Development of Refined Movement

I recently saw a video a friend posted of her son learning to commando crawl.  I immediately asked if I could use the video because I thought it was so great.  Luckily she said yes and you can see the video in this post!

What I loved about it is that with almost every move forward, he almost topples to the side.  He then has to bring his head and trunk back up to the middle for the next pull forward.  But because he hasn’t refined his movement yet, he goes too far and topples to the other side.  What’s great though is that every time this happens, his body is storing the information on how much effort he needed and it will begin to give him feedback to limit his movements so that he stays more in the center.  You can see in the next video clip (only 5 days later) how much less he falls to the side and how much faster his movements have become. And then in the next one (only another 5 days later), he is a commando crawling master!

We have all experienced this.  When we are learning a new skill, we are like the first video clip.  Our movements are clumsy and unrefined.  We use bigger, less efficient motions than what is required.  But each time we practice we refine our skills a little more so that soon we are efficiently performing the new skill.

It is for reasons like this that it is important to give babies and all kids, opportunities to explore their movement.  They are learning how their body works and creating new pathways that give them just the right feedback.  If they are never given the opportunity to practice it takes them longer to develop skills.   By overshooting over and over, they are learning from each movement to make the next one even better. This carries over to almost any new movement we are learning, whether we are a baby, a toddler, a teenager, and even possibly an adult!

Rubber Bouncy Balls

This idea is so simple I wouldn’t have thought of it except my nephew initiated it and we had a blast.  Basically my parents keep a glass jar of rubber bouncy balls for him to play with (note if you have little kids make sure they don’t put them in their mouth).  He brought the jar down and we went into the three season room (not sure why its called this since they use it all four seasons) which has a tile floor (any hard floor will do) and we turned the jar upside down and watched the balls bounce all over the floor.  We then had to go around and pick them all up.  In the process of picking them up we worked on squatting, quadruped, crawling, weight shifting, reaching, in hand object manipulation, various grasps, body awareness as we maneuvered around the furniture, visual scanning so that we didn’t step on the balls as we picked them up (and scanning to locate the ones to pick up).  Then we put them back in the jar which works on voluntary releasing, visual motor accuracy and tripod or pincer grasp.  If you wanted to really spice it up you could sit the jar on a chair or some other elevated surface and try to toss the balls into the jar.  Then you get to go chasing after them when you miss!  Or, you could practice bouncing the balls and trying to catch them which works on visual motor and hand eye coordination.

How do you use bouncy balls?

Core Strengthening with a Tunnel

We love tunnels and our kids love tunnels so we often find ways to incorporate them into therapy.  We have standard tunnels with a ‘solid’ form and we have lycra tunnels that provide resistance that the kids have to work against.  I thought I would take a moment and share one of the activities that we use our tunnel for to work on core strength (primarily) but other things as well.

We love to put the tunnel over top of our crash pad, although you can use pillows or couch cushions instead.  Then we have them crawl through the tunnel over the crash pad.  Often times they won’t be able to maintain hands and knees because it is a bit challenging but with practice their core gets stronger so they can crawl all the way through.  If you have them doing reps you may notice that they will start off maintaining hands and knees but with increased repetitions they aren’t able to maintain it.  This is because they don’t have the endurance in their core muscles to complete higher number of reps.  Since core muscles are mainly used in an endurance type fashion, to help keep our trunk stable as we go about our day to day activities, making this a high repetition activity is a must.  We use puzzles or toys with multiple pieces to keep the kids going over and over and over.

Some things to consider when you are setting up.  The softer the surface, the harder it will be for the child.  If you want to ease them into it find something that is a little firmer.  Next would be the steeper the incline or decline the harder it will be.  For a kiddo just starting out using a flatter surface will be easier.  You can also start them out on softer and steeper and as the repetitions increase make it firmer and flatter.

In addition to working on core strengthening it also gives kiddos a chance to crawl which many kids skip in this day and age.  With crawling they get to work on motor planning between their left and right sides as well as between their arms and legs and use reciprocal patterning.  All in all we love this activity!

