Starfish Therapies

December 9, 2017

Holiday Gift Giving Guide

twister yoga
It’s always amazing how fast the year goes by and how quickly another holiday season is already upon us! With that said, it’s time to start thinking about what gifts we can give to the children in our lives that they are sure to love but that will also encourage practice of motor skills and/or general physical activity.
Here are a couple of ideas to get you moving in the right direction!
  1. Pewi Ybike Walking Buddy and Ride On Toy: This is great for babies/toddlers in the pre-walking phase as they can work on reciprocal stepping using it as a ride on toy and can also use it as a push toy building balance and control.  It’s a little on the pricey side but toddlers will continue to enjoy zooming around on this one way beyond those first steps!
  2. Teeter Popper: We haven’t had the opportunity to try this one out but this wobble board looks like all kinds of fun.  It can promote sitting and standing balance, core stability and provides plenty of sensory feedback since the suction cups on the bottom pop as kids make the board move. Check out the video on amazon through the provided link for a demonstration.
Here are some of our Favorite Toys that can be used to encourage gross motor activity:

 

  1. Squigz
  2. Stomp Rocket
  3. Laugh and Learn Piggy Bank
  4. Stacking Cups
  5. Twister
  6. Melissa and Doug Puzzles (musical instruments, shapes, farm animals)
  7. Feed the Woozle
  8. Cones and Hurdles
  9. Spots
  10. Stand and Play Parking Garage
  11. Balance Board
  12. Monster Feet
  13. Yoga Ball
  14. Ring Toss
  15. Hippity Hop
  16. Scooter Board
  17. Activity Table
  18. Balls of all kinds (o-balls, playground ball, gertie ball)
  19. Hopscotch
  20. Activity Cards
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December 3, 2017

Using a Treadmill for Walking Quality

In last week’s post we talked about weight shifting and trunk elongation to help walking quality and energy efficiency. This week we are going to look at using a treadmill.

For some kids who are working on walking quality and efficiency foot placement can be a big deal. How they take that first step can affect everything else that goes up the chain to the hips, the trunk, and the head. By using a treadmill you can slow down the speed so they have time to think about what they are doing and get in a lot of practice and repetition (remember: repeat, repeat, repeat…). We also added tape down the middle to help provide a visual cue for foot placement to help decrease scissor stepping (when feet cross over midline while walking instead of going straight in front).

We also provided a wooden dowel in front to provide some balance assist (but with only 1-2 fingers resting lightly so they aren’t leaning on it). With some verbal cues for heel to toe foot placement, and the light support at the wooden dowel to help keep the trunk upright, it also helps to prevent other compensations that can occur from underlying hip weakness such as internal rotation at the hip to lock out the joint and create stability. But it also creates a crouching pattern that decreases efficiency and energy conservation with walking.

We are lucky enough to have access to a treadmill that can start at really low speeds. We did 2-3 minute increments of walking, over 4 different speeds, twice at each speed. As we were building up occasional manual cues were provided to assist with weight shifting, as well as pelvic and trunk rotation. After we got up to the highest speed we were going to, we went back down to the slowest, and repeated 2 sets at that speed without any manual cues. Afterwards, we went to overland walking. Since it still isn’t automatic (remember it takes lots of repetition to make it automatic) there were lots of verbal cues to slow down the walking rather than go back into the habitual walking pattern that automatically arises when they aren’t thinking about each step they take.

How have you guys used a treadmill to help walking quality?

November 26, 2017

Weight Shifting and Trunk Elongation

 

We have been working on walking with some kids that are working on improving their weight shifting and all the mechanics that go with that. Many of them have hip weakness which we are addressing but we are also looking at other areas to address as well. With the hip weakness you can often see a trendelenberg pattern (when their hip drops on the leg they pick up to take a step with). One way kids counteract this is to lean their trunk towards the side that they are standing on when they pick up their other foot to take a step. This provides them some hip stability but it decreases their efficiency and increases their energy utilization because they now are actively moving their trunk side to side with every step. It also makes it harder to fix on a target when walking and can cause path deviation.

So, we decided to help them work on elongating their trunk while weight shifting onto the stance side. To do this, we used a balance board to simulate the weight shifting. As their hip strength and overall balance improves we can take the balance board away and have them shift into single leg stance but for now we decided to only add one new challenge to the task and let them keep both feet on a support surface. We placed a target above their right side and their left side that was just high enough for them to reach when they reached overhead.

