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Most parents I meet want to know two things: “When will my baby walk?” and “When will my baby talk?” My answer is the same in both cases: “Be careful what you wish for.”

If only I could turn my physical therapist license into a crystal ball and make those kinds of predictions. Naturally I’d want to know what to expect next from my own adolescent children, both of whom walk and talk more than I ever thought possible. To the mothers of twins, who can’t wait for not only one, but two babies to get up and walk; I repeat: Be careful what you wish for. Most toddlers who are just beginning to walk are unsteady and likely to fall down frequently. When it comes to walking, baby is just as impatient as mom, ready to test-drive his or her newly discovered mobility skills, in multiple directions, with or without purpose. Toddlers remind me of adorable windup toys that move in straight lines almost robotically, with no rotation, rhythm, rhyme or reason, until they reach an obstacle. At first their preferred destination is mom, where they’re free to lose control as they receive a big hug and a smile for their effort. They’re bound to wobble, fall down, get back up, wobble and fall down again. All this is quite natural, just as it’s natural for parents to hold their hands, guide them, and be there for all those falls.

A baby learning to walk is like a teenager learning to drive. You learn through practice – through routine “test drives.” I can’t imagine teaching both my teenagers how to drive at the same time. Similarly, if you’re the parent of twins who are just starting to move around, you’re better off working on mobility skills with one twin at a time. Get the first one off to a safe, smooth, confident journey toward independence, and worry about the other one later. Most twins have individual mobility clocks anyway, so don’t worry if one baby starts to walk before the other. After all, you can chase behind only one toddler at a time, unless you’re lucky enough to have help on standby.

With 18 years of experience as a pediatric physical therapist, I still can’t answer the question, “When will my baby walk?” I can, however, always reassure parents of this – babies walk when they’re ready to, just as they came into this world when they were ready to. How truly amazing it is that these cute little creatures have the innate ability to walk, without verbal instructions, a permit, or a training manual. We are born with the mechanisms we need to develop mobility and language – we are destined to walk and talk. Walking, much like talking is the result of a developmental process that generally takes about 12 to 15 months. Your baby is smart enough to know when that developmental process is complete. Some babies complete it earlier and some later. Every baby is special, and it’s that uniqueness that adds so much beauty and excitement to our world.

So many things need to happen before a baby takes that first step. Walking requires being able to stand up. Standing up requires being able to sit up. And sitting up requires being able to hold the head up. Babies develop stability before mobility. They learn to move forward in a creeping motion after learning to stabilize and bear weight on their hands and knees. Once this is mastered, they creep or crawl to a safe and interesting place and learn to pull themselves up to a standing position. When they master pulling themselves up to a standing position, that skill becomes less interesting for them. Moving sideways along the table or sofa – or “cruising” – becomes the next challenge.

Babies must be ready to deal with that inevitable fall, so balance and postural responses are developing the entire time. Postural responses are how our bodies automatically adjust to displacement or shifts off center.

Even while babies are cruising from one piece of furniture, they know at some level that they’re not quite ready to walk. At this developmental stage, it’s important to work on their confidence. Babies are proficient while there is ample support in front of them. So what would happen if you picked up baby and placed her with her back to the table or sofa? Of course, this is not a position baby would ever put herself in, because it would require her to turn around and there’s no reason for her to do that. What if you then distracted baby with a song, a game of “patty cake,” or an interesting toy? This would enable her to work on her confidence and her balance simultaneously. If she were able to bend over and pick up the toy without falling onto her knees, her confidence would double!

When baby’s back is to the sofa, table, or wall is the perfect time to give him a brand-new (or hand-me-down) push toy. Today, push toys are also ride-on toys, educational devices, shape sorters, cause-and-effect toys, language facilitators, musical toys, and even computers. I prefer keeping it simple – perhaps a car or sturdy toy shopping cart. Walking skills usually are developing at 12 months, so what more useful first birthday present could there be than a simple push toy? If it’s also a ride-on toy, so much the better, as it will be used well past the second birthday.

Baby may be tooling around with his lovely push toy, but he still knows he’s not ready to walk. Although walking with the support of a toy is a good start, it’s not really walking.

