4 year old who always climbs steps with same foot

[Anonymous]

My four year old always climbs steps by leading with the same, right foot. He will do it alternating with both feet if we work with him but not on his own. He has had some mild speech articulation problems and is getting speech therapy. We also addressed some concern about his hearing by having his adenoids out and getting tubes in his ears. Finally, he is also very late and potentially stubborn about potty training. (He can do it when the rewards are great enough but usually uses pull ups and doesn't.) Does this indicate anything? It has been suggested to us that we get an OT evaluation. I don't know how worried to be.

[Anonymous]

Not super worried, but it is bilateral coordination issue

[Anonymous]

I would recommend an OT evaluation. My 4 year old still tends to lead with one step and we've been through PT, OT, and speech and so we know that it is due to low tone and weakness on one side. We've basically overcome the step thing (I believe the legs getting stronger also helps with that) but given the speech and potty issues as well, it is probably worth checking with an OT to see if there is low tone, sensory issues, etc. so you know how to best deal with this.

[Anonymous]

I agree with PP's, perhaps tone issues...but I would think a PT would be more appropriate because stairs are gross motor. I don't understand why an OT was recommended...they usually focus on fine motor skills, sensory issues and self-care--at least that was what I was told at my DD's OT eval.

[Anonymous]

I would call a clinic and describe the concerns and they will make an appt w/ the appropriate person. The potty issues combined w/ what you described could be a sensory issue which would require an OT.

[Anonymous]

My DS is 3. He was born with a disability that has been corrected through surgery. My son also climbs steps leading with the same foot. This is something that we work on with his physical therapist. I would recommend scheduling an evaluation. I do not believe that it is something your child will just outgrow.

I can't comment on the potty training - sorry.

[Anonymous]

OP, is your son aware of when he has to go? Does he recognize the sensations?

[Anonymous]

OP here. I'm not completely sure he does. He does have some idea but when he does keep his pants dry, it might be that he is just using the potty so often versus only using it when he needs to.

[Anonymous]

Anonymous wrote:I agree with PP's, perhaps tone issues...but I would think a PT would be more appropriate because stairs are gross motor. I don't understand why an OT was recommended...they usually focus on fine motor skills, sensory issues and self-care--at least that was what I was told at my DD's OT eval.

A lot of what OT's do also involve gross motor. I'm not an expert but we've used OTs and PT and it sounds like an OT would be better suited for this. If OP goes that route and it really should be a PT, the OT would be the first to say so. We started with a PT when our son was about 15 months old. He had a gross motor delay. He was meeting most of his milestones but wasn't pulling himself up as strongly as the pediatrician thought he should and he also wasn't walking. We had about a year of PT which focused on building his strength and getting him to use his large muscles effectively. He's now three and still has some weakness (which we only notice because we've been "trained" now) but we've learned enough to keep doing what he needs to improve. Once of the things we worked on was alternating steps on the stairs. He now recieves OT and is working on his fine motor skills but also his motor planning and motor/visual integration. I also have a 6 year old who's got the same issues and his OT is also working on that stuff.

[Anonymous]

OP - is your son able to run and jump like other children his age? Does he hang onto the rail when he is going up the stairs (in addition to the using only one foot)? Can he keep up with his peers with regard to gross motor skills? Does he look like he has larger calf muscles than what would be indicated by his abilities/activity level? We noticed all of these things (behind peers, using rail, one foot climbing, large calves ... turns out our son has a form of muscular dystrophy. I say this not to scare you, but to give you the warning signs that our pediatrician, OT, PT and childcare providers ALL missed; our son's particular form is typically misdiagnosed as minor developmental delay or hypotonia, and it isn't until the child is about 4-5 that the majority of cases are diagnosed. If your son has any or all of these symptoms, I would suggest you get a CK test done (a simple blood test that your pediatrician can do). While not definitive, it would lead you to further testing if required that could diagnose a larger underlying medical issue such as MD. Sometimes things like what you are seeing (and yes, speech delays can be present with MD) point to something larger than poor motor planning or hypotonia (our son's original diagnosis) when taken together as a set of observations.