3 things to think about as your child develops; Part 1

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Most of us as parents understand that our children would have achieved certain developmental milestones at certain ages, whether it is cognitive, social, behavioral or motor. As a physiotherapist, my interest lies greatly in the motor development of young children! For example, catching thrown items at 4 years old, skipping at 5 years old and so on.

There is a good reason why doctors and researchers have always used milestones to check in on the development of your young child. It gives them a way to understand whether your child is growing well physically and cognitively, as it requires both the maturing of the connections in the brain as well as the bones and muscles in the body to allow your child to develop into a healthy, playful, cheeky young person.

Both are inter-related! We need an environment where our child is allowed to grow and explore to build their physical bodies. As that happens, their minds are also connecting the dots between themselves and the world, expanding their perceptual and cognitive abilities. As the connections in their minds grow, the body is also influenced positively as the child responds physically to problem solving. A child intrigued by a puzzle will begin to handle the small pieces and attempt to fit them into the right places – an example of both cognitive and motor development influencing each other.

Parents should be aware of certain conditions in their children that may be influenced by motor development:

Knock-knees (Genu valgum)

It is common for young children to have knees that look like they are touching each other up till the ages of 7 years old, as the body is adapting to their growing height and weight. This is called physiological knock-knees and by age 8 to 10 years, the child’s legs will have settled in to what will likely be their adult alignment.

Knock knees in children are not usually a cause for concern and should improve as your child gets older – however, certain things might require getting a consult to identify if something else is contributing to the child’s knock knees. If the knock-knees:

  • Persist beyond the ages of 7 and seem to be getting worse, or
  • Only appears on one side, or is much worse on one side, or
  • Causes complaints of knee pain or difficulty walking, or
  • Causes clumsiness or poor balance
pink children shoes

It is worth identifying if the cause could be weaknesses around the legs that can be corrected by exercises or orthotics. Persistent knock-knees (knock-knees that extend past the ages of 8 years old) may not be a danger, but it can contribute to increased likelihood of ankle sprains or knee injuries as the child grows older.

Flat feet (Pes planus)

Flat feet is common in toddlers ages 10-14 months as they begin to walk, and the bones, connective tissues and muscles in their small feet being to adapt to the loads placed on it. They slowly grow out of it until the ages of 6 years old when the feet arches begin to develop well, and by the ages of 13 years old, a youth’s foot will usually have taken on it’s final adult form.

In between the ages of 6 to 13 years old, an active child has the chance to develop the strength of their feet well. It is only when a child begins complaining of pain in the feet especially after increased activity that a check should be done, to identify if decreased muscle activation in the small muscles surrounding their feet are contributing to impaired foot function, weakness, and their flat feet.

flat feet in children


Scoliosis is known as lateral curvature of the spine at least 10 degrees, with rotation of the vertebrae within the curve. Idiopathic scoliosis is most commonly seen in young children, typically presenting during childhood or adolescence. A simple and quick way of checking whether your child may have scoliosis is through what was call the Adam’s Forward Bend Test.

adam's forward bend test for scoliosis
With the feet together and palms facing each other, bend forward at the waist until the back comes into the horizontal plane.
juvenile scoliosis
If the child appears to lean more to one side, or a visible hump appears on one side (not symmetrical), then the child potentially may have scoliosis.

What causes idiopathic scoliosis is unknown, but early rehabilitation and chiropractic care may help in the associated weakness, posture, and potential prevention of worsening of the curve.

As with many conditions of the body, it can be hard to figure out what’s normal and what’s not as your child develops through the years. A signal that something is wrong is when they start complaining of discomfort or pain after activities – but even without any pain, and you notice a difference in the way your child walks, it could always be good to get it checked out.