As parents, we’re conditioned to think in terms of giving to our children – giving toys, nourishment, love, and anything else they need to for thriving physically and emotionally. Sometimes, however, it’s in their best interest if we “taketh” away.

If you’re really anxious for your child to walk, take that push toy away and hide it in the closet for two weeks, but only after your child is proficient with it. What do you think your child will do? Revert to that slower, less energy-efficient mode of mobility – crawling? Not a chance! Surely she’s still interested in moving around with the same alacrity and skillfully navigating her environment. Remember, we are destined to walk!

Many people ask about walkers, and there are many different opinions about them. Pediatric physical therapists are not supposed to like traditional walkers, and the truth is, walkers don’t help baby learn to walk. They do, however, satisfy baby’s need to move about in his environment, while allowing mom two free hands to do other things. This can bring great joy to both mom and baby! Safety is a major concern, and if you choose to use a walker, be sure it is always with adult supervision. If the topography of your home is such that there is even a slight chance that baby and walker could fall down stairs, I would avoid a walker altogether. Today, walkers come in a variety of fancy, cute styles and have adorable little attachments. This selection, coupled with the fact that we are a “baby container” society, makes them hard to resist. Even if you don’t buy one yourself, you’ll probably get one as a gift. Baby bouncers are another good alternative for keeping baby occupied, if not mobile. All of that spinning and rocking is good for baby.

What will ultimately help your baby learn to walk are lots of opportunities to crawl (creep), pull up to a standing position, and cruise. In other words, limit baby’s time in those “baby containers” and give him floor time to move on his own.

Another question I’m often asked is, “What should I have on my baby’s feet?” I have found that bare feet are the best thing for “walkers in training.” Babies flex their toes to grip the surface and for balance. We have sensory receptors on the bottoms of our feet that give us input and feedback on where we are in space, often referred to as “kinesthetic awareness.” These receptors help us with balance and postural reactions; hard-bottom shoes decrease these sensations. You’ll want to get rid of those hard bottom shoes the first time you’re kicked with them anyway. Once your baby is walking, a supportive yet flexible-sole sneaker is a great choice. Save those hard-bottoms for dress-up.

Now that baby is barefoot and ready to go, she must be able to stand by herself. Remember, we develop stability first, then mobility.

Before you know it, baby will be standing in the middle of the floor for several seconds at a time. Soon after that she’ll be standing for a full minute without even realizing it. When that happens, you’ll probably smile, cheer, and applaud as she acknowledges your praise with an unsure but accepting toddler gesture. She’s well on her way, and will be running before you know it! Now is the time for you to hurry up and make sure everything is secure, safe and baby-proofed. Remember . . . be careful what you wish for! [/toggle]

Let’s face it, most parents can’t wait for their child to speak his or her first word. It’s one of those developmental milestones that everyone looks forward to. After all, that’s when true communication starts, right? Well in reality, communication starts long before the first word and develops far beyond the child’s ability to say a few words. Communication is a two-way process that requires the giving and receiving of information between two people. Giving information (expressive language) is done not just through talking, but also through body language, gesturing, making sounds, and facial expressions. Receiving information (receptive language) is comprised of hearing, seeing, and processing what is being expressed. As parents and caregivers, you can help your child develop both aspects of interaction in order to be successful communicators. Let’s look at the first three years of life. Newborns and Younger Infants

You love to look into the eyes of your newborn or infant. You are curious about what they can see, if they recognize your face and voice, and if they can hear what’s around them. You may be surprised to know that children this young are already beginning to develop communication readiness. By looking at them and talking, you are encouraging the development of basic communication including eye contact, sound localization, primary imitation skills, and attention to sounds and voices. Until approximately three months old, your baby is beginning to show interest in interaction with both people and objects (rattles, mobiles, etc.) in their environment. They may move or blink when they hear sounds, look at your mouth and smile when you talk, begin to coo and gurgle, and of course, cry for hunger.

By six months old, your child is actively pursuing interaction. He or she can tell the difference between friendly and angry voices, and responds accordingly. Smiling at familiar faces is expected and crying stops when their name is called. Around this time, your child may play games with his own voice, laugh and begin babbling (using consonant and vowel sounds), and have different cries for different reasons. They are beginning to understand the patterns of communication and may stop making sounds when others talk or may make sounds in order to get attention.

