Help! My child won't walk!

I plan on doing a few of these over time to target specific milestones. First up, let’s talk about the big one: Walking.

Asking for help with achieving rolling, sitting, crawling, and walking are some of the most frequent questions I get as a Pediatric Physical Therapist. This is meant to just be a quick reference for ideas, by no means is it all inclusive, and as always does not mean to substitute for medical advice.

I get asked the question “When will my child walk?” so often in my practice. Let’s start with some basics. The gold standard for many families is that the kiddo is walking by their first birthday. We’ve been told a million times (or maybe that’s just me) that the typical milestone for walking is 12 months, but I’m here to tell you that it is not always the best information, and what you can do to help your kiddo walk when they’re ready.

I’ve had children learn to walk with me anywhere from 10 months to 24 months with no other diagnosis present. It probably goes without saying that if your child has something else going on like cerebral palsy, Down syndrome, or autism, that these numbers can be vastly different, however many of the tips I give below can still be helpful. For a typically developing child (I strongly dislike the word “normal”) I find that anything between 11 months to 18 months is pretty typical. That being said, we usually adjust for prematurity. If a child was born at let’s say 36 weeks (4 weeks early) we wouldn’t expect them to be functioning at their age level, we would expect them to be functioning at their age level minus 4 weeks.

Let’s start with the early walkers. Most often this is looked at as an amazing achievement, and Yes! It really is! However, when kids don’t spend enough time crawling on hands and knees, they miss valuable time spent strengthening their trunk muscles (think baby planks), strengthening their arms (all that pushing through the shoulders), and legs. They have decreased time spent working on coordination because moving the opposite arm and leg at the same time, and then progressing to reaching for objects helps build motor connections to their brains.

Early walkers often spend a lot less time cruising along furniture (that’s the side stepping you see along coffee tables and couches when kids are first learning to balance on their legs while holding on). This means that the inside and outside of their thighs aren’t as strong, and they may have more difficulty catching their balance from falling, and reaching when they start walking.

Let’s switch. Later walkers can be a whole variety of kids, sometimes they’re just generally more cautious than their early walking counterparts. I find that often these kids like to “perfect” the movements so that they’re comfortable before they start this new movement, these kids often go from holding an adult’s hand to full out running in the blink of an eye. Sometimes kids that walk a little bit later are just a little bit weaker in their trunk and just don’t have the strength to balance on their own. Personally, I usually won’t evaluate any child who isn’t at least 16 months old because a lot of times they figure out how to walk on their own. I can’t tell you how many times I see a kid for an evaluation for “delayed walking” and by the time they come back to see me a second time, they’re already taking steps.

Tried and tested tips!

1. If your child will stand at a couch or coffee table, but wont take steps away from it:

Place the coffee table and couch (or any other two support surfaces like a heavy box/step stool/weighted laundry basket) parallel to one another. Move them close enough so that the child can reach both at the same time but one is in front of them, and one is behind. Get their attention by using a toy, bubbles, anything so that they hold onto both surfaces and turn their entire body. KEEP DOING THIS! Now, once they’ve mastered switching from one surface to another, push one support surface back just an inch or two, now keep having them switch from one to the other. Every day push one surface back just a little bit. Eventually they will be far enough that your child will have to take one step towards the other surface. Keep going! Help them build their confidence! Eventually they will have to take multiple steps. I suggest using something SUPER motivating for this task.

2. If your child will walk with their hand held, but not on their own:

Try holding their hips, this will decrease dependence on hand holding. Sometimes I will wrap a sheet or towel around their waist so that the adult can stand fully straight. The child has something to hold onto (the sheet), the adult can gradually reduce support, and the child is safe if they fall. Try having them hold onto a hula hoop or jump rope instead of your hands. This allows support to be reduced. If successful I’ve seen children start to walk dragging the jump rope behind them not realizing that they really don’t have any support at all!

3. If the child won’t stand without support:

Place them with their back against the wall, a couch, or an adult’s legs. If standing against legs, the adult can give a little support at the shoulder. Have another person such as another caregiver or a sibling, blow bubbles (or anything else requiring reaching) so the child has to slightly shift their weight forward to reach. This is a great one for the child that has more anxious tendencies and doesn’t want to leave a caregiver’s side.

4. If they seem super unsteady when standing:

Encourage push toys! Now these are different than walkers (Please don't use baby walkers, I beg you!). These are like your shopping carts where the child is free to move and not strapped in. I love using laundry baskets too. Fill them up so that they don’t move very fast, and now you have an instant trunk strengthening machine. Let them get confident pushing something heavy and you’ll notice their balance and strength will improve.

Final thoughts

Just a few final notes to leave you with: Age ranges for milestones are just an average, and to be honest they’ve been talking for years about pushing them back due to safe sleep guidelines. Since children now spend so much time on their backs (which is really important) they are losing a lot of the tummy time that is important for their trunk strength. Children seem to be attaining milestones more slowly and many people are wondering if this is the reason. Obviously it is super important for kids to be sleeping on their backs to reduce risk of respiratory issues, so we may need to think about changing what “typical” is defined as.

Last note taken from the Campbell’s Physical Therapy for Children textbook: Learning occurs over considerable time and practice: new crawlers have been shown to practice balance more than 5 hours per day equal to approximately 3,000 crawling steps. Toddlers undergo around 14,000 steps and 100 falls per day. Hundreds of thousands of trials are spread out over months of development.

You see that? Falling is TOTALLY NORMAL. If there’s one thing you take away from this blog post, know that it’s okay for kids to fall. It’s how they learn how to protect themselves and react appropriately in situations.

As always if you have any questions, feel free to contact me below!

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