The World Health Organization published a global study that became a parameter for evaluating children’s motor development, a process of change in behavior, related to age, both in posture and in children’s movement.
A comparative base of the expected motor development, to what is actually achieved by babies and children, is an important milestone to diagnose more quickly those individuals who may have a neuromuscular disease, characterized by affecting the functioning of the muscles, the neuromuscular junction (structures that connect nerves to muscles) and peripheral nerves.
Among neuromuscular diseases, spinal muscular atrophy (SMA) is closely related to this development and is directly linked to motor milestones. It is one of more than 8,000 known rare diseases in the world and affects approximately 7 to 10 babies in every 100,000 live births, being the leading genetic cause of death in babies and children up to two years of age. The disease is characterized by progressive weakness, which can compromise functions such as breathing, eating and walking.
“The delay in some basic motor functions characteristic of the first years of life demands investigation. For example, up to nine months of age, the child must be able to sit up without support. If the baby does not reach this milestone, it is a sign of attention”, explains Dr. Adriana Banzzatto, a neuropediatrician at the Pequeno Príncipe Hospital.
At each stage of growth, other milestones also draw attention. In addition to those mentioned by Dr. Banzzatto, from 0 to 6 months, the child with the development considered normal is also able to support the head, propel itself upwards when lying on its stomach; press the legs down when the feet are on a hard surface; as well as holding a toy and swinging in suspended motions.
Signs of spinal muscular atrophy at this stage may be present, meaning that the child may not have head control, sits only with support, presents a “frog” posture when lying down with the belly up; and having trouble holding things due to decreased muscle tone.
From seven to 18 months of age, other motor milestones should be observed. “At this stage, the child with the development considered normal stands up leaning on something or even alone. He is also able to sit without support, crawl, push himself to stand, walk with support on furniture and can take a few steps without support”, adds Dr. Banzzatto.
Parents should start paying attention if the child, at this age, for example, sits independently, but does not walk; shows muscle weakness that prevents attempts to stand; has problems with the spine, such as scoliosis (abnormal curvature of the spine), and problems with swallowing, coughing or breathing.
After 18 months, the signs of a child whose development is altered by spinal muscular atrophy become relatively easier to perceive. In this age group, she is able to walk, but gradually loses this ability, the lower limbs usually show less motor development than the upper limbs, there is difficulty in swallowing and muscle atrophy, which prevents movement.
“It is important to be aware of the signs, if the child is fulfilling all the stages of the motor milestones in the expected period. If not, the recommendation is to look for a specialist, such as a neuropediatrician, who will be able to carry out the appropriate investigation. In case of spinal muscular atrophy, early identification allows for more efficient intervention, which can alter the natural course of the disease and provide better quality of life for the patient”, concludes Dr. Banzzatto.
Learn more about spinal muscular atrophy: In Brazil, there is still no epidemiological study that indicates the exact number of individuals affected by the disease. The disease is clinically classified into types (ranging from type 0 to 4) based on the onset of signs and symptoms and the motor milestones achieved by patients.
The World Health Organization published a global study that became a parameter for evaluating children’s motor development, a process of change in behavior, related to age, both in posture and in children’s movement.
A comparative base of the expected motor development, to what is actually achieved by babies and children, is an important milestone to diagnose more quickly those individuals who may have a neuromuscular disease, characterized by affecting the functioning of the muscles, the neuromuscular junction (structures that connect nerves to muscles) and peripheral nerves.
Among neuromuscular diseases, spinal muscular atrophy (SMA) is closely related to this development and is directly linked to motor milestones. It is one of more than 8,000 known rare diseases in the world and affects approximately 7 to 10 babies in every 100,000 live births, being the leading genetic cause of death in babies and children up to two years of age. The disease is characterized by progressive weakness, which can compromise functions such as breathing, eating and walking.
“The delay in some basic motor functions characteristic of the first years of life demands investigation. For example, up to nine months of age, the child must be able to sit up without support. If the baby does not reach this milestone, it is a sign of attention”, explains Dr. Adriana Banzzatto, a neuropediatrician at the Pequeno Príncipe Hospital.
At each stage of growth, other milestones also draw attention. In addition to those mentioned by Dr. Banzzatto, from 0 to 6 months, the child with the development considered normal is also able to support the head, propel itself upwards when lying on its stomach; press the legs down when the feet are on a hard surface; as well as holding a toy and swinging in suspended motions.
Signs of spinal muscular atrophy at this stage may be present, meaning that the child may not have head control, sits only with support, presents a “frog” posture when lying down with the belly up; and having trouble holding things due to decreased muscle tone.
From seven to 18 months of age, other motor milestones should be observed. “At this stage, the child with the development considered normal stands up leaning on something or even alone. He is also able to sit without support, crawl, push himself to stand, walk with support on furniture and can take a few steps without support”, adds Dr. Banzzatto.
Parents should start paying attention if the child, at this age, for example, sits independently, but does not walk; shows muscle weakness that prevents attempts to stand; has problems with the spine, such as scoliosis (abnormal curvature of the spine), and problems with swallowing, coughing or breathing.
After 18 months, the signs of a child whose development is altered by spinal muscular atrophy become relatively easier to perceive. In this age group, she is able to walk, but gradually loses this ability, the lower limbs usually show less motor development than the upper limbs, there is difficulty in swallowing and muscle atrophy, which prevents movement.
“It is important to be aware of the signs, if the child is fulfilling all the stages of the motor milestones in the expected period. If not, the recommendation is to look for a specialist, such as a neuropediatrician, who will be able to carry out the appropriate investigation. In case of spinal muscular atrophy, early identification allows for more efficient intervention, which can alter the natural course of the disease and provide better quality of life for the patient”, concludes Dr. Banzzatto.
Learn more about spinal muscular atrophy: In Brazil, there is still no epidemiological study that indicates the exact number of individuals affected by the disease. The disease is clinically classified into types (ranging from type 0 to 4) based on the onset of signs and symptoms and the motor milestones achieved by patients.
