How To Teach A Child With Apraxia To Ride A Bike

How do you teach a child with apraxia to ride a bike?  The same way to get to Carnegie Hall. practice, practice, practice (plus a few more tips below)

Question:

I am wondering if anyone has some ideas that would help me teach my almost 7-year-old, Jaeden, to ride a bike. He has moderate-severe verbal apraxia as well as gross and fine motor involvement. What I have noticed is that his core strength is weak and balance is a little affected. He has low tone. He desperately wants to be able to ride a two-wheel bike, but it is so difficult for him. Has anyone else experienced this? If so, what worked for you? I am also interested to hear if this is a common issue for kids with apraxia.

Answers:

Apraxia is typically multifaceted, so there may be other soft signs co-existing such a hypotonia (low tone) that you will be dealing with along with the motor planning deficits.  While some may choose an adaptive bike, the good news is that the global soft signs are common, and most children with apraxia do learn to ride a bike.  As with all complex and unfamiliar tasks, the unknown and uncertain can create barriers.

Answers below primarily from members of the Cherab Foundation for teaching a child with a motor planning impairment like apraxia to ride a bike are varied but in general, from reading through what works for most people you want a lightweight bike where you can lower the seat so that our child can touch the ground, remove the pedals so your child can use it to start as a scooter/glider.  Teach on the grass on a slight hill to start, and make sure they have the proper safety equipment on so that if they do fall they won’t get hurt.  The average age most learned to ride a 2 wheel bike was around 6 or 7 years old.   In general, your child will let you know when they are ready to try whether it’s before or after you are ready to teach it.  “Nothing great was ever achieved without enthusiasm.” Ralph Waldo Emerson

Balance Bike

“Temporarily turn the bicycle into a balance bike. (In fact, a balance bike is an ideal toy to help a child learn balancing techniques needed on a bicycle.) Go midway up a slight hill, and hold the bike while your child gets on. Have him or her put both feet on the ground, then let go of the bike. Tell your child to lift his or her feet about an inch off the ground and coast down the hill without pedaling. Because the bike is coasting slowly, the child can put his or her feet down if scared.”

“My son was 8 when he learned to ride a bike by first learning balancing on a scooter. A scooter is much easier to learn balancing being so low to the ground. After that, my son was able to transfer that concept of balancing without too much difficulty to a bicycle.”

“If your son gets frustrated, get him a balance bikes 3 wheel scooter to practice his balance, steering, and handbraking. ”

“Balance bikes provide an excellent alternative for learning balance, probably even better than training wheels. Balance bikes separate the steering and balancing function from the pedaling function, so the child can concentrate on learning to balance without the distraction of pedals.”

“I got my son a Strider balance bike. He HATES pedaling his tricycle and I decided that learning steering and balance first would make learning pedaling later less stressful.”

You can either purchase a balance bike or turn any bike into one by lowering the seat and removing the pedals.  Outside of saving money, there are practical reasons you may just want to purchase a regular child’s bike.

Lower the Seat Remove the Pedals

“This is the general idea of what I did to teach my son. The key points are

1. Remove the pedals and lower the seat
2. Have them push themselves forward with their feet
3. Once they master going straight, have them work on turning
4. Once they can push themselves every step without tipping (it’s harder for a child than it seems) then get them to go two steps (kick glide, kick glide) then three steps (kick, glide, glide) and so forth
5. Once they can do this, have them lift their feet up and push them by their seat (and be ready to prevent tipping) and let them glide further and further.
6. Once they can glide for 15′ to 20′ straight, have them repeat this and add turns.

This process teaches them balance. Training wheels are mainly for preventing hurt little bodies.”

“Make sure the seat is low. We had our daughter sit on the bike by herself to get the feel of it. We then did the usual pushing her. We finally let go. We had our daughter ride in our living room for awhile.  It was a slow process because of all the motor planning involved. The last thing she learned was starting the bike by herself. This was a big challenge along with turning. She is now going over a tiny ‘ramp’ that her father put together for her(a very determined little girl) Make sure your child is old enough as some may need another year or so.”

“Make sure your child can touch the ground easily.  Ask your child to stay seated on the bicycle and raise his or her feet an inch while trying to keep the bicycle balanced vertically. Count aloud to make a game of how long your child can keep the bicycle balanced at a standstill without touching down an outstretched toe.”

