One of the most common questions I get as a therapist is the prediction of when a child is going to walk. There are so many components to development that influence a child’s ability to walk, including postural control, strength, motor coordination, attention, motivation and even the environment they are in. The dynamic systems that interact to influence a child’s understanding of getting up on two feet as a form of transportation make it difficult to tease out exactly what component may be preventing a child from walking and also makes determining a specific timeline for motor developmental challenging. Developmental milestones are a typical progression that is seen from rolling, sitting, crawling and transitioning into walking, but these timelines don’t take into account the variability of motor development and how beautiful that can be. I have found that the best way to best predict when a child is about to start independently walking can be based on the emergence and achievement of pre-walking skills. Use of functional milestones are more reliable than trying to make a time-based prediction with regard to walking, similar to how functional abilities like hop testing are best for predicting recovery timelines after an orthopedic injury. Each of these skills represents a component of independent walking, and once a child is performing all of these things, independent steps are soon to follow.
1. Pulling to stand
This skill demonstrates a child’s interest in being on two feet. When a child is pulling up onto their knees or onto their feet in their crib, on a couch or a coffee table, he or she is telling us that they are ready to explore the vertical environment around them. A child initiating this skill helps us know they are motivated and ready for play in standing.
2. Cruising along surfaces
This skill demonstrates that a child is able to shift weight in standing to move on two feet. Standing at a support surface like a couch can be easy to do if you are leaning forward onto that support. However, to be able to move when standing at a surface, a child has to be able to reach outside their base of support (BOS) and coordinate their legs to move their center of gravity (COG) between both feet. Part of the difficulty with cruising is knowing to shift weight onto the contralateral leg to advance ipsilaterally, and this is crucial for advancing your feet when walking.
3. Cruising between surfaces
This skill demonstrates a child’s understanding of moving between places on their feet. To move between surfaces, a child needs to be able to rotate their trunk in standing to reach between surfaces, and this is the same rotation needed when walking.
4. Sit-To-Stand Transitions
This skill demonstrates the child’s ability to coordinate core, quad and glute strength for functional mobility. For walking, we need all our muscles working together as a team. A transition from sitting into standing requires our core to create a forward weight shift when we are sitting, our flutes to extend our hips up and our quads to straighten our legs into standing. These are all muscles we use in a coordinated pattern for walking, which is why being able to perform this transition is an indication of functional strength needed for walking.
5. Supported walking: push toys, walkers
This skill demonstrates a child’s ability to coordinate feet to produce the forward movement necessary for walking. We need practice with the forward progression of our feet under our body, so being able to walk with support, whether that be from a push-toy or a walker gives us that practice without the balance challenge. The level of support can vary between toys and walkers, so having a more stable toy may make it easier for a child who is new to standing play.
6. Two hand hold walking
This skill demonstrates a child’s emergence of using his or her feet as a form of transportation. Hand hold walking is a great way to help facilitate the natural diagonal weight shift when walking. There is less support when holding hands and walking so the balance challenge increases, while the child is getting to learn they can use their feet to travel between places.
7. One hand hold walking
This skill combines the knowledge of walking on two feet with the postural control needed for standing play. When you are only using one hand for support, a child no longer gets that facilitation of weight between feet and they have to initiate that themselves. To walk with one hand, a child has to have enough balance in standing to only need minimal support, while also coordinating their feet to move forward.
8. Independent standing
This skill demonstrates that a child has developed static postural control in standing. When a child feels confident enough to take both hands off a surface and stand without support, he or she is telling us they have learned how to balance their COG over their BOS when they are on two feet.
All of these skills are important prerequisite skills that a child typically is able to perform before independent walking starts. Using achievement of these skills to predict walking is more reliable than trying to guess in terms of weeks or months. If any of these skills seems to be extra challenging for your child, that is when reaching out to a physical therapist for strategies for success can help speed up the achievement of independent walking.