Helping Your Child With Special Needs Progress Toward Walking

By Michael J. Workman PT

I often get treatment related questions from parents about helping their children progress from various lower positions such as on the floor to sitting and crawling or from sitting and crawling to standing and walking.

This can be very frustrating for both parents and children and many times children are "stuck" and cannot figure out how to progress upward. Guidance from a physical therapist is often very helpful for these sorts of dilemmas and what I have to offer may give you some clarity about how to proceed with your particular situation.

Many times in developmental physical therapy we like to work a bit ahead of where the child is currently moving for two reasons:

The first reason being that if we work on more difficult movements than what the children can do, then their current skills become a little easier. The second reason is that we must first establish "higher level" positions in order for the child to see that there is a reason to want to move upward in more challenging and effective ways.

These concepts can be confusing so the following example might help you understand better.

I recently met a two year old boy with Down Syndrome who is not yet walking . His mother's main concern is that he really doesn't crawl well to get around. She is right! He scoots around on his rear-end getting onto hands and knees briefly and then spins back around onto his rear, repeating it over and over to very effectively get around his home without crawling. What we adoringly refer to as the "butt-scoot."

From experience I know that he is so good at using this technique that my chances of introducing the "proper hands and knees crawl" to him and him accepting it in place of his current version are very small. So I decide to leave crawling alone for awhile and move on to something more difficult.

After working with him for a bit, I discover that although he enjoys exploring his home from the sitting position he really does not know anything about standing and why it might be beneficial to him. So I decide that we must help him see that standing is also a very fun and effective place from which to explore. Why is standing fun? Standing is fun because it provides an entirely new height for kids to investigate.

In this little boy's case, he really had no idea yet of all of the new things that he could touch, spill and grab from standing. So the theory is that if I help him learn how to stand (supporting him as needed) so he can get into things like bookshelves, drawers, cupboards, doorknobs, toilet paper and so on, then he will be more motivated to get to standing in order to explore by himself...

Continuing on, if we establish standing as fun then he will also discover (maybe with our help) that the most effective way to get to standing is by coming from his hands and knees. By transitioning to standing from hands and knees the original concerns (from his mom) about crawling will be addressed because he will have to practice from the hands and knees position to get to standing, over and over with repetition.

In summary his crawling actually improved because we decided to work on a more difficult skill like standing and then naturally returned to crawling as we connected the two positions together. This connection would not have been possible, however, if we did not first provide the motivation by showing him that the standing position is a very fun place to be.

The strategy of first helping kids understand that higher-level, more challenging positions (like standing) are fun often makes the work of getting to those positions more worth the effort. Conversely, if we make them struggle to get to positions that they don't yet understand, they will miss the point of why exactly we are making them work. More helpful treatment ideas can be found on our blog at

I wish you love, laughter and fun with your children, you can do this!

Do you have physical therapy related questions about your child with special needs? Go to our website, and schedule a FREE 30-minute phone consultation where you can get your questions about physical therapy treatment, equipment and parent training answered by me personally.