"My baby is one year old and still can't walk without holding on. Is this a developmental delay?" "The child next door is chattering away at two, but mine only says mama and dada. Is this normal?" In the parenting journey, the most common anxiety parents face is "comparison." Every child is a unique individual with their own growth clock. However, from a medical and physical therapy perspective, while the "speed of development" can vary, the "sequence and quality of movement" follow an unbreakable pattern.
To enable earlier detection of potential developmental delays in children, Taiwan's Ministry of Health and Welfare has comprehensively expanded the "Child Development Screening Services for Children Under 7" starting July 1, 2024. This new system provides 6 free professional screenings, marking a major milestone in Taiwan's early developmental therapy. Today, Compass Physiotherapy will guide you through the secrets behind these screening indicators, teaching you how to become the first-line guardian of your child's development at home.
Why Do We Need "Standardized" Screening?
In the past, many parents held the traditional belief that "late bloomers will eventually catch up," thinking their children were simply late to develop. However, the development of the brain's neural networks has a "golden window": the period from 0 to 3 years old is when the brain is most plastic. If abnormalities in neuromotor or cognitive development are detected during this time, professional early developmental therapy intervention can yield twice the result with half the effort.
The 2024 new screening system categorizes a child's developmental abilities into four major domains: gross motor, fine motor, cognitive-language, and social-emotional. This is not just a checkbox test; it is a rigorous, evidence-based screening system.
Physical Therapist's Analysis: Core Milestones of "Gross Motor" Development from 0-6 Years Old
As physical therapists focusing on motor development, we have condensed this six-year golden period into four key stages and highlighted the "Red Flags" that require special attention:
| Developmental Stage | Age | Core Skills | Red Flags |
|---|---|---|---|
| Foundation Stage | 0–6 months | Head lifting, rolling, anti-gravity | Head Lag persists at 5-6 months |
| Mobility Stage | 7–12 months | Independent sitting, crawling, cruising | Unable to sit steadily at 10 months; asymmetrical crawling |
| Upright Stage | 1–2 years | Walking, squatting, dynamic balance | Unable to walk independently by 18 months |
| Functional Stage | 2–6 years | Running, jumping, sensory-motor skills, motor planning | Unable to jump with both feet at 3 years |
Stage 1: Foundation Stage (0-6 months) — Defying Gravity
The focus of this stage is on "anti-gravity" and "midline connection." Babies must gradually develop neck and trunk control from a floppy state.
Key Observations: Can they lift their head to 45-90 degrees during tummy time? Can they smoothly roll from supine to prone (bilaterally symmetrical)?
🚨 Red Flags: If by 4 months old, the head still falls back like a ragdoll when held upright, or if the limbs remain constantly stiff and tight and cannot relax, these are signs of abnormal neurodevelopment.
Stage 2: Mobility Stage (7-12 months) — Expanding the Radius of Exploration
The focus is on "locomotion ability" and "pelvic stability." The child progresses from belly crawling on the floor to standard hands-and-knees crawling like a puppy, and eventually can pull themselves up to stand by furniture and cruise sideways.
Key Observations: While sitting, can they maintain balance without hand support (independent sitting) and rotate their body or shift sitting postures to reach for toys? Are the movements of hands and feet coordinated and symmetrical during crawling (reciprocal movement)?
🚨 Red Flags: Still unable to sit independently at 10 months; or always dragging one side of the body with the other side during crawling (asymmetrical movement), which may imply poor neural conduction on one side of the brain or abnormal muscle tone.
Stage 3: Upright Stage (1-2 years) — Challenging the Lower Limbs and Balance
This is the moment parents anticipate the most: the child letting go and taking their first steps. This requires significant lower limb strength and dynamic balance.
Key Observations: Is the walking base gradually becoming stable and narrower? Can they squat down to pick up a toy from the floor and stand back up without falling?
🚨 Red Flags: If by 1.5 years old (18 months) they still cannot walk independently for more than five steps without holding on, or if they always walk severely on their tiptoes, a medical evaluation is recommended.
Stage 4: Functional Stage (2-6 years) — Advanced Integration of Neurology and Senses
Movements become extremely complex during this period, emphasizing "Motor Planning" and "Sensory-Motor Integration."
Key Observations: Can they go up and down stairs one step at a time without holding the railing? Can they jump with both feet leaving the ground simultaneously? Can they stand on one foot for more than three seconds? Can they accurately catch and throw a ball?
🚨 Red Flags: Still unable to jump with both feet off the ground at 3 years old (many children with clumsy gross motor skills will "step" instead of jump); frequently tripping for no reason, or being afraid of swings and slides (which may indicate issues with balance or proprioceptive processing).
FAQ: Common Concerns from Parents
Q1: My child skipped "crawling" and went straight to cruising. Everyone said he was smart, but why does his kindergarten teacher say he has weak pencil grip and can't sit still in class?
"Crawling" is the most crucial neurological integration training in human developmental history! When a child crawls on the floor, they are doing three extremely important things: First, bearing weight on their palms, which strengthens the web space and wrist and elicits tactile input in the hands (directly related to future fine motor skills like using scissors and holding a pencil); Second, alternating hands forward, which forces the left and right brain to communicate and coordinate across the midline (affecting future attention and reading skills); Third, lifting their head to look forward and judge distance, which refines visual-spatial perception. Therefore, skipping crawling to "stand directly" is definitely not a sign of being smart; instead, it deprives the brain of an important puzzle piece. For such children, physical therapists will recommend using various "climbing games" or "balance and coordination training" to make up for this missing integration experience.
Q2: When taking my child for a developmental screening, the questionnaire asks "can the child perform a certain movement." Sometimes he does it when in a good mood, but won't do it when in a bad mood. How should I fill out the form?
Parents must adhere to the principle of being "conservative and honest." Medically speaking, "being able to do it" means the child can demonstrate that skill "steadily and repeatedly" in a "natural, pressure-free environment without adult assistance." If you find that a movement is only successful twice out of ten attempts, or if it looks extremely effortful or uses strange postures every time, please boldly circle "No" on the questionnaire or proactively inform the doctor. Child developmental screening is not an exam; filling in "No" does not mean the child has failed. Instead, it allows them to get an early ticket to "professional early developmental therapy evaluation," enabling us to support them with the most professional resources.
(A child's growth happens only once; don't let "let's just observe a bit longer" miss the critical window for their development. If you have any concerns about your child's current learning progress or motor coordination, feel free to contact our official LINE account. Compass Physiotherapy will provide you with professional developmental assessments and developmental therapy approaches.)
References
- Irfan W, Weitzman C, Lipkin PH, et al. (2022). Promoting Optimal Development: Screening for Mental Health, Emotional, and Behavioral Problems: Clinical Report. Pediatrics.
- Bowler A, Arichi T, Austerberry C, Fearon P, Ronald A (2024). A systematic review and meta-analysis of the associations between motor milestone timing and motor development in neurodevelopmental conditions. Neuroscience & Biobehavioral Reviews.
- Boonzaaijer M, Suir I, Mollema J, Nuysink J, Volman M, Jongmans M (2021). Factors associated with gross motor development from birth to independent walking: A systematic review of longitudinal research. Child: Care, Health and Development.