Pediatric PT FAQ
Why is my baby’s head flat?
Infant skulls are softer than adult skulls due to the ongoing process of bone development. This means that when sustained and repetitive pressure is exerted on the infant’s head, such as from the uterine walls in utero or from sleeping on their back, the skull may “flatten” in response. This does NOT mean you should have your infant sleep on their stomach. Remember the phrase, “back to sleep, tummy to play!”
When should I be concerned by baby isn’t walking yet?
Current evidence indicates that the normalized age to develop the skill of walking independently is between 12-18 months. If your child is not walking independently at 18 months, it is recommended they be evaluated by a pediatric physical therapist. If you are considered that your child is a late walker or has shown delayed acquisition of other gross motor milestones, then earlier screening and/or referral to a pediatric physical therapist is recommended. There are many tools available to track your child’s milestones; Pathways.org is strongly recommended for their evidenced-based tracking tools.
Is toe-walking normal?
A child who walks with their toes/balls of their feet as the primary point of contact with the floor is often called a “toe-walker”. The heels are often completely lifted from the floor, but sometimes with mild toe-walking you may still see the heels touch the floor; this gait pattern often looks “bouncy”. Children who are learning to walk may experiment with different walking patterns, including toe-walking. By the time a child turns 2 years old, they should have developed the ability to land primarily on their heel with each step— this is called the heel-strike. Children who continue to prefer toe-walking after 24 months should be referred to a pediatric physical therapist for evaluation and treatment.
Sources:
- Jennifer M. Zubler, Lisa D. Wiggins, Michelle M. Macias, et al.; Evidence-Informed Milestones for Developmental Surveillance Tools. March 2022; 149 (3): e2021052138. 10.1542/peds.2021-052138
- Palisano RJ, Orlin M, Schreiber J, eds. Campbell’s Physical Therapy for Children. 6th ed. Elsevier; 2022.
