Starfish Therapies

October 17, 2014

Posture Tips for Parents and Caregivers

Filed under: Developmental Milestones — Starfish Therapies @ 2:00 pm
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wheelbarrow kiddo

We thought we would take a moment to share some posture tips for parents and caregivers to help prevent injury or overuse during day-to-day activities when caring for a young child. For additional information and a video demonstration on some of these techniques, please visit this link.

1. Lifting your child: Whether lifting your child off of the floor or out of their crib, you want to make sure you avoid lifting with your back and instead lift with you legs.

  • When lifting a child from the floor, the easiest way to do so would be to place one foot in front of the other and then bend your hips and knees until you are in a kneeling position on one knee (half kneel). Make sure you keep your back straight! Once in the kneeling position, lift your child up with both hands and bring them close to your body. From there, hold your abdominal muscles tight, and use your legs to bring yourself back into a standing position.
  • When lifting a child from their crib, you want to lower the rail as low as it will go. You’ll want to bend at your hips and knees to perform a mini squat, almost as if you were pretending to sit down in a chair. Make sure your back stays straight! Then, pick up your child with both hands and bring them close to your body. Then straighten your hips and knees and return to a standing position while keeping your abs tight. To place them in their crib, you’ll want to use the same ‘mini squat’ technique.

2. Pushing a stroller: When pushing a stroller, you want to avoid letting the stroller get too far ahead of you, as that will cause you to hunch forwards at your shoulders and upper back. Try and keep your back straight and use your entire body to generate the momentum needed to push the stroller forwards, not just your arms!

3. Carrying or holding your child: Try and avoid carrying your child with one arm and balanced on your hip. If this position is an absolute necessity, make sure you switch sides. This position causes certain muscles to lengthen on one side of the body, while other muscles on the opposite side of the body tighten, putting you at risk for postural asymmetries and potentially leading to pain.

August 11, 2014

Tummy Time – More Than Just a Buzz Word (A Blog Hop)

Filed under: Developmental Milestones — Starfish Therapies @ 10:00 am
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Tummy Time Therapy Blogger Blog Hop

Is Tummy Time Important A Therapy Blogger Blog HopBelow you will find all the posts in the Tummy Time therapy blogger blog hop. So many great ideas and thoughts on tummy time from Occupational Therapist and Physical Therapists.

The Importance of Tummy Time for Babies – Golden Reflections Blog

Tummy Time & Baby’s First Year - The Recycling OT

How to Use a Therapy Ball to Make Tummy Time Easier and More Fun for Baby – Mama OT

5 Awesome Toys for Tummy Time! – The Inspired Treehouse

Terrific Tummy Time Positions – Your Kids OT

Tips For Tummy Time From A Physical Therapist - Pink Oatmeal

Tummy Time : The Basics - Therapy Fun Zone

Tummy Time: Developmental Consequences & Future Implications - Tools to Grow, Inc.

Tummy Time Tips - Pedatric OT Tips

Tummy Time Just Isn’t For Babies – Your Therapy Source

Tummy Time – More Than Just A Buzz Word – Starfish Therapies

Tummy Time Never Gets Old – Playapy Platform

Tummy Time has become a common phrase in the last decade or so as a result of the NICHD Back to Sleep Campaign.  Prior to this time most parents put their children to sleep on their stomachs so Tummy Time was never an issue.  Now, with children sleeping on their backs they are spending 12 or more hours a day (if a parent is lucky and their child sleeps that much) on their backs which used to be devoted to time on their stomach.

And, in my opinion, another factor is the rise of innovative baby equipment that has been produced to make some aspects of parenting easier.  I know as a baby sitter I loved having the car seat that clicked into the car and then clicked into the stroller, or even the bouncy seats.  As a therapist I now see how all that equipment was taking away from time the child could have been equipment free, exploring their body and environment.

