off here. Both the pincer grasp between index finger and thumb to pick up a colored thread, and gestures like waving goodbye or pointing are advanced manual functions. Especially the latter.
So complement your postural and motor assessment with manual, manipulative, communicative, and simply cognitive aspects.
In the Denver screening you have some great items you can use. However, the gross motor section is not that good for babies in the Denver.
Above all, admire how the brain takes off after 9 months. It’s something incredible that reveals the miracle of the human being.
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