Çeviri: Duru GÜNEL
Walking (and why you can never see a physiotherapist’s child using a walker)
My youngest boy managing to stand on his feet on his own, queuing along the coffee table and walking by pushing a toy reminded me how surprising and important learning to walk is.
As a physiotherapist, one of the most common questions I am asked is “When is my child going to walk?” Walking is an extremely meaningful developmental touchstone for the children and families. For children, walking develops independence, discovery and learning alongside socialising and participation skills in domestic and community life. For families, walking is a visible sign of the development and health of child and therefore relieves the physical burden of being obliged to carry the child or use a baby carriage.
Although walking has many “normal” variations, it is a highly visible skill and it is therefore hard for the parents not to compare their child with other children. Especially if your child has walked late, it gets harder to avoid listening to the questions and advises of favourable friends, families and even strangers about his/her walking (ex. Did s/he start walking? No? You need to buy her/him hard bottom shoes!) To make an entry, I will start with a few fun facts about walking.
90,39% of healthy and typically developing children will often take their first steps at 9 to 15 months. On average, a child takes his/her first step one day before his/her first birthday but this can vary from child to child extensively. It doesn’t necessarily mean that there is something wrong if the child doesn’t walk until 15 months. I have seen a typically developing child walk between 15-18 months or even later and walking late is rarely an indication for showing something is wrong. However, in rare situations, delay in walking can be related with neurological problems or genetics, this is why if you baby doesn’t walk at 15-18 months, it is a good idea to talk with your pediatrician.
Learning how to walk requires multiple body systems. A child needs to have the sufficient power to stand up tall and move his/her legs in walking order to take his/her first steps. The brain needs to send signals to the body to activate the correct muscles in the correct order, the sensory systems need to send the brain information about how the environment looks and how the body feels and the child needs to be motivated to walk. Even the body shape/ size plays a role- babies have a very large head compared to the size of the body. One of the hardest aspects of walking is overcoming the weight of the head and controlling the head on the body. Smaller or shorter children can walk earlier than those with bigger heads and those who are longer or bigger. The last thing to say is that your child is not going to take his/her first steps until all the body systems are ready independent of how “strong” or “intelligent” or “determined” s/he is.
The best way to help a child learn how to walk is encouraging the child to creep, crawl and reach for the toys that are previously put around him/her after laying him face down. It might seem opposite to the general view, but the best way to teach your child how to walk is laying him/her face down and ensuring that s/he is learning how to play, move and discover. When babies are born after spending 9 months in mother’s womb, their bodies are bent or stuck in fatal position. Their ability to hold their heads, necks and bodies aligned is very little. The time spent helping them stretch the ö-muscles in the front body, helping them gain strength in their neck and upper back during the first few months is important. In the middle of their first year, children start pushing pushing the ground with their arms, come on top of their hands and knees, strengthen their lower back, pelvis, hips and legs. All this development is really important to learn how to stand tall on feet, take steps and to walk.
Walking barefoot or walking with soft thin bottomed shoes are the best for children who have just started walking or developing how to walk.
Baby walkers have a negative impact on the development of walking. Along with the serious security concerns(American Pediatry Academy banned baby walkers in Unites States and they have been banned in Canada for long years), baby walker do not help the babies learn how to walk. Actually, researcher show that children who spend time with baby walkers have the tendency to walk later than their peers. Baby walkers put the babies in an unnatural position, they don’t see their legs and feet while walking, they are debarred from the opportunity of creeping and pulling their feet back. For the parents who need to keep their babies inside for a while, a child garden or closed baby room is a way better solution. For the baby to learn how to take his/her first steps, a pushing toy ensures the baby to see his/her legs and feet, stand up tall and take steps more naturally. There are commercial pushing toys, but most of the families can also use ordinary home gadgets. For example an empty laundry basket, a baby carriage, grocery cart or a big empty box is ideal for pushing around the house.
Walking posture seriously changes in the first 3-4 years. Flat feet, walking on top of the toes or “crooked legs”, “locked knee- straight and back stretching knees-“or “ pigeon toed” walk can be normal in first few years of life. Walking typically starts to look like that of adults at 6-7 ages. If you have worries about your child’s leg or feet position during walking, you should see your pediatrician or physiotherapist to learn whether your child needs to see an orthopaedist or whether s/he is a candidate for feet orthosis. However, as long as the thing you are seeing is visible on both sides and not causing any pain or functional problem, there is a good chance that it is one of the many variations of “normal”
Developing brain and body are really interesting and they are different for each child who goes through the journey of walking. My sons are the perfect examples for this. The oldest one didn’t take a single step until 13th month and couldn’t walk properly until he was 15 months old. Walking on grass and on pebbled rough areas took him a few more months. My middle son took his first steps in the 11th month and never looked back again. In his first birthday, he was almost running to everywhere- at home, in the garden and in the park. My youngest child is 9 months old and he is already standing on his feet on his own. I presume that he will take his first few steps in the upcoming weeks. All three of the boys developed their walking skills in completely different ways, according to their own programs. But do you know what? They are all typical and equally incredible!
Walk, walk my little friends!