Movement – misunderstood & under rated

We have children with special needs where the primary concern of parents is ‘lack of sitting tolerance’ i.e. the child is always moving and walking around. Except for the sitting tolerance, the parents feel that their child is active and there is no problem with moving. As a sensory-motor therapist, my observation is that the child is moving around the room aimlessly and without any purpose or meaningful exploration. Most of the children demonstrate clumsiness of movement. And there is no variation in movement; either the child walks around or tries to climb short furniture in the therapy room frequently.

These atypical behaviors of moving around aimlessly and frequent climbing indicate that their vestibular & proprioceptive systems are not functioning adequately and optimally.  

 Why should we move frequently and variedly?

Humans were designed to move in space, just like we did so until 3-4 decades ago, prior to the advent of conveniences in life. In the first 5 years of life, children engage in active exploration of their surroundings, that leads to problem-solve and learning. They are required to move their head and body in various ways so as to provide input to their vestibular system. Variety of movements include bending down to pick up objects, getting down on all-fours, transitions between stand and squat, look up to reach and retrieve an object, climb up on different heights, walk on uneven surfaces, and the list goes on. Movement should also include effortful work such as push, pull, lift, carry, and drag.

 All such movements should be frequently done, not just on occasion. Let your child carry their own backpack, climb stairs, pull a small wheelie bag during travels, clear the table after a meal, wipe the table, make your bed, pull out wet clothes from the washing machine. Such tasks lead to increased visual-spatial awareness, problem-solving, and learning. These are skills that the child will need throughout their life; it is work that boosts self-esteem and self-confidence. When a child learns a new task, although with some struggle, the process of learning entails ‘figuring it out’ that consequently leads to neuroplasticity and better cognition as well.

As a course of development, gross motor movement leads to fine motor abilities. In order for our distal muscles to work, our proximal larger muscles need to be strong and efficient. If we expect a child to perform fine motor skills such as cutting, coloring, buttoning, and writing, they also need to have strength and control of the muscles surrounding the elbow, shoulder, upper body, and the core muscles. This strength and control of larger proximal muscles comes from using the body in various ways other than only walking.

The following video shows some ways in which opportunities for meaningful movement are provided at Activ Kaarya during therapy sessions—

https://www.youtube.com/watch?v=oFfTgbIFweQ

 It is a little paradoxical that meaningful movement is needed to improve attention, engagement, and participation in tasks.  Attention cannot develop while doing table-top tasks. Rather, attention improves when a young child actively moves through space, explores, and meaningfully interacts with their environment.

As an adult, think about how good you feel when you play a game of tennis, or go for a brisk walk, or clean up your room. This is because you have engaged in movement and exercise that release good neurochemicals in the brain. If you engage in various movements and exercise frequently and regularly, you will find yourself sleeping better, and will have more focus and attention towards your work. The same is for our children. Young children do need physical exercise in the form of activity and function.

 

Contemporary way of life

In our chase for convenience and the coverup of fast living, we forget to move our body in ways it should. Many of us rarely climb a ladder, or squat down to the floor, or sit on the floor even briefly. If adults moved frequently and in various ways, they become a role model for their child. Eg. climb 1-2 flights of stairs daily. It is good for you and your child.

https://sensoryintegrationbangalore.blogspot.com/2021/12/the-humble-staircase.html

 

 

In my clinical experience, I have seen children from grade schools who have anxiety, difficulty following instructions, struggle with attention in the classroom, become upset easily, and show aggression frequently. All of these issues are rooted in their vestibular, proprioceptive, and visual systems not developed adequately to help them cope up with the external world outside of home. As soon as we provide them with meaningful movement, effortful work, and functional visual activities in therapy sessions, their behavior and performance in classroom improves. My consistent suggestion to all parents has been to involve your child in age-appropriate house chores – making their own bed, folding clothes, sweeping and mopping, setting the table. Such tasks boost the child’s visual-spatial awareness, working memory, sequencing and organization of actions. More importantly, such chores allow body movement in a variety of ways that provide input to the vestibular system, that further boosts self-regulation and behavior.  