“Remove the training wheels and lower the saddle so your child can put his or her feet flat on the ground when seated. Adjust the handlebars to a comfortable position”

“Remove the pedals to start and make sure the seat is low enough so that your child can rest his feet on the grass.  Use a grassy area that has a slight slope.  Bring him to the top of the grassy slope and have him go down a few times at first using his feet, and gradually have him lift his feet more often.  Once your child masters balance, then put the pedals back on.  Hold the bike in the front or back and have them practice pedaling.  We also have a bike with training wheels so my son knew how to pedal but some kids have to learn how to pedal too.  Next step is with the pedals on, have him go down the grassy slope with his feet in the pedals so that when he gets to the bottom of the grassy slope he starts to pedal.  You can gradually raise the seat once he has his balance.”

“Make sure the seat is low. We had our daughter sit on the bike by herself to get the feel of it. We then did the usual pushing her. We finally let go. We had our daughter ride in our living room for awhile.  It was a slow process because of all the motor planning involved. The last thing she learned was starting the bike by herself. This was a big challenge along with turning. She is now going over a tiny ‘ramp’ that her father put together for her(a very determined little girl) Make sure your child is old enough as some may need another year or so.”

“Make sure your child can touch the ground easily.  Ask your child to stay seated on the bicycle and raise his or her feet an inch while trying to keep the bicycle balanced vertically. Count aloud to make a game of how long your child can keep the bicycle balanced at a standstill without touching down an outstretched toe.”

“Remove the training wheels and lower the saddle so your child can put his or her feet flat on the ground when seated. Adjust the handlebars to a comfortable position”

Grass

“Newly mowed grass is preferable to tall grass, which creates friction that restricts the bike’s momentum. The ideal location has a slight slope and is at least 20-25 yards in length and ends with a gentle uphill slope to gradually slow down the child’s bike speed.”

“You may want to try the grass first, it slows the bike down and the fall its softer. ”

“Take them someplace grassy with a slight hill.”

“I taught mine to ride without training wheels by using a grassy curb to push off from in the school’s parking lot. The raised grassy area is in the middle of the parking lot- worked great!”

“Put the bike on the grass and get in front or back of it for support.  Have him try to peddle just for a bit and then stop and put his feet on the ground.  Then repeat the cycle.  They need to know what it feels like.   That’s how my daughter learned.”

Lightweight

“Make sure the bike is lightweight. We bought Jeremy a larger bike, and it was too heavy for learning. We went to Goodwill and bought a $15 bike that was smaller and lightweight. He learned how to ride on it.”

Kindergarten Teacher/Mom Of Apraxic Twins Advice

“I’m no PT but these are just some of the things that have worked for my own children and my children at school.   I run along on one side and put my hand on their knee and say push down and usually press it down and make a gigantic deal out of it and how the other knee is going up..and again I use words with the whole process..whatever works like “push down”, “push down”.  When the training wheels come off I only teach on the grass.  My 2nd child taught me that after he decided to take his older brother’s bike and teach himself at 3- I turned around and he was riding.  Like why teach them on the sidewalk? (other than it is easier to pedal)  It works best going downhill.  Also, you can get those things for the pedals that your feet stay in and won’t slip. Good luck! ” Kathy

Bike Camp

“We took my then 7-year-old to a bike camp called Kids On 2 Wheels. It is a one week camp to teach kids with disabilities of all kinds to ride bikes. It was nothing short of amazing. It was staffed by volunteer PTs, OTs, students, phy ed teachers, etc. The camp attendees were kids with autism, down syndrome, and several kids like my Kyle that you couldn’t really tell what their disability was. Our camp even had one young man come that was a dwarf probably in his 20’s. They use various graduated equipment to progress the kids through to biking independently. They start with bikes with a kind of a roller on the bike instead of training wheels, then to a bike with REALLY fat tires, then they ride a tandem, and then hopefully they ride on their own. The equipment is all theirs, and they adapt it to fit your child. By the end of the week, often your child is riding their own bike, which they help you adapt to fit appropriately if needed. I know someone who is trying to bring the camp to Minneapolis next summer. She is working with the camp director, who I think is out of UW-River Falls, to find a school that would be willing to host it. If it comes to your city, I would highly suggest going. It was SO worth it for us – my son went from being afraid of his bike with training wheels to riding completely independently by the next week. They travel to many different locations – hopefully, they will be near you!”

icanshine.org used to be known as losethetrainingwheels.org  Find a program for learning to bike or swim  Or search to see if there are any other bike camps near you.

