Aetiologyĭelay in walking may be simply variation of normal. Walking is considered to be delayed if it has not been achieved by 18 months. Some children will fall outside the expected range and yet still walk normally in the end. Most children are able to walk alone by 11-15 months but the rate of development is very variable. Able to stand on one foot for a few seconds. 3 years: climbs stairs one foot per step.2 years: goes up and down stairs alone.12 months: stands and walks with one hand held.10 months: pulls to standing and stands holding on.(Age of crawling varies widely, and some infants never crawl.) 9 months: gets into sitting position alone.When lying face down, can lift up on forearms. 6 months: no head lag when pulled to sit.3 months: can hold head at 90° in ventral suspension.In ventral suspension (when held above couch with examiner's hand supporting the abdomen) can hold head at level of body briefly. 6 weeks: sits with curved back, needs support.This is an approximate guide to some of the gross motor development of a child in the first three years of life but variation is common : If the child is nowhere near achievement of the milestone or there are other causes for concern then referral is required. If a child has failed to reach a milestone at a given time but appears to be on the threshold of achieving it then a safe option is to review the child a month or so later to ascertain the progress made. Hence, even doctors who are not directly involved in developmental assessment must have knowledge of normal development. Most developmental screening is done by health visitors but, if they suspect a problem, they will bring it to the attention of the GP.
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