Starfish Therapies

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!
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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!
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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.
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October 8, 2017

Dribbling a Ball

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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?

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.

 

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?

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 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

July 23, 2017

It’s All About Motivation

Adventure

Many times I get asked about what kinds of activities we do with the kids, or how we get them to do what we want them to do when it may be hard work for them. The answer is always the same, it’s all about motivation. If you can make an activity into something that a child wants to do, then they will work hard at it, and usually repeat it multiple times.

I had written two posts a while ago about when we used songs to motivate kids that you might find interesting.

Well one of our other ways is to use obstacle courses, which we have talked about before. But how we make those obstacle courses fun is what this post is about! Here are a few ideas!

  • American Ninja Warrior Junior – I’ll be honest, I’ve never watched American Ninja Warrior. That being said, I’ve noticed a lot of our kids have, and they love it! We have been able to get more leverage from that show for motivating kids. We have done it in obstacle course format where we time them on the course (but they lose points if the quality isn’t there, so they don’t just rush through). We have created training programs for it so that the kids do exercises that will help them be American Ninja Warriors and then they get to create a course at the end of the session for fun. But the ‘training’ is where they put in the work. Although, even the courses they create are pretty challenging and work on the things that we would want them to work on.
  • Adventures – Some kids like to go on adventures. This could involve crossing a bridge (balance beam), climbing mountains (stepping stones), navigating the swamp or quicksand (crash pads), traversing lily pads (spots), rescuing friends (climbing up and down stairs), going into the dungeon (stepping up and down a ‘curb’ type step), setting off the flare for the support team (stomp rocket), using the magic key to open the secret door (making a basket with the basketball while standing on a balance board), crossing the forbidden forest (walking over a yoga mat with obstacles underneath to make it uneven), and the list could go on and on. Usually we have friends we rescue (a puzzle with animals, bean bag animals, stuffed animals) or we go collect treasure (a puzzle with different shapes) and the child gets to choose which we are doing on that adventure. That way they also have to go through multiple times.

What are some fun ways you have motivated kids?

 

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