I’m not saying get rid of all equipment or put your child to sleep on their stomach, but I think its important to make sure you are balancing things out.  For instance, if you went to the gym and lifted weights, and only used your right side, you would be disproportionately strong on one side.  This is the same for infants.  When they are on their back, they are working the muscles on the front side of their body (abs, neck flexors, hip flexors) and learning how to lift them against gravity so that they are getting stronger.  However, the muscles on the back side of their body are getting forgotten about.  Those include their back extensors, neck extensors and gluts (tush muscles).  The muscles on both sides of their body are important to their gross motor development as they learn new skills and move through the developmental milestones.

Some of the benefits of Tummy Time are:

  • Improved head control – ability to hold their head stable so that they can observe the world
  • Improved trunk control – ability to hold their body stable so they can begin to sit on their own and develop balance reactions
  • Stretching – After 9 months in the womb, babies have tight muscles on the front of their body and by being on their stomach they are naturally stretching out so that they can begin to balance out the front and back of their bodies.  In addition, the more time they spend in carriers and other pieces of equipment, it keeps them in a slightly flexed position.
  • Decreased chance of developing plagiocephaly – This is when they develop a flat spot on their head.  Some babies get it in the back or on the side of their head.  This is because the back of their skull is still ‘soft’ and when they have decreased neck strength to move their head, they often lie with their head in one position so it flattens out in that area.  When spending time on their belly, the facial muscles are firm and less likely to flatten out/deform.  It also gives the back of their head a break from constant contact with a surface.
  • Hip development – When babies are born their femurs (thigh bones) are rotated.  Natural development allows a derotation to happen as their gluts get stronger and place a pull on their bones.  While on their belly, they are naturally developing their glut strength by activating their trunk and leg muscles against gravity.  This promotes the natural development that is supposed to occur!
  • Arm strength – While on their tummy, babies begin to experiment with pushing up on their arms which develops their upper extremity strength as well as eventually leads into rolling over and further exploration of their environment and movement.  This is also a precursor to crawling as they learn how to coordinate their arm use.

Tummy Time

These are just a few of the reasons why I like tummy time.  I know it isn’t easy to find time in busy days but I also look at it as ways to get down on the same level as your baby and interact with them.  You can even get some good ‘face time’ in!



July 30, 2014

Feeding is (can be) Fun for Everyone!

Filed under: Developmental Milestones — Starfish Therapies @ 7:00 am
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Whether it’s someone who would rather eat macaroni and cheese 365 days a year than try something green, someone who’s idea of an exotic meal is a PB&J with crunchy Jif or someone who just doesn’t like the look of most foods, everyone knows at least one picky eater. Most finicky feeders are choosiest during childhood and grow out of their habits and into healthy, well-nourished adults over time. While it’s comforting to know that there is likely light at the end of the tunnel, having a picky eater can be stressful for the entire family.

Mealtime, considered by many to be a relaxing highlight of the day, often becomes a time of strained patience and stubborn resolve on both sides of the spoon. Parents waver between keeping the peace around the table and ensuring that their child does not consist on chicken nuggets alone and children begin to dread dinnertime like a chemistry test. This scenario is not uncommon. Picky eaters are prevalent and more often than not are able to become more adventurous eaters as they get older. In the meantime, there are ways to make mealtimes a little more bearable for everyone involved. Food can indeed be fun.

Exposure is Everything:

Many choosy feeding habits are derived from some kind of fear. Whether it’s a flavor, texture or smell issue, something about these ‘no way’ foods is scary to our picky eater. The best way to get over these fears is through many small, repeated interactions with these foods, no matter how low-key. Consistently serve picky eaters a very tiny portion of every ‘family food’ at meals whenever possible. Make it clear to the child that they do not need to eat the food, but they are expected to tolerate it on the plate. From here more challenging interactions with food can be encouraged (smelling, touching, kissing etc.)

Play is Placating:

Playing with food is often the first step in eliminating fear. Create messy activities involving some less-favored foods that focus solely on getting the child to interact with what they normally do not eat. Put some food coloring in yogurt and finger paint, make shapes out of wet noodles, find ways to make the food about the activity and not about the eating. Should some spontaneous snacking occur, fantastic!

