You moved to the fourth stage, having mastered and consolidated the program of the previous three, i.e. Has your child learned to stand up actively, crawl and turn around on all fours, sit correctly and stand at support on high knees and feet? It's time to study the program of a new stage!

If these skills are not available to your child or are not being done automatically, it is worth returning to the previous steps.

Tasks of the fourth stage

1. Stimulation of independent walking along low supports.
2. Stimulation of independent walking along the walls.
3. Independent walking.

Problems of the fourth stage

1. Standing up with two legs.
   

   

   

   
2. Low mobility.
3. Poor balance, fear of walking.
4. Pathological feet position
   

   

   Photos 1, 2. Feet of a healthy baby: the fingers are slightly bent, the arch is raised, the foot forms the maximum area of support.

   

   Photo 3. The feet are flat-valgus, toes are directed to the sides, the tendency to the X-shaped legs position.

   

   Photo 4. On tiptoe (equine feet position)

A child who has gone through all the stages of development according to the IDA (ideal development algorithm) and can stand independently at the support will begin to walk without any outside help. Moreover, such «help» can often be a disservice. Stimulating walking by holding hands, using walkers and jumpers can delay the physiological formation of movements. The same practice applied to a child who does not necessary skills according to IDA can lead to the development of pathological actions and in severe cases can cause CP (Cerebral Palsy).

Nowadays, we can quite often meet children who know how to stand up at the support, but who do not know how to crawl. The main reason is a disorder of the natural sequence of development (IDA). In such a situation, it is necessary to stop completely the stimulation of vertical positions, to master sequentially the exercises of the second and third stages, providing corresponding to these stages’ conditions of everyday routine; motivate a child to move independently around the residence.

Standing up from two legs at the same time most often means the presence of lower central paraparesis, which is usually accompanied by a disorder of feet installation and requires an emphasis on the exercise «low start».

EVERYDAY ROUTINE. EXERCISES OF THE FOURTH STAGE

4.1
Games standing at supports with the height of the child navel or a little bit higher contribute to the separation of hands from the surface during manipulations. Being involved, a child plays, gradually losing contact with the support.

4.2
Stimulation of walking along low supports. A child is standing by the sofa with the feet shoulder-width apart. We are forcing them to make independent side steps inside.

4.3
We draw the attention of the child standing near the low support on the side (at arm's length) with the placed object. If the child reaches with the hand, but they are afraid to make a step, we cover the palm of the outstretched hand, making it easier to make step-close. We increase the number of steps alternately in both directions at low support.

4.4
Stimulation of walking along the walls. With the help of interesting pictures (objects) located on the wall at the level of the child’s head in a standing position, we stimulate the child’s movement to them from low supports.

4.5
If a child has X-shaped legs, we make conditions for standing astride with the help of valgus feet placing or the «GOAT».

ATTENTION! Be sure to test the child with basic exercises of the third stage: «monkey», «Buddha», «seal», «rider», «low start». If difficulties arise, we focus on mastering.

With the formed habit of sitting in a W-shaped position, we fight with it using the «CATERPILLAR» and «TUBE».

EVERYDAY ROUTINE. EVERYDAY ROUTINE COMPONENTS OF THE FOURTH STAGE

For any child who has learned to stand up independently, the following conditions must be created.

1. The most frequent stay on the floor.
2. Spending little time in comfortable sitting positions, including eating time: an adult's hands, as well as high chairs, deck chairs, chairs, strollers, etc. with soft backs. All positions where the child comfortably leans the back are at least unhealthy.
3. Hard surfaces under the feet. Frequent and lasting standing on soft and uneven surfaces can cause the development of equinus, flat-valgus foot. A child crib, soft carpets, an adult bed, and adult legs make a false idea about support.
4. Grip minimizing. Standing positions, even with the most correct development, are difficult for children in contrast to the already familiar fours. A significant increase in height above the surface causes delight and fear at the same time. Trying to hold in place, the child grasps for any suitable item. Mostly, a household inanimate object is immovable (cribs, a plaid hanging from a sofa, furniture elements) and, helping to stand up or hold in place, does not help in any way. The child is forced to let him go and look for a new one or use support of other suitable objects. Leaning on objects and walls with an open hand, the child uses the opposite muscles used for grip, their antagonists - extensor muscles. This means the maximum inclusion of the legs muscles and feet in particular in the process of maintaining balance. Toes tighten, knees a little bit bend, feet are stepped widely and parallel to each other. The child maintains the balance. This is the development of walking without hands participation. How does walking develop in conditions where the ability to stay is constant, most often it is the fingers of adults? The child gets used to the constant tension of the flexor hands muscles; the need to include legs in the process of maintaining balance does not appear. A child with an intact nervous system and musculoskeletal system, naturally, begins to walk independently. However, such development is often accompanied by prolonged shakiness of the gait, insecurity, fear of walking independently, walking on tiptoe, X-shaped legs, flat-valgus feet. Leading by hand has a more negative effect on a child with perinatal damage of the central nervous system.
5. It is undesirable to use tools that facilitate verticalization. The use of walkers and jumpers, holding by hands distorts the child's idea of walking and also contributes to the formation of pathological feet position.
6. Walking barefoot on rough surfaces which irritate feet. It is especially important for children with valgus (flat-valgus) installation (deformation) of the feet and equinus (tiptoe). In the cold season, indoors, the best rough surface is spiky dirt-collecting coatings or a short-pile office carpet. Getting used to such irritants can be in socks, the thickness of which must be gradually reduced. In a warm season, we walk bare feet on the ground, grass, asphalt. Everyone can imagine the effect of such an impact, remembering walking barefoot on small stones or gravel. It’s impossible to stand on tiptoe, fingers tighten (it is very good on the contrast to popular beliefs), the arch of the foot rises, protecting delicate skin.

WEARING ORTHOPEDIC FOOTWEAR IS NOT ABLE TO ADJUST THE PATHOLOGICAL FOOT INSTALLATION.

Independent activities are organized under the principles set above. The position on the hands of an adult, the position and conditions for sitting and feeding are similar to those used in the third stage. The bathing position does not matter.

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