Tuesday, August 6, 2013

Learning to walk

Learning to walk is a complex skill that should not be rushed, and there is usually no need for a parent to become overly alarmed if his or her infant takes longer to begin walking than other kids, says a pediatrician from Baylor College of Medicine.

"During early parenthood, seeing your child take their first steps is one of the most anticipated moments," said Dr. Sara Rizvi, an assistant professor at BCM and a pediatrician at Texas Children's Hospital. "Often, parents become concerned if their child is not walking as soon as the other kids his or her age."

Parents should understand the complex motor skills and strength development that must slowly build to achieve successful walking. Rizvi outlined key strength and motor skill development parents can follow as their children grow.

Head and torso control
Before learning to walk or crawl, young infants must first master the skills of head and torso control, Rizvi said. They can usually control their head and neck, as well as roll from side to side while lying down around 4 months of age, and they can control their torso well at 6 months.

"Sitting without support is good evidence of being able to control the back and torso muscles," said Rizvi. "Around this time you will also see the infants try to plant their feet and also bounce themselves up and down when they are held upright."

These motions all help the infant to gain strength and control for the future.

Changing positions
Once an infant is sitting well without support, they begin to learn to change positions – moving from both lying to sitting and vice versa.

"By doing this, the infant develops better control and strength in their trunk and extremities," said Rizvi. "They may also roll more often and even attempt scooting while sitting."

Crawling
An infant will often begin experimenting with attempts at crawling somewhere between 6 to 9 months, depending on his or her strength, body weight and other factors such as chronic medical problems or prematurity.

When crawling the infant starts to move both the arm and leg on the same side of their body, then eventually learns and progresses to more advanced crawling techniques.

"Once they have mastered these skills, the infant is usually quite mobile and has developed sufficient strength to move onto the next big stages – standing and then walking," said Rizvi.

Parents should not be concerned if a child starts standing and cruising but has not started crawling yet, says Rizvi.

"It is not unusual for some infants to skip crawling altogether and go straight to standing, cruising and walking," said Rizvi. "Others may go through extended periods of time crawling. This is somewhat individual."

Heavier infants and premature babies may require more time to develop enough leg strength and motor milestones. As a result they often crawl and stand a bit later than others, Rizvi said.

Standing assisted, then alone
Learning to stand upright usually happens sometime between 7 to 10 months," said Rizvi.

Nearby objects, such as chair legs and low-lying tables, may help the child pull themselves up.

"These standing attempts help them develop strength in their arms and legs, as well as balance and lead them towards their first attempts at walking," said Rizvi.

Cruising

While holding onto objects such as a table, an infant may take a few steps. "We call this cruising and most children are doing this between 10 to 12 months," said Rizvi.

By 12 to15 months, most children will learn to stand alone unassisted and suddenly one day they will begin to take their first walking steps.

"Often they will drop back down to a sitting position or resume crawling when they are tired," said Rizvi.

Walking
After an infant masters the standing alone technique, and has taken those first few steps, they will gain confidence and begin walking unassisted. "They walk with a wide-based, waddling step," said Rizvi.

It is very exciting for parents to see a child gain this independence and mobility, Rizvi said, but remember to watch out for small objects on tables. "Keep small objects and safety hazards out of the reach of the newly mobile toddler."

An additional danger that parents should avoid, Rizvi said, are infant walkers. "Many parents are tempted to use them with young infants, but they have not been shown to help children walk sooner and can increase the child's risk of falling and injury."

If an infant is not walking well by 15 to 18 months age, parents should seek further evaluation by a pediatrician or developmental specialist.

"Do not become too alarmed if your child varies by a month or two from these guidelines," said Rizvi. "Most children will eventually master all the skills and walk well." Playing with your child will help them gain muscle control and strength and improve their development.

And don't forget to keep a camera handy to capture those first few steps, Rizvi said.

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