As children gain sufficient strength in their legs, arms, torso, and neck they will usually begin to attempt to pull to standing, crawl and cruise. Movements like these require both strength AND coordination of muscle movements. Children who have significant challenges may take a very long time to achieve this ability. Additionally, achieving the ability to balance in these positions and while moving requires even more skills. Some children have vestibular challenges as a result of a syndrome or because of medications. They may never feel completely comfortable moving and be reluctant to stand. Having opportunities to practice movement in an upright position is very important, even if the child never becomes able to walk independently.

Utilizing such Active Learning equipment as the HOPSA dress and Support Bench can help children develop these skills. You can also create Activity Walls that encourage the child to reach up and stand to interact with objects.

Below is a picture of a little boy using a HOPSA dress beside an Activity Wall.


 A Support Benches allow the child to move both arms and legs in a coordinated fashion as they would when crawling. Here is an example of a child using a Support Bench.









Below is a picture of an Activity Wall. At first the child may explore it in a sitting position. Placing the child on an Essef Board or other device that requires some ability to balance may also be a good idea if the child can sit without support. As the child begins to reach, he may pull up to his knees and play with things that are placed higher on the wall. Then, in time, he may pull up to standing, begin to cruise along the wall to explore items, and practice sitting down and standing up.


Attaching a ladder to a wall or a series of bars that the child can pull up to standing provides opportunities for independent practice of that movement. Below is a picture of a ladder with interesting objects attached to it and an Essef Board at the base. This would allow the child to work on pulling to standing, shifting weight, and balancing.









Ideas for Home

Having these pieces of specialized equipment can be very helpful, but even if you don't have these available you can provide environments that you can share with your child to achieve the same goals.  It is important to note that a child's safety is the most important thing when using any of these devices or materials. Adult supervision is critical. Never leave a child alone to play in these environments, however keep your support to a minimum. The child needs to try to do it on his/her own in order to achieve the skill. 

Use a low bench or hard bottom swing to position your child for crawling. Make sure the bench or swing supports the child across the chest and hips and is low enought to freely move arms and legs in the containers you place in front and behind. SAFETY FIRST! The adult MUST SUPERVISE THE CHILD AT ALL TIMES to make sure he/she does not roll off or topple the bench. These are not designed like the Support Bench which has more safety features in its design.

Below is a video demonstration of how this activity might look.

pulling to stand collage