Q&A: 15 Month Old No Longer Progressing with Physical Therapy

Tamara Guo Child Development, Special Needs Diagnoses, Toddlers 12 - 36 Months

We’ve been in PT since 9 months old. My son went from not rolling, to rolling, not crawling to crawling, and not pulling up to now pulling up and cruising well. He is now 15 1/2 months old and has stayed in this development spot for the past couple of months. He does not stand unassisted, squat to stand or walk yet. He babbles quite a bit, but does not say definitive words yet-not even mamma or dada, although he says dada, but doesn’t mean anything specific. I’m at a loss, as to whether or not we should continue PT and look at another early intervention resource. I feel like we aren’t learning anything new with respect to exercises and are just waiting it out for him to do these last few things on his own. He has always had a cautious personality and doesn’t take the risk to try to stand unassisted etc. What would you recommend as next steps? I hate for him to get further behind so I’m desperate.

I would first suggest speaking with your son’s PT to discuss your concerns, if you haven’t already. It sounds like your son has made a lot of motor progress in the past 6 1/2 months and now that he is cruising he is well on his way to walking. I am sure it is frustrating for you if he has been in this stage for a few months now and is still not walking independently, but it sounds like since all his motor milestones were achieved at a slightly slower pace he may just need that extra time to get the strength and confidence to walk on his own (especially since you also describe him as cautious in his personality). Even though you will often read that most children walk by their first birthday, there is a wide variance in what is typical for walking and some children walk as late as 18 months, and although late, it can still be considered within average. There is nothing magical a therapist can do to make a child walk before he is ready. Some families choose to pursue outpatient physical therapy through their local hospital or clinic in addition to early intervention if you feel like your son would benefit from additional therapy. Or perhaps your PT can increase the frequency of service in-home if this option has not been discussed? On our web page you can also find some other suggestions for exercises to try at home with your son, since we have received several questions recently regarding children who are late walkers. The first two questions/answers at this link might be helpful for you to read.

Regarding your son’s speech, I would be looking for him to be saying Mama and Dada specifically by age 15-16 months, and also be using a few single words or word approximations (like saying “ba” for ball or woof for a dog). Your son should also be using gestures and vocalizations to get his wants and needs met. You may also want to address your son’s speech with your early intervention team so he can receive a speech evaluation and perhaps begin speech therapy or developmental therapy for speech if warranted. Keep in mind that his speech progress could be on hold for the moment since all his energy is going into learning to walk and this is common. We sometimes see children have quieter non-verbal periods when focusing all their energy on walking… since both talking and walking are motor skills, little kids sometimes have trouble mastering both at once. For more information on typical speech development and red flags in speech development, check this link.

Tamara GuoQ&A: 15 Month Old No Longer Progressing with Physical Therapy