Poor balance , poor core strength , high guard hands

Hello, my daughter has been walking since 13 months , now 18 months . She still has poor balance , has her hands up most of the time in high guard , slightly pronated feet , and seems to have poor core Strength. She does have Ocular Torticollis ( 4th nerve palsy ), but I was told by her Opthamologist that wouldn’t cause the things above . Any help?

Hi and welcome to our community!

Is your toddler in PT currently? I can understand why the ophthalmologist would say that the eyes don’t directly cause poor core strength or balance, but we have to think of the whole body all together and when sight is developing atypically as in the case of ocular torticollis, depth perception can then be under developed. Babies learn depth perception as their eye work against gravity in tummy time and this can absolutely be affected in this case. If a baby struggles with vision it’s very common that the child would move more cautiously and show more clumsiness.

Has the dr. offered any treatment plan? There are vision therapists and many developmental optometrists recommend prism glasses to help improve vision for this type of case.

It’s all about looking at the whole body as one structure and how each part affects the rest. If your daughter isn’t in PT, it’s probably a good idea to start.

Happy to help with any other questions you have!

Thank you so much for your response . She is in PT virtually , but all I ever hear is “she looks fine” . As far as treatment for the ocular tort I was told my only option is surgery ? Which I am waiting until she gets a bit older … are there other treatments for this I should be exploring?

You are so welcome.

I don’t know enough about your daughter’s situation and the eyes are obviously not my speciality, but I do know that developmental optometrists focus on this area, usually more than opthamologists so that may be something to look into.

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@Starfishtherapies @OT-Philippines @Otholly @BreeMilani @NicoletheCOTA @Tinytotspt @madPT @PT4kidz80 @OTmomma

Does any of you have any tips to offer the mom?

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Following because my daughter, 18 months has similar PT concerns, torticollis, mild pronation due to hip weakness and weak core, and I’m getting a third opinion for ocular torticollis. I will say, we switched to in person private PT because we weren’t seeing what we needed with virtual and having hands on therapy.

Good luck, mama!

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Wow they sound very similar … how is her walk? Were you told she does not have ocular tort ?

It’s so hard without knowing the child but it sounds like really focusing on core (and the vision). Is she able to stand still? If not, work on her standing balance so she can easily stand still and engage with a toy. If you can use inserts to correct the pronation that also helps because it sets the foot up to provide a better foundation. Where are you located? Can you look at other options for PT?

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One said she had it, another day she didn’t. She walks well, just has those weaknesses and a bit less nimble than other kids. But seems ok.