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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Child has motor delay, not able to crawl, tends to stand up with support. Karyotype normal

Answered by
Dr.
Dr. Santosh Kondekar

Pediatrician

Practicing since :1997

Answered : 379 Questions

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Posted on Fri, 5 Oct 2012 in Child Health
Question: Hi,
This is regarding my 12 months old baby boy.
He is having a motor delay. He is very active makes lot of noise and plays well.
But is still not able to crawl/sit. He started rolling over @ 10 months and moves around rolling.
He tends to stand up with support all the time, and can stay like that for 30-40 mins.

I consulted a few doctors, we had a karyotype done and found nothing wrong.

Please let me know what I should do.
doctor
Answered by Dr. Santosh Kondekar 1 hour later
Hello XXXXXXX

Its very important that you have noted some degree of motor delay in your baby , and the delay appears significant enough to be intervened.

A 12 month old child should at-least be able to sit on own, say monosyllable words. point at objects, pick up small objects with 2 fingers etc. Unable to do this is surely a delay.

Often the delay may have no discover-able cause, but many time the cause may be since birth. So I would be more comfortable if i could know any birth history and any issues during pregnancy like say fever in mother that may affect baby to great extent.

Karyotype is just a way to know some syndormes like Down syndrome. But another important cause of delay in our country is hypothyroidism, so i would also recommend thyroid tests done for the baby.

Also follow the weight and height on growth charts (available freely at WHO or CDC sites), do look for any delay in weight or height in addition to head circumference.

The most important aspect of modifying this delay to near normal is early intervention therapy. Take the child to Occupational therapist (at apollo or NIMHANS) with this print out. Insist for detailed evaluation for tone abnormalities, and appropriate therapeutic exercises with multisensory and motor stimulation will be introduced in sequence. If late, these will be less effective.

Therapist may find increased tone, which may be requiring relaxation therapy with drugs or botox (refer back to me if any further details needed), so therapist may refer back to pediatrician who may ask for MRI brain in addition.

Patience and persistence often helps the child improve, but all depends on efforts taken for early therapy interventions.

I hope this give you enough understanding of what needs to be done in this case.
Please accept the query and post a review if so felt.
Thank you.

Dr Kondekar
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Santosh Kondekar 4 hours later
Hello Doctor,

Thanks for the detailed response.

As for the pregnancy history, the delivery was a C section one and was done in Madurai, Tamilnadu.
10 months into pregnancy there was excess liquid in the stomach and my wife was kept in ICU for observation, on some standard medication. Other than this everything else was normal.

We did the thyroid test when baby was 1 week old, and the reports were normal. Do we need to do again ?

Also we have been following the charts for height/weight. For the first 4 months baby was @ 70% wt/ht, but after the 4th month he was consistently in 50-55% for ht/wt and head circumference.

I think the next steps for us would be to do the following
1) Get the thyroid test done.
2) Visit Apollo and get detailed evaluation for tone abnormalities with a Occupational therapist.

Please let me know if you have any other suggestions based on the information given above.

-- XXXXXXX



doctor
Answered by Dr. Santosh Kondekar 17 hours later
Dear Mr XXXXXXX

You have understood well, follow the same. Your doctor may also ask a MRI scan of brain in addition (it may come normal but get it done). Do write back any follow ups to me.
Its fine that his growth hasn't suffered as much as development; but the delay can be attributable to mother's ICU admission causing damage to developing brain.

good luck and wishing your baby a healthiest outcome with therapy.

thank you for reply.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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