• Signs of Weakness
  • Clinical Evaluation
  • Testing and Referral
  • Resources and Tools
Signs of Weakness: Infant+ PDF Print E-mail
Written by Administrator   
Wednesday, 22 June 2011 17:04

Milestone: Pull to sit without head lag


Evaluate pull to sit with attention to head lag, until achieved

Surveillance & Next Steps

If a child has head lag at 4 months, carefully evaluate other age-appropriate motor milestones (e.g., rolling) and refer to early intervention for developmental stimulation. Re-evaluate in one month.

If child is not age-appropriate: CK and referral

What does weakness in pull to sit look like?

Developmental norms

Pull to sit with no head lag*: 50% by 3.5 months, 75% by 4 months, 90% by 6.5 months

*Source: Denver II

Download a pdf of the Surveillance and Referral Aid for Primary Care Providers. This Aid includes assessing weakness by age, clinical evaluation for muscle weakness, guidance on the use of CK testing, and the motor delay algorithm. These materials have been endorsed by the American Academy of Pediatrics.
Last Updated on Thursday, 30 August 2012 15:32

Did you know?

Signs of proximal muscle weakness include: abdominal breathing or accessory muscle use; a feeling of "slipping through hands" when held suspended by examiner under armpits; inability to voluntarily flex neck when supine or head lag when pulled to sit; difficulty rising from floor (including Gowers maneuver, full or modified)