Once we were set up, we asked them to shift over to one side and at the same time reach overhead to hit the target. This resulted in them lengthening their trunk on the side they were shifted to (as opposed to shortening their trunk because they were leaning to that side). Once they hit the target they shifted over to the other side and repeated the process over there. We did this in sets of 10. After that we did some overland walking with light tactile cues at their hips and verbal cues to reach overhead when they were on their stance leg.

Did it miraculously change their walking? No, but it started to introduce a new motor pattern that will require a lot of repetitions to become second nature, and it will require continued strengthening of the hips. But it is another component to helping with a more energy efficient walking pattern! Just remember, it takes lots and lots of repetitions to change a motor pattern – repeat, repeat, repeat…

What ideas have you tried?

November 19, 2017

Carnival Games

Are you working on ball skills with any of your kids? Looking for ways to mix it up? At one of our recent group sessions, we had the kids play ‘Carnival Games.’ They were working on the same skills but we changed the context and to them, it was a whole different ball game (pun intended)!

Here were some of the games we did (we’d love to hear of any suggestions you might have so we can add to our repetoire):

bowling

  • Bowling – Line the pins up and have the kids practice underhand bowling. They get two chances to get the pins down. You can add visual cues such as a tape line to help them with their aim. Or two staggered spots to help them with their stepping into the roll. You can also change the size of the ball. They could start with a larger ball and use two hands to roll it (sometimes this helps them understand the concept of rolling a little easier). As they progress the ball can get smaller. For a real challenge have them stand on one foot or in tandem stance (one foot in front of the other) so they can work on their balance.
  • Knock the Cans Down – I’m sure there is a more official carnival name but we’ll just go with this! You can stack cups into a pyramid or you can use bowling pins like we did and recreate the bowling formation. They get two chances to knock everything down. As you can see we also added a visual cue behind the pins to help with aiming. You can use staggered spots on the floor to help with stepping into the throw. You can switch it up and work on overhand or underhand throwing. To challenge the balance, just like with bowling, you can do single leg stance, tandem stance, or you could stand on an unstable surface like a balance board or a pillow.

bucket toss

  • Bucket Toss – With this one the child is trying to get as many balls into the bucket as they can. They get a point for each one. You can mix it up if you want to work on underhand or overhand throwing. And you can challenge balance just like in Knock the Cans Down! Change the size of the ball or the density of the ball. You can use an o-ball for easier gripping or a ball that is deflated slightly to make it easier to hold onto. Lots of ways to vary the activity. And, you can use the visual cue on the wall to help with aiming!
  • Hit the Spot – This game works on passing skills. You can put one or multiple spots on the ground and have the child work on bounce passing the ball to you while trying to hit the spot. Pick a number of times and they get a point for every time they hit a spot. If you are using multiple spots you can increase the challenge of the game by calling out what spot you want them to hit when they pass it. It also works on catching because you will be passing the ball back to them. They can have some fun with telling you what spot to hit also!

What are some other games you would include in your Carnival Games?

November 12, 2017

Thanksgiving Themed Games

Turkey Hunt
Thanksgiving is a time we all love gather with friends and family. Here are some fun ideas to keep the kids (and adults!) entertained and active during the long Thanksgiving weekend:
Turkey Tag: Make small turkey faces or attach some multi-colored feathers or cut pieces of construction paper to clothespins and clip on to the back of everyone’s shirt. Everyone has to run around, trying to grab the others’ feathers! Some ways to play: once all pins are off of someone’s shirt that person is “out” or collect 5 to “win”
Variations: Mix it up by working on other gross motor skills and instead of running, change it to hopping, or skipping, or galluping, or turkey walking (looks like duck walking).
Turkey Hunt: Hide different style/colored turkeys around backyard. Make a checklist to check off what ones are found/seen. Download the free printable above here
Variations: Similar to our gross motor easter egg hunt, you can put a gross motor activity on each turkey, or create a chart that corresponds to each number so that when everyone gets back with their turkey’s you can do the gross motor activities (i.e. jumping jacks, hopping on one foot, standing on one foot, jumping up in the air, etc).
Stuff the Turkey: Make a large turkey out of brown grocery bag and two small lunch bags to make the legs on top of the turkey. Use balls of paper to toss into the turkey-who can “stuff” the turkey with the most filling?
Variations: Stand on one foot or in tandem stance when throwing, throw overhand then underhand, throw under legs or over head from behind
Turkey Waddle Relay: Place inflatable turkey or a balloon between legs, and waddle like a turkey to a designated end point and back. Make this into a family-style relay race!
Variations: waddle backwards, hop, waddle sideways, hold it in your hands and ‘duck’ walk
Turkey Walk: Great for younger kids, ask kids to walk around a designated space acting out different types of turkeys. Examples include: happy, sad, tired, scared, excited, big, little, silly.

