Hesperian Health Guides

Activities for Standing, Walking, and Balance

In this chapter:

Usually a child progresses through these stages:

bears part of weight automatically when held like this

(standing reflex)
automatically steps if tilting forward


(stepping reflex)
sinks down when stood up,
baby with standing reflex, before 3 months old. baby with stepping reflex, before 3 months old. baby sinking when stood up, at 3 to 6 months.
0-3 months 0-3 months 3-6 months
stands
holding on
pulls up to standing steps sideways holding on steps between objects walks with 2 hands, 1 hand, and finally, no support
babies standing while holding on at 7 to 9 months.
babies stepping while holding on at 9 to 12 months and then learning to walk alone at 1 to 3 years.
7-9 months 9-12 months 9-12 months 1-3 years


You can prepare a child for walking by encouraging each of the above stages as the child develops.

CAUTION! If the child cannot balance when sitting, do not work on walking yet. Help her develop sitting balance first.
Hold the baby so that she uses the early stepping reflex to strengthen her legs. You can even bounce the baby gently. When the child begins to stand, support her hips with your hands. Spread her feet apart to form a wide base. First do this from in front, later from behind.
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DVC Ch35 Page 311-3.png Move her gently from side to side, so that she learns to shift her weight from one leg to the other.
CAUTION! In children with spasticity, this activity may increase muscle stiffness. DO NOT DO IT.
As she gains better balance, you can provide a light support at the shoulders. Or have the child hold a hose or rope. Because it is flexible, he needs to balance more.
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Later, he can hold onto the rope with one hand only.


To encourage a child to pull up to standing, put a toy he likes on the edge of a table.
When a child can almost walk alone but is afraid of falling, tie a cloth around his chest.
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Hold the cloth, but let it hang completely loose. Be ready to catch him if he falls.
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To encourage him to take steps, put something he likes at the other end of the table.
CAUTION! Do not let the child hang by the cloth. Have him bear his own weight. The cloth is only to catch him if he falls.



Other activities for improving balance:

Hold the child loosely under the arms and gently tip him from side to side and forward and backward. Allow him to return to a straight position. Turn it into a game.
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At first support the child while you do this. When his balance improves, do it without supporting him—but be ready to catch him if he falls.

Note: Walking backward helps children who tend to walk tiptoe to bring their heels down.


Practice walking sideways and backward. It is better to hold a child:
DVC Ch35 Page 312-2.png
a child has better balance if held at his waist rather than by a hand.
LIKE THIS
NOT LIKE THIS
His balance is centered in his body.
His balance is off center.


Support your child only as much as he needs, until he can walk by himself.

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Draw a square on the ground and help him to take steps forward, sideways, and backward. Follow the 4 sides of the square, always facing the same direction. Make it fun by having him collect a different colored tag or piece of puzzle at each corner—or however you can.
For an older child who has difficulty with balance, a homemade balance board will turn developing better balance into a game. Move slowly at first—especially with a child with cerebral palsy.
a board balanced on a log, with blocks to hold the log in place. A balance board with a wide rocker is better because it rocks more smoothly.
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Blocks to prevent rolling sideways. Some children will need a pole to hold onto.


Simple homemade parallel bars can help a child with weak legs or a difficulty with balance get started walking. Homemade pushcarts or walkers can provide both support and independence for the child who is learning to walk or who has difficulty with balance.
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A simple wooden walker with plywood wheels helps this developmentally delayed child begin to walk.



This page was updated:18 Sep 2024