From the Guidelines
Toddlers who are still requiring assistance with walking at 15 months of age should be referred for Physical Therapy (PT) as soon as possible, as early intervention is crucial for optimizing neuroplasticity and function, as highlighted in a study published in JAMA Pediatrics 1. When considering referral to PT, it's essential to note that typically developing children begin independent walking between 9-15 months, with the average being around 12 months. If a 15-month-old requires physical support to walk, this represents a potential developmental delay that warrants professional evaluation.
Key Considerations for Referral
- The child's pediatrician should be consulted to provide a formal referral to pediatric physical therapy services.
- The PT evaluation will assess the child's gross motor skills, muscle tone, strength, balance, coordination, and overall movement patterns.
- Early intervention can address underlying issues such as low muscle tone, balance problems, or coordination difficulties before they significantly impact development.
Importance of Early Intervention
According to the study published in JAMA Pediatrics 1, early diagnosis and intervention are critical for optimizing infant motor and cognitive plasticity, preventing secondary complications, and enhancing caregiver well-being.
Next Steps
Parents should not delay seeking evaluation, as early intervention during this critical developmental period often leads to better outcomes and may prevent compensatory movement patterns from becoming established. The frequency and duration of PT will depend on the specific needs of the child, but typically involves weekly sessions with home exercise programs for parents to implement between visits.
From the Research
Referral Age for Physical Therapy
- The provided studies do not directly address the specific age at which a toddler with assisted walking at 15 months should be referred for Physical Therapy (PT) 2, 3, 4, 5, 6.
- However, a study on children with Down syndrome suggests that PT, especially when started early in childhood, has a positive effect on the development of gross and fine motor skills 2.
- Another study emphasizes the importance of early identification and referrals to physical therapy for children with genetic disorders, highlighting the need for guidance and clarification in the referral process 3.
- While these studies do not provide a specific age for referral, they imply that early intervention is beneficial for children with developmental delays or disorders.
- A systematic review on physical therapy intervention for developmental coordination disorder also supports the use of task-oriented interventions, which could be relevant for toddlers with assisted walking 4.
- Additionally, a study on the effect of motor intervention for infants and toddlers with cerebral palsy found that task-specific motor training and constraint-induced movement therapy may improve motor function 5.