Starfish Therapies

October 1, 2017

10 Things You Didn’t Know A Pediatric PT Can Help With

In honor of October being Physical Therapy Month, we wanted to share a list of things that you may not realize a pediatric physical therapist can help your child with. If any of these resonate with you, call your local pediatric physical therapist to ask questions. Happy Physical Therapy Month!

  1. Yes we work with BABIES! Pediatric PT treats newborns for things like torticollis, plagiocephaly, and delayed achievement of milestones.
  2. Yes we facilitate BREASTFEEDING! Pediatric PT can help you and your baby with the following things: positioning, range of motion and mobility for access (latching), relaxation, and proper trunk and pelvic stability.
  3. Yes we support POSTURE and ERGONOMICS! Pediatric PT can analyze and teach both you (lifting safety) and your child (posture, backpacks, handwriting, and more).
  4. Yes we address challenges related to TOILETING and BEDWETTING! Pediatric PT works with your child to strengthen the pelvic floor, develop routines, and educate in all areas that affect toileting.
  5. Yes we provide NUTRITION SCREENING! Pediatric PT does nutritional screening to promote health and wellness, address obesity, and enhance rehabilitation.
  6. Yes we address CONCUSSIONS! Pediatric PT performs pre- and post-concussion screens including subsequent vestibular rehabilitation.
  7. Yes we analyze FOOTWEAR! Pediatric PT assesses proper fit and function of shoes for sports, everyday use, and even picking out their first pair.
  8. Yes we facilitate development of COORDINATED PLAY SKILLS! Pediatric PT helps your child keep up with their peers by working on body awareness and coordination for skills such as bike riding, monkey bars, skipping, jumping jacks, and more.
  9. Yes we support YOUTH ATHLETES! Pediatric PT not only treats injuries but prevents them through running and movement analyses, and performance enhancement training.
  10. Yes we perform GROSS MOTOR CHECK-UPS! Pediatric PT helps ensure your child is on track with their gross motor skills by recommending annual check-ups just like you go to the dentist every 6 months.

 

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September 29, 2017

Balance and Vestibular System Ideas

balance
Balance is an important part of movement and safety and is a requirement for every day activities. Balance can involve keeping two feet on the floor, or even standing on one foot. There are many activities that require balancing on one leg. Some of these are: running, stairs, kicking, and walking in varied directions.
Try these activities to improve your little one’s balance today:
  • Popping bubbles: Have your child stand on one leg, and use the other foot to try and pop a bubble.
  • Kicking a ball: Practice standing on one foot for 5-10 seconds prior to kicking the ball to your partner.
  • Balance beam: Make your own balance beam by using a pool noodle. Practice walking up and back. If this gets too easy, walk backwards!
Some of our older blog posts that address balance are:
The vestibular system is one of our key components of balance and helps individuals of all ages maintain visual stability. Children may experience deficits with their vestibular system for many reasons, and these deficits can impact their ability to actively participate in age appropriate activities and recreation. Here are some ideas for stimulating your child’s vestibular system:

September 21, 2017

Wheelbarrow Walking

wheelbarrow walking

Do any of you remember doing wheelbarrow races as a child? I do! I remember thinking it was hysterical that someone was holding my feet and I was racing someone else on my hands. Well, as much fun as that was, wheelbarrow walking is actually a great tool to incorporate with kids to help them get and stay strong.

Wheelbarrow walking works on strengthening the arms and the core. It can also support coordinated activity because of the need to walk reciprocally on their hands, while keeping their head up to see where they are going, and keeping the core muscles turned on so that the person holding their feet can better support them.

I am a big fan of multi-piece toys such as puzzles and shape sorters. They naturally build repetition into an activity. For instance, you can put the puzzle at one end and the pieces at another end. Place one puzzle piece on your child’s back just like they were a wheelbarrow picking up a load. Then have them walk on their hands to the other end to put the piece in the puzzle. Turn around and head back for the next piece. Keep repeating until all the pieces are replaced.

So how do you vary this by child? That’s easy!