At this stage, ask yourself: 1. Does my child make eye contact? 2. Is my child beginning to show interest in toys or other objects? 3. Does my child turn his eyes or head toward a sound or voice that is out of sight? 4. Is my child making sounds (coo) and starting to babble as he gets older? 5. Is my child expressing pleasure through smiling? 6. Does my child stop occasionally when told “no”?

Older Infants and Early One-Year-Olds

Now the real fun begins. Your baby is actively participating in more activities with more people. From about six to nine months, he begins to interact and show pleasure by clapping, yelling, laughing, and more complex babbling. He recognizes familiar people’s names and stop when his name is called. Your baby will enjoy simple games like “patty cake” and will begin to wave when someone says “bye bye.” Imitative skills are more developed and your baby will start to make the same sounds you do during interactive games and while talking. Your baby is beginning to understand that expressing himself can occur through different means.

Between the ages of nine and twelve months, your baby may start to point and gesture to get what he wants. Or maybe he will combine sounds and gestures for more effective communication. He is learning more from the environment, using the context to understand what is happening. For instance, he will get his bottle when told to do so during the bedtime routine, or he may eat his food when told to after being placed in his high chair. Your soon-to-be year-old child likes to play simple games like “peek a boo” and expresses himself using a combination of babbling and one or two real words. This is when he says “mama” or “dada” and really means it. What joy!

At this stage, ask yourself: 1. Is my child seeking and enjoying interaction? 2. Does my child imitate or try to imitate what I say and do? 3. Is my child following routine directions? 4. Does my child pay attention to someone who is speaking and look at common objects and people when they are named?

Toddlers

Your child will burst with communication over the next two years. One day your child will understand and say just a few words and within months, he will use three-word phrases and follow multistep directions. Between the age of one and three, your child will follow directions, first with a cue and within context (pointing, holding your hand out) and eventually without any help at all. He will begin to identify common objects and body parts, pointing to them when you name them. He will first express himself with a mixture of true words and jargon (their own language) and eventually speak solely through real words and begin to describe what he sees. You will notice your child’s ability to answer questions of increasing difficulty (who, what, where, doing, yes/no) and to ask for help and information. By three years old, he is communicating in an adult-like pattern, showing an increase in a knowledge of grammar (plurals, location concepts, negatives, pronouns), valuing interaction and pleased with his own ability to get information from his environment.

At this stage, ask yourself: 1. Does my child seek to get needs met through speaking and gesturing? 2. Is my child continuously learning new words? 3. Does my child use longer phrases as he gets older? 4. Can my child understand actions when they look at pictures? 5. Does my child identify objects by how they are used? 6. Does my child understand and use some descriptions (big, hot, etc.)

What difference does it make?

While most children develop at their own pace within a typical range, there are some children who develop differently and may need help in developing functional communication. You may notice that your child is not doing things that other children his age are doing, and have been doing for a while. The first thing to remember is not to panic. See your pediatrician and have a lengthy discussion about what your concerns are. Your doctor can refer you to the local early intervention program, which will provide you with an evaluation of your child’s overall development, including speech and language. It is important to have a full evaluation to rule out any underlying causes of communication delays. If your doctor tells you to wait but you remain uneasy, remember that you are not just your child’s parent, but his advocate as well. Check your local directory for early childhood services.

Each state is required by federal law to provide the necessary services to children with delays in all developmental areas. Time and time again, it has proven to be an effective way of addressing developmental concerns while incorporating what you, the parent, would like to see your child doing. It is a team approach that requires discussion about where your child is functioning and where your child can be, given the appropriate services. In some cases, it may be appropriate for your child to receive direct intervention while in other cases, consultation with a speech-language professional may be what you or another professional needs in order to facilitate communication. There is no magic formula and many times, it is a combination of the two.

Seeing the Future

Whether your child is communicating as expected or whether he needs intervention, you can always help him develop functional communication. Determining what you would like your child to understand and express will give you direction for how to communicate with him. What’s most important is that communication occurs naturally and within your child’s daily routine. Meet your child where he is and begin to lay the foundation for effective communication.