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12+ months: Climbing stairs PDF Print E-mail
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Tuesday, 17 January 2012 02:19

Greater than 12 months: Climbing stairs


Evaluate stair climbing at 2 years and up


Muscle weakness results in difficulty with stair climbing, which can be noted early.  Children who are weak often avoid stairs.  When going up stairs, they often crawl or stop to rest.  Children who are weak use their arms excessively to pull themselves up the stair railing, and do not alternate feet (go step-over-step).  Going down stairs, children who are weak also lead with one foot and usually have to hold onto the rail (but do not have as much difficulty as when going up).  

What does climbing stairs for a weak child look like?


Any child who uses the stair railing to pull him/herself hand-over-hand up stairs at any age (not just using rail for balance) needs further evaluation. Any child who cannot go up stairs alternating feet step-over-step by 3.5 years needs further evaluation.

Therapist Response to Red Flag

Evaluate in light of overall strength. Communicate specific concerns about stair climbing (in context of overall development and relevant environmental factors) the family and referring provider.  Provide evidence for weakness rather than poor coordination as a cause for the delay.  If weakness is suspected or identified, encourage a referral to a specialist (consider pediatric neurology) for a diagnostic evaluation.   

Specialist Response to Red Flag

Evaluate in light of overall strength. Draw a CK.  Refer for diagnostic workup if weakness is suspected or identified.

Download a pdf of the Surveillance and Referral Aid for Therapists and Specialists. This Aid includes signs of weakness by age, red flags and warning signs for muscle weakness, and referral recommendations.
Last Updated on Tuesday, 04 September 2012 21:52