As a pediatrician, I often meet moms worried because their toddler isn’t walking yet. You’re counting the months, wondering if something’s wrong.

It’s tough seeing other kids toddle while yours still crawls. The fear that this could signal a bigger issue keeps you up at night.

With 20 years of experience, I’ve helped countless families through this. I’ll explain why some kids walk late and share clear steps you can take to support your child’s first steps.

How Does Normal Walking Development Look?

Children typically begin walking independently between 8 and 18 months old [1]. Most take their first steps by 12 months. The World Health Organization considers this entire range normal, giving you room to breathe when your little one falls outside the average [2].

Before walking, several motor milestones must take place:

• Infants develop enough trunk muscle strength to sit without support.
• They start crawling, scooting, or moving in various ways to navigate their environment and build their strength [3]. Some babies might skip this step.
• Next, they often pull themselves to a standing position using furniture, then progress to cruising (walking while holding onto objects) for balance and coordination.

If your toddler is stuck in the cruising stage, don't worry. Some kids can walk independently, but prefer holding a parent's finger. They still lack the confidence to let go. That's not the same as true delayed walking.

Gender also doesn't affect walking onset. Research shows no association between when boys and girls start walking [4]. Differences only appear later in sports-related skills like throwing and hand-eye coordination.

When Should You Be Concerned About a Walking Delay?

Most children begin walking sometime between 12 and 18 months, but there's a wide range of normal. Some toddlers take their time, especially if they’re focused on mastering other motor skills.

Still, if walking hasn’t started by around 18 months, it’s worth checking in with your pediatrician, just to rule out anything that might be slowing things down. As kids grow older, like into their second or even third year, delays become more noticeable and often benefit from a more thorough evaluation.

Other concerning signs include:

• Muscle weakness
• Abnormal muscle tone
• Difficulty maintaining balance while sitting
• Significant delays in other motor milestones
• Family history of genetic or neurological conditions
• Regression in previously achieved motor skills.

How Age Affects the Level of Concern

Pediatricians often use standardized screening tools to assess walking and other developmental delays. Tools like the Ages and Stages Questionnaire (ASQ) or the Child Development Review – Parent Questionnaire help identify whether your child is meeting appropriate milestones.

These checklists look at multiple areas of development, such as motor skills, language, problem-solving, and social interaction. Your pediatrician uses them as a guide in deciding next steps.

And if a 3-year-old is still not walking, that typically points to a significant delay that requires an evaluation from multiple medical professionals.

As part of the evaluation, doctors often assess head circumference, body mass index (BMI), and other growth parameters to look for signs of underlying conditions that could affect motor development.

In certain cases, your pediatrician may also recommend neuroimaging, such as an MRI or CT scan, especially if there are signs of neurological abnormalities like persistent muscle tone issues or asymmetric movement.

Physical Causes of Delayed Walking

Congenital Hip Dysplasia

Congenital hip dysplasia affects how the hip socket forms [5]. During routine well visits in the first year, pediatricians examine hip movement.

When they detect problems, they might perform a hip evaluation and x-rays to confirm the diagnosis. Treatment for this condition usually involves wearing a harness device through age 6 months to reshape the hip sockets.

This allows the top of the femur to fit properly. If detected later or if harnessing fails, a medical specialist might suggest casting or surgery [5].

Congenital Foot Deformities

Congenital foot deformities also impair walking ability [6]. Congenital club foot occurs in two out of 1000 newborns [7]. While it may be associated with genetic disorders, 80% of cases are isolated findings [8]. Treatment involves casting to stretch muscles and reshape the foot, or daily physical therapy.

On the other hand, a condition called metatarsus adductus can create a "c-shaped" appearance in one or both feet. It also affects two out of 1000 infants [7]. Some children outgrow it without intervention, while others benefit from physical therapy, serial casting, or orthotics.

Neurological and Genetic Causes of Delayed Walking

Hypertonia

Hypertonia causes stiffness or tightness in leg and foot muscles [9]. These infants have legs that resist flexing at the ankles or bending at the knees. When held upright, kids keep their legs extended and may point their toes.

