Typically, toddlers may achieve milestones later than their peers who do not experience delays. At Valencia Pediatrics in Victorville, California, pediatric care remains consistent to monitor development and offer early intervention if necessary. Dr. Rainilda Valencia, a pediatrician, suggests regular developmental screenings to track progress in reaching milestones such as walking.
When should my toddler start walking?
Young children begin to walk once their leg muscles have developed enough strength, usually between 9 to 18 months of age. It is considered within the normal range if a child does not walk by 14 months.
It’s important to remember that every child develops at their own pace, so don’t be alarmed if your toddler takes a bit longer to start walking. Encouraging activities like tummy time, crawling, and assisted standing can help your child build the necessary strength and coordination for walking. If you have concerns about your child’s development, consult with their pediatrician for guidance and support.
What should I do if my toddler isn’t walking?
If a toddler is not walking between 14-18 months, the following steps depend on the child’s age. It is important to encourage walking by building confidence and coordination skills.
When your toddler isn’t walking by 14 months
If a child is 14 months old and has not started walking but is achieving other developmental milestones, it is recommended to allow them to develop walking skills naturally. Encouragement can be provided by placing toys within their reach.
When your toddler isn’t walking by 18 months
If a child has not started walking by 18 months, scheduling a developmental screening is advised. The absence of walking may not always indicate a delay but could point to an underlying condition.
What happens at a developmental screening
Dr. Valencia suggests developmental screenings at 9, 18, 24, and 30 months to ensure the child is progressing adequately.
These screenings evaluate gross motor skills, physical growth, language abilities, and learning skills. Early detection enables timely interventions when necessary.
Contact Valencia Pediatrics at 442-204-0019 if you have concerns about your child’s walking milestones.
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What Is Classified As Delayed Walking For Kids?
Parents often express concerns about their child’s walking development. Podiatrists can assist in monitoring and addressing issues related to walking.
What Causes Delayed Walking In Kids?
Delayed walking can have various causes, ranging from neurological disorders to learning disabilities. Factors like family history and prematurity can also influence walking delays.
Should I Worry If My Child Is Not Walking By The Expected Age?
If a child is healthy and progressing normally but has not started walking by 18 months, an assessment may be necessary. Some children may begin walking later without facing any problems.
What Are The Risk Factors Of Leaving Delayed Walking Untreated?
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The importance of assessing delayed walking is crucial to identify underlying issues like hypotonia and learning difficulties, which can be treated through physical therapy. Delaying treatment may lead to further developmental delays. If concerned, seek assessment for your child to ease worries and take early action. Treatment approaches depend on the cause of the delay, with suggestions including activities like tummy time and practice standing. Podiatrists specialize in foot and leg care for children, addressing walking delays through assessments and treatment options. It is noted that children with autism may or may not experience delayed walking, and podiatrists can provide support based on the cause of the delay. Spondylodiscitis is a condition involving inflammation of vertebral bodies and discs. Detecting this condition in children can be challenging due to subtle symptoms and inconclusive lab tests. Case studies, like the one discussed, aid in promptly diagnosing similar cases. The case study featured a 19-month-old boy who demonstrated reluctance to walk and a slightly elevated temperature. Collaboration with general practitioners and specialists led to the diagnosis of spondylodiscitis. Detailed information regarding the patient’s medical history is outlined in the case study. The diagnostic process focused on the hip joints, with an MRI scan revealing abnormalities in the lower back. The findings indicated an inflammatory spondylodiscitic event. Numerous tests were conducted, showing normal blood results and no abnormalities on an abdominal ultrasound. A lumbar puncture and X-ray did not reveal any pathology. Given the investigations and consultations, a spondylodiscitis diagnosis was confirmed. The patient received intravenous antibiotics and wore a back brace. The patient’s condition showed improvement with treatment, yet a follow-up MRI displayed changes suggestive of infectious spondylodiscitis. Further antibiotics were administered, and the patient responded positively to the treatment. After five weeks, the patient was discharged. Follow-up appointments were arranged, and medications were prescribed for home continuation. Overall, the treatment was effective, enhancing mobility and providing pain relief. Approximately five weeks post-discharge, the patient’s mother sought medical attention due to frequent vomiting. Examinations by the GP and pediatrician revealed no abnormalities. An MRI from April 2012 showed progress in the patient’s condition, with a follow-up scan recommended in 6-9 months.
Figure 4.
Fourteen weeks following the diagnosis, a sagittal MRI scan of the spine was conducted.
Discussion
Although spondylodiscitis is more common in adults, there is limited information available regarding children. The condition’s prevalence is rising among older individuals due to various factors, but occurrences in children are rare. This discussion is centered on spondylodiscitis in pediatric patients.
The pathophysiology in children differs from adults, highlighting the importance of vascularized intervertebral discs. Symptoms in children can vary and may be subtle. Diagnostic procedures encompass blood tests, x-rays, MRI scans, and biopsies. In children, treatment for spondylodiscitis involves a combination of antibiotics, spinal immobilization using a corset, and pain management. Most children respond well to treatment, necessitating long-term monitoring. This case report underscores the challenges associated with diagnosing spondylodiscitis in children and the significance of timely treatment based on clinical and radiological findings. The inclusion of tests such as the erythrocyte sedimentation rate (ESR) and MRI spine is crucial in diagnosing spondylodiscitis in children presenting with walking refusal symptoms. While performing an MRI scan on every symptomatic child may not be practical due to resources, monitoring ESR levels provides a cost-effective approach that can prompt further investigations, including MRI scans, if elevated. This case report contributes to the ongoing dialogue on this matter.
Learning points
Children naturally inclined to explore their surroundings often commence walking early in life. Therefore, it is vital to note any reluctance to walk exhibited by a child. Active listening remains a cornerstone of effective medical practice. At times, a mother’s intuition can lead to a correct diagnosis, raising questions about potential recall bias. Though uncommon, rare diseases can manifest in general medical practice. Healthcare professionals must remain open-minded, considering alternative explanations for patient symptoms. Timely diagnosis of spondylodiscitis often hinges on ESR and MRI tests, particularly in children showing signs of walking refusal and unexplained symptoms.
Footnotes
No conflicts of interest exist.
Consent from the patient has been granted.
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BMJ Case Reports articles are made available with permission from BMJ Publishing Group