Learning & Development: Physical Development: Part 2 - Tummy time

Babies acquire a huge number of movement patterns and new movement abilities during the first nine to 12 months of their lives. At the same time, something very interesting is going on in the brain. It is as though the baby is fast-forwarding through the brain development of all our evolutionary ancestors.

It begins in the watery environment of the womb, where the movements the baby makes are 'piscean' or fish-like. The next stage is the 'reptilian', when babies begin to make attempts to move on their tummies like a reptile - think of the way a lizard or crocodile creeps along on four legs with its belly close to the ground.

When crawling on hands and knees begins, then we have reached the 'mammalian' stage, moving like a quadruped animal on four legs. The fourth stage is the 'primate', where babies move from crawling to walking but where the hands are still important for balance and for holding on to things for support.

Finally, we reach the 'human' or bipedal stage, when we have confidence and balanced control in moving on two feet. This leaves the hands free from the task of weight bearing, so that we can develop high-level manipulative skills. It also means that babies are then able turn their attention to the uniquely human tasks of learning to talk and use symbolic language.

On the floor

A baby's first playground is their mother, or other primary carer who carries the baby around, rocking them to sleep and stimulating them through touch and gentle sensation. When not being held, it is the ground that provides the next natural playground.

When a baby is lying on the floor, the contact with the ground surface provides them with a whole range of tactile experiences, as they explore gravity, body position and friction with the surface as they wriggle and squirm. All of this is helping the baby build 'proprioception' - the knowledge of where they begin and end.

Babies lying on their backs, kicking their legs, are finding out how long they are. Waving their arms tells them how wide they are. Lying on their tummy, a young baby can experiment with a whole range of spontaneous and, at first, involuntary movements. The accidental shifts and wriggles of the body quickly become more co-ordinated and controlled. Through increased muscle tone and neck control, the baby first learns to hold up their head, and soon after is starting to support some of their weight on their forearms.

There is some concern now that for a variety of reasons, babies and young children are not having enough of the floor play experiences that are so important for their physical and neurological development. Research into Sudden Infant Death Syndrome (SIDS) has led, quite rightly, to advice that babies should not be positioned for sleep on their tummies. This seems, though, to have increased public anxiety about putting babies in the 'prone' position at other times. Increased use of car seats and bouncy chairs also mean that many babies are left with fewer opportunities for playing on their tummies or backs. However, there would seem to be evidence that missing out on this vital opportunity for development can have quite serious consequences for the baby and in later life.

Benefits

There are many physical benefits to tummy time. It:

- helps to lengthen the spine and develop neck extensor muscles

- expands the chest cavity, which allows for deeper breathing

- allows weight bearing through the hands. This helps develop the full palm stretch, which is important for finger dexterity, strength of grip and fine motor skills

- encourages close-range eye focusing. Eye focus and tracking have an important part to play in a child's physical and learning development

- decreases the primitive early infant reflexes that tie head movement to whole body movement. This frees the head to move separately from the body, which helps head alignment

- helps develop movement across the mid-line of the body. These cross-lateral connections are thought to be important for higher-level thinking and memory skills.

Problems

There are several problems that might be linked to a lack of tummy time. These include:

- Twisting or arching of the neck (torticollis) and flat spots on the head (positional plagiocephaly)

- Low energy and fatigue as a result of poor breath control

- The difficulties with grasp and fine motor skills that are linked to reduced weight bearing on the palms can lead to problems later on with pencil control and handwriting.

- Eyes may not learn to work together when focusing, which has an impact on later reading and academic skills.

- If early primitive reflexes are not inhibited through natural movement exploration, they may persist and get in the way of later postural reflexes developing. This can affect all aspects of physical development and body control, including athletic skill and the ability to sit still.

- Back and tummy muscles may not develop well, which can lead to later health and mobility problems.

Planning

Tummy time and floor play are valuable at any age, and children who may have not had enough 'reptilian' experience in their first year of life will benefit greatly from being encouraged to get down on the floor and wriggle about on their bellies or backs.