Remove the Pedals and Lower the Seat.  The Sustran Method

The Sustran method illustrates why purchasing a regular child’s bicycle may be better than purchasing a balance bike.  This video provides a  practical demonstration of how to help a child cycle free of stabilizers by one of Sustrans’ experienced School Officers

Article about the Sustran method by Michelle Woo Parenting editor, Lifehacker

“Remove the pedals and lower the seat so that the child is able to plant both feet on the ground. (Alternately, toddlers as young as 18-months can start with a balance bike, though Sherratt says these bikes might not last as long as parents hope because children often quickly want to move onto real bikes.) With the child sitting on the bike, show her how to use brakes.

Glide Forward With “Giant Steps” and “Kangaroo Hops”
When the rider is ready, encourage her to move forward on the bike by taking giant steps (Sherratt shouts “Fee-fi-fo-fum!” so the child can imagine being a giant). After she’s gotten the hang of that, have her do “kangaroo hops,” which are essentially big, smooth glides.

Put One Pedal Back On
Left or right, it doesn’t matter, Sherratt says. After it’s on, have the child sit back on the bike. Stand behind her, hold onto her back and wiggle her a bit with the brakes on to make sure she’s secure.

Practice the “One-Pedal Scoot”
Have the child place one foot on the pedal and scoot forward using the other foot. Keep reminding her to look straight ahead—not down at her feet.

Put the Other Pedal Back On
It’s time to ride.

First go: Have the child sit on the bike with both feet on the pedals. Hold onto the child’s back and upper arm to begin and tell her to look straight ahead and start pedaling. Keep holding onto the child as you walk forward and then slowly release your grip. Say “stop” after about 10 feet.

Second go: Hold the child’s back and upper arm, and have her start pedaling on the count of three. Slowly let go and as she rides, step back to exaggerate the distance she’s traveled. Say “stop” after about 20 feet. Get excited about how far she went.

Third go: This time, only hold the bike handle and the child’s clothing so she feels more independent. On the count of three, release her and let her ride for as long as she wishes.

Finally, after cheering your child on, step back and maybe hide the fact that you’re crying a little. We know. Look at her go.”

Teach your child to ride a bike in minutes with Pedal Magic 

Lynn P. a mom from the Cherab Foundation wrote, “I taught my son in 10 minutes.  I also have watched many children with motor planning issues learn in our office parking lot with the OTs using this method. It’s all about understanding that you turn the handlebars into the direction you are falling. But the natural tendency is to turn away from the fall. It is very simple you hold the handlebars and tilt the child in the bike 15 left and right. Until they correct the wheel correctly at least 5x in a row. Correctly is turning the wheel toward the tilted side. Then stand behind them holding the seat repeat the same. Once they correct it appropriately you give them a push and off they go. You need a big lot because they go in a big circle at first! My son was low tone and no matter what I did he just couldn’t stay up and was so frustrated with falling. This corrected it perfectly. He understood which way to turn the handlebars to stay upright after 10 min of practice.

More Step By Step Tips

“As soon as you begin teaching your children to ride bikes, encourage them to start out with proper safety equipment. This even goes for kids who ride tricycles.

It’s a lot easier to get your children into the habit if it’s established early. To make it fun for them, you can buy a plain helmet and let them customize it with stickers and markers. Don’t forget gloves and knee pads, too. A child who falls and gets hurt may get turned off bicycles at an early age, and at best will take longer to learn because of fear. Having their own gloves makes them feel special; they’re a much better bike accessory than streamers, bells, or baskets.

The first and most important skill for kids to master is that of balance. The ideal bike for learning how to balance is actually a bike that’s too small or too short for efficient riding. The rider should be able to sit on the saddle with both of their feet flat on the ground and their knees slightly bent. The bike can then be used as a hobby horse to increase their balancing skills with the feet always ready to stop a fall.

Another good way to practice balance is using the balance beams at the park. I also found that my daughter loved to practice her balance by doing yoga with me.

In the beginning, it may be useful to remove the bike’s pedals so that the feet can swing freely. Ideally, the bike you’re using will have at least one hand brake, so that the child can stop while using both feet for balance.

