Wednesday, March 8, 2017

Dos and Don'ts of Promoting Independent Walking!

One of the biggest and most monumental milestones in a child's life is when they take their first steps. Walking allows kids to explore their environment and start to be more independent. Plus, it's super fun watching a child learn how to walk for the first time! I have created a list of DOS and DON'TS that I believe will help you as the parent or caregiver to get your child up and walking! (DISCLAIMER: This is an opinion post - any views or opinions represented in this blog are personal and belong solely to the blog owner and do not represent those of people, institutions or organizations that the owner may or may not be associated with in professional or personal capacity, unless explicitly stated)

#1: DO allow them to be barefoot!

There are two big reasons as to why I always take my kids' socks and shoes off for their PT session: 

1) Being barefoot gives their body the sensory input that they need to improve their proprioception. It allows them to figure out where their feet are in relation to the surface and in relation to their entire body, which in turn helps them learn balance and coordination.

2) Being barefoot allows babies to flex and improve the strength of their forefoot and toes as they learn to crawl, pull to stand, and cruise along furniture - this applies to when they get older and the learn how to walk as well!

Shoes don't give kids as much sensory input as they would receive when their barefoot and they definitely don't allow kids to flex their forefoot and toes. If you are taking your kid outdoors, make sure the shoes are low profile, light weight, soft-soled and flexible to allow for as much ankle and foot motion as possible.

#2: DON'T place you kid in a baby walker!
My biggest concern first and foremost is that it is a safety issue. The American Academy of Pediatrics have banned baby walkers in Canada and want the US to do so as well due to their high risk of injury from falls down stairs and allowing children to access dangerous household appliances and objects. Other than the safety issue, research shows that kids who spend time in baby walkers actually tend to walk later as compared to their peers who do not use a baby walker. Some reasons I don't like the baby walker are:

1) The baby walker does not allow them to see their feet and legs, which is crucial for them learning how to move their legs and step properly. Imagine trying to knit a sweater for the first time but not being able to see the yarn, needles, or your hands! Kids rely heavily on their visual system in their early years to learn how to maintain their balance, so by being able to see where they are stepping and where their feet are going helps them tremendously.

2) The baby walker does not allow them to perform other gross motor functions to get them to walking, such as crawling, pulling to stand, or stepping with support. It is a completely dependent piece of equipment that does not allow kids the opportunity to explore their environment as independently as possible.

3) It put babies in an unnatural standing position. Although it is very exciting to have your baby stand, place them in standing positions that are more functional, such as holding your hands or having them hold onto a support surface.

I understand that life can get busy and baby walkers seem like an easy alternative if you need to keep your kid contained for a few minutes. I would suggest placing your child in a playard or a gated baby-proofed room as better solutions to keep your kid safe while giving them opportunities to learn how to move independently.

#3: DO use push toys!
While baby walkers are limiting and don't allow them to see their feet move, a push toy allows them to see his legs and feet. This allows kids to practice standing and walking in a way that is more natural than the baby walker. While there are commercial push toys available for purchase, you can use regular household items such as a large box, hamper, rolling office chair, you name it - any of these will work!

However...

#4: DON'T force them to stand or walk!
If your child isn't ready to stand or take steps, forcing them to do so with a push toy or with your help can instill fear and anxiety in your baby. These feelings of animosity to may lead to delayed standing or walking. Instead of forcing them, motivate them!

In order to do so...

#5: DO place toys up high and at different heights! 
Children need to be motivated in order to move. If there is a toy they absolutely love, place them not only up high where they need to stand to reach them, but place them in different areas throughout the house. By placing them in different areas, you're giving your child the opportunity to access their toys in different ways to allow them to gain as much practice as possible in different situations. Think of it like hitting a baseball - you can practice as much as you want hitting the ball when it's pitched right down the middle, but when you get into the game, if they throw a curve ball or a slider, you'll have a much harder time hitting the ball since you only practiced one type of pitch!

Some of my favorite toys to encourage reaching up for toys and letting go of the support surface include bubbles, balloons, and balls big enough that require two hands. Bubbles and balloons are fun because they can be unpredictable and require dynamic balance as they move their eyes, rotate their head and trunk, and reach out with their arms for the bubbles and balloons. Having them reach and play with a bigger circumference ball encourages them to let go of the support surface and work on weight bearing through their legs.

#6: DON'T stop your baby from falling, as long as it is safe!
I like to compare the gait of a new walker to a drunken sailor on a ship during a storm - as they learn how to walk and gain the strength and balance required for the task, they may sway around, wobble back and forth, and occasionally take a spill...and this is okay! When they fall, their body learns that whatever they did to cause them to fall will not work, and in the future their body will work to figure out how to avoid the fall again. Kids learn not only about balance, but about their protective reactions to make sure they don't get hurt when they fall. The more they fall, the quicker these reactions become, making it safer for them to protect themselves when they fall again. And when they fall, don't make a big deal out of it. Although they may cry, it may be more because they are frustrated that they lost their balance versus getting hurt. Your tone of voice really will affect their personal reaction to the fall, so keep it light and happy as if that was meant to happen! Just make sure that your house is childproof by the time they start to take their first steps to allow them to really work on honing their newfound walking skills.

And since we're talking about falls...

#7: DO let them explore different surfaces!
Different surface changes will definitely challenge their balance, and the more surfaces you can expose them to, the better they will become at adapting to that change! At home, you can have you child walk over hardwood, tile, carpet, and even rugs that are slightly elevated. Take your child out to experience different settings! The playground, the beach, and other family's and friends' homes will expose your kid to not only different settings, but different challenges and a new place to explore!

#8: DON'T compare your baby’s development to other babies!
Remember that each child is unique in their own way, and that goes for their gross motor development. Even siblings may develop at different rates! Different factors play a role into when babies reach their milestones, such as body weight, personality, and exposure to the task. Babies that are born pre-mature or have been hospitalized for an extended period of time may not reach their milestones at the same time as babies born full-term. Don't forget that your baby loves you and whatever you do will impact how they feel, so continue to be their #1 fan no matter what.

#9: DO make her first steps into a big deal!
Your child took their first steps! CONGRATS! This is so exciting! Make sure you share your excitement with your baby. The more excited you are, the more excited they'll be, and the more they'll want to keep learning to take more step.

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Resources:
http://blog.dinopt.com/independent-walking-kids/
http://www.bmj.com/content/324/7352/1494
https://consults.blogs.nytimes.com/2010/02/22/the-dangers-of-baby-walkers/?_r=0
https://kendrapedpt.com/
http://www.wikihow.com/Teach-Your-Baby-to-Walk