There are a number of walking harnesses out on the market today. They can help you as a parent not strain your back bending over to hold up your toddler. And if your child has low muscle tone, it is a good idea to avoid holding their arms in the overhead position as seen below:
Their shoulder girdle may not be strong and stable enough to be supportive for the rest of their body. And we don’t want to stretch out their little joints.
I would not use this device on a child under ten months, and in general I do not recommend encouraging early walking (under eleven months) for an otherwise typically developing child. Remember the goal is to have them crawl for at least 2 months before walking.
I do recommend shortening the time when your child starts to pull to stand on their own, and cruise- and their actual first steps. If they have been cruising for more than two months and they are 14 months old, then I would increase the amount of time they are on their feet and walking. The biggest reason is that many children won’t take off with their language until they have mastered walking. Why is this? There aren’t enough hours in the day, nor energy in a child, to focus on two big skills at once. Developmentally there should be a burst of language around 18 months. So it is nice if your child is a confident walker by then.
Below are a number of Harness options and the pros and cons of each
A&S Creavention® BabyWalker Baby Walking Protective Belt Carry Trooper Walking Harness Learning Assistant Version 2.
The bar across the top is easy to hold and you can control your child’s body easily. You can help them to move forward or encourage them to go a bit slower, or help them not lean so far forward… you get the idea. You could hold the bar with one hand for a second if you needed to reach something.
The chest strap can end up pulling up under your child’s arm pits and raise their shoulders up. This position would be uncomfortable, and not the alignment of their body that you want for your child as they are learning to walk.
This design with two straps may be hard to coordinate with your arms if your child is unstable.
The Pro of the following design is the pelvic support will help control your child’s lower body somewhat. The chest straps may give enough support to the upper body for your child. And it has a bar which as we noted might be easier than straps for you to manage.
The Con: Because children at this age are top heavy, it leaves a good amount of their body unsupported above the axis of the harness. This may be fine for many children. If your child needs a fair amount of upper body support and they try to lean on the chest straps they may not feel secure.
Here is a video of a Toddler with Mom using the first type of harness.
When his parents first tried it a month earlier, we decided he was not ready to use the harness. He needed more support than the harness gave him.
Here are the skills he now has that told me he is ready to use the harness:
Crawling- and in this case up an incline wedge:
Playing on hands and knees:
Pulling to stand on a vertical surface
Here is another technique that can save your back: A home made push toy!
Pushing a kitchen or dining room chair across linoleum or wood floor will build up their upper body strength and give them practice walking. Hold the back of the chair and gently help them move it forward- for them- backward for you. Have a toy on the chair like a piano.
For more ideas on helping your child learn to walk check out this blog:
Just a heads up on the Boston Abilities Expo taking place at the Convention and Exhibition Center- Hall C. September 16-18.
Registration is free.
This is a great resource for families and professionals. From their web site:
” Every event opens your eyes to new technologies, new possibilities, new solutions and new opportunities to change your life. Where else can you discover ability-enhancing products and services, play a few adaptive sports, learn new dance moves, attend informative workshops and only scratch the surface of what Abilities Expo has to offer? Register for free today.”
Hope to see you there!
So you realize that your child is a toe walker?
What do you do next?
It is a movement disorder, with a number of factors to consider.
The first issue is to stretch the heel cords, and hip muscles, while strengthening the opposite muscles.
The next step is to determine why your child has chosen an inefficient way to walk. More than likely it is related to one or both of the following: weak core or sensory processing disorder.
The last steps should involve gait training and considerations of casting and bracing.
If your child is weak, then stiffening their whole body by going up on their toes can help them maintain higher muscle tone, and recruit more muscles to work for them.
The solution is to strengthen the core muscles, then retrain the walking pattern. Your PT has many ways to do this with fun exercises, use of gym balls, scooter boards, and a home exercise program.
For retraining walking your therapist may use: theraband, treadmills, obstacle courses, hurdles etc.
Here is a fun “tool” to use for a child under the age of 7 or 8 . I found these duck feet at a toy store. Swim flippers cut down a bit, or Dad’s big shoes would work as well.
The duck feet are causing this child to take higher, longer steps.
She can not walk on her toes with these on, so she is getting her heel in contact with the floor. I would want these to be worn for 30-60 minutes a day.
If your PT feels your child has sensory processing issues she will address the areas in a number of ways. Your therapist should evaluate your child’s tactile, proprioceptive, visual and vestibular systems- all parts of our sensory systems to determine what senses may be behind in development and causing your child to want to walk on their toes.