 

https://sensoryintegrationbangalore.blogspot.com/2024/08/moments-of-learning-in-natural.html

 

https://sensoryintegrationbangalore.blogspot.com/2016/10/home-choresessential-functional-training.html

 

 

All parents need to seriously reflect on ‘how much’ and in ‘what ways’ is your child moving throughout the day.  A child’s routine involves traveling to school and back, attending 1-2 structured classes, doing homework, and the day is over. Structures sports and activities are good, however, they do not provide the cognitive benefits of free play and unstructured tasks such as house chores. In my experience, children who are occupied in too many activities after school demonstrate fatigue and irritability. Therefore, it is wise to minimize multiple structured activities after school, and replace them with free play, house chores, and spending quality interactive time with your child.

Bridging Sensory and Motor Components in Pediatric Therapy

Dr. Ushma Goradia discussed the critical importance of bridging sensory and motor components in pediatric physical therapy, emphasizing the pyramid of learning framework developed by Kathleen Taylor and a special educator. This framework identifies eight sensory systems as the foundation, with particular focus on the “power senses” of vestibular, proprioception, tactile, and visual perception, which work together to influence motor output, behavior, and cognitive responses in children.

The integration of sensory and motor components requires a holistic treatment approach where therapeutic activities like prone weight-bearing, trunk rotation, and gait training provide dual benefits by addressing both motor skills and vestibular function simultaneously. Physiotherapists must recognize that movement is crucial for development across multiple domains and should consider sensory integration when treating children with neuromotor impairments, distinguishing between sensory issues that show observable physiological responses and purely behavioral problems.

Parental involvement, particularly from mothers, emerges as a critical success factor in pediatric therapy, helping to build trust and comfort while addressing potential child discomfort due to touch hypersensitivity. Parents need education about therapeutic processes to support their children effectively throughout treatment. Clinicians should watch for specific red flags in conditions like hemiplegia and cerebral palsy, including asymmetrical posture, balance issues, body awareness problems, vestibular and proprioceptive concerns, and tactile defensiveness.

Treatment strategies for sensory processing issues involve gradual exposure to different textures, emphasis on movement therapy, systematic approaches to tactile defensiveness, and holistic methods that combine sensory and motor elements. The fundamental clinical insight is that physiotherapists must understand how sensory processing impacts motor development, as this connection is essential for creating more effective pediatric interventions that address the whole child rather than isolated symptoms -- Dr. KD Mallikarjuna, PT

Ushma ma'am, your emphasis on adding sensory integration gives the exact perspective to paediatric Physiotherapy needed. Humans are sensory beings. So taking into account all their sensory experiences and understanding their implications on therapy was well explained -- Dr. Vidhya Venkatesh, PT

Dilemma of the Dominant hand

The right hand holds a significant importance in Indian culture. Not only the right hand, but also the right foot. Giving money to a vendor or an autodriver, accepting ‘prasad’ at a temple, to making the first step in a new home are all done with the right side of the body. Some regions of the country call the right hand as ‘seedha haath’ meaning correct side and the left hand as the ‘ooltaa haath’ or the wrong side.

Being a physical therapist and having lived in the USA, the right hand being sacred and the left believed as unholy truly baffles me. The USA has a much larger number of people who are left dominant. In contrast, in urban areas of India, the left dominant child catches negative attention and is perceived as something wrong. My son is left-handed; he writes and eats with his left hand. During his preschool years, many people asked me to correct his dominance! But I taught my son to remain cool!!

A 7 years old girl was brought to my clinic due to behavioral and anger issues. (A diagnosis of autism was doubted by parents and past professionals at the time). She was also emotionally distraught in that she would cry without any reason, hit another child, and had poor sitting tolerance. Careful history revealed that parents were unsure about their daughter’s dominant hand. The child’s grandmother insisted that she use her right hand for eating, and hence the parents tried to insist on the same. Besides the sensory-motor therapy that was indicated for this little girl, my first priority was to educate parents on not forcing use of a particular hand and to let the child just ‘be’. In a few weeks, the child started calming down, following verbal instructions fairly well, and more importantly participating in fine motor skills and using the left hand for writing. Therefore, I strongly urge parents to not force your child into using the right hand only. 

I have had several children with delayed speech and poor fine motor abilities, who were forced to hold a crayon and eat their food using the right hand because the grandmother said so. 

Beginning at age 6 -12 months, a child uses 2 hands together and gradually shows preference for either hand around age 3-4 years. Dominance is generally established by 6 years of age. 

The other important point for parents to realize that we perform majority of tasks such as buttoning and tying shoelaces using both hands together in various ways (bilateral integration). Tasks such as opening or closing a bottle requires that you hold the bottle with 1 hand (non-dominant) and open or close with the other  hand which is the dominant one. You hold the paper with non-dominant hand and cut using the dominant one. So the non-dominant hand becomes the helping hand that provides stability, while the dominant hand is the working hand that performs the task. As you go through your day, try to consciously think when and how do you use your hands. 