  1. Distance to walk – Start with shorter distances. If they are doing really well you can increase the distance by moving the puzzle board just a little further away.
  2. Number of repetitions – Start with carrying just one piece back at a time. If they seem to be tiring, start adding more than one piece to the wheelbarrow. This way they still complete the puzzle but you have decreased the number of repetitions.
  3. Where you are holding them – The closer to their arm pits you provide support, the easier it is for them. The closer to their ankles that you provide support, the harder it is for them. Just like goldilocks and the three bears, you want to hold them in just the right spot. This means that they can walk on their hands without letting their belly sag towards the ground. If you see their belly sagging (or back arching) you may want to move closer to their arm pits. Once they have mastered keeping their core strong, you can slowly move closer towards the ankles.

There are other variations to make this fun besides just completing a puzzle or a shape sorter. Here are a few ideas I had:

  1. Treasure hunt – Start with a treasure list and have the items hid in the room that you are in. Have them walk on their hands to collect the treasure. They can hold the items in the ‘wheelbarrow’ while they collect each of them.
  2. Race track – Create a race path that is clearly marked and use a stop watch to see how fast they can get around the race track. If they have to pause on the track it’s like taking a pit stop. Clearly, they’ll want to take less pit stops to get faster times. Be careful they aren’t going so fast that they start to sag at their core.
  3. Staying in place – Rather than walking on their hands, have them assume the position and put papers with different colors or letters or numbers in front and to the side of them. Call out a color (or number or letter) and have them use their hand to touch it. You can get tricky by telling them what hand to touch it with (similar to twister).
  4. Going backwards – You can do almost any of the above ideas backwards. It’s a great way to make the activity novel. You can also combine forward and backwards to make it extra tricky!

Since you are the one that will be helping, you want to make sure to take care of your back as well. Be careful that you aren’t bending over to support them. Use a rolling stool or a scooter board, or walk on your knees (but I would recommend knee pads if you are going to be doing this a lot).

September 13, 2017

Single Leg Stance

We often have parents come in and ask for us to help their child be able to stand on one foot better. Usually they have heard that this is a skill that all children should be able to do. But why? What does standing on one foot help with? Here are some of the skills that are improved when single leg stance improves:

  • Going up and down stairs
  • Kicking a ball
  • Stepping over obstacles
  • Getting dressed
  • Standing up from the floor
  • Hopping
  • Skipping
  • Walking with a narrow base of support (i.e. on a balance beam)

 

So what are some activities that could help your child to improve this skill? Here are a few:

  • Toe taps – Place a spot in front of your child and have them tap their toe on it. Make it a game by calling out numbers to see how many they can do. Or switch it up between left and right foot. You can do this on the ground, or raise the height to make it more challenging. You can also move the target from in front to diagonal to the side. ToeTaps
  • Foot on a ball – Find a ball and have your child try to hold one foot on top of it and maintain their balance. You can time them to see how long they can go for, or have two people doing it at once to see who can last the longest. Make sure to switch up feet. Softer, squishy balls are easier to balance while larger, firmer balls are harder to balance on.
  • Popping bubbles – This one is fun because what child doesn’t love bubbles? Blow bubbles and have them try to stomp on them to pop them! SLS bubbles
  • Stepping over obstacles – Have your child try to cross a room while stepping over obstacles in their way. You can use small books, pool noodles, toys, groceries, or anything that you can think of. Shorter and narrower are easier than taller and wider. Also make sure it is a stable obstacle and not a ball that will roll if they bump into it. You could also use painters tape to make obstacles across your hallway so they have to step over varied heights of tape.
  • Yoga – Tree pose is one of our favorites. Kids like to imitate it and they can ‘cheat’ by putting their foot down close to their stance foot if the knee is too challenging. single leg stance

What are some ways you work on single leg stance?

September 4, 2017

Fun with Painter’s Tape

Painters Tape

Looking for easy and fun activities for your kiddos to do at home? All you need is painter’s tape and a little imagination! Here are four different gross motor activities with simple set ups to work on balance, strength, motor planning, coordination, and body awareness.

