If your child has mobility challenges, you may have heard about standing frames and pediatric walkers (or gait trainers). While both are important tools in therapy, they serve very different purposes, and understanding these differences can help you make the best choices for your child’s care. Many children with physical disabilities or developmental delays benefit from using both a standing frame and a walker, just at different times and for different reasons.
Generally, by 12 months of age, typical developing children spend a significant amount of their waking hours standing. Therefore, children who are not able to spend this amount of time in standing have reduced opportunity to explore this developmental stage and may have compromised orthopedic development, which is essential to allow for bone, joint, ligament and muscle growth and formation. Standing frames are for children who cannot stand in neutral alignment for prolonged periods of time or cannot walk on their own yet. These devices gently support a child’s body in an upright (standing) position. Your child may be strapped in with padded supports to keep them safe and comfortable while they stand.
Standing frames help children who can’t stand on their own experience the benefits of being upright.
Parents often find standing frames valuable because they give their children a way to experience the world upright, even if just for short periods each day. Standing frames help children who can’t stand on their own experience the benefits of being upright. Think of it as a daily standing practice in good alignment – standing can improve their overall health and development.
To achieve the most benefits, children must be in the standing frame 5 days a week. The recommended timeframe is based on the specific goals/objectives, which include:
The average recommendation to achieve these benefits is 30-60 minutes of standing for a minimum of 5 days per week, though your child’s physical therapist will be able to advise you on the most appropriate dosage for your child’s goals.
Pediatric walkers are used when your child is ready to take steps with help. They encourage your child to be more mobile and independent. Walkers build strength and confidence, helping kids explore their environment and socialise with others. If your child can bear some weight through their legs, they’re learning to take steps or need help with balance, or they want to move around more freely (at home, school, or therapy), then a walker is an essential item for your child. If your child can fully weight bear and can take handheld steps, a walker can be used to increase endurance, improve gait patterning and motor planning.
Depending on your child’s abilities and therapy goals, some children benefit from both, using a standing frame during one part of the day, and a walker during another. Both standing frames and walkers are powerful tools that can help your child grow stronger, more independent, and more confident. If you’re exploring these options, know that you’re not alone; many parents walk this journey, and the right support can make a big difference. We understand it can be a little overwhelming, and you might be wondering: Do we really need both a standing frame and a walker? This comes up a lot in the clinic, and the short answer is sometimes, yes.
Each piece of equipment supports your child’s development in a unique way, and when used together, they can help your child grow stronger, healthier, and more independent.
If your child is over a year of age and is not weight bearing through their legs, a standing frame is essential; if your child can take a few steps in a walker and relies on the pelvic support or pommel, a standing frame is still essential for your child to fully weight bear in neutral alignment and receive prolonged passive joint and muscle stretches. If your child is using a walker and has lower limb muscle contractures or abnormalities in gait pattern due to high or low tone, the use of a standing frame is essential. If your therapy team recommends both, it’s not about “more equipment,” it’s about giving your child more opportunities to grow, move, and thrive in their own way.
If you’re unsure of what equipment is right for your child, have a chat with your physical therapist. They can help to assess your child, make recommendations, and support you through the trial process of the different equipment available.
