First Year of Life. What are the Psychomotor Delay Signs?

Luca’s six months old. I’m a bit worried because if I put a nice toy in front of him, he doesn’t try to take it with his hand and bring it to his mouth. Then he rarely looks at me and smiles at me. Could there be problems? Should I request a pediatric examination?

Yes, the baby could have a psychomotor delay or a neurological problem.

This article, with many example videos, is dedicated to normal development in the first year of life and the warning signs for possible problems.

Attention. All content and media on this website is created and published online for educational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. You must always seek the advice of your own doctor regarding any information that you find in this website.

What are the milestones in psychomotor development?

From birth your newborn baby acquires, week after week, new motor, cognitive, social and emotional skills.

We, paediatricians, evaluate these “stages of psychomotor development” during periodic health visits, for example at 1 month, then at 2 months, and so on.

But sometimes it happens that a baby does not acquire skills that it should have at a certain age.

Or he regresses and loses a capacity he had.

In most cases this is due to normal variability among children. For example, some walk at 11 months, others at 18 months.

But in some cases this delay is due to pathological problems (e.g. metabolic or neurological diseases or others).

It is very important to try to identify real developmental problems as soon as possible.

Why?

First to make a diagnosis, then to start rehabilitation treatment as early as possible, e.g. physiotherapy. In practice, a specific intervention plan to promote development.

Can I suspect a psychomotor delay in my child?

Yes, you can.

In fact, it is often the parents who warn us that something is wrong.

Fortunately, most of the time we reassure them, but on rare occasions we confirm the suspicion and send the child to the specialist.

In this article you will find a guide, and videos, on how to suspect a possible problem, depending on the age of the child.

One month newborn. What are the warning signs of a possible delay in development?

The child does not move spontaneously and harmoniously.

If supine (on its back) the newborn stands still with its arms and hands extended. It does not move its arms and legs.

When gently seated, it cannot control its head even for a few seconds.

If the baby is held vertically, its legs do not push against the surface, e.g. the floor.

Also, when the baby is held suspended by his or her belly, he or she cannot lift his or her head for a moment, which remains flaccid below the horizontal line of his or her back.

Normally, your one-month old baby looks at you and smiles. He is already trying to communicate with you. Then he often follows your gaze with his eyes.

However, there can be problems if the newborn does not look at the parents’ face or does not keep his or her gaze for a few seconds when the parent slowly moves his or her head sideways.

Then he doesn’t smile and doesn’t react when you approach him.

Two-month-old baby.

What are the motor signs of a possible psychomotor delay?

These are the warning signs.

If put on his back the child remains almost motionless. Normally children of this age move their arms and legs in a harmonious and symmetrical way.

In addition, when you lift the baby with one hand on the belly, the baby is very flaccid and the head and legs tend to fall like a stuffed doll. Normally the two-month-old child, when raised in this way, tends to keep his arms and legs bent and tries to lift his head.

When you try to sit him up, he can’t even control his head for a few seconds, but this dangling forwards or backwards.

If you put him on his stomach, he can’t lift his head.
In this video you will find an example of how to recognize these warning signs.

Find the comparison between normal (typical) development and atypical developmental delay of a 2-month-old child.

Normal sensory development and signs of possible problems.

In this video, you can see some normal sensory steps for a child from 0 to 3 months.

Sensory development stages. What are the signs of a possible problem?

The baby never brings his hands to his mouth.

If you hold an object or toy close to his or her face, he or she does not look at it or look at it for a moment but does not follow it with his or her eyes as you move it slowly.

Communication: normal development and signs of possible psychomotor retardation.

In this video, you will find the normal communication skills for a child from 0 to 3 months old

Communication: what are the signs of possible delay in development?

The baby doesn’t react to loud noises, he stands immobile.

Furthermore, he does not look at you, or looks at you for a moment, but does not follow you with his eyes when you move slightly.

The child does not smile at you and, even if you stimulate him or try to talk to him, he does not make a sound.

4 month old baby. What are the signs of a possible psychomotor delay?

The baby does not move harmoniously and symmetrically, but moves in jerks or asymmetrically.

If placed lying on his back, he does not lift his head.

In addition, when lying on his belly, he does not hold his head up to 90 degrees and does not try to lift himself by holding his forearms.

If you sit him or her up, the child cannot control his or her head, but it tends to fall down or sideways.

When you hold her on her stomach, she cannot keep her head on the horizontal line.

When held upright, she does not push with its feet towards the surface.

What happens when you propose objects or toys to her?

The child does not try to grasp objects.

She does not take objects or hands to her mouth.

You can see these things well in this video.

It is in English, but easy to understand. Here you can see a 4 month old child with normal development (typical) and a child with psychomotor retardation (atypical).

Communication. What are the warning signs for a possible problem?

The child does not look at the face of the parent, or does not follow his or her gaze.

Then he or she does not look at objects when they move and does not move both eyes in all directions.

