Toddlers. They weeble, they wobble and they fall down. A lot! The question is really, how often is too often? Toddlers are still remarkably unstable and often over-confident. Two year olds are much more confident with their physical abilities but they don’t have a very good idea about when to stop. They love to run, swing, climb, and ride on toys they can push with their feet, but they can easily get it wrong so bumps and minor falls are common. The average two-year-old falls 38 times a day. It will take time before the toddler achieves the skills, strength, balance and rhythm of a secure walker. In fact, pediatricians say it is normal for toddlers to fall, even on flat ground, until 4 years old. Toddlers are learning how to coordinate their movements for this new skill of walking. I like to remind my families that the first time they learned to ski or roller skate they fell a lot too!
In a study of 130 toddlers (12 and 19 months old), the researchers found that the toddlers fell on average 17 times an hour. If they were new walkers, they fell an average of 69 times an hour. The toddler’s height and flexibility make short falls relatively harmless. Thankfully, most bumps require a kiss and maybe even some ice to make the boo-boo better.
There are several other reasons that a toddler can fall:
- Toddlers grow at a rapid rate, and shoes that fit one day may not fit the next. If the toddler’s shoes are too small, he can suddenly start tripping, falling, or having other issues walking or running about.
- If a toddler has had a sudden growth spurt, he will need to find a new center of balance. This might mean more spills as he figures out how to move his new, suddenly taller body.
- Most toddlers are farsighted and have trouble judging distances.4 If your toddler seems to constantly “over-step” stairs or misjudges picking up toys, he may need to be seen by an ophthalmologist, as these behaviors may indicate vision concerns.
Here a few ideas you can share with families to help decrease injuries while still allowing the toddler to explore their environment.
- Childproof with walking in mind. Check for sharp corners on counters and coffee tables. Check for unstable end tables and chairs. Watch for dangling cords from electronics and blinds. Keep drawers, doors and appliances closed when the toddler is moving.
- Avoid extra-hard surfaces. Try to avoid surfaces like concrete, brick, tile, slate, and stone floors or hold your toddler’s hand while he walks over these harder surfaces.
- Bare feet! Bare feet are preferred, especially when walking around the home. If a toddler wears socks use nonslip bottoms. If using shoes, make sure they fit properly and have good traction.
- Try not to overreact. Avoid rushing to your child and making a big deal every time he falls. It can make him unnecessarily fearful of falling and can discourage him from exploring.
As early interventionist, what other ways can you encourage families to let their toddlers safely explore their environment? Have you ever provided a fall log to a family?
- Toddler Health: Bumps, Bruises, & How to Tell if it’s More Serious. http://smartmomma.com/Toddler/bumps_and_bruises_toddler.htm
- Miller D. (November 1999). Toddler falls: When should you worry? http://www.cnn.com/HEALTH/children/9911/10/head.falls.wmd/
- Adolph KE, Cole WG, Komati M, Garciaguirre JS, Badaly D, Lingeman JM, Chan G, and Sotsky RB. n.d. How do you learn to walk? Thousands of steps and dozens of falls per day. Psychological Science. 1-14. http://www.psych.nyu.edu/adolph/publications/Adolph%20EtAl%20HowDoYouLearnToWalk.pdf
- Clumsiness (Frequent Falls & Bumps). http://www.whattoexpect.com/toddler/behavior/clumsiness.aspx
This information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
Kim Lephart, PT, DPT, MBA, PCS is a dynamic pediatric physical therapist with nearly 20 years of experience. She is board certified Pediatric Clinical Specialist. She is a team player who enjoys the collaborative model of working with parents, teachers, occupational, speech and vision therapists to meet a child’s individual therapeutic needs. She has worked with children in a variety of clinical settings including private clinics, school systems, home health, outpatient rehabilitation, aquatics, and early intervention programs. She currently works for Rappahannock Rapidan’s Early Intervention Program. Of all of Dr. Lephart’s accomplishments both professionally and personally, she is most proud of her four children. She is a busy mother of children ranging in ages from high schooler to pre-schooler