Have you noticed that your child is walking on her tiptoes? It’s certainly not an uncommon sight, but it is one you’ll want to watch if it goes on past age 3.
It is natural for toddlers 18 months and older to experiment with toe-walking as they learn to walk and run. However, if they continue to toe-walk on the balls of their feet past age 3 and no underlying diagnoses exist, the behavior will need to be addressed. Called idiopathic toe walking, this condition can cause a child’s calf muscles to shorten making it more challenging to walk flat-footed.
Why do children walk on their toes?
The three most common reasons children tip-toe or walk on their toes include:
Sensory Processing Difficulties
Children with sensory processing difficulties may walk on their toes for two reasons due to hypersensitivity to floor textures and surfaces or desire for increased sensory input and feeling within the joints.
Underlying Medical Conditions
Underlying medical conditions like cerebral palsy or muscular dystrophy may be another reason a child walks on the balls of her feet. These medical conditions cause an abnormal increase in muscle tone, which can lead to toe-walking.
A child may toe-walk simply because she prefers to walk on her toes. And, if done continuously, toe-walking or tip-toeing can cause her calf muscles to shorten making it more difficult to walk normally.
How do I help my child stop toe-walking?
If your child’s continuous toe-walking concerns you, please contact your pediatrician to schedule an appointment for further consideration. Your doctor may refer you to a licensed pediatric physical therapist to evaluate your child’s muscles and strength by assessing her leg muscles and ankle movements.
The physical therapist may recommend an at-home exercise program targeting the calf and front leg muscles. The ultimate goal will be for your daughter to walk using a heel-to-toe pattern rather than choosing her tiptoes.
Some common stretching exercises physical therapists may recommend for toe-walkers include:
Ask your daughter to lie on her back with her knees straight. One at a time, bring her feet up towards her head while bending her ankle.
Have your daughter put her hands on a wall with her feet pointed toward the same wall. One foot should be behind the other with the front leg bent. Instruct her to lean into the wall keeping her back leg straight. Both of her heels should remain on the floor while she stretches.
Long Sit Stretches
Ask your daughter to sit with both legs straight out in front of her while wrapping a towel around both of her feet. She should hold the towel at both ends and pull the towel back towards her body while keeping her knees flat and back straight.
Heel Drop Stretches
Have your daughter stand on a step. While keeping one foot planted firmly on the step, ask her to place one foot halfway on the step and drop her heel to feel a stretch in her calf muscle.
Please note, while simple to execute, these exercises should be initiated under the guidance of a physical therapist who will demonstrate the correct stretch positioning, the number of repetitions needed and the appropriate amount of time to hold the stretch.
Filed under: Awareness, Physical Therapy, Raleigh Therapy Services
May is Better Speech and Hearing Month and now is the perfect time to spotlight the special role speech-language pathologists, more readily referred to as speech therapists, play in children’s lives. It’s easy to think that a speech therapist is someone who works with others to correct mispronounced words and help them speak—however, speech therapists do much, much more than that.
Speech-language pathologists are professional therapists who evaluate and treat speech, language and swallowing disorders. A pediatric speech-language pathologist may work with a child in any of the following areas:
- Feeding & Swallowing – safely eating, drinking, and swallowing
- Articulation– producing the correct speech sounds
- Voice– speaking with vocal quality, pitch, loudness, and resonance
- Expressive Language – using language to communicate functionally
- Receptive Language– understanding what is being communicated
- Pragmatics – using social language in order to convey needs and participate in conversations
- Fluency (Stuttering)– speaking using a normal flow and rhythm without interruptions
- Hearing – communicating in the presence of a hearing disorder
Preschool & Daycare Speech and Hearing Screenings
Your first introduction to a speech-language pathologist may actually be at your child’s preschool or daycare. It is a common practice for local speech-language pathologists to offer free speech and language screenings for young students at these early learning centers. With your consent, a speech therapist will conduct a brief screening to review your child’s articulation, language, voice, fluency, and hearing.
