Favorite Toys: The Vet

I know we took a brief break from blogging but we’re back! We are going to start adding blogs about some of our favorite toys to use in therapy and how and why we use them. The first one is The Vet (here is another smaller version).

This toy has a lot of uses for occupational therapy since it has keys that you have to match up by color to open the individual doors. Since we do mostly physical therapy, we use it as a motivator, and the extra fine motor work they get to do is an added bonus!

We have used this toy for all ages. Currently I have a 12 month old using it (yes, the skills are higher than where he is but he is really interested in it so it works great as a motivator) and we kids up into double digits using the toy.

In this video we are working on hip stability and balance. Once she is finished her toe taps she gets to squat down (working on staying in the middle, and not shifting too far to one side) to open or close the doors. We would increase the number of taps between her opening or closing the doors and she was only allowed to open or close with each squat (anything to get more repetitions in!).

We have also used this toy to increase repetitions on the stairs as well as walking back and forth between support surfaces to improve ambulation. Anything with lots of pieces and parts is great for repetitions.

You can also use it to work on squatting. You saw some squatting in the video, but you can also ‘drop’ the keys repeatedly or have all the animals on the ground and the vet up on a higher surface to practice going down and up. If you want to work on balance with squatting and playing in squatting, just change the positions and have the vet on the floor and the keys and animals on an elevated surface. It takes longer to put the animals in and out and open and close the doors!

How have you used this toy?

What is Core Strength?

Why are pediatric PTs always talking about core strength and what does that term that is thrown around so frequently even mean? And is core strength the same as trunk strength and is that the same as core stability? Hopefully, this brief overview will help to clear the air!

 

Core: When we think of the “core” of the body, our first thought is the abdominal musculature.  While the abdominals play a crucial role in all of our functional movements, they are just one of the many important muscle groups that make up the “core.” We can also add shoulder, scapular, back, and hip muscles to the list. We can think of anything from the neck down to the upper leg as part of the “core.”

 

Core Strength: Core strength refers to the ability of the indicated muscle or muscles to perform as movers. For example, a sit up or moving from extension to flexion requires core strength.

 

Core Stability: Core stability refers to the ability of the indicated muscle or muscles to perform as stabilizers, therefore, preventing movement of a joint or joints. When we are referring to core stability, we are most often referring to how well the core muscles can work to prevent unwanted movement of the lower part of the spine and pelvis. For example, when we squat to pick up our kids, laundry baskets or grocery bags, we want the abdominal muscles to work as stabilizers to prevent unwanted movement of the lower spine.

 

Trunk Strength/Stability: Okay, okay, so what is trunk strength? Well, as pediatric therapists, we often use the term “trunk” and “core” interchangeably. They are just two different terms that mean the same thing. So, if you see both terms in a report or other documentation pertaining to your child or yourself, feel free to ask us! Most likely, we are talking about the same thing but we strive to improve our consistency and you can help by bringing it to your attention.

 

For more information on the importance of the core musculature as well as for tips/ideas on how to improve the function of the core, take a look at some of our previous blog posts.

 

Core Strength – Building a Solid Foundation

 

Core = More than Just Abs

 

Having a Ball with Core Muscle Strength

 

 

 

Holiday Gift Giving Guide

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

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?

Thanksgiving Themed Games

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.

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.

Jumping and Balance Path

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?

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!

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.

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!

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.

Dribbling a Ball

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?

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.