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As a parent, you want to see your child grow, move, and thrive. But sometimes, you might notice things like delayed walking, clumsiness, or difficulty with certain movements. This is where pediatric physical therapy (PT) comes in!
Many parents have similar concerns when it comes to their child’s motor development. So, let’s dive into some of the most frequently asked questions that pediatric PTs hear—and what the latest research and expert guidance say!
1. When should my baby start rolling, crawling, or walking?
Every child develops at their own pace, but there are general milestones that serve as a guide:
Rolling: 4–6 months
Crawling: 7–10 months
Walking: 12–15 months
If your child is significantly behind in these areas or skips crawling altogether, a PT evaluation can help determine if they need extra support (APTA, 2023).
📌 Tip: Encourage tummy time daily from birth! It strengthens core and arm muscles needed for rolling, crawling, and sitting.
2. My child is a “toe walker.” Should I be worried?
Toe-walking can be common in toddlers learning to walk, but it should fade by age 2. If your child continues toe-walking beyond this, it could be due to:
Tight calf muscles
Sensory processing differences
Neurological conditions (e.g., cerebral palsy, autism)
A pediatric PT can assess whether stretching, strengthening, or orthotics are needed.
📌 What to do at home: Have your child walk barefoot on different surfaces (grass, carpet, tile) to encourage heel-to-toe walking.
3. What are “W-sitting” and “crisscross applesauce,” and does it matter how my child sits?
“W-sitting” is when a child sits with their legs bent outward in a W-shape. While this position feels natural for some kids and is a typical position children experiment with, prolonged W-sitting can:
Put strain on hips and knees
Reduce core strength and balance
Make transitions to standing harder
Encourage crisscross applesauce, kneeling, or side-sitting instead (APTA, 2023).
📌 Tip: If your child frequently W-sits, provide small stools or cushions to encourage better postures.
4. My toddler falls a lot—should I be concerned?
It’s normal for toddlers to trip and fall as they learn to walk, but red flags include:
Frequent falls after age 3
Poor balance or coordination
Walking with feet very close together or very wide apart
Avoiding running, jumping, or climbing
This could indicate low muscle tone, balance issues, or coordination difficulties like Developmental Coordination Disorder (DCD) (APTA, 2023).
📌 Fun Activity: Play “floor is lava” by stepping over pillows or climbing cushions to improve balance!
5. How can I help my child with weak core muscles?
A strong core is essential for sitting posture, balance, and coordination. Signs of weak core strength include:
Slouching when sitting
Trouble sitting upright for long periods
Difficulty with jumping, running, or climbing stairs
Core-strengthening activities:
✅ Animal walks (bear crawls, crab walks)
✅ Wheelbarrow walking
✅ Balance games (standing on one foot, wobble boards, walking over couch cushions)
📌 Tip: Make it fun! Incorporate core exercises into obstacle courses, yoga, or dance.
6. Should I worry if my baby isn’t crawling?
Crawling builds core strength, coordination, and hand-eye tracking, but some babies skip it and go straight to walking. While not always a concern, skipping crawling may be linked to later motor coordination difficulties.
If your child:
Scoots only on their bottom
Uses only one side of their body to move
Hasn’t shown interest in crawling by 10 months
A pediatric PT can assess their motor patterns (APTA, 2023).
📌 Encourage crawling with:
Placing toys slightly out of reach
Crawling through tunnels or over cushions
Tummy time play to build strength
7. When should I see a pediatric physical therapist?
If you notice:
🔹 Delayed motor milestones (rolling, crawling, walking)
🔹 Poor balance or frequent falling
🔹 Difficulty with stairs, jumping, or running
🔹 Postural concerns (slouching, excessive W-sitting)
🔹 Toe-walking beyond age 2
A pediatric PT evaluation can provide insight and personalized exercises to help your child move with confidence (APTA, 2023).
Pediatric physical therapy isn’t just about fixing problems—it’s about empowering children to move, play, and explore the world confidently! If you have concerns about your child’s motor development, don’t hesitate to reach out.
Dr. Rebecca Turkel is a Licensed Physical Therapist, Craniosacral Fascial Therapist, Certified Early Intervention Specialist, Certified Educator of Infant Massage, Certified in Neonatal Behavior Observation, and Integrative Breastfeeding Educator.
Dr. Turkel has 20 years of experience working with families in an Early Intervention setting as a Developmental Specialist and Physical Therapist as well as 15 years of experience working at Boston Children's Hospital as a Physical Therapist.
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