Spastic Diplegia

Signs & Symptoms by Age

Spastic diplegia usually isn’t obvious at birth — it tends to reveal itself gradually, as a baby misses or delays certain motor milestones. Here’s roughly what that can look like at different ages. Every child is different, and this is a spectrum, not a checklist that has to match exactly.

Infancy (0–12 months)

  • Lower muscle tone in the trunk, often alongside tighter-than-typical tone in the legs
  • Delayed rolling, sitting, or pushing up
  • “Scissoring” — legs crossing or stiffening together when held upright
  • Stiffness noticed during diaper changes or when legs are moved passively

Toddler years (1–3)

  • Commando-crawling (pulling with arms, legs dragging) instead of typical hands-and-knees crawling, or skipping crawling altogether
  • Toe-walking, or a wide, stiff-legged gait once walking begins
  • Delayed walking — often noticeably later than typical developmental windows
  • Legs that cross or scissor when standing supported

Older children

  • Fatigue with walking or standing that seems disproportionate to the activity
  • Tightening in calves/hamstrings that seems to increase with growth spurts (this is common — muscles can’t always lengthen as fast as bones grow)
  • Possible mild involvement in the arms or hands, though this is usually much less pronounced than in the legs
From our experience — pending: what were the first signs you or your pediatrician noticed with J, and roughly when?

An important caveat

None of this means every child with delayed walking or toe-walking has spastic diplegia — plenty of typically developing children toe-walk or crawl atypically. This page describes patterns that, together with a full clinical evaluation, can point toward a diagnosis — not a self-diagnosis checklist.

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