A child (or adult) who has not had enough experience in the 'prone' position may well resist getting on their tummy, so use cushions or rolls to make it easier and probably more appealing for them.

- Make sure there is always plenty of floor space as an alternative to tables for activities.

- Put books, puzzles, drawing and writing materials on the floor to encourage time on tummies.

- Why not try group or circle time on your tummies (adults included)?

- Listen to music on your backs and wriggle around to the beat.

- Lying on your tummy looking into a hand mirror or a book on a stand encourages the use of neck muscles

- Use a long piece of slippery floor covering or satin (possibly taped or held down) for children to belly-crawl and slide along. Place some object at the end that they have to reach.

- Try snake or crocodile races, crawling on tummies all the way. Try sprinkling sticky stars or sequins on the floor - and the winner is whoever has most stuck to their bellies at the end!

- Bolster cushions, rolls and gym balls of various sizes are great for lying on, and for rolling, rocking or crawling over.

- Don't forget to make the most of outdoor space for time spent on tummies and backs. Use slopes for rolling and sliding. Lie on your front to look closely at the grass or to watch an ant or a wriggling worm. Lie on your back and watch the clouds go by!

Future articles in this series will look at the importance of crawling and locomotion, balance and vestibular development for children from birth to five. The next article will be published on 21 May.

- Anne O'Connor is a freelance early years consultant and trainer. Anna Daly is an associate lecturer at University of Central Lancashire and a freelance community dance artist, specialising in projects and training for early years dance play. She was formerly training and development co-ordinator with Ludus Dance and continues to work with them.

ADULTS ON THE FLOOR

- Get down on the floor yourself! Demonstrate that the floor is a fine and exciting place to be and explore. Having movement or dialogue conversations at floor level on backs or tummies offers a wonderfully intimate connection.

- As always with recommendations for physical activities, keep observing the child's responses, especially the non-verbal ones, to make sure they are comfortable and so that you are ready to extend or consolidate an experience with them.

- Trust what you see and feel, and respond accordingly. If children are happy, engaged and curious, gently continue with the activity, or if they are not willing or happy to explore further, stop the activity.

- Use your own body. Rest babies over your knees (maybe with a book, toy or mirror to look at) or over your shoulder. Lie on your back with a baby or small child on your own chest or tummy. As well as chatting or singing songs this way, you can hold them and roll gently side to side, or play tapping or stroking games. Get down on hands and knees and make shapes, like low bridges, for children to crawl under on their bellies.

MASSAGE IDEAS

When changing babies' nappies or when they are comfy on the floor, fit in a quick simple massage on their backs or tummies. Clockwise circles on the tummy can be very soothing and help digestion. Gentle rubs or stokes on the back are comforting and can help calm or soothe an agitated or restless child.

An invigorating touch can be raindrop fingers, tapping on different parts of the body - not too tickly though, as this can just irritate the child!

Try massaging gently with a koosh ball or soft ball, over surfaces of the body and up and down limbs. This helps feed a sense of the baby's body map.

Try full body swooshes with see-through light fabric. While the child is lying on the floor on their back, drape them with the fabric, keeping eye contact, and slowly or quickly pull the fabric the length of the body.

Bit of peek-a-boo too!

Take time to try varying pressures and speeds and keep observing how the child responds to the touch - if they are uncomfortable or not in the right mood, try again another time.

REFERENCES AND FURTHER RESOURCES

- Judy Towne Jennings, Infants benefit from early use of position, http://www.physical- therapy.advanceweb.com/Editorial/Content/Editorial.aspx?CC=189606

- Institute of Neuro-Physiological Psychology, www.INPP.org.uk

- 'Move on' by Mike Jess and Jan McIntyre of the University of Edinburgh (Nursery World, 29 January 2009)

- Sally Goddard Blythe, The Well-Balanced Child: Movement and early learning (Hawthorn Press)

- Penny Greenland, Hopping Home Backwards

- Jabadao, www.jabadao.org