This is my new walker (about 1 month walking). He CAN sit on his own. But often he is sitting as pictured. Head will be back or head will be chin to chest.

Took his pants off today so I can observe his legs. Is this normal for a new walker?

I've googled, but my search terms aren't pulling up anything similar.

I'm sorry for the sideways pics. Although straight on my end, they are uploading sideways.

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That top picture is especially concerning. I'm no means qualified to say yes or no but I'd certainly want to have him looked at by a pedi. I've never seen a new walkers legs look like that.

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It looks like knock knees!

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http://www.childrenshospital.org/con...oms-and-causes

No clue about the sitting though. Can he cross them?

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I've never seen a child with legs like that. I it were my own, I would definitely get it checked out.

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I had a child enrolled in my center who had this, and the pediatric orthopedic specialist wasn't at all concerned. He DID NOT sit like that, though and had no trouble otherwise. It's more severe than we typically see but it's reallllly common to some degree in children, they just usually have a lesser degree of it and chunky thighs hide it, too.

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https://community.babycenter.com/pos..._kneesbow_legs

has a picture of how I see many toddlers looking in the ankle width area.

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Yes, he can cross his legs.

I thought of knock knees too but his looked so severe I didn't know if they would be considered knock knees.

Do knock knees cause pain? He just sits all day long. Doesn't play or eat. He is currently sitting on a rug with 3 other children his age. A wooden block is about 5 inches from him and instead of engaging with the blocks/children he is playing with the snaps on his onesie. I am taking into account separation anxiety and parallel play for this age (18 months) but something just seems off.

I've noticed when he immediately stands he isn't as "knee knocked" as the pictures. But once he is standing for 1 minute+ his legs go inward, hi torso goes to the left and he pelvis juts out.

FWIW, he is also unable to step over things. EX: the dividers that divide my grass and gravel, it's maybe an inch high. He stops or trips on it. Won't pick his feet up to step over it. Same with the patio poor coming inside from outside.

I am trying to 1) give him a proper adjustment period an 2) gather all of my info/thoughts before bringing it to mom's attention. At home she says he runs, eats a ton and plays. Here? Totally different child. Sits, doesn't eat, play, engage or reach for things.

Him sitting normally:

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Maybe it's knock knees combined with an overall lack of muscle tone. Sitting with his legs so far out makes me feel like it's a trunk/muscle control issue.

Knock knees also shouldn't affect gait and movement. That's definitely a red flag.

The kiddo in the center had no pain, and played/acted normally other than his knees looking obviously different. They are that severe, and the ankles almost roll in when he stood for a long time.

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Looks like hypotonia to me, given the head back or forward stuff. Could be an explanation with the knee knocking too. I'd recommend he be evaluated and send along a written page of what you're seeing at daycare, include pictures if you can and when these things are happening.

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Is there anything on his physical form?

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No, nothing noted on his form.

I too thought of low muscle tone.But also read that low muscle tone isn't an actual diagnoses but a symptom of a larger more in depth diagnoses.

He fatigues so easily. But does he fatigue easily or is used to being babied, used to being carried and is mad that I expect him to walk on his own and therefore is appearing to be fatigued?

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Possible undiagnosed CP?

https://www.abclawcenters.com/freque...erebral-palsy/

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I need a medical degree for this job lately, I swear!

I have my own ?? about a dck, but I'm hoping the parent sees it (motor skill issue) It's on the pedi form as 'potential gross motor delay noted'

but when I showed it to the dcm, she acted clueless and has commented 4 times about how athletic he is like his Dad (I have seen her FIVE times total so...)

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You have no idea how many times this thought has occurred.

Think mom is in denial?

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The first photo definitely raises some flags. Can you mention it to DCM?

"Hey Susan, I'be been observing Johny and I noticed that when he stands his knees tough and his ankles don't. His lower legs splay out at an angle. It could be something that he grows out of but it's my obligation to bring up anything out of the ordinary and since I have never seen this in any other daycare children in the X number of years that I've been doing daycare I feel a sense of urgency to bring it up. I really think it's important to take him in to his pediatrician as soon as you can get him in and mention my concerns to his DR. I'd also like to give you a note to give his DR. with my observations and a few photos as examples for his DR to see. If there is something atypical going on with his legs it's best to notify his DR as soon as possible so it can be monitored and if any physical therapy is needed it's best to start as young as possible for the best chance of getting it corrected before he gets a little older and it's harder to repair. Again, it could be nothing but my experience and gut are telling me it's important enough to bring up again to his DR."

Something like that that is sensitive but still communicates the urgency for possible intervention. She could be in denial. Does he have a hard time keeping up with other children his age in your care? Perhaps bring that up as well? It's possible that he doesn't interact with children his age other than daycare so maybe DCM and DCD don't have any other comparison and they don't know.

