Why Crawling is a Key Milestone in Development

By Megan Dominick, OTR/L CAS
Mary Washington Pediatric Therapy

Have you ever heard a parent proudly say, “My children skipped crawling and walked earlier than most babies; they must be advanced”? In 2021, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) removed crawling from the developmental milestone checklist, no longer considering crawling an official milestone. The main reason is they were unable to accurately determine when 75% of babies should begin crawling.

Ready for a mythbuster? Crawling is a KEY milestone in a baby’s development.

To clarify, when I talk about crawling, I am referring to babies on all fours, hands and knees crawling. Crawling begins after babies are secure in sitting and begin to explore transitioning in and out of sitting, realizing that there is much to explore than just what is put in front of them.

As a licensed/certified pediatric occupational therapist, I would expect them to crawl on hands and knees between 9 and 12 months. This is a crucial time in a baby’s core muscle development.

Those few months spent crawling before pulling to stand, cruising and taking steps, set the foundation for building shoulder stability, abdominal and hip strength, hand eye coordination and joint stability.

Your baby's first steps are very exciting and definitely something to celebrate! However, if you notice them trying to pull-to-stand and be on their feet without first exploring crawling for a few months, I recommend providing opportunities that encourage more time on hands and knees.

I have coined the phrase “Knock ‘Em Down” when discussing this topic with my patients’ families. It is my light-hearted reminder to consider crawling as an equally important milestone in their children’s development that should happen before walking.

Let me provide a bigger picture. Skip ahead to elementary school days, sitting at a desk for much of the day. Does your child have trouble sitting up for an extended period of time—fidgeting and wiggling, slouching, laying arms or head on the desk?

All of this can be a sign of poor core strength and postural control. I have worked with many children, elementary and middle school-aged who have had this difficulty. And when I inquire about the crawling milestone, most of the parents respond that their children skipped crawling.

So, my focus with those children in occupational therapy has become going back to basics, if you will, by completing activities in various positions, especially on all fours and either building the foundational skills or practicing maintenance of those skills they may have missed so early on in their development. This connection has made a positive difference in my practice over the years.

What are some activities you can do with your child to support crawling?

• Create an obstacle course with crawling through, over and under things in an organized order
   
• Pretend you are different animals crawling around while making animal sounds
   
• Move around the house or natural environments using bear walks or crab walks
   
• Drive toy vehicles around a track or on the floor while on all fours

If you have concerns or questions about your children’s development or simply need support for milestone development, I encourage you to speak with your children’s pediatrician regarding an occupational therapy evaluation. Trust your gut; you know your children best! Encourage crawling before walking!