Delayed ambulation in young children presents a difficult problem to both parents and physician. It may be caused by neuromuscular disease. A child who is not walking by 18 to 20 months is considered to be delayed in ambulation. Assistance should be given in preambulation activities (e.g., sitting, crawling, creeping, standing) when such delay is anticipated. Balance and support are two requirements for independent walking. The use of aids, such as the tilt board, stand-up table, and parallel bars, sometimes supplies the necessary balance and support. These can be constructed inexpensively by the parents. Minimal bracing, crutches, and canes are additional ambulation aids. Disabled children usually exceed our expectations but may fall short of their parents' hopes.
Johnson EW, Spiegel MH. Ambulation Problems in Very Young Children. JAMA. 1961;175(10):858–863. doi:10.1001/jama.1961.03040100022007
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