Furthermore, the child does not smile and does not try to make sounds.

He does not calm down easily, he does not allow himself to be consoled.

6 months old baby

What is the psychomotor development of a 6-month-old child?

In this video (in English but easy to understand) you can get an idea of normal development at 6 months.

What are the motor signs of possible delay in development?

The baby’s movements are not symmetrical or harmonic.

When lying on his back (supine) he does not lift and keeps his head up.
In addition, the child does not roll when lying down, for example when lying on his back, he does not turn around to put on his stomach.

When lying on his stomach (prone), he does not stand on his hands and does not keep his head up.

If you try to sit him up, the child cannot control his head, but his head swings.

Then when the child is lifted with one hand on his belly, he cannot hold his head up well, which dangles often below the horizontal line of his back. Always in this position, the legs are not bent, but stretched out, flaccid.

If put on his feet, the child does not support his weight but tends to bend his knees.

The child seems very stiff, with contracted muscles. Or he looks very flaccid, like a rag doll.

You can see these things well in this video.

It is in English, but easy to understand. Here you can see a 6-month-old child with normal development (typical) and a child with psychomotor retardation (atypical).

Sensory aspects: signs of possible problems.

When you put a toy in front of it, signs of possible problems are these.

The child does not grasp objects with the palm of his hands. He does not carry an object from one hand to the other.

He also does not try to reach for toys that are out of his reach.

The child does not put his hands or objects in his mouth.

Communication: signs of delay.

With regard to communication, signs of possible delay in psychomotor development are as follows.

The child does not smile. He is not interested in the environment.

In addition, there is no lallation. The baby does not try to communicate.

He does not seem interested in playing and interacting with his parents, responding with smiles or excitement during play.

The child does not respond or react to sounds or noises.

9 months old child

What is the normal development at 9 months?

In this video (in English but easy to understand) you can get an idea of normal development at 9 months.

Motor development. Signs of possible delay.

Baby’s not moving symmetrically. He cannot change position (e.g. turn around when lying down).

If placed supine (lying on his back), the baby does not grasp his feet. When placed prone (lying on his stomach), he cannot turn back.

Then he does not crawl, move or move to pick up an object or a toy. The child cannot sit up.

If put on his feet, he can’t keep his weight by resting on the soles of his feet.

The child does not have the reflex of a parachute (if suspended and moved forward or sideways, the child stretches his hands).

Normally at this age the child picks up objects well and explores the house.

The child does not pass objects or toys from one hand to the other. He does not pick up a small object with his thumb and index finger.

The child does not explore the environment and objects or toys (with mouth, eyesight, hands). Also, it does not look for hidden objects.

Sensory and communication aspects indicative of possible delay.

The child makes some sounds, but has no lallation (e.g. does not say mamama, bababa, etc. …). He does not laugh.

Then the child does not turn to the origin of sounds or voices and does not react when you call him by his own name. He doesn’t try to attract attention.

The child is not interested in his environment. If you point at something with one finger, the child does not look in that direction.
He does not look at a falling object or toy.

12 months old child

What is the normal motor development of a child at 12 months?

In this video (in English but easy to understand) you can get an idea of normal development from 10 to 12 months.

Quali sono i segni di possibile ritardo psicomotorio?

Il bambino non riesce a passare dalla posizione prona (di pancia) a quella supina (sulla schiena).

Inoltre non riesce a sollevarsi in piedi, o non riesce a tenersi in piedi.

Il bambino non cammina se tenuto per mano e non gattona.

Ha difficoltà a muoversi per cercare di raggiungere un oggetto fuori dalla sua portata.

Se gli presentate un giocattolo o oggetto, i segni di possibili problemi sono questi.

Il bambino non prende i piccoli oggetti con presa a pinzetta.

Se il bambino vede che i genitori nascondono un giocattolo, non lo cerca.

Non mette degli oggetti in un recipiente, dopo dimostrazione.

Il bambino non utilizza oggetti comuni, ad esempio non tiene il telefono all’orecchio o non porta il cucchiaio alla bocca.

Aspetti sensoriali e comunicazione: segni di possibile ritardo

A questa età il bambino vi guarda spesso, dice qualche parola e interagisce biene con voi.

Il bambino non cerca o mantiene il contatto visivo con i genitori.

Non dice nessuna parola, come “mamma” o altro.

Inoltre non ride e non reagisce a semplici domande, come: “dov’è la mamma?”.

Non reagisce nemmeno quando lo si chiama con il proprio nome.

Il bambino non si gira verso l’origine di un rumore.

Non imita i gesti dei genitori, come salutare, fare ciao.

Poi non imita qualche sillaba o suono dei genitori, come il verso di un animale comune.

Quando gli viene richiesto di portare un oggetto, il bambino non fa nulla.

Non si interessa all’ambiente circostante.

Il bambino non indica con il dito degli oggetti o persone.

Altre risorse utili

Ospedale Bambin Gesù

Centers for Disease Control and Prevention