I am trying to emphasize that development of both hands is crucial as the development of a child progresses from the first year of life to school years. As parents, offer objects to your young child somewhere in the center of their space and let them pick it up with any hand. Observe during many occassions as to which hand the child advances to pick up or pull something first. But do not force or insist on using the right hand only. 

Floor Sitting

Do you sit on the floor at least once a day? Does your child sit on the floor for activities such as art & crafts, or for eating snacks and meals? 

Do you sit on the floor multiple times in a day? How long do you sit on the floor each time?  When was the last time you sat on the floor? I urge all young adults and middle-aged individuals to reflect on these questions. With older adults, and people with joint issues (hip-knee-ankle-low back pain), it becomes a different scenario.

Why do I emphasize sitting on the floor frequently or often through the day? The number of times you rise from the floor, with or without hand support, has a positive effect on your heart and lungs. The capacity to engage in physical work in terms of frequency and duration is known as endurance, and reflects the health of your cardiopulmonary system. The number of times you get down to the floor and rise up into standing reflects your endurance.

Multiple benefits of sitting on the floor Sitting on the floor for work or sitting on lower surfaces that are shorter than regular chairs provides a different feeling or emotional groundedness. This is something that cannot be described in words, but is an experience to be realized. 

Better flexibility in all the joints of your lower body is a huge plus in a few days after you periodically get down to the floor and later rise up. 

Regular habit of sitting on the floor positively influences your gut health and the digestive system, and provides a deep sensory input to your abdominal cavity.  

You will feel lighter in your body and supple in your general movements.

Benefits of floor sitting will take you a long way physically and emotionally.

                                              Photo Credit : Freepik.com 

Individuals who have no joint problems and wish to start floor sitting, need to do it gradually. You can start by sitting on lower surfaces such as a 12” height stool or a ‘peedah’ or ‘modha’ that are old-style furniture still seen in many Indian homes. For work, you can put your laptop on the center table or coffee table.

In my practice, I see so many children in grade school who either have difficulty with sitting on the floor or can’t sit on the floor for at least 8-10 minutes. These difficulties are either due to decreased flexibility of hips & knees or due to lack of habit (practice) or both.

 

Myth: Sitting on the floor is not important anymore, we don't need it.  In the contemporary world, we think about anything through the objective lens, trends, and scientific evidence. We quickly accept or reject something based on a bunch of papers and numbers. As a physical therapist, I wish to point out the value of sitting on the floor, it is a topic that is debatable and holds limited scientific evidence. However, when viewed in a different perspective, sitting on the floor has been a common practice across all the ancient cultures of the world. In India, we sit on the floor for all our religious functions. Although the Indian toilet that required squatting has disappeared from the middle and upper classes, the squat position is commonly used by laborers, farmers, and domestic helpers. 

Look around in your immediate environment. The domestic helpers, cooks, and gardeners may be older than you, but are able to get down to the floor with ease. It is because they do so frequently in their life throughout the day. This is called ‘practice’ or ‘repetition’ or being used to it. 

So remember to sit on the floor if you still can,  or sit on a pillow or a cushion, or sit on a lower height of 10-12”.  There is nothing wrong in taking hand support of any furniture while getting up. But do not give up on floor sitting while you are in your 30s and 40s. If you do have pain in any joints, contact a physiotherapist and take charge of your flexibility. Do not forget the habit of sitting on the floor. 

More importantly, get your children to sit on the floor for many tasks. Make it a habit - frequently throughout their time at home. They can sit on the floor in various ways, but not in W-sitting! Remember that frequently sitting on the floor provides you with a feeling of connection to gravity, to Mother Earth! It is a great feeling that is fast being forgotten. 

Moments of Learning in the Natural Environment

Just as a young child needs to learn how to take a bath, use the toilet, wash hands, feed, and dress independently; they also need to learn some basic chores at home.  I have advocated for engaging children in house chores to so many parents – regardless whether the child is on a typical progression, has autism, or has sensory processing differences, or diagnosed with attention deficit, or demonstrates handwriting issues.

Creating Opportunities  Home is the natural environment for a child, where they spend the most time with family, while engaging in daily routines. Everyday tasks that seem mundane to many of us, but yet need to be done, can provide learning opportunities for young children. These learning opportunities can be rich and varied, 2 components that are so important for motor planning and motor learning. 

