Starfish Therapies

May 2, 2012

The Ability to Focus on More Than One Thing (aka Multi-Task)

I recently had an aha moment with regards to what it takes to learn new things when I was working with a student and trying to teach them everything that goes into being a pediatric physical therapist (its amazing how much there is to think about at any given time!).  On Monday my post was about Motor Control and Motor Learning and talked about how to help kids learn new things more efficiently.  Well sometimes I forget how much goes into learning something new.  When a child or even an adult is learning something new they are focused on that specific activity.  If you start trying to talk to them or add distractions in, the quality of what they are trying to learn will go down.  If all they have to focus on is one specific thing, they will begin to master it.  Now, its not really practical to just focus on one thing at a time so as they begin to master what they are doing, its good to add in distractors or make things a little more complex.  This helps with carryover of the skill to new and different environments.

I have a kiddo that has spastic quadriplegia cerebral palsy and he is learning to walk without any assistive devices such as a walker or canes.  He is getting really good at it and can even talk while walking for the most part.  He still needs to be reminded to catch his balance or he will ‘forget’ to turn on his muscles in time.  Yesterday I wanted to work on making his walking even more efficient so it becomes easier for him so we started trying to work on narrowing his base of support (or walking with his feet closer together).  I came up with the idea of putting two lines on the floor and having him try to keep his feet in between the lines.  He only had to walk about 8 feet this way.  Well, just by adding in the visual component (the lines) and the responsibility of keeping his feet in between those lines his walking went down hill.  He couldn’t walk in a straight line and the pace he walked at slowed down by at least a factor of 5, maybe more.  He even had trouble just looking at the lines while he walked.  I realized that I was asking too many things of him.  He had gotten to the point where walking down a hall was pretty easy but by adding in the visual and the expectation to keep his feet in a certain area, he had too many things to focus on so everything decreased in quality.  Today we went back to the drawing board and tried having him walk just looking ahead at the ipad and he did great.  Then we tried walking using cones as a guide and he did pretty good.  Tomorrow we are going to try just giving him a tape path to follow on the floor and we will worry about the base of support another time once he masters following the path.

It was a great lesson to me that I can’t change the demands of the task too quickly.  My favorite example to give people when I am trying to explain this is to think back to when you were learning to drive a car.  Every ounce of your being was focused on driving that car in a straight line.  The radio was off, no one could talk and you barely breathed.  You had to think about every move of the steering wheel, how much you were pushing down the gas and exactly when to push the brake.  Now, after you have mastered that task think about all the things you do while driving – most of which we shouldn’t.  I bet there are some days that you drive somewhere and once you are there you don’t even realize how you got there.  That is when things are automatic and you don’t have to think about it.

So, hopefully you will take this into consideration whenever anyone, whether old or young is learning something new, whether a skilled movement or something from school.  It takes time and practice to develop mastery and you need to slowly add in variables so that there is continued success with whatever is being learned – don’t pile on too many things at once!


1 Comment »

  1. Hi there! I love your blog! I am a school based pediatric PT and have really enjoyed your posts, you have given me many ideas to use in working with my students. I was wondering if you have ever worked with a child with a metabolic disorder. It is very different than the normal PT patient and I would love to talk to another PT who has some experience in working with a child with a metabolic disorder. You can reach me by email at Thanks! Michelle

    Comment by Michelle — May 2, 2012 @ 2:29 pm | Reply

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