This muscle tightness, specifically in the Achilles tendons, can lead to complications. It may result in unbalanced toe-walking. Some infants also experience spasticity, where the leg remains in a very tight, flexed position.

Hypotonia

In contrast to hypertonia, some infants experience hypotonia. This condition reduces the core muscle tone, making sitting or standing upright difficult. When held upright, these babies may slide downward and out of their parents' hands due to weak trunk support.

In certain conditions, truncal hypotonia can occur alongside arm and leg hypertonia, leading to a complex mix of muscle tone abnormalities [10].

Hemiparesis

Hemiparesis causes stiffness or weakness on one side of the body [11]. Brain injury from meningitis or birth hypoxia can impair movement in one leg. The muscles may be tight, making it difficult to straighten or extend the leg.

On the other hand, the baby's muscles may be weak, which may manifest as decreased use or dragging of the affected leg.

If there's a family history of developmental conditions, your pediatrician might recommend genetic testing to rule out inherited syndromes. These tests can help uncover the underlying causes of unexplained delays.

Birth Complications That May Cause Delayed Walking

Premature Birth

• Premature infants born before 37 weeks of gestation face particular challenges.
• Those born before 33 weeks achieve walking and other motor milestones later than full-term infants [12, 13].
• Even infants born between 33 and 36 weeks may show mild delays, especially with post-birth complications.

Proper assessment of preterm infants requires using "corrected age," which is the baby's current age minus the weeks premature [14]. A 2-month-old baby born at 32 weeks (8 weeks early) should have newborn-level developmental skills. So, you should expect a two-month delay in walking onset.

Most premature infants receive follow-up care from neonatal teams after hospital discharge. When a medical professional notices a delay, they usually suggest physical therapy as the first intervention.

This can increase muscle strength or improve leg flexibility. With appropriate interventions, most infants catch up to their peers by age two to three [15].

For children diagnosed with medical conditions that impair walking, no specific "catch-up age" exists. How quickly they start walking depends on the underlying condition and response to treatment.

Intrauterine Growth Retardation

Intrauterine growth retardation restricts fetal growth due to reduced placental blood flow, maternal chronic illnesses like diabetes or lupus, or fetal organ malformations.

These newborns weigh below the 10th percentile [16]. Because brain formation and innervation are impaired, these babies experience developmental challenges including delayed walking [17].

Prenatal Exposure to Toxins

Prenatal exposure to toxins like nicotine, recreational drugs, and alcohol adversely affects the developing brain. Cocaine exposure is particularly associated with delayed motor skills [18]. These babies have increased muscle tone in their legs, making sitting alone and crawling difficult.

They often toe-walk and have balance difficulties. Most respond well to physical and occupational therapies when intervention begins early.

Environmental Causes of Delayed Walking

The most common non-medical cause of delayed walking is limited opportunities to practice. Infants and toddlers who are frequently held or carried have minimal floor playtime.

• "Tummy time" increases head and neck control while building core and arm strength. Aim for one to two minutes of tummy time or floor play after every diaper change.
• For older infants, floor play encourages rolling, crawling, and cruising. The American Academy of Pediatrics also recommends 30 to 60 minutes of daily floor play for infants [19].

Infant walkers have regained popularity despite previously being removed from the market. While babies may seem agile in walkers, they become accustomed to the upper body support in the process.

Most studies find that they delay independent walking ability. After discontinuing walker use, children typically begin walking independently within one to two months.

The Path Forward for Late Walkers

Most kids who take a little longer to walk eventually catch up, especially when no underlying medical issues are present. If your toddler seems hesitant to take those first steps or is moving more slowly than peers, it’s okay to ask questions.

Sometimes a bit of extra support, like physical therapy or more floor time, is all that’s needed. But if walking still hasn’t started well into the second year or beyond, your pediatrician can help you explore next steps and make sure everything is on track.

Proper footwear also plays a crucial role in supporting walking development. Quality orthopedic shoes designed for first walkers provide necessary support and protection while allowing natural movement patterns to develop.

First Walkers offers specialized orthopedic shoes designed to support healthy foot development in children taking their first steps. These shoes include features that promote proper gait development while protecting delicate, growing feet.