Walking Up and Down the Stairs
Published on in Trisomy 21 Update
Published on in Trisomy 21 Update
Walking up and down stairs is a skill we do multiple times throughout a day. It becomes an automatic skill that we do not think about performing once we achieve the motor plan of stair negotiation. We see stairs in front of us and are able to easily walk up and down without much thought, with good balance and with one foot on each step.
Most children begin walking up and down the stairs around 2 years old, after they have refined their independent walking skills. Children with trisomy 21 can also begin walking up and down the stairs shortly after they learn to walk — with appropriate modifications and support for the task.
When a child is able to four-point crawl but is not yet walking independently, the child can creep up stairs and creep down the stairs backward on his belly. Many children are interested in creeping up the stairs, but may be resistant to coming down backward. Activities such as coming down off the couch and bed backward and sliding down a slide backward serve as practice for coming down the stairs backward. Some children are fearful of moving backward because they cannot see where they are going. Start a few stairs from the bottom at first if the child is fearful. Always be close to the child for supervision to prevent him from falling down the stairs. Use appropriate gates at the top and bottom of all stairs to block stair access when you are not able to assist your child.
Once your child is walking and ready to learn how to navigate the stairs, these are some helpful tips to help with success and efficiency and to help prevent injury.
Progressions I like to use when first teaching children how to walk up stairs are:
Progressions I use when teaching children how to walk down stairs are:
Helpful strategies to help children alternate their feet include:
At school, stairways tend to be busy, loud areas. Walking without a railing, with a backpack and with noise are all challenges faced at school. Ask the school physical therapist to make sure your child is safe and successful navigating stairs. Stair skills can be practiced with the therapist in a controlled, quiet environment and followed through at home to gain the necessary practice before transferring the skill to the busy school day. Timing your child while on the stairs and comparing it to the time it takes for the rest of the class to do the stairs is important information when evaluating stairs. A child may be successful at home and in therapy but have a hard time at school.
Children will encounter stairs when they go out to the playground at recess. Walking up stairs to a slide, stepping over a small curb or railroad tie, and stepping down off a small step without a railing are common obstacles on a playground. Practicing these skills at home and in therapy may help them improve on the playground.
Your child’s footwear can also be a factor on the playground and stairs. Children with trisomy 21 often have pronated feet (when feet roll inward), low muscle tone, decreased strength and ligamentous laxity. Make sure your child has appropriate footwear, preferably a supportive tie sneaker and orthotics, if prescribed. Your child’s backpack should also be considered. Make sure the bag is the correct size, the straps are adjusted correctly and your child is not carrying too many items, making the backpack too heavy.
Stair climbing is an important skill that can be improved with practice at home, during school and in therapy. Consult with your child’s physical therapist to inquire how well your child walks up and down the stairs during the school day. Practice, proper footwear and an appropriate backpack will have an impact on your child’s success keeping up with classmates during the school day.
Contributed by: Helen Milligan, PT, MPT
Categories: Trisomy 21