How have you used tunnels?

 

Ideas for Helping Kids Develop Better Posture

Posture is always an interesting topic.  As adults we are often trying to improve our posture because we have started discovering that poor posture can cause other problems like pain.  These are things we don’t think of when we are younger and don’t always think about for our kids.  Posture is something that can and should be worked on from when kids are little so that they can hopefully avoid long term problems as they get older.  I have to thank one of our readers for coming up with this idea!

Here are some tips and ideas for exercises/playing that can also work on posture:

• Make sure kids hamstrings stay flexible.  Its a lot easier to keep them flexible than to stretch them later.  When hamstrings are tight it can tip our pelvis backwards so that it flattens our low back spine.  To help with keeping hamstrings flexible have kids avoid w-sitting and long periods of kneeling as these will both shorten the hamstrings.  They should sit in a variety of positions such as ‘criss cross’ or with their legs straight out in front of them.  Here are some different sitting positions.
• Core strength is really important.  Some of my favorite ways to improve core strength for kids other than having them do sit ups are:

1. Lots and lots of climbing.  Since its getting nicer out this should be easier because parks are lots of fun.  The more unstable the climbing surface the more they will have to work their stabilizers and abdominals.  I love climbing nets or climbing domes.  Even ladders work well for this.
2. Animal walks are a lot of fun and really challenge the core.  Some of our favorites are bear walking (hands and feet) or crab walking or dog/cat walking (straight crawling).  You can have animal parades or animal races.  You can change the terrain by going over uneven surfaces such as cushions or you can go up and down hills.  You can make animal obstacle courses where they have to be the animal and go around cones, over obstacles and through tunnels.
3. Use a therapy ball.  Have your kids sit on it and move it around in all directions with fast and slow motions.  Or have them bounce on it. Try to give as little stabilization as possible (try for just the legs) and make sure they aren’t using their hands to hold on.  If you can get them to engage their hands in play such as clapping or touching their head or reaching to the sky it automatically encourages more upright posture.  I will also have kids reach for items such as bean bags and then throw them for a target while sitting on the ball.

• Try sitting on an unstable surface.  There are wedges or core discs that are out there that can provide the ability to wiggle while sitting and allow kids to keep their core active and engaged.  You need to try it out though because sometimes it can be too challenging and they will just sink into a slumped posture.  Also if you can make a sitting surface a little higher than normal so their feet still hit the ground it can encourage an upright posture more than sitting at 90/90.  Or if you have a therapy ball that they can sit on with their feet on the ground while watching tv or doing other things it really works to keep the core active.  You have to make sure that they are safe while doing this though.
• Swinging at the park especially when they are self propelling naturally engages the postural muscles such as the scapular retractors and the abs. In addition they get some great vestibular input.
• Bike riding is really fun and great for core strength and endurance.  If you really want to get the core working ride up slight inclines and hills, they will have to use their arms and abs to generate power from their legs.
• Reaching in sitting will also encourage upright posture.  Have them sit in a variety of positions or on a variety of surfaces and play games where you make them reach up and in front or to the side.  Watch their posture to make sure they are engaging their core muscles.

I probably have a ton of other ideas but this is a start.  What are some of your favorite ‘exercises’ for encouraging improved posture with kids?

Learning to Commando Crawl

In this video I show some ways to help your child learn how to crawl on their belly.  I’ve talked about some pre-crawling items in other posts and this would still be considered pre-crawling but now its about pulling it all together.

When kids are on their bellies, they need to know that they can move forward.  Often they will push up on their arms to look at something they are motivated by but they don’t yet know how to stay up while pulling themselves forward on their arms.  You can give them a little assistance and stability to take them through the motion so they know its possible.  Same with their legs.  They often figure out how to reciprocally kick their legs as if to push forward but they don’ t know how to get the traction necessary to make the push.  By stabilizing their foot or knee slightly you can give them the assist they need to get a feel for the motion.  Sometimes they need a bigger boost (like a push from behind) to feel that they can move their body forward in this position.  Once they get the individual components it just takes lots of practice and opportunity and motivation for them to develop this great skill.

