Toddler Not Walking and Possible Low Tone?

Updated on December 20, 2010
S.C. asks from Seattle, WA
12 answers

My 16 month old daughter isn't walking and just recently learned to pull up and cruise. Our Pedi suggested at her 12 month c/u that she seemed to have mild low muscle tone. She sits in a 'W' with both legs tucked underneath her or with one leg extended. She has very poor balance and gets down from standing by falling backwards on her bottom. When she stands or walks with help her knees are locked. She also walks on the insides of her feet, which cause her legs to bow inward. Has anyone experienced this? What you recommend an EI evaluation? Our Pedi is more of a wait and see kind of guy, but if there's a serious problem I'd like her to be seen sooner than later. Any advice or insights are appreciated!



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So What Happened?

It's been awhile since this was posted, but wanted to update anyway. Might help someone whose child has similar issues. I did have my daughter evaluated in all areas by Early Intervention. She showed a significant delay in gross motor and qualified for PT services. She was immediately fitted with ankle-foot orthotics and started walking within days. She took her first steps at exactly 18 months. She has been receiving services for the past 17 months and is about to age out. I am so glad I followed the advice of many parents here. She has made so much progress and has only a mild delay now. She is walking well, running, jumping(just achieved), climbing and generally keeping up with her older brother's pretty well. We still have issues to work on. She cannot walk up and down stairs independently yet and her right side is weaker than her left. We will be looking into private therapy once she turns three. I am so glad we didn't wait and see. EI has helped her significantly and also me in knowing how to help her work on and achieve goals. I'm amazed everyday at how far she has come. My advice to parents in this situation is to definitely get an evaluation. It's free and then you will know with certainty whether your child needs services or not.

Thanks again for all your wonderful advice!


Featured Answers



answers from Seattle on


Try a Chiropractor, my friends son was doing the same thing and with just a couple appointments with the chiropractor he was up and moving...

Good luck

More Answers



answers from Minneapolis on

Hi S.,

My son was 16 months old when he walked. He was, however, pulling himself up and cruising around furniture for months prior to that. My ped did not seem to think there were muscle tone issues and I believe would have recommended intervention if she had felt there were. I would get an evaluation simply because I've always read early intervention is key.

I was prepared to take my son at the 16-month mark when he began to walk and really closely monitored it throughout the winter last year to make sure he was catching up with his peers in terms of running, climbing, etc. I'm happy to report he is 26 months old and I see no difference in his physical skills compared to other children his age. I just read my fall 09 post about his not walking and remember how freaked out I was about my son not meeting this milestone earlier, so I can appreciate and sympathize with your concerns.

Get her tested so you can know, one way or the other.



answers from Great Falls on

My son is almost 16 months and isn't walking alone either. He is still cruising around. He has low muscle tone also. He has a larger head and torso. He weighs 30 pounds. He has been seeing a physical therapist since he was about 6 months old due to delays with holding himself up with his legs, rolling over, crawling, and now walking. Today we had our appointment with the physical therapist and she states we need to get a foot brace to help support his foot. He also stands on the inside of his foot all the way back to his heel. I would recommend taking your daughter to a pediactric physical therapist. It has sure helped us with some ideas to do with our son to help him meet his milestones. Also you should check in your community if there is a Family Outreach to contact. These are paid by the state regardless of your income. You will get someone to visit your house and work with your daughter and do an intake worksheet to see where she is developmentally. There is help out there, you just need to look. I wouln't take your Dr.'s "wait and see how it goes" philosophy. The earlier you catch something the easier will be to work on now. Good Luck!



answers from Dallas on

Get an OT and PT evaluation from your local childrens hospital. She sounds just like my daughter. We waited until she was 4 and she began to notice and verbalize to us that she wasn't fast. That was heartbreaking and I wish we wouldn't have played the wait and see game. It didn't help and asking for help is nothing to be ashamed of. That is their job and they are the experts. They will test her and tell you how many months developed she is. She may be 16 months but performing at 11 or something like that.

They are going to tell you go not let her do a W sit. When she does that her legs are providing the balance and strength and she doe not have to work. Gently move her legs forward or criss cross so that her core stomach and back muscles have to support her own weight.

Mine qualified for Sure Step braces that went inside her shoes. This helped with balance and stability and she only had to wear them for about 8 months. The balance and stability also gave her confidence to try new things on the playground which was wonderful. Also, we do once a week therapy sessions for 45 min. First with OT until she made big gains and now once a week PT sessions. A year later we are about to be dismissed and are almost caught up with her peers. The motor lab that she does therapy in is so much fun for my daughter and she likes therapy equal or more than ballet class. I just can't figure out why I waited so long!

I would call and get the evaluation process started. It cost me a copayment and that's it. If she is behind they will present you with a plan of action. If she is on level they will put your mind at ease. If you can afford the copayment then I would do it in a heartbeat because its win win for your family. Also, it took almost 2 months for mine to get an evaluation apt. Hope this helps a bit.



answers from Las Vegas on

Go to EI and have them evaluate. They will be able to tell you if your daughter needs therapy or not. My son has had EI for speech since he was 18mo. My dr and SO MANY others told me to wait, and i am SO GLAD that I DIDN"T. He is doing great in speech now (32mo). I have a friend whose son is the same age and was delayed in speech, but she did the "wait and see" thing, and her son is not doing as well as mine.

