Parental perspectives of foot-care and footwear in children and young people with learning disabilities

This blog is a summary of findings of a completed research study led by Stewart Morrison of the University of Brighton.


Foot and ankle pain in children and young people are quite common and can range from skin and nails issues through to more complex bone and soft-tissue problems.  Foot and ankle pain are often short-term but can impact on a child’s ability to play and interact with their peers.  Accessing health services is important to manage foot problems as soon as possible and to minimise the development of more complex issues.

In the context of children and young people with intellectual and / or developmental disabilities, it can be challenging to recognise foot problems, particularly when children can have difficulties with the recognition and expression of pain.  Foot problems are very common in adults with intellectual disabilities, but we don’t know very much about the types of foot problems commonly experienced by children and young people.

We undertook a survey of UK-based parents / parental caregivers of children and young people with intellectual and/or developmental disabilities to help us understand the foot-care needs of these children.  We reached parents via Twitter, with charities (such as the Down’s Syndrome Association) and from word of mouth.  This survey was completed by 49 people and the key findings from this survey were:

  • Foot problems were common with 75% of the respondents highlighting a concern.
  • Flat feet were the most common foot-related issue (51%) that parents were reported.
  • Concerns about joint hypermobility was also common (35%).
  • 57% of the survey respondents reported receiving foot-care advice for their child but less than half of the parents felt confident in knowing how to manage their children’s feet problems.
  • Difficulties with finding suitable footwear were reported in 48% of the responders. Over half (55%) didn’t know what features to look for when buying shoes.

The results from this survey tell us that the burden of foot problems in children and young people with intellectual and developmental disabilities was considerable.  The findings highlight the importance of access to foot-care services for these children and young people.

The Down ’s Syndrome Association receive many enquiries about footwear and we understand that footwear fitting is a challenge, often constrained by limited size and width fittings available on the high-street. Here are a few key pointers when looking for shoes for your child:

  1. It sounds obvious but make sure that the shoes fit and, if needed, can accommodate orthotic devices. Shoe fit is more complicated than it sounds so try and get your child’s feet measured at regular intervals. The shape of children’s feet develops over-time and demands on the footwear also change. There are many fitting guides and gauges online and these can be a useful starting point.
  2. Width fitting is a common concern from parents and, if possible, take the time to talk to specialist footwear retailers and understand the options available to you. You may want to consult with the Society of Shoe Fitters or the College of Podiatry for more specialist advice.
  3. The shoes you buy should be comfortable, stable and supportive. Excessive joint mobility in the feet is common in Down syndrome and you may feel that boots (with some ankle support) are more beneficial. Be mindful of the weight of the shoe. It shouldn’t be too heavy.  Flat and flimsy shoes should be avoided.
  4. The shoes you buy should have some mechanism for holding the shoe on the foot. This could be velcro, buckles or laces. This is particularly important if you child is participating in activities.

This blog post was written by Stewart Morrison from the University of Brighton.

Twitter:  @S_Mo_15