Start Small:

Try to build bridges to new foods based on what your child already enjoys. If they enjoy raw apples, consider other crunchy sweet fruits like pears or melon. The leap from chicken nuggets to smoked salmon is probably too overwhelming, but fish sticks might be manageable. Remember that these changes, while humble to onlookers, are huge for kids.

Variety Variety Variety:

One common side effect of picky eating is ‘food jagging’, tiring of and eliminating foods that are eaten too often. It happens to all of us, but it can be particularly dangerous for picky eaters who already have a limited diet. Encourage your child to help make their favorite foods a bit different every day. Maybe cut fruits up in a different way, add some food coloring, or sprinkle on a little cheese. These small changes can be the difference between keeping a food in the repertoire and kicking it to the curb.

Patience and Practice: Growing into a more adventurous eater is a long process. The fears and aversions that children have developed have been ingrained for years, and breaking these habits will take time. Consistently making an effort to slowly challenge these fears will indeed pay off.

July 23, 2014

Sensory Options at Home

Filed under: Developmental Milestones — Starfish Therapies @ 2:11 pm
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crash pad

There are kids out there that seek out rough play because it feels good to them. Examples would be crashing to the ground, wrestling, running into friends/adults, and/or just doing many things throughout the day with a greater amount of force. To register touch input they often seek it out in a way that seems to us like it may hurt. They have a higher pain tolerance and are more likely to cry from a scratch that they can see, than a bruise from crashing to the ground onto their knees. What follows is some ideas that you can have on hand to provide them with some deeper input to decrease them seeking it out throughout the day.


Lycra Tunnel: This is basically lycra material sewed into a tunnel (it does have some stretch to it). Have the kids crawl through on hands and knees while you hold one end. It’s going to give them resistance as they go through. For increased resistance have them push a therapy ball through that fits in the tunnel with them.


Therapy ball: You can bounce or roll your child on top of the ball. You can also roll it on top of them and pretend your rolling them out like dough. You can ask them if you are doing it hard enough. Kids will typically want a good amount of pressure if they are input seekers.


Mini Trampoline or Pile of Pillows/Crash Pad: A mini trampoline if you have access to one can be beneficial in giving lots of heavy input to feet and bodies. If you don’t have this, setting up a pile of pillows, couch cushions, or things that are soft in general can work as well. You can allow your kids a safe place to run and crash so that they are not doing it on the ground or into walls or friends.  You can also make a crash pad out of high density foam pieces and a comforter cover!


Heavy Blanket: Have them crawl underneath and all the way through and playing a game with it (ex. bring all of the puzzle pieces through). You can also roll them up like a burrito, depending on their tolerance for this, but it does give a good amount of input if you roll them tighter. If they like to move, you can have them transition the blanket from place to place and carry toys in it as well to add some weight.


Household Chores: Have the kids help with heavy carrying or moving. Let them know the laundry basket is too heavy and you need their help in moving it. Pushing the vacuum can be another good one, as well as pushing/moving furniture.


You are replacing your child’s ‘crash’ seeking behaviors with more purposeful and safe activities throughout their day. Teaching them safe ways to get the input they need will hopefully cut back on the amount they are seeking through peers or when not in ideal situations. You can teach them to ask for some of these activities to replace the other unsafe behaviors as well so that they become more independent with accessing these tools. Trying to decrease this behavior all together would be difficult for both the child and yourself since it’s something they feel their body needs. Instead, giving them options to increase their safety, but still access the input they seek, will in the end benefit both of you.

July 18, 2014

Playground Play

Filed under: Developmental Milestones — Starfish Therapies @ 6:47 pm
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Playground Play

I was browsing through instagram a while ago and saw this great photo (above) of my friends’ son playing.  It immediately reminded me (not that I needed much reminding) why I love playgrounds for kids!

