Importance of Gait Analysis for Toddlers

Independent Walking Milestone

Independent walking is a key milestone in a child’s development. It is the final of six gross motor development milestones outlined by the World Health Organization Motor Development Study (Sitting without support, standing with assistance, hands-and-knees crawling, walking with assistance, standing alone, and walking alone).¹ Age of milestones and general clinical examinations are the most typical ways for identifying motor impairments in children. However, this is inexact due to the range of ages in which milestones are achieved. For example, 1 in 10 typically developing toddlers do not reach the independent walking milestone until after 14.4 months, while 12 months is a commonly reported normal age for this milestone.² In other words, it is difficult to identify motor development delays based primarily on the age at the time of a milestone. Once independent walking starts, toddlers gait pattern develops quickly, transitioning from flat-foot stepping with no arm swing to mature gait pattern by the age of 3. These changes are all taking place in the context for rapid growth of the neuromuscular system, ossification of bones, and changes in foot anatomy as the arches form.²

Walking’s Impact on Development

While independent walking is a major milestone in motor development, it also impacts language, communication, and social development. Mobility is key for exploring the world. Walking allows a child to move through an environment quicker and with less energy exertion. Walking allows movement with free hands, creating the opportunity for new interactions allowing for touch, holding and handing objects.³ Recent research from Wilson et al. highlights the importance of tracking changes in gait function in toddlers in order to identify motor function delays and the impact those delays can have on other development.

Recent Research

The work done by Wilson et al. compared temporal spatial gait metrics from toddlers with Autism spectrum disorder (ASD) with typically developing toddlers. 51 typically developing toddlers and 45 toddlers diagnosed with ASD walked across a Zeno Walkway System and velocity, cadence, step length, and stride width were reported. The ASD group had a walking onset age of 12.8 months, which would commonly be seen as normal, but they showed a lower gait speed, lower cadence and shorter step length when compared to their age-matched typically developing peers. This indicates that after onset of walking, gait pattern is slower to develop in children with ASD. ³

The researchers point out that this slower pace leads to toddlers with ASD needing to exert more energy to explore the same space, leading to less exploration and social interaction. While the children in the ASD group had a normal onset of walking, their slowed motor development can impact social and language development as well.³