I started working with a little boy we’ll call Ronaldo when he was stuck in sitting.

This happens to some babies, especially those who avoid tummy time. They learn to sit and think, “This is pretty great. I can see the whole room, and it isn’t nearly as hard as being on my tummy.”

The problem is that they may not have developed the strength and movement control needed to get themselves out of sitting.

That was Ronaldo.

We worked on strengthening and helping him become more comfortable moving from side to side while sitting. Within a month, he was moving out of sitting and crawling across the room.

He had progressed even faster than I expected. Then he got stuck again.

Ronaldo could pull himself up at the couch, although it took quite a bit of effort. Once he was there, he would wait. He wouldn’t step to either side. He wouldn’t lower himself back to the floor.

He was stuck in standing.

At first glance, this looked like a completely new problem. But it was actually the same underlying problem showing up at a more difficult stage.

When Ronaldo had been sitting, he was afraid to move because he wasn’t sure he could control the movement.

Now he was standing, and his response was the same. He tightened his muscles and tried to stay perfectly still because he wasn’t sure he could keep himself upright if he moved.

Once we recognized the pattern, we had a good idea of how to help him.

Just like before, we needed to improve three things:

• His comfort with movement
• His control
• His strength

We started by placing our hands gently around his hips and moving him from side to side while he stood at the couch.

He became upset quickly, so we slowed down and made the movements very small. As he became more comfortable, we gradually moved him farther and farther.

Eventually, he started shifting from one leg to the other on his own.

But becoming comfortable with movement was only part of the solution. He also needed enough leg strength and control to lower himself safely.

For this, we worked on starting to get control of his knee as he bent it. We placed a toy beside him at about knee height. To reach it, he had to bend his knees slightly and lower himself.

For strengthening, we practiced sitting down and standing back up.

I placed my thigh directly behind his knees and held him around his hips. Then I slowly lowered him until he was sitting on my thigh. Once he was there, we placed something he wanted on the couch to encourage him to stand back up.

With practice, Ronaldo learned to take steps to either side and lower himself from the couch.

His story illustrates something important: A child may overcome a challenge at one stage and then encounter the same basic challenge again later.

A baby who is uncomfortable shifting weight in sitting may later resist shifting weight in standing.

A baby who relies heavily on one side while rolling may show the same preference while crawling or pulling to stand.

So when your child is having trouble with a new skill, look backward.

Ask yourself:

“Have I seen a similar pattern before?”

The position may be different. The milestone may be different. But the underlying challenge may be something your child has already learned to overcome. If we use the same principles we used before, we will be able to help our child overcome this new challenge more quickly and with more confidence.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.