Besides just giving kids the opportunity to run around, play and explore, when I am working with a kiddo at a playground I am almost never at a loss for things to do.  Depending on their age and skill level, here are just a few things you can do with kids at a playground:

  • Climbing -  There is climbing for all ages (even the non walkers).  You can use stairs to go up and down, although on a play structure its always easier to get kids to go up, much harder to convince them not to go down the slide!  Stairs can be crawled on or walked on.  For the walkers there are generally railings that allow early walkers to practice with some stability or for the more advanced they can try it without hands!  There are also almost always an array of ladders to climb.  What’s great about playground ladders is they come in all shapes and sizes.  There are standard ladders, there are twisty ones, there are rope nets, even ones I like to call rainbow ladders.  With this large variety kids get a chance to practice their motor planning and problem solving with regards to navigating the ladder.  To summarize, climbing is great for glut (tush muscles) and core strengthening, working on reciprocal movements and motor planning/coordination.
  • Monkey Bars – Monkey bars or even the bar above the slide (like in the picture above) are great for hanging on!  Kids can work on their shoulder/shoulder blade strength and stability – which help improve their fine motor skills, as well as their core strength.  When they begin to traverse monkey bars they learn how to generate momentum and movement while maintaining stability.  It also gives kids an opportunity to play around with different grips and get immediate feedback for strength and control.  Lastly, kids can play with acrobatics and hang upside down and pull themselves up so they are sitting on the bars.  All of this helps body awareness, problem solving, coordination, etc.
  • Swings – Swings are not only fun, they let your child increase their vestibular input, work on the coordination of their legs and trunk moving to keep the swinging motion going, and core strength.  Not only are kids excited when they learn how to make themselves swing, but it also means less time for you to stand around and push them!  In addition, just learning how to get onto the swing by themselves takes balance, coordination and problem solving.  For the little kiddos being pushed in the swing, they are getting opportunities to work on head control and trunk control during movement.

What are your favorite things about playground play?

May 30, 2014

Favorite Summer Toy: Hula Hoops (Blog Hop and Giveaway)

Filed under: Developmental Milestones — Starfish Therapies @ 12:41 pm
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Hula hoops are a great summer time (or anytime) toy.  Now don’t automatically assume it means you need to know how to ‘hula hoop’ in order to play with them.  I’ll be the first to admit that I’m terrible at ‘hula hooping’ however there are a ton of other ways to have fun with them.

Hula Hoop Paths

Movement Through Space – If you get a few hula hoops you can line them up in a row and you can practice locomotor skills through them.  Start simple by having kids walk through each one.  Next can be running through them.  Add in some jumping and hopping as well.  To get more complicated you can create movement patterns similar to hopscotch where they have to jump in one then hop in the next one or skip hoops as they run through them.  You can also do side stepping and leaping.  I like this activity because it works on movement through space with the child being aware of their path.  They also have to coordinate their movements while remembering a pattern/instructions.  If you have enough hoops and kids, you can even make it into a relay race!

Visual Motor – Hula Hoops also make great targets.  You can set them on the ground and use it as a visual for bouncing a ball in.  This could be done by yourself with dribbling skills, or using a tennis ball to practice bouncing and catching.  It can also be used with a partner for bounce passes and having to bounce the ball in the hoop before your partner gets it and bounces it back.  You can keep score for how many times you each get it in the hoop!  Also, you can use it as a throwing target.  If you have a tree you can hang it from a branch and practice throwing balls through it or being really tricky and getting a frisbee through it (my frisbee skills are about as advanced as my hula hoop skills)!  If you don’t have a tree you could prop it up against a support or leave it flat on the ground and try to throw or toss an object into or through it.  If you are leaving it on the ground you could use chalk and add rings inside of it and try to toss bean bags in.  Each chalk circle could have a set number of points and you could see how many points you get (similar to darts or ski ball).

Body Awareness – Some other fun ideas to use a hula hoop for are as a jump rope and as an actual hula hoop.  For jump roping (yes, even adults can still do it – I tried it today) you hold onto one edge of the hula hoop and swing rotate it so it swings over your head and then you jump through as it comes back down to your feet.  Similar to a jump rope you have to be aware of where your body is as well as rhythm and coordination but with the hula hoop its a closed loop so you have to know where your head is as well as your feet.  For actual hula hooping (is that even a word?) you can do the traditional version around your waist/hips but you can also experiment with other body parts such as arms, legs and even your neck.  It allows kids to know where the parts of their body are and focus on how they are moving and controlling that one area such that it is isolated to get the movement they want.  What’s great about the hula hoop is they are getting immediate feedback.

