Children initially begin to walk between the ages of 12 and 15 months. In the early stages of walking, you may notice your child “waddling” with their feet wide and their arms out like an airplane. Once a child has become more comfortable with walking, you may notice them becoming “brave” and attempting to walk fast or even run. As a child goes through these stages of development, you may find your him or her falling several times during the day.

It’s normal for children to fall frequently as they are learning to walk. In the early stages of walking/running, a child is learning to plan movements, find their balance and explore new-found independence.

As children gain more control of their body, you will find they begin to walk with a narrower base and their arms are at their side. A child will walk/run with decreased hesitance and you should notice less falls. This will occur within the first 2-3 years of learning to walk.

When should you be concerned about your child’s falling? There are many different reasons why children lose their balance throughout the day.

• Pay attention to when your child is falling and ask yourself a few simple questions:

• Did the type of shoe he or she is wearing change? Often times children have difficulty finding their foot placement with new shoes, especially ones that are heavy (such as a boot) or non-supportive (such as a sandal or slip-on shoe.

• Are they only falling when reaching a curb or changing surfaces? Sometimes vision can play a big role in a child’s ability to maintain balance with walking and running. If you suspect a visual deficit, you should contact an eye care specialist.

• Does your child only fall when playing with peers their age? Children have to think constantly about their next move when walking/running during play. You may find that they will trip or fall when attempting to keep up with peers their age. This could be the cause of decreased coordination, meaning they are having a difficult time organizing movements during play, causing them to fall.

• Try to pay attention to how your child is falling, sometimes a child may have a difficult time clearing their toes when walking/running and will fall. This would be good to mention to your pediatrician for possible referral to a physical therapist.

If your child is falling more than 10 times per day and doesn’t fit into the above categories, it may be beneficial to talk to your pediatrician about a physical therapy evaluation to assess your child’s needs.

About the author

Morgan Hubbard, PT, DPT, is a physical therapist at Cook Children's. Physical therapy at Cook Children's focuses on large motor and functional skils to enhance development, restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's has Rehabilition Services in locations in Fort Worth, Hurst and most recently in Mansfield. If you would like to schedule an appointment or speak to our staff, please call 682-885-4063.

Last month alone, eight children were taken to Cook Children’s Emergency Department after being hit by cars while walking or riding bicycles. The same number of children were injured in February.

“Over the past couple years, we’ve seen the numbers increase,” said Sharon Evans, Trauma/Injury Prevention Coordinator at Cook Children’s. “We can’t say why this is happening, but we do know children do not have the cognitive skills to cross a street safely by themselves until they are at least 10.”

According to a new study released by the University of Iowa, 10 may still be too young. Researchers suggest children may not have the perceptual judgment or motor skills needed to safely cross a street until they are 14 years old. The study used virtual reality to simulate a busy street. Then, children, ages 6 to 14, were asked to cross multiple times.

The results show the children, up to their early teenage years, had a difficult time deciding when to cross the street. The study also evaluated how often the children were involved in an accident during the simulation.

Accident rates from the study:

· 6 year olds – 8%

· 8 year olds – 6%

· 12 year olds – 2%

So what do parents need to know?

Do not allow children under the age of 10 to cross the street by themselves. Even better, wait until they are a teenager and able to confidently know when to safely cross.

Cook Children’s recommends teaching these behaviors before allowing a child of any age to cross the street alone:

• Look left, right and left again before crossing the street. Cross when the street is clear, and keep looking both ways while crossing. Walk, don’t run.
• Understand and obey traffic signals and signs.
• Walk facing traffic, on sidewalks or paths, so that you can see oncoming cars. If there are no sidewalks, walk as far to the left as possible.

“When I visit children who have suffered pedestrian injuries, the most common thing they tell me is that they thought the driver saw them,” explained Evans. “It’s important to teach your children that just because they see a driver, it doesn’t mean the driver sees them. They need to make eye contact with the driver and wait for the driver to stop and signal to them before attempting to cross the street.”

Multiple studies suggest that walking even 20 minutes daily can decrease your risk of mortality and improve your quality of life. Read how a busy working mom finds the time to exercise, and read her perspective on the many benefits of regular exercise. Come on moms out there! You can do it! If not for yourself, then for the long term health of your family.

New year. New you!

From Alison Groom:

Being a working mom of three small kiddos is a hard job for anyone, but finding the time to be healthy and active while being a working mom of three kiddos can be a tough job in itself. For me, finding the time to do something active can be hard and I am certainly not perfect at making it a daily priority, but I do my best to do it as much as possible throughout the week.

What I have recently noticed is that my kids watch and mimic every single thing I do. The way my 3 year old talks to her baby dolls is often a reflection of how I speak to her. The same goes for what I eat and how I live my life. Statistics say that if a parent smokes cigarettes, the children in the home will likely smoke as an adult too.

This is also the same for being active. If my children learn the fundamentals of being healthy and staying active as kids, they will likely continue that throughout the adolescent years and into their adult lives. My 7 year old has started wanting to exercise with me and will often ask to run on the treadmill when we are playing in the driveway. I keep our treadmill in the garage because it keeps me from having an excuse not to run.

