Physical Therapy Tips for Your Child: Walking Up and Down Stairs

Learning to safely and functionally walk up and down stairs is an important preschool skill. Practicing and mastering this skill will help your child to develop strength, smooth control of the leg muscles, balance, coordination, and safety awareness.

Like most motor skills, there is a developmental progression for walking up and down stairs. Walking up steps is typically easier than walking down and is frequently mastered first during each step of the developmental progression.

Developmental progression for walking up and down stairs: (note: often walking up develops first)

• Creeping on all fours up steps forward and down steps backwards

• Walking up and down steps with two hand support

• Walking up and down steps with one hand support (on railing or adult)

• Walking up and down steps independently holding one hand rail, placing two feet per step (sometimes referred to as “marking time”).

• Walking up and down steps without hand support, placing two feet per step

• Walking up and down steps independently holding one hand rail and alternating feet (placing one foot per step)

• Walking up and down steps independently without hand support alternating feet

Tips for helping your child improve skills on stairs include:

• Practice stepping up and down curbs with hand support at first. This will help your child to develop the leg strength necessary to walk up and down stairs.

• Use a railing that your child can reach and hold onto. Spindles (the vertical posts that hold up a banister), may be easier for a young child to grasp than a banister because he can choose his preferred height for grasping.

• When placing two feet per step, most children lead with their dominant leg walking up steps and their non-dominant leg walking down steps. Allow your child to choose which leg he prefers to lead with until he is ready to alternate feet.

• To walk up steps facing forward, your child will need to step up with his preferred foot and then lean his trunk forward over the step and over his foot.

• When holding your child’s hand to go up stairs, position yourself behind your child and hold his hand in front of his chest at or below shoulder level. This will prevent you from pulling him up to the next step and will help him to develop arm and leg strength to lift himself.

• When your child is first learning to go up steps with hand held assistance, it is best to have your child place two feet per step, marking time, rather than alternating feet.

• When holding your child’s hand to go down steps, position yourself in front of your child two steps below him and facing him. You will step down the steps backwards and hold his hand in front of his chest. Help him to focus on one step at a time.

• When your child is learning to use a railing, your may need to hold your child’s hand on the railing and help him to advance it up or down. Ideally, your child’s hand should grasp the railing in front of his body. When your child is ready to walk up and down steps with only one hand on the railing, encourage him to hold a small toy in the other hand. This may help him to forget about holding your hand.

• When your child walks up the top two steps alternating his feet, he is likely ready to practice alternating his feet up stairs. He may need encouragement and prompts to lead with his non-preferred leg because, when marking time, only the leading leg needs enough strength to lift his body weight. Prompts can be given by helping to lift under the thigh of the non-dominant leg. Your child may require practice leading with the non-dominant leg up curbs to build up strength. He may also need prompts to advance his hand up the railing each step rather than only before stepping up with his preferred leg.

• Alternating feet down steps requires more strength, balance, and control than alternating feet up steps. It is easiest to first learn to step down the last step with the non-preferred leg and then gradually alternate down from each higher step. To teach alternating feet down steps, you can use the verbal cue to “reach” with each foot while you touch each foot alternately to prompt him to switch feet. You can also use visual cues by pointing to each step as your child reaches with his foot.