November 4, 2017

What Contributes To Your Child’s Balance?

balance beam 1

There are three main components that make up a person’s balance. These include: vision, somatosensation, and our vestibular system. These components need to work seamlessly together in order to allow both adults and children to maintain their balance in all different environments and scenarios.

 

Vision is pretty simple: what you’re able to see with your eyes allows you to keep your balance. You may notice that your young child needs to look down more frequently, especially in newer environments. Somatosensation is what we are able to feel, and particularly important for balance is what we are able to feel with our feet. This comes in handy for walking across uneven surfaces, such a grass or dirt. Our proprioceptive receptors are able to detect changes in terrain and accommodate accordingly. Finally, our vestibular system is what is located in our inner ear. This system allows us to detect changes in movement and motion, and accommodate accordingly.

 

If one component of balance is unavailable for use, the other two must compensate for this loss. Take vision for example: When you are walking at night or in the dark, your vision is at a disadvantage, and therefore, the vestibular and proprioceptive systems have to compensate for the corresponding loss of visual input. Many people, children included, may tend to over-rely on vision, particularly if the other two components aren’t functioning properly. It is therefore essential to ensure that all three components are contributing to one’s balance.

 

An example of the development of the somatosensory component is evident in young children when they are first learning to stand. You may remember your child rocking back and forth from their feet to their heels. This allows the child to gain knowledge of their limits of stability, and is also providing essential somatosensory input. They will learn to associate the feeling of being too far on their toes with a loss of balance, as well as going too far back on their heels. This discovery play is essential for all children, and helps to develop a sense of what appropriate balance feels like!

 

The vestibular system becomes essential for maintaining balance during movement.  The development of this system can be enhanced by encouraging  your growing child to participate in activities that involve movement—such as swinging, jumping, and playing catch!

 

It is essential to encourage kids to explore and discover their balance! Some activities that encourage balance development include: standing on one foot, walking along narrow surfaces (such as along curbs), jumping off higher surfaces, standing with their eyes closed, and walking along uneven or unsteady surfaces (such as grass or tan bark or over pillows at home).

Here are some older blog posts that address activities that can work on balance!

October 29, 2017

Core Workout: Hungry Hippos meets Wreck it Ralph

I happened to walk by another one of my therapists using a really fun and creative way to work on core strength with kids. I know I have done my share of walkouts over a ball or peanut with a kiddo but this was so much more fun. In addition to working on the core, it also works on upper extremity strength, shoulder stability, and motor planning.

She helped to stabilize his feet on the ground while both of his hands were on a scooter board. There were several bowling pins set to the front and to an angle from the kiddo. He had to hold his core tight while pushing the scooter board out to knock over the bowling pin and then bring the scooter board back. The goal was to see how many he could knock over at a time. They had a target number and he ‘won’ that round if he hit the target number. You can always tell when a game is fun when they want to do more rounds even though they say on one break ‘this is hard.’ I’m pretty sure I would have trouble doing even one repetition!

Here is a brief video of the activity.

Has anyone else tried any other variations of this? We’d love to hear about them.

October 22, 2017

Jumping and Balance Path

Jumping Course

I know we’ve talked about a jumping path before but I loved this path that I happened to observe one of my therapists using with her kiddo. It incorporates jumping forward, jumping over, jumping on, jumping off, jumping open, and jumping close. And then, it adds in balance via single leg stance and toe taps!

The best part was, watching her kiddo help her put it together and knowing that he had put his cut out feet in the open position like she had asked him to.

Here’s a video of the final product!

What other variations can you think of?

