Some Hyperactive Children May Skip the Crawling Stage and Just Run
16 September 2003
Q. One of my friend's daughter has a strange problem.
She is 7 years old; she basically skipped the crawling stage
and started walking very early. She is very intelligent,
however, she does not like to sit still for an extended period
of time. In order to keep her attention in studying, the
private tutor has to build in some activities (such as asking
her to get up and walk across the room to check the answer)
in order to keep her attention span. My friend read somewhere
that the lack of crawling can affect sitting or willingness
to sit for extended period of time. Is this true? Do you
have any suggestion why she is like this and what can be done
to help her?
A.
Your friend's daughter does not have a strange problem.
Skipping the crawling stage does not cause her attention
problem or willingness to sit still. However, all the
observations that you described are actually connected. Let
me explain to you in greater detail here.
Almost all children go through a set of developmental stages
that is well recognized, regardless of ethnic background or
where the child is born. Most infants start smiling and
laughing around one to two months, and they turn over between
3 to 5 months of age.
Around 6 to 8 months, most babies would be able to sit up.
From then on the development is much more variable. Many
children begin to crawl at around 8 months, initially with
their elbows pulling the rest of the body around. This is
called commando crawl. Later on, they learn to tug their
knees under the belly and crawl on all fours.
At around the same time, most children will pull themselves
up and stand, followed closely by cruising around furniture.
Some children may stay at this stage for one or two months,
and occasionally even longer. Other children seem to have
more confidence on their feet and let go of any support. At
the beginning, many are scared once they found out they are
standing alone, and would sit down on their buttock. This is
an important learning experience: by trial and error.
At some point, all children will learn to let go and take the
first step. This is probably the most exciting time for the
parents, seeing their children taking their first steps.
Some children learn to walk faster than others. The average
age that a normal child would learn to walk independently is
around 12 months. However, many completely normal children
may not walk independently until 14 to 16 months of age. They
may cruise around the furniture at ease, but they are too
afraid to let go. Once they develop that skill, there will
be no stopping in walking and running.
On the other hand, some children develop the motor skill much
faster than average. A very small percentage of children do
not go through the crawling stage before standing and walking.
Somehow these children find that they can pull themselves to
stand after they have learned to sit. Once they start standing,
they would rather move around on their feet instead of on
their buttocks.
Although crawling is a natural developmental stage in almost
all children, it is not exactly necessary before standing and
walking. If a child skip the crawling stage, it does not
affect their future learning at all.
However, skipping the crawling stage and walking very early
can be a symptom of hyperactivity. Once they learn to walk,
they will run instead of walking wherever they go. Many of
these children also love to climb and jump from chairs and
tables, and not afraid of height. They are more 'accident
prone.'
Because they are hyperactive, it is also difficult for them
to sit still and pay attention. Not infrequently, if they
have to sit still, they would become fidgety. Their hands
may explore everything within reach, and their feet can be in
constant motion. These children have great deal of difficulty
sitting still for any period of time.
Short attention span often goes hand-in-hand with hyperactivity.
They can be distracted easily when they have to focus. Many
also complain being bored and need others to entertain them
constantly. Although they are often very smart, sitting down
to do academic work can be extremely challenging. An average
seven-year-old girl may be able to sit still to work for ten
or fifteen minutes. A hyperactive girl, on the contrary, may
not be able to focus for more than two or three minutes.
Because of their intelligence, many children can still function
fairly well in the early elementary grades. However, their
teachers may have difficulty keeping them in their seat and
have to remind them constantly to focus on their work instead
of talking to other children. Some, especially boys, can
become disruptive in class and make it difficult for themselves
as well as others to learn.
When they get older, their hyperactivity may decrease, especially
when they hit teenage years. However, their attention span
is still much shorter than their peers. As a result, their
school performance may decline in later elementary or junior
high school years. Their self-esteem often plummet and many
believe they are not as smart as their classmates. Some may
give up totally on education because they don't experience
success. This is a real tragedy because most of these children
are extremely bright.
What I have described here is a medical condition called
Attention Deficit Hyperactivity Disorder, also called ADHD.
Although I cannot make the diagnosis from your description,
there is a high probability that the girl you described can
have this condition. The best way to find out for sure is to
request a thorough assessment. Depending on the school
district, this assessment may be performed by the school
psychologist. A referral to a paediatrician who is experienced
in dealing with children with ADHD can be very helpful. In
some places, paediatric psychiatrists are the ones who assess
these children.
If she does have ADHD, the strategy that her tutor employed
is very effective. Since she has difficulty sitting still,
asking her to sit down for half an hour to do her homework
can be extremely frustrating. She may sit there for that
period of time, but she would not be able to focus for that
long and be productive. The longer she is required to sit,
the more frustrated she would become. Allowing her to get up
and walk around can reduce her frustration and improve her
performance.
Other strategies that can be used include breaking up the task
into smaller chunks, each lasting no more than a few minutes,
and giving her short breaks in between. Rewards can often be
helpful. Some children can become overwhelmed if they encounter
a whole sheet of work. Giving one or two problems at a time
can prevent her being overwhelmed.
It is very important to reduce distraction in her environment.
The television should be turned off, and noise level should
be reduced to a minimum. She may not hear what her tutor
says, but she can hear everything down the hall. Some children
can do their homework right after school, while others require
a break from school work for a while. It is something that
parents have to explore by trial and error.
Many teachers find that they can maintain these children's
attention by keeping them close to the front of the class and
away from windows or doorway.
You can find more strategies from the following books:
Answers to Distraction by Drs. Edward Hallowell and John Ratey,
and
Teaching the Tiger by Marilyn Dornbush and Sheryl Pruitt.
The following websites also provide credible information
on ADHD:
www.cps.ca
(Canadian Paediatric Society),
www.aap.org
(American Academy of Pediatrics),
www.chadd.org
(Children and Adults with ADHD).
I should mention here that many children with ADHD will benefit
from medications. Whether a child requires medicine or not
can only be determined by the family and their physician. At
the present time, the most effective medications available in
Canada are the stimulants, including Ritalin and Dexedrine.
Both of these medications are very effective, with little or
no side effects. The dose of medication needs to be adjusted
carefully, with the assistance of the physician.
Recently, a new formulation of Ritalin, called Concerta, was
released in Canada. The short-acting Ritalin is generally
effective for 3-4 hours. As a result, many children need to
take one dose in the morning, one dose at noon in school, and
one dose after school to help with homework. Children usually
don't like to take medicine in school because they are teased
by other students. As a result, the medicine is often
conveniently forgotten.
Concerta, on the contrary, can work for as long as twelve
hours. One capsule in the morning at breakfast can provide
effective medicine throughout the school and into the evening.
As a result, these children can focus to learn in school and
do their homework afterwards.
Although medicine may not be necessary for everyone with ADHD,
most children will benefit greatly from medication. It can
improve their attention span so that they can sit down for
longer periods of time to complete their work instead of just
rushing through. Some children have difficulty learning social
skills because they cannot pay attention to social cues and
body language. Most parents find their ADHD children develop
better social skills when they receive medicine. Many children
also benefit from counselling by experienced psychologist.
I hope this information does clarify your friend's misunderstanding
regarding the crawling skill and its relationship to sitting
still and paying attention.
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