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Delayed gross motor development

Author: Szilvia Golács, conductor, TSTM-therapist, mentor

Instructor at TSMT-HRG College

To view the mechanism of action of TSMT and HRG therapies on delayed gross motor development, click here.

What is delayed gross motor development?

Motor development of children has long been at the core of research by children’s professionals as the basic means of learning about the world. Motor development is a development unfolding as a genetically encoded process, in which the stages of movement development follow a certain order along the straightening of the body. We all have the mental image of a lying infant who initially keeps moving its arms and legs without any coordination, then flips from his tummy then back to tummy again, then starts belly-crawling, moving around on all fours, climbing, then sits up, pulls himself up to stand and finally walks unassisted. The infant’s motor skills do not cease to develop, they will become more and more coordinated, it will be able to plan and execute complex movements, and all this in changing circumstances.

The stages of motor development follow each other in a given order, during the exercise of each form of movement besides strengthening of the musculoskeletal system, the locomotor and vestibular systems mature, movement coordination, static and dynamic balance, spatial perception develop, which enable the child to successfully cope with the challenges in different areas of life. (Ferenc Katona: Clinical developmental neurology, Medicina, 1999.)

Ideally, the stages of development follow each other in a biologically defined order and quality, with typical developmental milestones: the 2-3 month old baby lifts and holds up his head first, at 3-4 months of age he rolls from belly to back then back to belly, between 6 to 8 months they start creeping, between 8 to 10 months they learn to crawl and to lean over onto all fours, around 10 to 12 months babies pull themselves up to a stand, and by 12 to 18 months start walking without support. In addition to gross motor skills, fine motors skills, manipulation and speech motor skills continue to mature as well. If these developmental skills of motor development appear with a delay of several months or do not appear at all, your child has a developmental delay.

There are, of course, individual differences in the process of motor development, but the order of each milestone, the process and timely development of each stage ensure the maturation of the corresponding areas of the nervous system, help the formation of various neural pathways and cross-channels, the use of increasingly complex connections, the processing of stimuli from the outside world and giving the appropriate responses to them. It is important to mention that gross motor delay does not necessarily determine future learning problems, but rather indicates certain functional differences, however in children with learning problems, personality and behavioural disorders, the characteristics of different or delayed gross motor development are always present.

What can cause delayed gross motor development?

Studies have shown that there are several reasons for delayed gross motor development. This is important because it can be used to select the right therapy. A certain type of therapy is required to replace the missing external stimuli, another therapy is needed when the child’s processing of sensory stimuli is disturbed, and a different approach is used when the problems are caused by some kind of underlying food allergy or nutrient-processing disorder. Sometimes the combined use of multiple therapies helps trigger the process of development.

How can TSMT and HRG help?

The LongiKid© screening test helps to point out the underlying causes of the developmental delay: the immaturity of the nervous system; deficiencies of movement coordination, balance or bilateral movements; abnormal forms of movement or postures; deficiencies of attention or inadequate motive for movement can all be the causes for developmental delay.

If there is a difference in muscle tone, manual therapy (DSGM, Pfaffenrot therapy) can be used to “prepare” the muscles and joints for proper motor function. These procedures help break up muscle adhesions and achieve the right tone. Passive manual therapy complements the active tasks of HRG and/or TSMT, helps maximizing the use of muscles.

The tasks of HRG and TSMT can be performed from the age of 3 months (even earlier if necessary). The diversity of tasks provides an opportunity to chose from tasks that stimulate the passive vestibular system, thus triggering the maturation of the nervous system; enabling the therapist to use forms of movement that fit into the developmental process; developing the appropriate motor responses in postural equilibrium, activating symmetrical operation of the two halves of the body; and through the use of gross motor skills promote the of use active tasks developing fine motor skills.

During HRG therapy, the warm water helps to relax tight muscles and provides continuous tactile stimulation through the skin. With the help of buoyancy certain tasks are easier to perform in water, in addition, the versatility of tools provide many opportunities to maintain postural equilibrium, to develop head, torso, arm and leg control, and to improve movement coordination. Based on the screening test the therapist is aware of the child’s personal challenges, therefore he/she is able to prepare a customized set of tasks, which assist the child in overcoming the obstacles.

In some of the tasks, the child is a passive observer, while in other tasks he is an active participant, which helps develop the motive for movement, cooperation, social skills, single-channel and multi-channel attention, muscle tone regulation, and inhibition of the possibly remaining infantile (primitive) reflexes. Regular, repetitive tasks performed in a given amount help in triggering the maturation of the nervous system, in creating the missing forms of movement, in planning and performing the movements according to a certain age.


  • Ferenc Katona: Clinical developmental neurology, Medicina, 1999.
  • István Farmosi: Motor development, Publishing House Dialóg Campus 1999, 2005
  • Csaba Pléh: History of Psychology, 2010 Excerpt