Bottom-Shuffling and Poor Stereoacuity


bottom_shufflingAny idea what bottom-shuffling is?  Hint: we’re not referring to a shady dealer in Atlantic City or Vegas.  It’s when an infant moves about in a sitting position, with our without use of the arms.  It’s also referred to as bottom-hitching, and here are a couple bottom-shufflers in action:

Cute, ay?  Bottom-shufflers tend to walk a bit later than their non bottom-shuffling counterparts, but I’d never really given much thought to it until I read this article in the January 2013 issue of Optometry and Vision Science: Poor Stereoacuity Among Children With Poor Literacy: Prevalence and Associated Factors, and learned that bottom shuffling is a factor significantly associated with poor stereopsis.  To quote from the body of the article:

“A twofold increase in the prevalence of poor stereoacuity was observed for low-literacy children who were reported to be bottom shufflers as babies.  This association was independent of prematurity.  Crawling on all fours at the appropriate developmental age may provide suitable visual input for good stereoacuity development.  In other words, sensory-driven neural activity, such as visual input from the crawler’s view of the floor, could assist infant brain development, including visual maturation.”

14 thoughts on “Bottom-Shuffling and Poor Stereoacuity

  1. I was staggered to read this VisionHelp Blog; surely bottom shuffling has been known for many years to cause poor Jump Accommodation, poor Stereopsis and consequently poor reading ability.

    Saw this with my grandson some eight years ago and pointed out to his parents (both teachers) that problems with reading would be ahead. They did not believe me until at the age of 6 ½ they found his reading was well below par.

    After assessment and consequent vision therapy there was rapid improvement in his reading – soon reading well above his age average ability.

    As to VisionHelp Blog, I always look forward to reading this very useful and interesting Blog.

    Michael Blackstone

    Michael Blackstone FCOptom., 2, Loudwater Ridge, Rickmansworth, Herts. WD3 4AR, England

    Tel. 0044 (0)1923 896158 Mob. 07775 924904 E-mail:michael.blackstone@virgin.net

    • Thank you for commenting, Michael. Glad to hear your grandson benefited from vision therapy. When you state that surely bottom shuffling has been known for many years to cause poor jump accommodation, poor stereopsis and consequently poor reading ability — can you point me toward where you have seen this in print before?

  2. Reblogged this on The View From Here and commented:
    A very interesting read from one of my favourite blogs, “The Vision Help Blog”.

    While neither of my children were bottom-shufflers (I think my daughter crawled on all fours for about a quarter of a second before she decided it was much faster to stand up-right and walk!) I still found this article about the correlation between bottom-shuffling and the potential for poor stereoacuity very interesting. Admittedly, I had never heard of it before now.

  3. Bottom shuffling can cause huge issues with fine motor, grasp, bilateral skills, and core strength as well. Crawling (on belly) then creeping (all fours belly off floor) are vital parts of development. If an infant bottom shuffles instead of wanting belly time then it can also be a sign of ear pressure, sinus pressure, food sensitivities causing sinus pressure, ear infections, and touch defensiveness to the hands. All are red flags that need a good pediatric OT to look at and probably a nutritional biomedical work up as well to look at possible food sensitivities to cow’s milk and wheat.

  4. But does bottom shuffling really CAUSE vision issues? Wouldn’t vision issues lead to this behavior, and then the behavior might perpetuate problems with vision development? Differences in motor skills, posture, etc. are ASSOCIATED with vision issues, right? If your binocular vision is off, your motor (posture and balance, etc.) would likely be off/different too, right? My daughter Stella crawled for two months, then walked at 10.5 months and I remember someone saying she should’ve crawled longer, practically blaming me for allowing her to walk on the early side. I guess I wish that pediatricians had more awareness of the wide range of signs that vision might be an issue–but in my experience, they really don’t! I wish they would read this blog. My pediatrician told me that Stella toe-walks because her calves are tight, and I guess I can’t help but be contrary and questioning, because I said, “Aren’t her calves tight because she toe-walks?” He wasn’t amused. I related all this to this post–because she had some differences that I now associate as almost being side-effects of her strabismus, but not causes of it. THANKS!

  5. A little late in commenting on this, but a big part of this is the integration of primitive reflexes. The STNR ( symmmetrical tonic neck reflex) is the reflex that teaches aninfant how to disocciate upper from lower body. When a child starts experimenting with weight bearing on all fours…the STNR gives them the initial cues to rock back and forth. This then has to first integrate

  6. post continued….hit “post” on error. …was saying…This then has to first integrate in order to allow a child to move the arms without involuntary movement taking place in the hips. When the rocking starts, the visual system is having to accommodate as the child fixates on items of interest and the body rocks back and forth..thus the involvement of stereopsis and further development/plasticity of those visual-spatial system (all leading up to reading performance). So, there is a reason the child is not integrating STNR and therefore cannot learn to crawl (now of course this may not be the case for every single child..but generally speaking). Poor reflex integration/maturation are going to be huge signs of developmental concerns/delay…and reading is likely not the only problem for that child.

  7. Hii. Great post. Thank you for generous;y offering so much great information. As an OT, I believe we suspect delays in visual motor development associated with delayed crawling and propensity toward scooting, but great to see that the research is there! I’m wondering about poor integration of visual input associated with influence of the ATNR reflex. I’m beginning to think that my daughter is struggling with this (almost 14 months), crawled early, but since I’m a picky OT, probably not as reciprocally as I would like. Any thoughts that you can offer on this reflex and visual skills. Considering VT, but the expense is tough for us right now,

    • when you think about ATNR it is in that plane dividing the body in half…left from right so a child who hasnt integrated ATNR will dispplay difficulties with midline crossing, bilateraal integration, and specifically horizontal pursuits related to vision. at 14 mnths old it may be a bit hard to truly assess all thosee aspects bc she is still so young. you could attempt ATNR test which would involve her being in quadruped with her in neutral; then you rotate her head to the side and if her elbow breaks (elbow opposite to direction of head), then it may demonstrate poor ATNR integration. However, may just be too young for an accurate result. Check out RMT (rhythmic mvmt training) or books by Sally Goddard. I am a worried OT mom too, so you could just consider incorporating play focusing on bilateral integration, play at midline, and a lot of upper body weight bearing activities that involve having to isolate head from body in different planes.

  8. This is absolutely absurd. There is no correlation. It is purely coincidence. You can not say that all bum shufflers are slow learners. My daughter bum shuffled and she is a very intelligent little girl who is also a very quick learner. You simply cannot apply that statement to every child to shuffle on their bottom! Just absurd!!

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