The best part is that the child can learn within the house. Don’t miss out on creating opportunities of learning for your child right at home!

In the contemporary fast-moving world, doing house chores is looked down upon, under rated, or thought unessential. However, as a mother of 2 children and as a pediatric therapist, I always believed in the value of learning basic chores early on in life.  These tasks are functional, and are important  survival skills that are required to be done daily or frequently--

• ·       Carry plates and utensils to the sink after a meal.
• ·       Wipe tables.
• ·       Water the plants.
• ·       Fold clothes and towels.
• ·       Dry clothes on a rack.
• ·       Clean up own room.
• ·       Peel boiled potatoes.

Family time & Bonding  Home chores are shared responsibility where family members can work together, thus spending quality time that leads to bonding. You can use the time to communicate with your child while doing the task. For your child, the bonuses are elevated confidence, increased self-esteem, and learning to take responsibility.

While consistently engaging in tasks frequently and consistently at home, your child learns problem-solving and motor planning.  A little progress each day or week, adds up to big changes in life such as providing a sense of accomplishment and boosting self-confidence.

This may come as a surprise to many parents, that the longest study at Harvard found a strong connection between doing house chores in childhood and happiness and success in later life.

https://mcc.gse.harvard.edu/whats-new/chores-caring-kids

Value based Tasks There are logical and scientific benefits of learning basic chores - primarily the variation in movement as well as the demand to problem-solve -- factors that lead to neuroplasticity in the brain, that is the purpose of any therapy provided to children with special needs.  In other words, creating changes in the brain and building neural networks in response to experiences.  This is akin to learning a new language or playing music. Please read my blog post

https://sensoryintegrationbangalore.blogspot.com/2016/10/home-choresessential-functional-training.html

Pulling wet laundry out of a washing machine, putting the heavy wet clothes into a bucket, and pushing the bucket towards the drying rack are all examples of tasks that provide proprioceptive, vestibular, and tactile input. Combining all of these tasks becomes a house chore as a whole.

Watch the following video that shows Activ Kaarya kids engaging in various tasks at home. Each of them has autism. 

All the children in the video had motor difficulties, tactile defensiveness, repetitive stimming, restlessness, lack of sitting tolerance, and poor ability to follow commands.  After a time of 12 – 18 months of therapy at Activ Kaarya, each of them gradually started engaging in small chores at home. 

It is so heartwarming to see the children work in their natural home environment as a process of learning. 

Parents also deserve credit because they took the effort to work with their child at home based on therapist suggestions. 

• ·       pulling off dry anjeer / dry figs from its string
• ·       putting items in the refrigerator
• ·       peeling boiled potatoes
• ·       pulling clothes from a drying line
• ·       squeezing orange juice manually
• ·       organizing washed utensils
• ·       folding clothes
• ·       picking greens
• ·       cutting string beans

Children with special needs take a longer time and many more repetitions to learn any task as compared to children on a typical developmental course. 

Sensory-motor tasks practiced during therapy sessions can be carried over at home in the form of house chores.  Early on at the commencement of sessions, we encourage children to put away equipment such as pillows, scooter board, mats, heavy bean bags etc…providing some physical assistance as needed. Samples of such sensory-motor tasks during therapy sessions at Activ Kaarya are shown in the following video –

Home chores are functional, and require movement of head & body in various directions, turning the head and body, reaching, bending, squatting, using both hands together. Hence the child receives various sensory benefits while learning tasks that are functional and essential. 

Do not miss out the value of learning tasks at home!

#bodyrotation #bilateralintegration #childdevelpment #sensorydevelopment #sensoryintegration #tactile #proprioception #movement #functionaltraining #learning #homechores #housework #tasks

 

Weighted Vest

Can we use weighted jacket for my child? Is a weighted blanket beneficial? Can a body sock help?

These are questions that parents ask me frequently. But a clear answer is difficult without considering many perspectives. 

Weighted vests and compression vests have been used by therapists to provide deep pressure input to the trunk which is known to improve attention, decrease fidgety movements, and promote self- regulation in a child. All of these lead to better performance in general.

The purchasing cost of these products in India have significantly come down during the last few years. Yet, in my perspective, the affordability of these equipment for a middle-income Indian household remains low. When several sensory equipment are available now in the country, how do you figure out which one is useful or not, which one is better than another, and what would work for a particular child during a certain time period?  