The free screening will provide a quick snapshot into your child’s speech and language skills by utilizing a research-based tool to indicate a pass/fail status. A hearing test may also be performed simultaneously. If your child fails his or her screening or hearing test, a more in-depth assessment is typically recommended to determine if a delay or disorder exists.
Some signs of speech and language disorders that speech-language pathologists will watch for in children include:
Feeding & Swallowing Disorders:
- Difficulty chewing
- Choking, coughing, or gagging on food and/or liquids
- Difficulty transitioning to solids or higher textured solids like meat
- Difficulty transitioning from bottle to cup
Speech Sound Disorders:
- Incorrect pronunciation of the letters p, b, m, h, and/or w by 1 to 2 years of age
- Incorrect pronunciation of the letters k, g, f, t, d, and/or n by 2 to 3 years of age
- Unclear speech to both familiar and unfamiliar listeners at 2 to 3 years of age
- Speaking with a hoarse or breathy voice
- Speaking with a nasal voice
- Not smiling or interacting with others by 3 months of age
- Lack of babbling at 7 months of age
- Not using gestures by 12 months of age
- Inability to understand what others are saying between 7 months and 2 years of age
- Unable to say more than 50 words by 2 years of age
- Unable to combine words by 2 1/2 years of age
Fluency (Stuttering) Disorders:
- Frequently repeating parts of words or whole words at 2 1/2 to 3 years of age
- Stretching sounds out like “n-n-n-no” for “no” at 2 1/2 to 3 years of age
- Struggling to get sounds or words out by 2 1/2 to 3 years of age
- Lack of attention to sounds
- Not responding to name when called
- Inability to follow simple commands
Filed under: Awareness, Better Speech and Hearing, Parenting Tips, Raleigh Therapy Services, Speech and Language Development
Is your child’s backpack loaded up and full of books? Is he starting to complain of backaches? Do his shoulders hurt?
Carrying too much weight in a bookbag or wearing the bag incorrectly, can lead to some issues for your student. In fact, a student’s backpack can be the culprit for a number of aches and pains as well as poor posture and weakened muscles.
While you may not be able to do anything about the workload and books your student brings home each day, you can give him some tips to ensure he’s properly using his bookbag to curb unnecessary pain.
Loading a backpack:
- Make sure all items in the bag are needed that day
- Place the heaviest items against the back of the bag
- Use outside pockets to carry smaller items
- Try to fill compartments and pockets evenly to distribute weight
Students who wear their bookbags correctly will also lessen their risk of shoulder and back pain. Make sure your child knows the right and wrong way to wear their backpack.
Wearing a backpack:
- Utilize both shoulder straps for even weight distribution
- Tighten the shoulder straps to ensure the bag doesn’t hang loosely on the shoulders
- Adjust the straps, so the bag sits in the curve of the child’s lower back when worn
- Wear both the waist and chest straps
- Wear the backpack only when necessary
Raleigh Therapy Services Occupational Therapist Maria Georgiou added, “Your child’s backpack should not weigh more than 10 percent of his total body weight. If it does, speak with his teacher to find a solution to lessen the weight of the bag by reviewing the actual contents he needs to complete his work.”
Buying a Backpack
Another item to consider in reducing your child’s backpack pain is to determine if you purchased the right bag for him and his school needs.
Important features to consider when selecting a backpack include:
- Organizational pockets and compartments
- Waist and chest straps
- Two wide-padded shoulder straps
- Extra back padding
- Lightweight canvas material
- Structure and size; a book bag should not be larger than the child’s back
Continued Back or Body Pains
If your student continues to experience back or body pains even after discussing the proper way to wear and load his bookbag, you may want to speak with his pediatrician. She may want to see him to assess your concerns and determine if an ergonomic evaluation is needed.
Filed under: Awareness, Occupational Therapy, Parenting Tips