If your child has tactile defensiveness; then placing their whole foot on the floor is a challenge. This needs to be addressed before they can be convinced to change their walking pattern.
Some activities might include: Stomping/marching in bare feet, Placing feet in a bin of sand, rice or pasta, giving their own foot a massage with oil, then a towel.
Your child have diminished proprioceptive input- which goes hand in hand with low muscle tone and a weak core. So bouncing along stimulating their inner ear- vestibular system-tells their body where it is in space. (Because their muscle and joint receptors aren’t giving them enough information.) In the picture below, alot is going on. I have my little friend in a semi squatting position- resting on a stool- reaching forward is giving pressure into her left foot. The right foot is getting input from a mini back massager I got at the local drug store; her Mom is trying it out. They will use it at home nightly for 5-10 minutes on each foot. They will do these two activities separately.
If your child has delays in functional vision, than they may be off balance as they walk. To work on vision you can check out my blog on vision and bike riding, the activities are appropriate for toe walkers. Many children who toe walk are cautious on stairs ( could be depth perception), and not able to catch a ball ( maybe lack of visual convergence).
The vestibular system may be delayed. This is a complex system that works closely with vision and assists in maintaining balance. Your therapist may use slides, swings, trampoline, scooters, balls, and tie these activities into a visual activity at the same time- scanning, holding gaze etc.
And lastly balance should be assessed and addressed if it is a problem. Your therapist may use a balance beam, rocker board, half foam roller, dyna disc. They may have your child do activities on one foot, or build an obstacle courses.
Home exercises must be done to carry over gains made in therapy.
If your child has very tight muscles, or has been toe walking for years, they may need further intervention.
It is important to have a Pediatric Orthopedist work with you, your child and your PT to determine what next steps are needed.
If your child’s ankles are very tight a cast may be put on for a week or two to stretch out the muscles. This is painless, but a significant inconvenience.
Resting casts may be fabricated, to be worn each and every night to help stretch the ankle, and or keep the ankle stretched out after the casting.
Other types of night splints might be custom made of plastic, or a dynamic system like the Ultra Flex Bracing System.
Once the ankle muscles have gotten looser, it is important to consider what assistance might be needed to break the toe walking habit.
Orthotics and Bracing may be needed. A starting point might be a metal insert usually fabricated by an Orthotist, which inhibits the ability to toe walk. It is a piece of aluminum that is cut to be the size of the sole of the shoe, it goes under the insole of the shoe. This makes it very hard for many (but not all), children to go up on their toes.
If this does not work, then the next step is to have a brace made by an orthotist which will help retrain the correct walking pattern. Something similar to what is shown in this picture. It is to be worn most of the day. Consider how long your child spent walking on their toes; they need 6 months to a year to change their walking pattern. Some children need more time, some less.
These two are hinged;- so your child can learn to flex their upper leg over their lower leg and foot.
This can all seem overwhelming for what appears to be just a bad habit.
But long term toe walking can lead to the heel cords being so tight, that children have trouble, walking, running, going up and down stairs, and squatting. It can lead to ankle, calf, and knee pain. It can cause tripping, and falling, as well as not keeping up with their peers on the playground, or with sports.
Talk with your pediatrician about your concerns and consider scheduling an appointment with a pediatric physical therapist, and a pediatric orthopedist. Having the habit broken at age: 2, 3, 4 or 5 years, is much easier than at 10 or 12 years of age.
The Upsee by Firefly is a product that many parents ask me about. I decided to post a video of my friend Aaron and his Mom using it. They enjoy walking together. She feels stable. But she would never do this alone. For one reason; she can not get Aaron into it by herself, and for another, she is tied to him, and if anything were to happen she can not move fast, or undue him from her easily. So she does it when he has home therapy, or when Dad is home.
As a therapist I have many critiques about this product. Basically it is not encouraging a typical walking pattern.
Is it doing him any harm? So far I have to say no.
Is it fun? Yes he and Mom are having a great time.
Is he learning about time and space as he moves about in an upright position? Yes
Is it cognitively appropriate for him to explore his environment on his feet at this age? Yes.
Is it stimulating his vision? Yes
As a Mom would I do it? Yes I think I would try it.
It is expensive and I would try to find someone to loan me one first if at all possible.
I would try to find one used, children will outgrow this device at a fairly young age.
Firefly does have a fairly decent return policy on their web site.
Here is another Mother’s experience with it.