I am a wimp when it is cold and I do not run when it is raining, so if it is in the garage, I have zero excuses for why I cannot run on a cold or rainy day. We often go for "family walks" after dinner too. We look like a circus sometimes with my 3 year old wanting in and then out of the stroller, the two giant dogs getting tangled leashes or tripping up my 6 year old, but it is family time. It is a time that we talk about our day, we teach our kids about nature and try to find interesting new things to discover. It is also a great time to talk about being healthy and about the benefits of walking and exercising for our growing bodies. It is exercise that allows us uninterrupted time with our precious kids, which is a win win if you ask me. J

Exercising does not have to take an hour to do. I work from home, so when I put my kids down for a nap, I hustle out to the garage to run on my treadmill. It may only be a 10 minute run, or a 20 minute fast paced walk.

Sometimes, I only have time to do a couple sets of pushup and sit ups, but that is better than nothing! A walk around the block can quickly turn into two laps around the block, and then to a mile and so on. Making a conscious effort to walk faster while grocery shopping can be a simple step toward elevating your heart rate and getting your metabolism up for the day. The hardest part about working out for me, is putting on my shoes. Once they are on, I am ready to go.

Make a decision for yourself and for those precious children who ARE watching your every move to be healthy. Take twenty minutes out of your day for you to have a moment for yourself. Exercising is also a GREAT way to release your tensions and anxieties of your day. I often take a moment to run or workout just to clear my head and have a moment to do ME for a minute. That can be so hard for people to do, but it is so beneficial. I promise, if you take twenty minutes to yourself each day, you WILL be a better mother, a better wife, and a better you. Look into different methods of exercise. Reach out to friends, neighbors, or family to see if anyone is also wanting to exercise but needs someone to hold them accountable. Having a partner to walk with around the neighborhood or do a workout video with when the kids go to bed is great! It gives you some time to interact with another adult, vent about your day, and also to be held accountable to doing your workout each day. Start with baby steps and find the right workout or activity for you. If you find pleasure in what you choose, you will likely stick with it.

Last year, the Cook Children's Trauma team saw 22 children, either biking or walking, who were hit by cars from August through the month of October. Eight children were hit by cars in September and 10 in October. 

But with school already started, so are the dangers of kids and cars.

Already, a teen was hit in front of a high school in Crowley. The injuries seem to be minor, but it places an emphasis on how vulnerable children are near or even in front of schools.

More children are hit by cars during September than any other month of the year, according to Safe Kids Worldwide.

“Children do not have the cognitive skills to be crossing streets safely alone until at least age 10,” said Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s. “They haven’t yet developed the depth perception or the ability to maturely judge the speed of an object.”

Kids age 10 and younger should not walk or ride bicycles, scooters or skateboards alone to school because they:

• Are easily distracted by friends and toys.
• Can’t determine the direction of sounds. Some children may be listening for sounds and may not realize that some newer model electric/hybrid may not make much of a sound at all.
• Can’t judge the speed or distance of a moving vehicle.
• Don’t understand how long it takes a vehicle to stop.
• Have too narrow a field of vision.

Even when kids reach age 10, it’s still best for parents to accompany them to school whenever possible.

Teaching Your Child Pedestrian Safety

“When I visit children who have suffered pedestrian injuries, the most common thing they tell me is that they thought the driver saw them,” explained Evans. “It’s important to teach your children that just because they see a driver, it doesn’t mean the driver sees them. They need to make eye contact with the driver and wait for the driver to stop and signal to them before attempting to cross the street.”

While teaching your children to ride their bikes or walk to school, don’t forget to tell them to cross only at crosswalks; look left, right and then left again; and to watch for cars that are turning or backing up. The best way to teach your child pedestrian and bike safety is to be a good role model yourself. It’s also a good idea to encourage your children to wear bright clothing and reflectors when they’re walking before dawn or after dusk.

"It’s important for parents to remember they are the most important models of proper pedestrian behavior for children," said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. "Parents should also make sure they follow the rules when they are driving in school zones, including going the speed limit at all times through the zone and not texting or talking on the phone."

Safe Kids recommend teaching your kids these safe behaviors:

• Look left, right and left again before crossing the street. Cross when the street is clear, and keep looking both ways while crossing. Walk, don’t run.
• Understand and obey traffic signals and signs.
• Walk facing traffic, on sidewalks or paths, so that you can see oncoming cars. If there are no sidewalks, walk as far to the left as possible.

Practice safe behaviors:

• Don’t allow a child under age 10 to cross streets alone as he may not be able to fully appreciate the speed of cars on the road.
• Require children to carry a flashlight at night, dawn and dusk. Add retro-reflective materials to children’s clothing so that a child can be seen by motorists, even in the dark.
• Don’t let kids play in driveways, unfenced yards, streets or parking lots. Drivers may not see or anticipate children playing.

Interactive Infographic: How to not get hit by a car - Safe Kids Worldwide

With an average of 44 kids getting hit while walking every day in the U.S., it’s time for action. HOW TO NOT GET HIT BY A CAR is a fun new interactive infographic that guides walkers through seven common ways kids get hit by cars, and seven ways to avoid it. Parents and kids alike give it great reviews; not only do they think it’s fun to experience the action, they can usually relate to it. Try it out and see if you make any of the common mistakes when you cross the street.

Try the interactive infographic from Safe Kids

For more information

Whether it is the correct use of a child passenger seat, drowning prevention education in the schools, or providing a better awareness of poison hazards to new moms, we are working to create safe homes and communities for children.

• Bicycle safety
• Car safety
• Safe Kids Tarrant County
• CARE Team
• Drowning prevention
• Human trafficking
• Oral health prevention
• Poison prevention
• Sexting
• TV and furniture tip-overs