Baby Bipedal

"Is your little one walking yet?" This well- meaning question can tear at the heart of a parent whose child has the developmental disability known as Down syndrome. While a child who is not developmentally disabled can be expected to begin walking between the ages of nine and seventeen months, children with Down syndrome typically begin walking considerably later--between the ages of thirteen and forty-eight months.

Two professors in the Department of Kinesiology at Indiana University Bloomington's School of Health, Physical Education, and Recreation hope to intervene in the delayed developmental process of babies with Down syndrome. Beverly and Dale Ulrich are conducting a study in which one group of these babies is encouraged to make stepping motions on a motorized treadmill. A second, control group of babies with Down syndrome does not receive the treadmill practice. The Ulrichs hypothesize that "direct practice of stepping can increase the consistency of the available pattern-generating ability and, therefore, hasten the onset of walking." The accelerated acquisition of walking skill can lead to a multitude of benefits, both for the babies and for their families.

The Ulrichs have been awarded a $370,000 grant from the National Institute for Disability and Rehabilitation Research to conduct this study. The current study has grown out of previous work that they have done in the field of therapeutic intervention for youngsters with Down syndrome--a field that Beverly Ulrich says is just beginning to mature. "At first the emphasis was on clinical treatment of the physical problems that babies with Down syndrome often have," she says. "Many are born with heart defects, visual problems, hearing problems. Now even very young babies are having these problems corrected. Doctors are recommending open-heart surgery for them, and they can receive hearing aids and eyeglasses. Until now, that's where the research funding has been going. Now that we have come that far in terms of the medical research, we need to look toward improving the quality of life for these babies."

In the mid-1980s Beverly Ulrich began experimenting with treadmills in collaboration with Esther Thelen, professor of psychology at IU Bloomington and the first scientist to do research on the stepping patterns of infants on treadmills. After conducting several studies with Thelen, Ulrich began applying the treadmill to questions about disabled individuals that her husband, Dale, was encountering in his role as director of the IU Motor Development Clinic for Handicapped Children. Eligible subjects of the current study can begin to participate when they are able to sit up well on their own while manipulating a toy. The treadmill training takes place in the babies' homes. The intervention group babies--those using a treadmill-- are guided on the treadmill by a parent as they develop stepping patterns. Every two weeks the Ulrichs and the other members of their research team visit the households of the babies' families to evaluate progress. The babies are videotaped every four weeks, and the researchers analyze the babies' movements with the help of a sophisticated video and computer system. Babies from both the control group and the intervention group will continue in the study until they can walk on their own.

The Ulrichs predict that eventually the treadmill will become part of the standard physical therapy regimen for babies with Down syndrome. "We're very hopeful about that," Beverly Ulrich says. "It may be that the intervention will turn out to be the most relevant for those babies who are at the extreme end of the delay range, those who otherwise wouldn't begin walking until they're about three or four years old, and maybe it will be less necessary for those babies whose walking ability is less delayed."

Gaining the ability to move from place to place independently, Beverly Ulrich says, transforms daily life for these babies and for their families. "When babies first locomote, they seem to begin to understand some spatial concepts, such as behind, and around, and hidden, that do not seem so clear to them when they are passively being moved around," she says. "When they shift to walking, they have opportunities for more extended play skills. They can manipulate toys as they walk around. They can share things more easily with their peers. They can socially interact more appropriately for their age group. In addition, parents have told us that when an infant with Down syndrome begins to walk, it means a great deal to them. It greatly reduces their stress."

--Karen Grooms