Applied Evidence

Developmental Trajectories of Locomotor Skills in Infants With Down Syndrome.

Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association · 2026 · Cohort · PT

Ellen N Sutter, Ashley N Collimore-Doherty, Erin Wilkerson and 2 others

PMID 42397384

Infants with Down syndrome spent less than 3% of play time moving around and did not increase this as they gained new motor skills.

Even after learning to walk, most of their movement stayed on the floor, unlike typically developing peers.

Key findings

1Infants with DS did not show an increase in percent time locomoting with age or with acquisition of new motor skills, while TD infants showed a significant increase with age.

2At each motor skill level, a median of less than 3% of the session was spent locomoting for infants with DS.

3Among infants with DS who had attained cruising or walking milestones, upright locomotion accounted for an average of 25.1% of overall locomotion time, while 74.9% was spent using floor mobility.

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What it does not show

Only 13 infants with DS, and only 2 achieved independent walking during the study, so conclusions about the transition to walking are very limited. All DS infants were recruited from a comprehensive care center and most were already receiving physical, occupational, or speech therapy, so findings may not apply to infants without access to these services. The small sample meant the study could not examine the role of co-occurring conditions such as sensory impairment or cardiac surgery. The TD comparison group was not directly matched to the DS group in age or skill level; all available TD data were included to reflect variability in typical development.

The easy way to misread this

Do not read the 74.9% floor mobility as evidence that infants with Down syndrome cannot walk or should not be encouraged to walk — only two of the thirteen infants achieved independent walking during the study, and the finding describes a movement preference pattern in those who could walk, not a motor inability. Equally, do not assume the less-than-3% locomotion time reflects a global activity deficit; it is specifically the proportion of a structured 30-minute play session spent in locomotion bouts, not a measure of total daily movement.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →


The study

Participants
13 infants with Down syndrome (≤24 months, able to sit independently, not yet walking independently) and 25 typically developing infants (6–20 months, independent sitting)
Certainty of evidence
Low

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Ellen N Sutter, Ashley N Collimore-Doherty, Erin Wilkerson, et al. Developmental Trajectories of Locomotor Skills in Infants With Down Syndrome. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association. 2026.

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