It's great of you to be concerned. Thank you for caring

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My kid with CP does this. With the head, it's because it's the easiest position (requires less muscle to hold his head up when he lets it fall back).

I'd definitely suggest to parents that he gets assessed at a children's hospital by experts. I wouldn't leave this to his PCP, who has already missed it.

At a minimum, I'd guess that the child needs some physical therapy. Cerebral Palsy is often undiagnosed until the child ages. Are you aware of any problems with his birth where CP could have occurred?

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I was thinking about this also. I can think about several instances when I was concerned over something either for myself or my children and it was noted yet brushed off by our PCP. It wasn't until I asked for a referral for a second opinion or went around them to a different DR that anything was done about it. Sometimes it was nothing but at least 3 times it was something serious (my DD's severe ADHD, my DS's speach impairment, my DH skin cancer on his face).

Without us as adults insisting a potentially severe issue can continue with no intervention

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My daughter has that...she's 7, and has had orthotics to correct it since she was 2. It's working, we're avoiding surgery.

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SMH. People have NO CLUE how much stuff we have to deal with. Seriously, we are ALL Wonder Woman!!!

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Yes I absolutely plan to bring it up to mom. I intend on sending an email with my observations and pictures along with my suggestion to get an eval. I just feel so strongly that something is not right. There is too much going on in multiple areas of development. I am taking separation anxiety into consideration.

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I wonder, since he is so new to walking, that this is a matter of his balancing himself until he leg muscles get stronger.

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Definitely something up here for sure. All of the behavior combined does not indicate knock knees to me. He has never been seen by a DR (or the dr is an idiot) I can pretty much guarantee it! Mom is lying. No way this child is running around at home etc.

Trust your instincts. I would look up different types of bone diseases or issues like hip dysplasia. That can cause all sorts of issues. To me this is what it looks like. The bones are not fluid, might be misaligned or joints out of socket that sort of thing?

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I agree that would raise some red flags to me. I would talk to DCP about what you see/ your concerns.

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either that or no kid experience to base anything from. I'm seeing more of that- only children, no close relatives, no babysitting in high school experience even. Many of my daycare parent's first times caring for a child is their own.

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Spoke to mom last night at pick up. I was originally going to send an email and just decided to address it then and there. Showed mom the pictures and described what I see here, mom was surprised. Said DCB doesn't do any of that at home.

At home he eats like a horse (they have to tell him to slow down) he plays, sits upright, maneuvers corners well (here when walking he only walks in straight lines. When it is time to turn or pivot he falls to the ground.) I asked if his pedi has ever mentioned possible low muscle tone, she said no.

Little one is due for his 18 month check up and immunizations. Mom said she would likely schedule that this month and talk to the pedi about it. She said his stance when standing wasn't normal, but really didn't seem too concerned.

Mom also mentioned he gets a bottle of oatmeal in the morning before coming here..... I try to not be concerned with what parents do at home (their home their choice) but this one shocked me. I was so shocked I didn't think to ask why he drank his oatmeal instead of eating it with a spoon but I did wonder if that is contributing to his none eating here.

I'm at a loss. I have had kids with severe separation anxiety. Sleep and eating schedules have been changed and social butterflies turned introverts, but the children adjust usually within a month and things are back to normal. I have never had psychical discrepancies due to separation anxiety. Is that even possible?

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I don't think dcm is being honest with you. There is definitely something physical there...that wouldn't magically change at home. In my opinion, she is either just denying it, or really out of tune with her child.

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I had a dck once with hip dysplasia and had a similar gait while standing. My dck had to have surgery and a lower full body cast for a few months.

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Oh gosh, poor thing. I hope he/she is okay now!

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I have seen a lot of this in my community, but thankfully many of my parents have had experience with nieces, nephews, friends children, etc.

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Ask mom for a video.

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this! Ask for videos of him doing all the stuff at home so you can see how he is at home so you can try to replicate it at your house.


This way it doesn't look like you are calling them a liar

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Do you think mom is being honest? Ask her for a video and see what happens. No way a child without any developmental issues completely changes their personality and physical abilities because of separation anxiety in my opinion!

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Mom said she was going to take a video so she could show me. She jokingly called DCB a liar. I told her I would like to see the video - I hope she shows me one tomorrow as I am truly stumped here.

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I asked our physical therapist about this. She said the leg thing could be normal. She said that this happens when kids learn how to walk, BUT that if it continues or if it has been going on since BEFORE walking, then orthotics could be necessary.

The other things I mentioned to her, though, she said sounded concerning. The PT said that there COULD be muscle tone issues that could be addressed.

I would refer the child to birth to three for a complete evaluation, and hope that they can identify any issues. Birth to Three will evaluate for FREE, they can even come do it at daycare if the parents are "too busy" and sign a release.

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Thank you for this!

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