Pre-Crawling: Problem Solving and the Desire to Move

This post probably should have come before last weeks post about pivoting and reversing but they are still all part of the same idea for kiddos who are learning how to figure out a new movement such as commando crawling.  You can see in the video that he sees a toy or toys that he wants to get to and then he uses every part of his body to figure out how to move forward to get there.  This can also include incorporating rolling from side to side in an effort to produce forward movement.  Kids are amazing at how they will figure out to get what they want.  The first thing that is important is the desire to move.  Some kids develop this on their own and some kids need to be shown that moving is fun.  That could look like engaging them with a toy and then moving it slightly further away (still within reach but they have to work for it).  Then keep moving it just a bit further and help them get to it so they can learn that moving will get them to places and things that they want.  In this video I just let the kiddo figure out how to move on his.  In some upcoming videos you will see me help him work on figuring out how to coordinate his arms and legs, but the fact that he is working so hard to get to where he wants to go is really important for the development of his motor planning and coordination.  He gets important feedback regarding what works and what doesn’t work.  You will also notice that he can’t keep his head up and move the rest of his body at the same time.  He comes up to check for his target and then his head goes right back down again while he tries to push with his legs.  He is using his head the same as he would an arm or a leg and at this point he can’t coordinate head and neck extension with movement in the rest of his body.  Same with his legs, they are very symmetrical which is normal.  They move together and do the same thing.  You will notice in last weeks post (which was videoed chronologically later than this one) that he is able to move his legs separately and have them do things differently.  This is appropriate developmentally.  He is working out how to be efficient.  Keep watching/reading for more on pre-crawling and progressing to commando crawling!

Pre-Crawling: Pivoting and Reversing

Before kids can learn to crawl they need to work on the components of crawling.  In addition to those components many of the kids learn how to commando (or belly) crawl first and in order to learn this they have to work on the same components.  Two of the pre crawling activities that kids will do is pivoting on their bellies as well as pushing themselves backwards.  This is their opportunity to explore movement and learn that they can cause movement from one point to another.

They start to put together using weight shifting through the arms/shoulders and through the legs/pelvis along with trunk sidebending and elongation.  These coordinated movements will allow them to start moving in a directional way.  When the kiddo uses pivoting they are using one side more than the other and when they use reverse movement they are able to use both sides of their body in a coordinated and equal way.  This is different that doing things symmetrically (which means they use both sides in the same way at the same time).  They are using their left and right side reciprocally so that a movement on the left will then be copied by a movement on the right and will continue to go back and forth.  This reciprocal movement is a building block for crawling, walking, running, skipping, riding a bike, etc.

By pushing themselves backwards they are learning how to use their arms to help with movement.  It takes less effort than pulling themselves forward (which becomes more efficient by the use of the legs to help).  When the legs are incorporated for forward movement it not only involves reciprocal arm and leg movement but also contralateral coordination (i.e. left arm and right leg and then right arm and left leg).

We will cover more pre crawling  development over the next few videos, so keep your eyes out for them.

Ideas for Weight Bearing – Arms

I usually spend a lot of time thinking about legs and weight bearing and weight shifting because I’m often working with kids on walking or balance or other skills that require them to use their legs.  Well sometimes we need to work on weight bearing through their arms as well.  This could be to work on shoulder girdle (the shoulder blade area) stability, core strength, weight shifting, or encouraging the use of one arm if it is a little weaker to name a few of the reasons.  Here are some ideas that we have used:

• crawling, bear walking, crabwalking – over level ground or uneven ground or cushions.  This will help with weight shifting as well as strengthening.
• push ups – to make it fun for kids I will often help them out by stabilizing them at the hips and using bean bag bugs and have them try to ‘kiss’ the bugs
• wheelbarrow walking – to make it easier hold the kiddos closer to the hips and level to the ground, to make it harder hold them closer to the feet and at a bigger angle to the ground
• bean bag toss (or other throwing game) – have the kiddos lie over a bolster, peanut, cushion or some other item so that they have to hold themselves up by the arms.  Then they can try to throw bean bags at a target or make a pyramid with cups and have them try to knock those over or even set up bowling pins and roll balls at it.  For best results have the kiddos switch hands so they will work on weight bearing on both sides.
• bombardment – a game we made up that has the kiddo in the same position as the previous activity and then roll balls towards them and have them try to stop them and roll them back to you.  You can create points and everything.
• ball on a wall – I don’t have a real name for this one but I will have kids keep a ball on the wall with their arm fully extended.  They have to try to roll it around and keep it in a 12″ x 12″ square for a certain amount of time.  You can change the size and weight of the ball to make it easier or more challenging.  You can also have them try to coordinate a ball with both arms at the same time.
• steamroller – Have your child lie on a foam roller, bolster, peanut, or small therapy ball and have them use their hands to walk their body out as far as they can.  You can have tape lines on the floor to see how far they can make it without collapsing, and then of course walking back.  You can also have a toy out in front so then they have to weight shift onto one arm to use the other arm.

That’s just a few of the ideas that we’ve used.  I’m sure more will come to me later but I would love to hear the things you have done for weight bearing on the arms!

Stomp Rocket – Oh the Possibilities!

The stomp rocket is one of my favorite toys to use in therapy.  Initially we started using it to encourage standing on one leg, but over the years we have come up with a plethora of ways to create therapy uses for it!  Some of them are listed below:

Single Leg Stance – In order to step on the stomp rocket the kiddo will ideally have to pick up one of their feet while the other one stays on the ground.  Because they have to pick it up higher than they would for taking a step during walking, they leave their foot in the air for a little longer, also allowing them to get a better stomp!  Once our kids master the ‘stomp’ part we will have them hold it for a count of (pick a time) so that they have to start balancing on one foot.

Weight Shifting – Again, in order to pick their foot up to stomp on the toy, the kiddo needs to shift their weight onto their standing leg.  Because they have to pick the foot up a little higher to clear the ‘stomp’ part its harder for them to do a partial weight shift.

Force Production/Regulation – Whether they are using the stomp rocket with their hands or their feet, they need to generate enough force (in a timely manner) to propel the rocket off the end of the stand.  Some kids have no problem with this, however, some kids will take tentative steps or allow gravity to pull their foot down which doesn’t allow the proper pressure to generate for shooting the rocket off!  A trick to give them some success in the beginning is to only put the rocket part way down so that less force is required to propel it into the air.

Visual Tracking – When kids first start to use the stomp rocket they often can’t attend to what they are doing and then watch the rocket go into the air.  A lot of times they miss the actual rocket flying through the air.  Because its fun to watch and the kids are motivated they will pretty quickly start to figure out (with some help from you) that they need to also pay attention to where the rocket is flying through the air.  If you have them retrieve the rocket as well, it helps if they know where it has landed!

Sensory Input – We had a kiddo the other week who was loving the stomp rocket.  He wanted to do it over and over again.  His mom was amazed because he has really tactile sensitive feet, and he was doing this activity in bare feet.  With that in mind, we adapted the stomp rocket to add different textures to it so that he would get input from different textures to the bottom of his feet while doing an activity that he really liked.  Also, we changed the surface the stomp rocket was resting on.  We put it a few steps into a grassy area so that he had to walk a step or two on the grass to get to it.  You could easily make walkways of different sensory material as well as the overlays of sensory material to decrease tactile sensitivity or just to increase tactile input (can be used on hands and feet).  Here are some ideas for sensory input to incorporate!

Jumping – Kids can practice jumping onto the stomp rocket to get a more powerful flight.  It allows them to work on jumping forward, up and to a target (all of which can be challenging when done purposefully).

Hand Use – You can work on hand strength by having a kiddo squeeze the bulb in their hand to make the rocket go.  You can also work on using an open hand by having the kiddo activate the stomp rocket by having to use a flat hand.  They can crawl to it or bear walk to it or just sit and use a flat hand.  You can also use this activity for upper extremity weight bearing and weight shifting.