Some other fun ideas:

  • Team work activities where you have two or more people in the hula hoop and they have to move across space together (similar to a three legged race).  You can make the trek as complicated or simple as you want.  To add to the difficulty level you can blindfold all but one of the people so they really have to work as a team.
  • Hula hoop rolling.  You can place the hula hoop on its edge and see how far you can roll it, or who can roll it the furthest.  You can also draw chalk lines and try to keep it rolling on the line for as long as possible.
  • Extra large ring toss is always fun.  If you have stumps or other outdoor items that work well as a post you can try to use the hula hoop as a ring to get around it.

What are some of your favorite activities with a hula hoop?

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April 24, 2014

Some More Tummy Time

Filed under: Developmental Milestones — Starfish Therapies @ 8:00 am
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I had the pleasure of hanging out with my friend and her 3 1/2 month old (2 1/2 months corrected) the other day and I just can’t resist the opportunity to check out motor skills.  When playing with her son, he is at that stage where his extensors are starting to kick in for short periods.  When I give him just a little extra support at his shoulder girdle he is able to lift his head just a little higher and just a little longer.  So many times I hear that kids don’t like tummy time, and that can be the case, but when you get down at their level (similar to the picture), it offers a great opportunity for them to engage with you and for you to entertain them!  My favorite part of the day was when her husband came home from work and as we were heading out the door for a girls dinner, he asked ‘has he had enough tummy time today?’ And according to my friend, that wasn’t just for my benefit!

Here are some of our past posts on tummy time to give you some inspiration!

Tummy Time:  Whats the big deal?

Strategies for Tummy Time

Tummy Time:  The cornerstone of movement

Tummy Time:  Its a ball! (video link included)

Tummy Time with Lamaze Spin and Explore

April 20, 2014

Sidewalk Chalk

Filed under: Developmental Milestones — Starfish Therapies @ 4:18 pm
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sidewalk chalk

With the weather getting nicer, you may be looking for some outdoor activities.  Sidewalk chalk is a great tool that is limited only by imagination. Just think of all the things you can do with it. Besides drawing pictures in your driveway, sidewalk chalk can be valuable tool when working on improving your child’s motor skills, the most obvious one being practicing their drawing and writing skills. But they can also strengthen their arms through weight bearing, work on their balance, learn to visually track, improve their jumping skills, and learn sequencing with a little help from this outdoor favorite. Here are a few ideas:

  1. Drawing on the ground – in order to draw on the ground, your child has to sit or lay on their belly on the ground. This means that they’ll likely be bearing weight on their non-dominate hand the entire time they are drawing and strengthening that arm. If you feeling adventurous try challenging them to draw with their non-dominate hand.
  2. Draw hopscotch on the ground – they can practice jumping together and apart in order to complete the hopscotch or hopping on one foot as their skills develop.
  3. Draw a “balance beam” on the ground – they can practice walking on the line without stepping off. If they get good at walking forward, try walking backwards or sideways. You can also try making a squiggly line.
  4. Draw a racetrack for them to ride their bike/trike, or sit and ride toy around – this will make them visually follow the line while riding in order to stay on track.
  5. If you get bored with all of these, try drawing an obstacle course and putting them all together – you can draw bases to hop between, a line to walk across, a hopscotch to jump through, and even hand and foot prints to do animal walks on.

And don’t forget all the fun you can have washing your daily activates away so you can draw new ones tomorrow! What else have you done with sidewalk chalk?