  1. Weaving through spider web:  Use a hallway to span tape from one wall to the next in a varied pattern as seen in the picture. Have your kiddo step over, army crawl under, and crouch through to get to the other side. Giving them a chance to problem solve how to get from one end to the other works on motor planning and being able to adjust their body and avoid contact with the tape challenges their awareness of their body in space. Here are some posts on painter’s tape spider webs, and jungle vines (just adapt for painters tape)!
  2. Walk the line: walk forwards, backwards, sideways:  The beauty of painter’s tape is that it can easily be applied and removed from so many surfaces. Regardless of your floor type, you can create patterns on the ground for your kiddo to walk across. This challenges their balance and ability to move with a narrower base of support. You can also have them hop on one foot down the line or hop back and forth between lines to build strength and power. You can add more variety by having your child walk backwards or sideways! Here are some other post on similar ideas such as balance beams, more balance beams, and jumping paths – just adapt and use painter’s tape!
  3. Spider web walking:  In addition to lines, you can create a spider web out of tape and challenge your child to walk on the line to get different critters within the boxes or you can have them jump from box to box to avoid touching the spider web! Here is a longer post on this idea!
  4. Tic tac toss:  Take the tic tac toe game off the paper and turn it life-size by taping a grid on the ground. Use two different color bean bags to duel it out amongst family members or friends. If you want to add more physical challenge you can incorporate similar concepts to what is explained above including walking heel to toe to your chosen box or hop from square to square to drop it in rather than tossing.

Now grab some tape and let the fun begin!

August 27, 2017

Squat, Stand, Tip Toes

 

One of our previous PT’s stopped by and brought us a 10 year birthday present (We had just celebrated our 10 year anniversary). She was so excited when she saw the Little People Stand and Play Rampway because she thought it would be great for kids to use to work on standing, squatting, transitions on and off the floor, and more. And yes, we have used the toy in the way we thought, although we’ve also found its good for tip toes as well! Sometimes we are inspired by a toy and sometimes we have an idea and find a toy that will help motivate. This happens to be one of those times that we were inspired by a toy!

As you can see in the picture, we set it up on a support surface so that the child would still have to get in to standing to reach the top. An added bonus was that she had to get up onto her tip toes to reach. To work on being all the way down on the floor transitions, you could have the car end up under the bench. They may try to reach in squatting, which also is good for them to do, but many times they will get onto their hands and knees or into sitting so they can reach a little easier. Then they have to practice the transition from the floor into standing. If they choose to stay in squatting they get to work on balance and stability while reaching outside their base of support.

What are some of your favorite toys for working on standing, squatting, and tip toes?

August 20, 2017

Jungle Vines

 

We love taking students for their clinical internships. They often bring fresh ideas to our treatment plans. This is an exercise that our most recent student came up with, and of course we have all found a reason to use it with our kids! Feel free to change the name of it, this is the name we use when it is part of an Adventure for one of our kids.

We take our climbing net and we string it up parallel above the floor in our Universal Exercise Unit. The height can vary depending on the skill of the child. For some kids, having it lying flat on the floor will be challenging enough. You can also use an agility ladder for this activity, or create a grid with tape. (we have done a similar activity with tape across a hallway but made it more of a maze)

Because we like to get in multiple repetitions we usually have a toy with many pieces (such as a puzzle or animal bean bags). Then the child can ‘rescue’ friends, or a monster, or whatever they feel like.

It works really well for working on single leg stance as the child usually takes some time when lifting their foot up to clear the obstacle and then place it in the next hole. It also works on balance (one foot and two feet) while they plan their next move and use precision to make it through the jungle. Of course there is motor planning and coordination as they pick their path through the jungle and figure out how they need to move to get to the other side, and then actually execute the plan.

What other ways have you done activities like this?

August 13, 2017

Find the Bucket

IMG_4595

We love collaboration with other providers. We are lucky enough to have an OT company that we reciprocally share space with. This allows us to pick their brains and them to pick ours. One day they were talking about using our platform swing and how to work on visual motor skills and this activity was born. We of course have adapted it depending on what exactly we want to focus on that day, but I’ll give you the basics and then you can adapt at will!