There are other equipment too - swings, rocker board, therapy ball, fine motor toys, sensory fidgets. What can parents buy, what can they avoid buying, how much investment can they make, and how do you decide one versus another.

Product Picture from Amazon

This post is about the weighted and pressure vest, the body sock, and the weighted blanket.  Each of these provides deep pressure input, and in that they are similar but not the same.

The body sock is made of lycra, one can think about it as a lycra sack with openings in the centre.  A child wears it, and moves their body segments or moves the body as a whole while being in the body sock. Lycra material provides some resistance and therefore proprioceptive input to the body. Most children enjoy wearing this body sock, but there are many others who are not willing to put it on, or cry when the mom attempts to make them wear it.

Product Picture from Amazon

The weighted blanket is useful during sleep time or nap time, or for draping it for a short time during wake hours.

The weighted vest and the compression vest offer deep pressure input. The proprioceptive input through each is similar, but not the same. The weighted vest provides a sense of grounding to the body. The compression vest provides a sense of ‘continuous hug’ to the body.

In a nutshell, each of the four equipment is beneficial to a child with autism, ADHD, and sensory processing differences. Points to consider prior to buying-

1. Is the child going to allow you to put it on in the first place? As described with a body sock, many children are not willing to put on the weighted vest. It may take many attempts to try putting it on before the child accepting it. This requires parents to be extremely patient for many days or weeks.

2. If the child does like it and wears it, will they leave it on for 20-30 minutes prior to removing it? India is a tropical country and we don’t live in air-conditioned rooms all the time. Except for winters, a child feels hot and perspires while using the weighted vest. The compression vest has to be carefully worn, because it may affect the child’s respiration and air exchange if there is increased compression.  

3. Some children don’t like to cover themselves with a regular sheet or a blanket, which rules out the use of a weighted blanket. But if the child has serious sleep issues, a weighted blanket is highly likely to help.

4. The last and most important information I would like to share is that there is no single equipment that would be magical. It would only be helpful, but not a concrete solution. For a child to make gains in therapy, we need a variety of equipment and variety of material, as well as repetition / persistence.

5. Research findings have not reported significant behavioral changes in children using weighted vests.

Using the Indian ingenuity or jugaad, I use weight cuffs on ankles or the abdomen during therapy sessions. But I admit that most children take them off immediately or cry or refrain from allowing us to put them on. So we keep trying for many sessions, sometimes for weeks and months.

The weighted vest is viewed as a passive equipment. In order to provide active proprioceptive input, do the following frequently and consistently. These are examples of active physical work by the child; the brain always learns better during active engagement.

·       Have your child push a heavy chair frequently and make a game out of it.

·       Have them pull a weighted trolley bag in the house, and in the apartment grounds.

·       Have them wear a backpack that weighs 10% of their body weight and take them for a walk.

·       Climb the ladders and use the wall climbers in the park.

In my clinical experience in India, I use the pressure vest for infants and toddlers to achieve a better trunk control during therapy sessions…..only during cooler weather in Bangalore.  Very few parents, about less than 5% have bought a weighted vest or a body sock. And after buying, either they have not been able to use it for more than 3-4 months or used sparingly due to personal reasons.

Some parents have bought therapy equipment as suggested by other therapists, and then have complained that it was not useful. For others, there was a complain of lack of space and a sense of frustration as to ‘how much can we buy’?

Due to all the reasons discussed, I refrain from asking any parent to buy therapy equipment, particularly when cost is a factor, the weighted vest being one of them. Parents can try it out - but cost, usage, storage, and the amount of benefit it will provide to your child is debateable. 

Note: Another option is to buy an inexpensive jeans jacket which most likely has 4 pockets in front. One can stitch patches of cloth behind too. Make small sand bags and insert them into the pockets. You have made a weighted jacket in the least expensive way. A few of my parents have done this many years ago. 

Before buying a weighted blanket, maybe you can do a trial of using 2-3 blankets at a time to see if your child keeps them on. 

 #weightedvest #weightedjacket #bodysock #weightedblanket #compressionvest #sensoryintegration  #deeppressuretouch #deeppressureinput #proprioceptiveinput #proprioception #attention #focus #movement #selfregulation

 

 

Walker for my Baby?

Can we suggest a walker in babies with milestone delays as they have less lower back strength? 

This question is frequently asked to me by parents and fresh therapists alike. Walkers become an attractive toy for young parents because they offer mobility to a young child. 

