Tying Shoes

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Tying their own shoes is a BIG DEAL for children and is just one more step on their path to independence. Children with hemiplegia can learn to tie their shoes. Below, parents share their experiences with shoe tying. Remember to take it slow, expect frustration, and practice, practice, practice. That big smile that you'll see when they master this skill will be a delight! And then your child can tell their friends, "I can tie my shoe WITH ONE HAND, can you?"

From Leanne, mom of a son with hemiplegia:
It took two years to teach my son to tie his shoes. We practiced every day and we went step by step. I will write the shoe tying steps for a child with right hemiplegia. With this procedure, the right hand will only be required to hold and pull the laces.

LESSON I
Step one: With right hand, hold left lace.
Step two: With left hand, twist right lace around left lace.
Step three: With both hands, pull the laces tight.

LESSON II
Step one: With left hand, make a loop with the right lace (which is now on the left side).
Step two: Hand off the loop which is in the left hand to the right hand.

LESSON III
Step one: With the left hand, bring the left-unlooped lace around the right-looped lace.
Step two: With left hand, form a loop with the unlooped lace by pushing it with the pointer finger through the opening between the two laces which was formed by doing the previous step.
Step three: With left hand, grip the newly formed loop.
Step four: With both hands, pull the loops tight.

You might be on Lesson I for months. When he accomplishes one lesson, then go on to the next. And of course, feel free to break the lessons down even further. I figured this was a good fine-motor exercise and that helped me keep him at it. In the end, it gave him independence.

From an OT:
A word story I learned (and taught) after basic knot has been taught: First comes the ground by tying the knot, then make a tree trunk (one loop), the rabbit (the other loop) runs around the tree and goes in and through the hole (between the ground and the tree trunk). This last step is important as some children try to go under the knot as well.

If the rabbit goes around the tree (and index finger) twice, the bow stays tied much, much longer. It's very disheartening to kids who are learning to tie when the bows come undone just because they weren't pulled snug enough. The rabbit story actually confused my son. What finally worked was getting him to realize the function of the index finger in the process: not only does it help pinch the loop lace, but it also creates the hole that the wrap lace follows through.

There's another way of tying that looks like a regular bow. I learned this when I worked at a gift wrap counter one December; you can make a fast, nice-looking bow that way. (And the ribbon doesn't get crumpled from being the rabbit.)

First, tie the foundation half knot. Then gather a loop out of each lace and tie those two loops in a half knot. I put dots on the laces to be the folding points so that my son would judge the loop size right. It's sturdier when the foundation knot and the loop's knot are made like a square knot instead of a granny knot. "Right over left, left over right, Keeps the knot neat, tidy, and tight."

A little tip that I picked up helps children to make the bow loops, as they often have problems judging where to put the laces together to make that loop. If the laces are marked with whiteout or black marker, just a small dot or line, the child can match the lines putting both lines/dots together and the correct size loop is instantly formed. No frustration on judgement of placement to ensure the loop is not too long or too short.

From an OT:
I have a book called "Red Lace, Yellow Lace" which I bought at an office supply store in the educational section. It has a rhythmic verse which gives instructions for each step of shoe tying, one one each page. The book is attached to a larger cardboard which has a picture of a shoe with holes punched and an actual lace for practice. One side of the lace is red and the other is yellow. If anyone is interested I will get publisher information. Red Lace Yellow Lace Learn to tie your shoes book from Amazon

Adapted Technique

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The information contained in this Children's Hemiplegia and Stroke Association (CHASA) Web site is not a substitute for medical advice or treatment, and CHASA recommends consultation with your doctor or health care professional.