Target Practice – You can also set up a target to try to aim the stomp rocket at and see if you can hit the target, whether with the rocket starting from the floor or the child holding it and pointing it at the target.

One more thing – they also make a bubble stomp rocket which should provide tons of motivation and other ideas such as finger isolation to pop the bubbles and running to chase them!

What are some of the things you have used the stomp rocket for?

When all things aren’t equal – Legs

I recently had a parent ask about ideas to help her child who has weakness on one side of her body more than the other side.  I figured I would write about some of the ideas that I use although please be aware that there are a ton of ideas and it depends on the developmental stage your child is at and specifically what skills they are working on.  For this case I am going to give ideas for kids that are working on skills such as walking or stair climbing.  I’m going to look at ideas for encouraging the use of both legs more equally. (In order to differentiate the legs I will talk about them as the weaker and stronger leg, hopefully this does not offend anyone)

Climbing – I love having kids crawl up and down steps.  This is a great way to work on both sides of the body together but still encourage them to activate the side that is weaker.  It works on developing reciprocal activity (which is needed for walking and crawling) as well as motor planning, coordination and leg strength (especially the butt muscles).  Make sure your kiddo is switching legs as they try to crawl up, using one knee on the next step up and then shifting their weight onto that leg as they bring the other leg up.  Make sure they are shifting their weight onto the leg that is leading so that they are practicing weight shifting as well as taking maximal advantage of the opportunity to develop leg strength.  They may need a little help especially if it is the weaker side.  Make it motivating by putting a favorite toy a few steps above them or using a toy with multiple pieces that they need to go up and down to get all the pieces (i.e. puzzles).

Up and Down Hill – Walking up and down inclines can also work to help your kiddo develop strength equally on both sides.  Especially on the way up they have to engage their butt muscles in order to keep their balance and on the way down they need to maintain control so they don’t crash.  You can have them walk or crawl up and down the hills.

Step Ups and Downs – If your child is standing and walking already then working on step ups and downs is a great activity.  I like to use smaller stairs and encourage the kiddo to go up leading with their weaker leg and come down leading with their stronger leg.  This way the leg that isn’t as strong gets to develop strength and power as it lifts the kiddo up to the next step and it develops control as it lowers the kiddo down onto the next step.  If your kiddo can ‘cheat’ while on the stairs then find a few phone books you can tape together or a step stool that is at a height that is challenging but they can have success (usually with a little support).  When I work on these kind of skills I pretend we are going over a mountain and usually I have bean bag animals or puzzle pieces on one side and their ‘home’ on the other side so that they think they have a purpose in going over the step over and over.  Same rules apply, stepping up you put the weaker leg on the step and going down you leave the weaker leg on the step.

Single Leg Stance – Now this can be challenging if your kiddo can’t fully stand or balance on one leg by themselves yet.  Here are some ideas to help that skill evolve as well as work on keeping their weight on the weaker leg.  You can have your kiddo stand with the stronger leg up on a slight height like a phone book or a step stool and play with them.  If they have challenged balance you may need to stand close by.  You could have them stand like this while playing with magnets on the refrigerator, drawing at an easel, playing games on an ipad, etc.  Just make sure they aren’t leaning on the support surface too much!  Another way to encourage single leg stance and shifting onto their weaker leg is to use a stomp rocket.  The stomp rocket is a toy that is so much fun!  Have them use their stronger leg to stomp on it which makes them have to stand on their weaker leg.  As they get better at this you can have them hold their foot up for a count of (1,2,3,etc) before they are allowed to stomp.  Depending on how good their balance is you may have to give them a slight hand (not too much support) while they balance before stomping.

Kicking a ball – Have them practice kicking a ball.  You can have the ball be standing still or it can be rolling towards them (depending on their level).  In order to pick their foot up to kick the ball they will need to balance on their weaker leg.

The above ideas all can help with stability and strength on their weaker leg.  If you are looking to have them work on lifting their foot more with things like walking then you can reverse some of the activities I listed or you can also try some of the ideas I talked about for improving foot clearance.

Please share other ideas!