A good place to practice balancing and stopping is on a grassy field, perhaps with a slight downgrade. If the bike doesn’t have a handbrake, you can always install one yourself with minimal cost and effort.

Unfortunately, it’s often difficult for parents to justify the expense of a smaller bike that will be outgrown shortly, so there’s a constant temptation to buy a bike that’s a bit too large on the theory that the child will “grow into” it.

On level ground, get your child to sit on the bike and push it along with his or her feet. Once they get used to this (after about 15 minutes), try to give the bike a little push and get them to lift their feet off the ground. You can also find a gently sloping road where they can coast downhill at a safe speed to get used to the feeling of balancing the bike when it’s in motion. Once they’re comfortable, try to get them to steer the bike to one side and then the other. It should take about three lessons like this, of about an hour each, for your child to master balancing.

At the end of the third lesson or so, fit the pedals back on to the bike. (You’ll have to monitor the right time to do this; some children are quicker to learn balance than others and will soon get bored with coasting. Similarly, less coordinated children will take more time to get comfortable on the bike.)

You’ll have to hold the bike upright for them at first by gripping the middle of the handlebar with one hand and the back of the saddle with the other. A gentle push should be enough to get the momentum going for them to start pedaling. Don’t hold the handlebar while they’re riding because it will prevent them from feeling and understanding the balance.

Try to get them to relax and not to grip the handlebars too tightly or tense up their bodies. They’ll begin slowly at first, maybe three or four pedal revolutions, but by the end of the fourth session, they should be able to ride for more than 50 feet without putting their feet down.

During this time, monitor your child’s progress and evaluate whether the saddle can be raised to give them greater bio-mechanical efficiency. In the learning stage, try not to raise it beyond the point where the child can reach the ground. Raising the saddle will often improve their steering, especially if the bike is small for them.

Once they’re comfortable with pedaling, they usually figure out very quickly how to start pedaling from a stationary position without having someone hold the bike upright for them. They’ll know to position the pedals for their feet (everybody tends to have a favorite leading foot), in the 10 or 2 o’clock position before starting to pedal.

STEP 1 Start on a flat piece of ground and have your child practice mounting and dismounting the bike. Try not to hold the bike steady while the child gets on and off. Ask the child to stay seated on the bicycle and raise his or her feet an inch while trying to keep the bicycle balanced vertically. Count aloud to make a game of how long your child can keep the bicycle balanced at a standstill without touching down an outstretched toe.

STEP 2 Temporarily turn the bicycle into a scooter. (In fact, a scooter is an ideal toy to help a child learn balancing techniques needed on a bicycle.) Go midway up the hill, and hold the bike while your child gets on. Have him or her put both feet on the ground, then let go of the bike. Tell your child to lift his or her feet about an inch off the ground and coast down the hill without pedaling. Because the bike is coasting slowly, the child can put his or her feet down if scared.

STEP 3 When the child can comfortably coast down the gentle hill without pedaling, try it with feet resting on the pedals. Repeat this action several times until the child feels comfortable coasting and doesn’t put his or her feet down to stop. If the child asks you to run beside the bike the first few times, do so, but don’t hold the bike. When the child can easily coast 10 to 20 yards, make the game more challenging by seeing how slowly the child can coast. Balancing a bike at slow speed is tougher than at high speed. This also introduces the braking action under safe conditions.

STEP 4 Have your child begin pedaling as he or she rolls. Repeat until your child feels comfortable, gradually moving higher and higher up the hill. After several successful rides, raise the saddle and go to a flat part of the field, a parking lot, or a cul-de-sac to ride loops and to practice turning and braking. Make sure that children who have difficulty starting from a standstill begin the action with the pedals in the proper “power position.” Smaller kids may feel more comfortable placing one foot on the raised curb and pushing off.