October 15, 2017

Halloween Inspired Gross Motor Games

Looking for some fun things to do with the kids that are Halloween Themed and will work on those gross motor skills? Check out these games!
Pumpkin Bowling: You can literally use a small round pumpkin or you can use a ball that is orange (if you don’t have one – get creative and make one to look like a pumpkin)! Have your kiddo stand at the designated spot (you can literally use a spot if you want), if you want to get really creative you can make it a gravestone or something else Halloween themed! This is where you can challenge their balance. Have them stand on on one foot, in tandem stance, or stand on a balance board or dynadisc, have them stand backwards and roll the ball through their legs – the point is get creative and have fun! Have them roll the pumpkin to knock over the ghosts. This can be paper towel rolls or white cups with ghosts faces drawn on them. You can stack them in pyramid style or set them out in traditional bowling pin formation. We’d love to see pictures of your set up!
IMG_5195
Spider Web Walk: We’ve talked about this one before and there are lots of ways you can make it more or less challenging for the kids. Use tape to draw a spider web on the floor and find challenging ways to walk around the web. Read more here.
Painters Tape
Witch Hat Ring Toss: Buy some witches hats or cover athletic cones in black construction paper to make your own. Same as with pumpkin bowling (read above for ways to work on balance) create a starting point and then have your child try to throw a ring onto the witches hat. You can have one hat that they have to get multiple rings on, or have multiple hats set out that they have to try to toss towards. Let’s see how many ringers they can get!
IMG_5194
Pumpkin Patch Stomp:  Blow up some orange balloons (you can draw on them if you want to make them look more like pumpkins) and try to stomp on them! To make it a little easier you can put some sand or water in the balloon so they won’t move away as easily. The more air in the balloon, the easier it is to pop, but if it is less full, its easier for the child to get and keep their foot on it. You might want to have a mix of balloons to vary the difficulty.
Pumpkin Walk: Have your child try to walk across the room, or on a balance beam while balancing a baby pumpkin on their head. You can also change this to Witches Hat Walk and make a witches hat out of an athletic cone and do the same thing (the hat might be easier for the little ones because it has a flat bottom)
Spider Web Crawl: Use toilet paper or white streamers to create a web across a hallway. Have your kids try to crawl over and under without breaking the web! For some other ideas read more here.

October 8, 2017

Dribbling a Ball

IMG_5143

We were recently working on ball dribbling skills with some kiddos. They had been practicing them off and on for a while but were still finding it hard to dribble the ball while walking down the hallway. So, we decided to spend one whole session devoted to bouncing the ball and progressing this skill. To do this we looked back at the how motor learning occurs and started with blocked practice of the basic skill and slowly added to it to get to the skill we wanted. The best part was that at the end of the session the words ‘that was easy’ were actually spoken – this was so great because when we first said we were going to go out and dribble down the hallway that same child said ‘oh no, that’s hard.’

  1. Using a spot on the ground and the wall behind the child we started with bouncing the ball in place on the spot. The wall was used to help provide a cue to stay up tall as there is a tendency to bend at the waist and get closer to the ball rather than bouncing the ball hard enough to come back up high enough. We let the child choose how they wanted to bounce the ball and it usually started with both hands bouncing the ball and then catching it and then bouncing it again.
  2. Next, using the same props/cues, we progressed to bouncing it with two hands up to 3 bounces. This way they were working on continuous bouncing and not bounce and catch. Once 3 was mastered we slowly progressed until we got to 10 successful bounces.
  3. Next, using the same props/cues, we repeated the above step but by bouncing with one hand. We continued to progress this until we got up to 10 successful bounces with one hand.
  4. At this point we moved into the hallway (and this is when the words ‘oh no, that’s hard’ were spoken). We had them dribble the ball while walking for up to 3 bounces. Most used two hands and we let them. Again we slowly progressed until we got to 10 successful bounces while walking.
  5. Next we decreased to one hand and repeated the above steps until we got to 10 successful bounces while walking. This was when it was declared ‘that was easy.’

At this point the child began dribbling the ball the full length of the hallway. What was fun to see was that there was control of the ball. Even when it bounced slightly to the left or the right, they were able to maintain control and keep dribbling forward!

Now, in subsequent sessions we will have to continue to practice this but ideally we can begin to decrease the number of steps and then begin to generalize the skill and introduce different games that involve dribbling.

How have you worked on dribbling with kids?

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