How do I make my 5yo walk?

[lollilou2]

He has motor development delay (struggles with stairs, jumping, keeping up with peers when running), hyper mobility and hypotonia.

He uses a large pushchair when out, but I’d like him to walk more. In general, he only walks about 5 minutes before he’ll ask to be in the pushchair. If we don’t bring it, he’ll just ask for a carry and not move until he gets one.

Any tips how to up his stamina?

What support is DS receiving? Does he have physio? Has he seen OT? Have you thought about things like rebound therapy, horse riding, swimming/hydrotherapy/aquatherapy? These can help build things like stamina.

How is DS’s communication? Would he communicate if he was in pain.

How is DS’s sleep? Fatigue can play a big part, especially with hypotonia and hypermobility.

Forcing DS to walk for longer than he is able to could well be counter productive so I would be careful about insisting.

Thank you for your response. Physio have give him some exercises to do at home, which we are doing. Paediatrician hasn’t mentioned getting him any OT though, but I’ll look into the other things you’ve mentioned!

He has delayed speech but does communicate when his legs hurt, the problem is the paediatrician thinks he’s relying on the pushchair too much and that he should be walking instead.

You can request a referral to OT yourself. It doesn’t need to come from the paed. In many areas, you can self refer. If you can't and the paed won't, ask the GP.

Similarly, physio needs to be ongoing rather than just sending you away with exercises then discharging.

Has DS had a biomechanical assessment? This is often done by podiatry.

Does DS have an EHCP? If so, physio (and things like rebound therapy that I mentioned) can be included in there.

It’s all well and good the paed saying DS needs to walk more, but if the alternative is DS not walking, which is what is currently happening, then it actually reduces mobility because you will get to the point where avoid going places. If DS has developmental delay more widely, which it sounds like DS does, then the not walking could also be due to DS’s other needs, such as sensory overwhelm. If that’s the case, lots find an SN buggy or wheelchair helps them cope with the environment (people, noise, sun/lights…) in public. Things like sunglasses, ear defenders and a big hood can also help if these are issues.

Thank you for such a detailed response. I will definitely fight for more help for him. He is getting assessed for ASD, but no EHCP.

He’s also had genetic testing which all came back normal- while seeing the genetic physio he did say that although his ankles roll in, DS wouldn’t need orthotics or podiatry, just more walking.

There’s times we do avoid going out as I don’t drive and using public transport with this pram is terrible- it’s awful to fold, we get funny looks as if he’s too big for a pram.

Does he enjoy swimming?

I think swimming a couple of times a week could help.

You can request an EHCNA yourself. On their website, IPSEA has a model letter you can use.

For the times you do use the buggy, you can get tags that say the buggy should be treated as a wheelchair i.e. you should have priority over other buggies on the bus not being used as wheelchairs.

Yes he likes swimming, is there any certain activities we can do when he’s there?

EHCPis likely to get rejected - there’s non verbal children in DS’s school who require one - to - one and even their parents are having to appeal to get an EHCP for them.

Many parents have to appeal, some more than once, but it doesn’t mean you shouldn’t request an EHCNA. The vast majority of appeals are upheld. LAs refuse to save money, not because DC don’t meet the legal threshold. From your posts (delayed speech, delayed mobility and motor skills, obviously some social communication and interaction difficulties if DS is undergoing an ASD assessment), DS definitely meets the legal threshold and you should make the request.

I'm not an expert - as @BrightYellowTrain says, hydrotherapy is one avenue to explore. But if lack of walking is from lack of muscle tone or joint weakness, then non weight bearing exercise can only help?

Would a balance bike be fun for him? You can get quite light ones now so they’re not such a drag to carry when not in use. They are very good for building up leg strength.

(Said someone who knows nothing of the conditions he’s struggling with )

Any swimming where he's using his legs is going to help I'm sure, even just walking around in a pool. Would snacks help? Go for a walk, when he's had enough head home and distract him with a snack for the walk back. Start by taking him out for a few little walks a day and build up perhaps.

With hypotonia, a trike may work better than a balance bike. You can get SN for older children with a handle on the back, so if DS needs a rest, you can push.

Make it fun! Walking for the sake of walking is not most 5 year old’s idea of fun. Get him to somewhere fun without walking and then get him out the buggy. Does he like playing in water (streams, the beach, splash parks) or in the woods, or at a big play park that he doesn’t normally get to go to? Does he like playing with a ball with you or walking round a museum or an aquarium or a farm park? If he’s having fun he will do as much as he is able. Give him lots of opportunities to do fun things but don’t push him beyond his limits physically, in a sensory sense or in any other way.

It is so easy when a medical person says do x, to get yourself into a state about. I’ve been there. Small changes over time are best. Maybe one extra trip somewhere each week, which gets longer over time as he gets used to it or builds up stamina.

Have you investigated disability sports in your area? If he’s struggling to keep up with his peers he might find the more supportive, more inclusive and more positive vibe at disability sports better for him. The people who run them are generally really good at making sure everyone feels good about themselves.