Four year old still using pram and not toilet trained?

[BeanJuiceq]

I’m just looking for advice -

my four year old son refuses to walk more than 2 minutes at a time before he says his legs are tired - checked by GP, nothing looks abnormal. Does anyone have any tips to get him walking more?

Also, he refuses to poo on the toilet. He will happily wee on the toilet, goes all night without an accident - but will poo in his underpants still.

any advice appreciated ☺️

...

One of mine we just had to wait for it to right itself over time. It was compounded by ADHD and an ability to ignore any toileting messages when hyperfocussed. However since then, and with subsequent hypermobile DC we have had the advantage of a) earlier diagnosis and b) a really, really good, albeit private, OT who worked with us to improve interroception. We had to drive an hour and ten minutes each way, once a week for over a year, but it was life changing. PM me if you'd like details.

Also, @BeanJuiceq , have a look at his feet or get him to a podiatrist. Walking became much easier for all once they had orthotic inserts in their shoes, as walking on hypermobile / flat feet can be like trying to run on sand dunes, all the time. It also runs in families - my DM has just been given orthotic insoles at 78 and suddenly has no foot or ankle pain at all 🤦.

Were you using a toy pram?

Or is your child unusually large?

Get done neurological tests done your gp or a physiotherapist should be able to check them.

I’ve just read high grade myopia and Strabismus Is a sign too, can anyone clarify? He’s not ‘high grade’ but wears a -4.50 prescription lens.

It can certainly be part of it. We all (as a fully hypermobile family) need a reading prism in our glasses to force our eyes to work together, and I have an eye that gets lazier when I am tired as I get older. It makes sense, since hypermobile EDS is a connective tissue disorder involving too much collagen so, eyes would also be affected.

I'm sorry this has all landed on your head at once, it can be a shock. But the earlier you find out, the more adjustments the school can make to help.

Get rid of the pushchair.

Like PP have said I'm also not one for armchair diagnosis but this limited walking at the age of four COULD potentially be a sign of a medical issue and particularly when you couple it with the toileting issues. Does he go to school or nursery, you said school but just wanted to check he's in reception not nursery? As if he's not in reception yet he will still be under your health visitor so I'd make contact with them in the first instance and tell them your concerns. If he's in reception it will have to be the GP instead.

We are a few yrs behind you OP, my DS just turned 2 so obviously not the same and people don't bat an eyelid at him being in the buggy but I can foresee judgey comments as he ages, he's significantly behind his peers in gross motor development. This is because he is hyper mobile in most of his joints, has completely flat feet, femoral retroversion (a problem with his hips), and therefore a very odd, unsteady gait and tires easily. He wears orthotic boots that the hospital provides and he's under the orthopaedic team just for monitoring, he will have a review in about a year. He has previously been under the physios too for advice and monitoring until he started walking confidently (late walker at 21 months). Interestingly he suffers from constipation and a horrible cycle of witholding and nappy rash etc too which is all quite distressing for him, never knew there could be any kind of link.

Obviously I'm not suggesting your son has the same diagnoses/issues as mine but it's worth getting him reviewed. We've found we really had to push again and again for any kind of review or assistance, even though my DH is a healthcare practitioner himself and knew straight away there was an issue when his walking was delayed.

Can I ask if it’s the GP who can diagnose or if he will need a referral? Also, do they use the Beighton Score on children of his age? He doesn’t seem very flexible to be honest!

Some GPs will diagnose, but they're not always well-trained in it and often spout total nonsense (they initially told me NICE would "only allow diagnosis in adulthood, once the child had stopped growing". This was both bollocks and actively harmful).

My DC saw Dr Nathan Hassan, who appears to have now retired, but who recommends his Paediatric Rheumatology colleagues here privately, which was not cheap but was very effective as it plugged us into a group of professionals who dealt with all aspects of hypermobility.

However, if you can get a referral to any paediatrician who knows about hypermobility / EDS it will be a very good start.

My DS hasn't been diagnosed with a "condition" per se just hyper mobility in most of his joints. This was assessed and noted by physiotherapists. My DS was referred to them by the health visitor. Hypermobility in children is common and usually isn't caused by any underlying condition and usually improves as children age.

Well been to see GP, give his legs a check and said everything looks normal ☺️

Hi everyone! How did you get on op? Sorry for jumping on but those of you with dc diagnosed with hyper mobility how did you get your diagnosis? I’m at my wits end with everything and don’t seem to be getting any help

I'd tell him the buggy is broken and put it away so he can't see it. Tell him he's a big boy and can walk now. I'd encourage him to go on his bike or scooter every day to strengthen his legs. Maybe get a trampoline too if you have a garden so he can bounce to strengthen his legs. If he doesn't use his leg muscles they will remain weak.

@Spirro my son was in a regular silver cross pram until he was just turned 7 (he’s Asd) and needed it for anxiety/sensory issues. It was slowly breaking tbf as he is big for his age too!