We set up the platform swing and place a bucket of some sort underneath it. The child shouldn’t be able to see the bucket when the swing is at rest, but it should be right at the front of the swing so its easy to find when the swing is moving. Get some balls for the kiddo to drop into the bucket once the swing starts moving. This gets them to work on their visual motor skills, their timing, their motor planning and coordination.

To take it a step further you can change what position you have the child in on the swing. For our kiddo we start in prone prop, then move to quadruped, then high kneeling, then half kneeling. This lets them work on core strength, and balance.

We have the kiddo reach for the ball before they are able to drop it in the bucket. This encourages weight shifting, reaching, hand-eye coordination. They also have to hold their balance while they are weight shifted and the swing is moving which helps with righting reactions.

The dropping the ball in the bucket while the swing is moving, is of course the fun part! The kids find it hilarious to ‘find the bucket’ and get super excited whenever their ball makes it into the bucket!

Has anyone else done an activity like this? What variations have you used?

August 6, 2017

Feed the Woozle

Another game I have never played, but one of my therapists found a really fun way to use it to motivate one of our kiddos to work on stairs, and more specifically stairs while carrying things. You can take the general idea and use it for other activities you are trying to get kids to do!

We put the Woozle at the top of the stairs. At the bottom of the stairs the kiddo gets to roll the dice and figure out how many pieces of food he gets to take up to the Woozle (1, 2, or 3). [Note – also working on counting and numbers]

Once that has been determined he picks the food (which have amazing names – a favorite is the Lemon Flavored Underpants) and puts them in a cup (we use stacking cups). [Note – also working on fine motor skills]

He then carries the cup up the steps to the Woozle to feed him. The trick is that in order for the Woozle to know that its the kiddo approaching to feed him, and not a ‘bad guy’, he has to step on the taped x’s. Which of course encourage reciprocal stepping (occasionally the x’s get missed and we use our judgement if we want to repeat or let them go, especially if they are doing reciprocal anyway). [Note – and visual processing, coordination, motor planning, balance]

Once to the top, he feeds the Woozle and then comes back down the stairs holding the empty cup to fill back up with more food. [Note – also works on floor to stand and stand to floor each time, or squatting]

I don’t know about your kids, but ours think this is hysterical and love picking out which food they are going to give him, and they find it funny when he only gets one piece of food. Little do they realize that means they have to do more reps to get rid of all the food!

What other ways have you used Feed the Woozle?

July 30, 2017

Jumping Path

jumping path

As I was browsing through Facebook the other morning while trying to get my morning started (yes, this has become my new snooze button), I saw a video someone had shared of kids using a jumping path. I thought is was so great that I took a screen shot of the video and brought it into work so that we could recreate it. Luckily, we have cut out feet that we had purchased at a conference a few years ago so this project didn’t involve much planning.

It is such a simple idea yet so great in that it works on many skills. A few of those skills are:

  • Jumping – This one is pretty obvious. However, we have kids that struggle to keep both feet together while jumping (they do more of a staggered jump), and we are always looking for new ways to get more repetitions of jumping in. This is an easy way. Even if all of the feet were facing the same direction (forward, or backward, or to the right, or to the left) they would still get jumping repetitions in.
  • Motor planning – The child has to look at where their feet are, look at where the next feet are, and plan how they are going to get there.
  • Spatial/body awareness – The child has to understand where they are in space in relation to where they want to be
  • Coordination – Getting their body to move in the way they have now figured out they need to move to get to the new set of feet
  • Balance – It can be a little more challenging to jump and land on a precise location and stay there than to just jump forward and land wherever you want

Has anyone else tried this activity? Do you have any variations? I did figure out that you can make it easier or more complex by how you place the feet.

  • Having the feet all pointing the same direction is the easiest.
  • Next would be having them pointing at 90 degrees from each other (forward, right, forward, right)
  • Clearly having a pattern of only two directions (see above) is easier than multiple directions
  • The hardest would be a completely random path with 90 to 180 degree turns throughout and going in all directions
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