Delayed Walking in Toddlers: How Paediatric Physiotherapy Supported the Journey to Independent Walking
This case study is part of a new series where one of our lovely paediatric physiotherapists shares real-world learnings from children and families we support through physiotherapy. This is a real case involving a child seen through our mobile paediatric physiotherapy service in Greenacre, NSW. To protect the family's privacy, all identifying information has been removed or changed.
Our hope is that by sharing these anonymised stories, families can better understand how paediatric physiotherapy and NDIS-funded supports may help children experiencing similar challenges.
When a Toddler Isn't Walking Yet
One of the most common reasons families seek paediatric physiotherapy is concern about delayed walking.
While every child develops at their own pace, some toddlers need additional support to build the strength, balance and confidence required for independent mobility.
This case study follows the journey of a young toddler who was referred to physiotherapy due to delayed walking and gross motor development concerns.
Presenting Concern
When physiotherapy commenced, this toddler was primarily moving around by crawling and cruising along furniture.
The family reported that their child could stand briefly and take a few assisted steps but lacked the confidence and balance needed for independent walking.
As childcare was approaching, parents were increasingly concerned about how their child would manage playgrounds, walking between activities, and keeping up with peers.
Assessment Findings
Physiotherapy assessment identified several factors contributing to delayed walking:
Reduced standing balance
Limited confidence when moving away from support
Difficulty turning and changing direction
Immature walking pattern when taking independent steps
Challenges negotiating obstacles and uneven surfaces
Importantly, steady progress was already emerging. The child was motivated to explore their environment and demonstrated increasing interest in standing and walking activities.
Physiotherapy Approach
Therapy focused on building the foundations for independent walking through play-based activities that could be incorporated into everyday routines.
Rather than concentrating solely on walking itself, intervention targeted the underlying skills required for successful mobility, including:
Standing balance
Postural control
Squatting and returning to stand
Transitional movements
Obstacle negotiation
Confidence moving between surfaces
As mobility improved, therapy goals became increasingly functional, reflecting real-world activities the child would encounter at childcare and in the community.
Progress and Outcomes
Over time, the child progressed from taking only a few uncertain steps to walking independently for meaningful distances.
Other improvements included:
Increased standing endurance
Improved balance during play
Greater confidence carrying toys while walking
Ability to transition from floor to standing independently
Improved ability to navigate obstacles and uneven surfaces
Increased participation in daily routines
By the end of the intervention period, walking had become a regular part of the child's day rather than something that occurred only with encouragement.
While some aspects of gait maturity were still developing, the child had made significant gains in functional independence and confidence.
How Physiotherapy Can Help Delayed Walking
Walking is more than simply taking steps.
Children require a combination of strength, balance, coordination, postural control and confidence before walking becomes efficient and reliable.
Paediatric physiotherapists assess the specific factors affecting a child's mobility and develop individualised programs to target those areas.
Treatment may include:
Balance activities
Gross motor skill development
Strengthening through play
Environmental challenges
Parent education and home activities
The goal is to support participation in everyday life, not just achieve a milestone.
When Should Parents Seek Advice?
Consider seeking a physiotherapy assessment if your child:
Is not yet walking independently
Seems unusually unsteady
Frequently falls
Relies heavily on crawling
Avoids standing or walking activities
Has difficulty keeping up with peers during gross motor activities
Early assessment can provide reassurance for families and identify practical strategies to support development.
Can NDIS Physiotherapy Help?
Many children with developmental delays or gross motor difficulties may be able to access physiotherapy through NDIS funding if they meet eligibility requirements.
NDIS-funded physiotherapy can help support:
Gross motor development
Independent mobility
Participation at childcare or preschool
Home and community access
Family education and goal setting
The specific supports will depend on each child's needs and goals.
What Parents Can Learn From This Case
Every child develops differently. Delayed walking does not automatically mean a child will experience long-term mobility difficulties.
This case highlights the importance of:
Early assessment when concerns arise
Consistent practice within daily routines
Focusing on balance and confidence, not just walking
Setting meaningful goals linked to participation and independence
With the right support, many children can make significant progress in their walking and gross motor skills.
Frequently Asked Questions
Is delayed walking common?
Delayed walking is one of the most common reasons young children are referred to paediatric physiotherapy.
Can a child still be developing normally if they walk late?
Yes. Some children simply require more time and support to develop the strength, balance and confidence needed for walking.
What does a physiotherapist assess in a child who is not walking?
A physiotherapist will typically assess gross motor development, balance, strength, coordination, movement patterns and functional mobility.
Can physiotherapy help once a child has started walking?
Absolutely. Physiotherapy often focuses on improving balance, turning, obstacle negotiation, stair skills and confidence after walking begins.
This article was written by Shashini Soysa a senior paediatric physiotherapist at Sydney Child Physio.
If you have concerns regarding your child’s coordination, strength, flexibility, endurance, or motor control contact us to have a paediatric physiotherapist assess your child in the comfort of your own home.