IS IT TIME? When is your child ready? After the child masters a bike with training wheels, it’s time to remove the training wheels and make the move to a two-wheeler. Don’t force a child to make this step; wait until he or she is ready. There’s no ideal age for a child to learn to ride a two-wheeler. If your child exhibits fear or does not seem ready, it’s best not to push too hard. Just because the neighbor’s kid can ride his two-wheeler does not mean your child should be able to do it, too. Children develop coordination and agility at different ages, so avoid comparisons. Instead of age, consider these factors: Interest: If your child asks questions about bikes, expresses a desire to ride with family and friends, characterizes tricycles, toy bikes, or training wheels as being for “babies,” these are indicators that your child is ready to roll. Balance: Children who ride bikes at a young age are more apt to have displayed athletic ability in other earlier developmental activities like walking while balancing on a sidewalk curb or on railroad ties. Generally, if a child can jump up and down on one leg and then switch to the other leg without falling, chances are good that riding a two-wheeler won’t be a problem. Size: Most kids who successfully learn to ride can sit comfortably on a two-wheeler, meaning they have inseams of 17 inches or more.

GETTING STARTED Remove the training wheels and lower the saddle so your child can put his or her feet flat on the ground when seated. Adjust the handlebars to a comfortable position. Strap on the child’s helmet and tuck in shoelaces. Have your child wear snug denim long pants and a long-sleeved shirt in hopes of keeping scrapes to a minimum. Find a grass field with a slight downhill angle. Newly mowed grass is preferable to tall grass, which creates friction that restricts the bike’s momentum. The ideal location is at least 20-25 yards in length and ends with a gentle uphill slope to gradually slow down the child’s bike speed.

COMMON MISTAKES Don’t make learning day the first day on a new bike – it adds an unfamiliar bike to an unfamiliar experience. If you buy a “big-kid” bike, let your child ride it with training wheels before the big day, or take the training wheels off the old bike, then use the new bike as a reward for mastering two-wheeling. Don’t trick the child by claiming you’re holding on when you’re not. If the child crashes, you erode trust and break the child’s confidence. Before you begin to run, tell your child you plan to let go at some point if he or she looks stable. Don’t use the raised training wheels or one-pedal methods. Raising the training wheels or removing a single pedal makes the bike unstable and doesn’t teach balance, the key element in learning to ride. Don’t think the learning process will be crash-free. When teaching your child to ride a two-wheeler, explain that it takes time to learn how to balance and that most kids fall at first. Be a cheerleader, provide a shoulder to cry on, and be prepared to apply bandages. Most important, accept the possibility you may have to wait for another day. A common mistake that children make at the outset is turning the handlebars in the direction away from the fall, making the fall worse. Teach your child to turn slightly in the direction of the fall in order to regain balance and prevent the bike’s falling over. Have patience. There is a wide range of ages at which children master basic balancing, with the average being about 6 years, but normal variation means anywhere from 4 to 9. It is important not to push too hard. This can be a real problem for children of active cyclists, as excessive pressure may take all the fun out of the experience. If you allow your child to learn at his or her own pace, it is more likely that cycling will become a fun family activity for all of you. For helpful information on topics such as riding safely in traffic and proper hand signals, check out the League of American Bicyclists (bikeleague.org).

IF THIS DOESN’T WORK Before you decide to try the run-beside-the-bike method, try this: Have your child sit on the bike with his or her feet on the pedals. On a level surface, hold the back of the saddle as you push the bike at a walking pace. Reassure your child that you won’t let go and that the bike is under your control. With the bike supported so it won’t fall as you push, alternate leaning the bike to the right and to the left while your child turns the handlebar in the proper direction. This teaches the child the feeling of how to adjust the handlebar and his or her body to maintain balance – the key step to riding a bike. Keep repeating the action until the child feels comfortable.” David F

Update From A Mom Who Learned That We Need To Believe In Our Children

“Do any of you remember that I posted a while back about my 5-year-old son requesting to have his training wheel taken off? I cringed at the thought because I know balance is an issue and I did not want to see him fail. Many of you gave me suggestions on how to do this. Anyway, tonight my son was riding his bike (starting, stopping and full deal) all by himself. I was astounded! . We have it on video cam, digital cam, THE WORKS! I am so proud! I am glad that my son believed in himself enough to take the plunge even though his mom did not have faith (I feel awful!). Knowing him, he probably knew how I felt but persevered anyway. These kids teach us more than we could ever teach them!”

Advice if the above advice doesn’t work for your child

“My daughter, almost 8, has been working on this skill for years. Her balance just isn’t good enough to ride. We finally went to a bike assessment at a children’s hospital. While we can’t afford the specialized bikes they suggested, they told us about these FatWheels. Were getting them for her, and we can’t wait!” Another option could be the PlasmaCar

LISA GENG