April 9, 2014

Making Use of the Junk Drawer

Filed under: Developmental Milestones — Starfish Therapies @ 9:00 am
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Wait don’t throw that away! Our junk drawers can hold some quick and easy fine motor and visual activities for our kids. Let’s get creative with what we unknowingly have in our possession already. Here are some great ideas and activities to do with 3 things that may be in a junk drawer:

Rubber band:

  • Place the rubber band on the index finger and thumb and have them open their fingers against the resistance of the rubber band. They can also put the band on their thumb, index and middle finger to work on strengthening the tripod grasp as well.
  • Stretch the rubber bands over blocks and paint the bands for a fun stamp.
  • Stretch the rubber bands around a small white board and hang the board up or leave flat on the table in front of child. They can place anything under the bands to make their own picture. Animals, crayons, or any small item that’s available. Picking up the bands works on pincer grasp and they have to use two hands to both hold the band and place the item under. Hanging the board up would also work on reaching with bilateral hand use.


  • Make a chain of paperclips or undo a chain of clips. This works on motor planning, bilateral hand use and finger dexterity skills. You can pretend its fun jewelry after putting it together as well.
  • Hang a paperclip from a string and add a balloon to the paperclip. You can adjust the height to play different visual and gross motor games with this. Up high you can try hitting the balloon with your hand. Or use a bat or stick to make it trickier for those that have more visual difficulties. You can also have the kids jump and try and hit the bottom of the balloon with their heads. Bringing the balloon low they can work on kicking. They also can lay on their stomachs or backs and try and hit the balloon with their hands or feet together to work on flexion and extension strengthening.


  • Sorting games: you can sort the different kinds (rubber, metal), as well as the different sizes. Painting them different colors, can give them another way to sort them as well.
  • Place the washers in different spots and make a game out of collecting the washers. Give them an unsharpened pencil to walk with in one hand and they have to go around and collect the washers to place on the pencil. Increase the difficulty by having them collect in a certain pattern. This is great for eye-hand coordination, bilateral hand use and visual tracking skills.
  • Play a toss game. Taking a paper cup and placing it a small distance from your child you can play a tossing game in standing, sitting, on their belly, etc.

Next time you empty out that junk drawer, get creative and explore the different uses of everyday items that are found in your home. Your kids will love it!


April 3, 2014

The Ins and Outs of Pencil Grips

child at desk

A pencil grip can be a quick and easy fix for an awkward grasp. There is such a huge variety of them out there, but how do you know what ones to choose. Here’s some quick tips on how to choose a pencil grasp for your child.

The Simpler the Better: If your child needs a pencil grip, they are most likely having difficulty planning how to hold the pencil in the first place. Keep it simple so the grip doesn’t become as frustrating as the pencil initially was to hold. It will also make it easier to transfer from pencil to pencil if needed and recall how to hold it correctly each time.

Look at the concerns: The type of pencil grasp that your child will use is going to depend on what the areas of concern are when they are holding the pencil. Here are some common concerns, along with which direction to possibly take:

  • Low tone (fine motor weakness): This can be observed one of 2 different ways. One such way is when your child is holding the pencil too loosely and often resorts to an awkward grasp to compensate. The other way is they will look like they are actually applying too much force when writing and are using it as an over-compensation for the weakness. Thicker or jumbo grips are usually easier for these kiddos to hold onto and can cut back on some of the force when writing concerns. Weighted pencils or grips can also help in some cases, so the child doesn’t feel the need to push down the pencil so hard when writing.
  • Motor Planning: This is when your child just can’t seem to get the motor patterns correct for holding the pencil. These are the kids that the more simple the grip the better. Single grips or crossover grips would be most beneficial for these kids.
  • Kinesthetic feedback: These kids usually grip the pencil with a tight fisted grasp or barrel grasp. They’re looking for input when writing in order to fill a sensory need, as well as give them some proprioceptive feedback to assist with guiding the pencil. Wider or jumbo pencil grips or textured ones may be most beneficial for these kids.

Make it Fun: There’s different colors, shapes and even grips with glitter. You want to get the right type of grip, but you want your child to be excited about using it as well. Let them choose colors or other features of the pencil grip as long as it doesn’t impede overall function of what you wanted it to do originally.

It’s not forever: Pencil grips are just to encourage the use of an appropriate grasp for the time being and not to use as a permanent fix. It should assist your child in making the grasp more of a habit and you should be able to eventually end up with no use of no grasp at all. Just another helpful trick along the way.

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