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12+ months: Rise to stand PDF Print E-mail
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Tuesday, 17 January 2012 02:19

Greater than 12 months: Rise to stand from floor

Description

Watch for independent rise from floor from a supine position after child is able to walk well without assistance (generally 12-16 months); watch to see if child uses a Gower’s maneuver (full or modified, by putting hands even briefly on knees or thighs) or cannot rise without pulling up.

Discussion

Repeat any time concerns are raised about walking or other motor function, to evaluate for regression.

Tip: An early Gower’s can be very subtle. Watch what it looks like.

RED FLAG

A child who cannot rise from floor to stand without support (including without using hands on knees or thighs to push up) by 18 months, or who shows regression in rise to stand, needs further evaluation.

Therapist Response to Red Flag

Communicate specific concerns about rise from floor (in context of overall development and relevant environmental factors) to the family and referring provider. Provide evidence for weakness rather than poor coordination as a cause for the delay. Encourage a referral to a specialist (consider pediatric neurology) for a diagnostic evaluation.

Specialist Response to Red Flag

Draw a CK and refer for diagnostic workup.

Download a pdf of the Surveillance and Referral Aid for Therapists and Specialists. This Aid includes signs of weakness by age, red flags and warning signs for muscle weakness, and referral recommendations.
Last Updated on Tuesday, 04 September 2012 22:20