  Walkers can vary in their design and therefore serve different purposes. This is one type of walker, an upright push-toy that my own kids used in the 90s. 

  Product Picture from Amazon

In contrast, the walker shown above has 4 wheels and a sling seat. Many parents use this walker because they feel that the baby will start to walk earlier. However, research looking into the walker conveys the opposite. Using a walker does not or may not help the baby to walk, but rather interferes with the development of important milestones. When this walker is used early on, starting around 7-8 months of age, muscles of the body do not get utilized the way they should be, as a part of development. And hence can sometimes have negative implications in the child’s future.

In my long experience as a pediatric physical therapist, I witnessed the time when these walkers (wheels and hammock seat) were banned in the USA in the late 80s. Much later in 2004, Canada placed a ban on all sales of these walkers including the used ones at yard sales. In the late 80s, I was working in New York city. At the time, in the world of pediatric physical & occupational therapy, there were discussions about the negative consequences of this walker.  Experienced therapists who worked with babies were quick to observe the drawbacks of using this walker. I do not remember how those walkers came back to the market, because I did not see them in the 90s when my own children were growing up in the USA.

There are many articles online that discuss the pros & cons of this walker. Some favorable arguments state that besides mobility, putting the child in the walker provides some respite to the mom. Others speak about the safety hazards when young children use the walker.

Being a pediatric physical therapist, I would like to speak about developmental concerns when an infant is placed in a walker for prolonged time periods.

When parents use the walker for a 9-10 months old child with  typical development, you are taking away the opportunities for tummy time, crawling,  tall-kneeling, and pull-to stand, all of which hold multiple benefits.  Frequently missed opportunities of these crucial movements result into compromised trunk muscle stability and core activation. Weight-bearing on the feet may not be adequate and can possibly lead to toe-walking. Furthermore, the muscle work that occurs numerous times during transitions between various body positions – lying to rolling over, sit-to-all fours, crawling to sitting, sit-to-kneel, pull-to-stand……that is so important for sensory & motor development…..is missed out. (Hence the importance of a moving infant spending time on the floor; today it is called as floor time. Traditionally, floor time was amply provided to babies so that they could roll over, come to sit, and progress to crawling that would lead to exploration of the environment).

Amongst children with developmental delays, prolonged use of this walker is likely to cause abnormal tightness in hip abductors, hip external rotators, and the tendo-achilles muscles. Other likely consequences would be decreased proprioception through the lower trunk and the lower extremities. Hence trunk strength, weight-bearing through the hands & upper body, cross crawling, trunk rotation, all do not develop adequately and lead to deficits in vision perception, vestibular processing, and reflex integration. All of this is sensorymotor development that occurs during the first 2 years of life. When the child has developmental delays, you are causing further deprivation of sensory-motor components by using a walker with wheels and hammock seat.

I am not trying to project that only after crawling, a child can walk. Rather, in early intervention session, I include many positions in parallel -- prone, all 4s positions, weight-bearing in supported standing if possible.  And gradually progress to walking with pushing a heavy chair (any chair with weights on it), while I facilitate the lower extremities as needed.

The consequences of using a walker may look different for different children, and are likely to be realized only after a few years. I have many children starting grade 1 in regular schools who have been referred to me for handwriting and attention. They have a history of not crawled or used the walker in early childhood. And now at 6 or 7 years of age while in grade school, they have poor core strength, weak hands and finger strength, thus leading to issues with handwriting and attention. I believe that young parents need to be educated about the role of tummy time and crawling and the value of transitioning between positions frequently as an infant. 

I absolutely agree that we need early mobility for our children with developmental delays, but not at the compromise of trunk stability and weight-bearing through various joints. The early mobility can be provided to the child in other ways.

Watch the following video; this walker was used more as a play item, months after the child has achieved independent walking. This child is using the push-toy walker just as if it was a cart. He steers it, pauses to bite on an apple while holding on to the walker, and uses the walker to run fast. This is a 22 months old child. He is learning how to steer the walker, turn it around, pull it and push it with the right force required. In the process he is learning so much  – body-spatial awareness, force gradation, and sense of direction.

There are Indian versions in wood material that children of my generation had used decades ago.

 

 

Product Picture from Amazon

However, we did enough crawling, prone, rolling, and pull-to-stand prior to using these. And that made all the difference in development as well as learning!

#childwalker #babywalker #walking #balance #trunk #hip #crawling #sensory motor #childdevelopment #movement #mobility #injuries