Once we got Brennan up on his feet, we realized that he would roll his ankles (as picture below) and would also hyper-extend his knees. This seemed like it must be uncomfortable for Brennan, could be part of the reason he is reluctant to bear weight on hi feet and could also cause alot of pain and problems for him in the future if not corrected. I consulted with many people (pediatrician, physical therapist, Down syndrome clinic, orthotists) who were able to provide me with little to no useful information. All agreed that he would benefit from some type of brace or ankle foot orthosis (AFO), but none could tell me which type of AFO.
Finally, Brennan's swim therapist in collaboration with an orthotist were able to determine what type of support Brennan needed.....a hinged AFO. The hinges on the AFO can be tightened or loosened to restrict or allow for more movement. To start, Brennan are tightened to restrict motion and also to keep him from hyper-extending his knees. The AFO also provides the support he needs to keep his ankles from rolling. As his strength increases, the hinges will be gradually loosened to allow him to do more of the work. And at some point he will move from his current brace that goes up his calf, to one the goes just above the ankle.
It certainly took some time to figure out what type of orthosis Brennan would be most beneficial for Brennan, but I feel confident that the right decision was made and am excited to see the progress he will make now that his feet, ankles and legs are properly supported.