Kaari Pieper, PT, DPT
Prairie Grit Therapy
Every parent who has worried about how their baby moves has heard some version of it.
He will get there. Every kid is different. My sister's boy did not walk until he was almost two and he is fine. Give it time.
Often that is true. Children vary enormously, and most of them do get there.
The problem is that wait and see is not a plan. It has no end date, no checkpoint, and no definition of what you are waiting for. So the waiting just continues, and a year goes by.
Sometimes waiting is exactly right
A pediatric physical therapist telling you that half is important, because the opposite advice gets oversold.
Plenty of what looks concerning in a young child resolves without any intervention. Some kids fight tummy time and still learn to crawl. They walk late and then run fine. They go through stretches of looking clumsy while they grow. Not every difference is a problem, and not every problem needs therapy.
We say that out loud at evaluations more often than families expect.
Wait and see is fine. Wait and watch for something specific is better.
What waiting costs when it is the wrong call
Three things happen while a family waits.
Patterns harden
A child who moves a certain way for six months has practiced that way thousands of times. The same pattern at two years has been practiced far more. Changing it later is not impossible, it is just a longer job.
Compensations stack
Bodies are efficient. When something is hard, a child finds another way to accomplish it, and that workaround becomes its own habit. Now there are two things to address instead of one.
Confidence goes
This is the one families underestimate. A child who keeps falling behind on the playground stops going to the playground. By the time anyone intervenes, the physical gap is only part of the problem.
A better question than “is my child behind”
Comparing your child to a chart or to the neighbor's kid produces a lot of anxiety and not much information.
Ask about direction instead. Is this child gaining skills over time. Not whether they hit a milestone on a particular week, but whether the trend is upward over a couple of months.
A child who is late but steadily progressing is a different situation from a child who has not changed since spring. The second one is worth a call regardless of what the chart says.
Worth a call now rather than later
None of these mean something is wrong. They mean the question is worth asking out loud.
Your baby strongly favors one side, or resists turning the head one direction
Skills have stalled, or something your child used to do has gone away
One side of the body works noticeably better than the other
Your child walks on their toes most of the time, not just when excited
Your child avoids playground equipment, stairs, or running with other kids
You have been told to wait and see more than once, and the waiting is not getting easier
That last one counts. If you have been worried long enough to look this up, that is information too.
What an evaluation actually is
It is a conversation, not a verdict
We ask what you are seeing and what your concerns are.
We watch your child move. Most of it looks like play, because that is how a child shows you what they can do.
We measure strength, range of motion, balance, and coordination.
We tell you what we found in plain language, including when the answer is that nothing needs treating.
We come up with a plan together, including fun, practical activities to help your child make progress.
If therapy makes sense, the plan gets built around your family's routine.
Physical therapy evaluations require a referral, so start with your pediatrician or call us and we will walk you through it.
Why this month
October is National Physical Therapy Month, and the theme of it is prevention. Doing the work early rather than repairing the consequences later.
For adults that means strength and balance before a fall. For children it mostly means not spending a year waiting for something that would have been faster to address at the start.
You do not need a diagnosis to ask a question. You just need to stop waiting for permission to ask it.
Prairie Grit Therapy provides pediatric occupational, physical, and speech therapy in Minot, North Dakota, inside the Minot Family YMCA. To ask a question or schedule an evaluation, contact our office.