EI can't hurt. It can only help. Good luck...

BTW I didn't walk until I was 16.5 months...and now I consider myself very athletic.



answers from Columbus on


It is always best to get intervention early, rather than waiting to see for developmental issues. You have several reasons to have her evaluated. You can start with a state early intervention program, but you also will want to have private evaluations as state services are not designed to be everything that a child may need and you will want her to get every possible intervention as early as you can get it.

While 16 months is not so late to not be walking yet, the low tone and W sitting are signs that the reason she is not walking is an issue, and if I were you, I would not wait to see if something more serious were causing the low tone, and thus the slow motor development when I could have therpay for her now that would help her in the future regardless of the cause. You can't go back and get early intervention if it turns out to be something that you could have acted on and you will only be happy if it turns out to be nothing if you decide to wait. Right now, you can't tell which child you have, because some kids with serious issues look just like your child does right now.

An evaluation is a win win for you. You either walk out of the evaluators office knowing that your daughter is fine, or you walk out knowing what to do to help her. I would call EI and make an appointment with an Occupational therapist today.



answers from Norfolk on

My son walked at 14 months. But he'd been climbing, crawling, and cruising since 9 months. Once he was walking (they all have poor balance till they get the hang of it), his gait went through various stages, sometimes bowlegged, sometimes pigeon toed and knock kneed (his Dr at every stage said it was all normal development), but by 3 yrs everything came together and he could run like the wind. At birth he was just over 9 lbs. At 1 yr he was 25 lbs. It took him a little longer to walk because his muscles needed to be a bit stronger to lift his weight. I don't know how much your daughter weighs, but she's pulling up and standing - that's a good sign. And she's walking a little bit - also good. It sounds like she's coming along at her own pace. If there's any walk and push (or pull) toys, she'd probably love those. Anything that gets her moving (bouncing, walking, crawling, etc) will help her muscle tone, and the more she uses them the stronger they will get.



answers from Seattle on

You might also try getting her adjusted by a chiropractor. My son started crawling at 14mos and walking at 18mos. He is now 2.5yo and delayed in his gross motor locomotion. He could not walk up and down the stairs very well, balance was off, and climbing was very hard for him. Well, we took him to our chiropractor and they watched him walk and noticed his gait was off. His right side was not as mobile. His hips were really tight. They adjusted him and wow! The difference was instantaneous! He is now climbing really well, balance is better, and he is walking up and down the stairs without help. And it only cost a co-pay. Just thought you might try it. Nothing to lose really. :)



answers from Chicago on

Try some mommy-and-me classes. You could do swimming or gymnastics or some kind of movement class. Our parent-tot gymnastics classes start at 18 months (some start earlier) and the toddlers who can't walk or can't walk well can move around and test their skills in a very safe, padded area. Just moving around and exploring may help with her muscle tone. And if she'll be onto a big squishy mat!

It may also spark her interest and get her wanting to move around more.

Good luck!



answers from Hartford on

hummm It is great that you are not pressuring her and you are letting her develop in her own time bc yes all kids are diff. however I would not want to wait and see bc MOST things you read say that they should be walking by then, and if you are worried then it cant hurt to have an eval. and some PT.We have something called birth to three in CT and they do free in home eval. if there is a problem they will also help you find the rescources you need to help you and it is all free! I dk if you have something like this in your state, but you can ask...or just for peice of mind look up our states site to see what they have for development of gross motor, as the site has a lot on it. Also I have been told (not sure how true) that sitting in a W is not good for children. good luck xo



answers from Seattle on

i had a friend who had a similar problem. Physical therapy for kids can definitely help. I am of the mindset of fixing it sooner than later is better.
Birth to 3 is a national program ran through the county that you can refer your child to (w/o dr) and get some of those services or at least connect you up with some.
We've used birth to 3 for speech services.


answers from New York on

For what I read this is not just a problem about your daughter not walking. If she was just not walking, I will tell you to don't worry because everykid is different and some start later then other but in a year you couldn't tell who walked first and who later.
However, I really think you need another ped.
My daughter use to walk with her inside feet too, and many people including my doc. told me that that was ok, and that eventually she would start walking normal.
But it didn't happen, at the end I had to go to see an specialist and my daughter had to use special shoes to correct this.
I am sorry I can remember the names that the specialist told me it was call, this was around 10 years ago.
The specialist also told me to not let her sit one her knees (the W shape you are talking) because it was also affecting her already problem.
In our case it wasn't nothing that need any kind of operation or anything, but she had to use special shoes for 2 years and they were very bulky. Now I think you don't need to wear those shoes, they gave you some, I forgot the name again, something to put in your own shoes.
Sorry about the name thing.
Anyway, I think is a possibility that your daughter could the same problem my daughter had, and you should try find a foot specialist (again, I am sorry with no remember the names).
Btw, my daughter walks fine now, every once in a while she does walk a little with her feet inside but at this age she knows she has to remember to don't.
So far she hasn't need to wear anything special anymore.

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