Before we can move forward and address questions about what may happen in the future if it is left untreated, we must first take a look at the child right now. Consider the following things first:

~Age of your child: Typically, if a child is not yet bearing weight on his/her feet on his/her own, he/she is not yet appropriate for any kind of foot orthoses or orthotic insert. Weight bearing not only includes walking but also sitting with weight shifting forward through legs, pulling up and standing, and cruising are all forms of bearing weight through the feet.

~Muscle tone of your child: Most physical therapists, occupational therapists, and physicians can help you determine whether your child has normal, high, or low muscle tone, which would then direct you to the appropriate type of orthotic support if necessary.

~Strength of your child’s feet and ankles: If you notice that your child has a tendency to stand with more weight through some parts of the feet versus others, or that his or her tolerance for standing seems less than normal, discuss possible causes with your physical therapist.

~Physical abilities of your child: ask your physical therapist what the normal gross motor skills are for a child of his/her age. Determine whether your child has an easy time completing these skills, or if he or she might be able to complete a task easier and in a more energy efficient manner by wearing orthotics.

It is also important to note that in typically developing children, an arch in the foot is not yet developed until between the ages of two and three. Before then, a child’s foot will look different than an adult’s, both in sitting and in weight bearing positions. This does not necessarily mean that your child is not a good candidate for orthotics, but is simply a variable that should be taken into consideration.

If your child is an appropriate candidate for orthoses, whether it be for “flat feet” or some other condition, your physical therapist can direct you on the next steps. Your child will require a prescription from a physician if the orthotic is to be covered by insurance; however, there are “off the shelf” options that may be appropriate as well. Your child may also require a letter of medical necessity if the orthotic is to be covered by insurance.

Lastly, it is important for you as the parent or caregiver, your physical therapist, and your orthotist, to have open communication about the ideal orthotic for your child. Orthotics can be a big commitment for some families, as they are worn daily, and only in certain shoe styles. It is critical for all members of the team to be in agreement so that the child may receive the best outcome possible to continue to promote his or her development.