Did you ever wonder why an infant or toddler would crawl or walk to get their favorite toy only sometimes as they are learning these skills? But at other times they’ll look, they may start moving for it, but ultimately look around and find something else to play with? We find it all has to do with their perception of their abilities and what they’d need to do to get their favorite toy.
When you are teaching or encouraging practice of motor skills by moving those favorite toys around your house, it’s important to keep in mind the idea ‘just right challenge’ or that your child perceives that they can accomplish their goal, but is still challenged to improve their skills. If they perceive the activity as something they are able to do, they go for it. If they think it’s too hard, they find another toy.
This is why you often see therapists moving furniture half an inch farther apart at time, or ‘accidently’ bumping a toy a little farther away when the child is half way there while crawling to push kids to go just a little further without significantly changing how the child perceives the activity.
If your child goes after that toy every time, would they still do it if it was a little farther away or on the couch or half way up the stairs instead of the floor? If your child looks around for something else to play with, what happens if you move their favorite toy just a little bit closer? Have fun experimenting with finding the motivation that is ‘Just Right’ for your kiddo!
A great way to work on core and upper body strength, as well as bilateral hand use is to put your climbing rope in a lycra swing. Its really hard to get any traction/stability from your feet and you get to rely on upper body and core strength to get yourself up high enough to rescue the monkey!
The kids find it to be hard work and are often exhausted after doing this activity but they get a great workout with it.
What are some variations that you can think of?
We are constantly looking for ways to keep things fresh for some of the kids we see here so we were excited when Your Therapy Source did a post on Beach Ball Ther-Ex Games. Our therapists took that idea and came up with Boot Camp Ball. There are a few ways you can use it, as there are numbers, shapes and colors involved but we kept it simple and just used the numbers.
First, they came up with a list of activities that were numbered (see photo).
Next, the kiddo would pick which hand would be the ‘magic’ hand
Then, they would catch the ball (in standing for this kiddo because we were working on standing balance and bilateral hand use). Whatever number was under the ‘magic’ hand is the activity that they would do based on the corresponding number on the activity list.
Then they would repeat.
By calling it boot camp we were able to keep the pace moving and they thought it was great when there were activities like sit-ups on the list.
There are lots of ways to modify this depending on what you are working on with your kids. For instance:
- You could have them point to a number on the ball and touch it with one finger if you are working on finger isolation
- you could use shape/color combinations for kids that are working on recognizing them, or to provide more combinations
- By doing the shapes, numbers and colors you could make a really fun flow chart that would mean they would have to match up which variables were present to find out their activity
- You could do catching sitting down if standing up was too challenging, or standing on one foot if it wasn’t challenging enough
The big thing is, its another opportunity to make doing the same activities over and over again FUN!
How have you used this idea, or an idea similar to it?
Transitions can be hard for everyone involved. However, its also a good skill to practice so that it can slowly become easier. We have been trying over the last several months to try to reschedule kiddos with a different therapist when their regular therapist is going to be out. There are some really great benefits when this is done.
- Kids are given the opportunity to use their skills with a new person (are they able to generalize outside of their comfort zone)
- There is a new set of eyes on the kiddo which may see things that the regular therapist doesn’t notice because of familiarity
- Brainstorming and idea generation can occur to keep therapy fresh
- Transitions not only benefit the child, but the parents/care takers as well. Parents become so comfortable with their therapists, that it may be more difficult for them to do the transition, than the child.
- Provides a fresh venue for the child and will often highlight challenges that the child is still having outside of the therapeutic environment because they are working with someone new and less ‘comfortable’
I know this is a short post but I thought I would share some of our observations! That being said, I do believe in the continuity of a therapist working with a child, I just like to mix it up every once in a while because I do believe it is beneficial for all involved.
When kids begin to learn new skills repetition is key. This is how they learn what works and what doesn’t work and what they need to fine tune until they have mastered the key. For some kids repetition comes naturally, for some, they may need a bit more encouragement. Basically you need to figure out what motivates them. Over the holidays I was hanging out with my god daughter and I couldn’t help but push her gross motor skills a bit. (poor kid her mom is a speech therapist so she didn’t stand a chance with the two of us around!)
Some of the things we practiced were jumping, going down stairs and standing on one foot. Jumping as you can see in the video was easy to get the repetition. We put words to the actions, I showed her what to do and she mimicked me. She thought it was hysterical and wanted her dad to keep saying ‘bend-jump’. For that activity it didn’t take much to motivate her to practice the skill (she even got air a few times). With going down the stairs, I basically showed her once or twice on the bottom two steps how to hold her hand on the wall/rail and step down and she was just so proud of herself that my cousin reported she now only wants to walk down the stairs. Lastly, with the single leg stance we were playing with the stomp rocket so the toy itself was motivating. She loved ‘stomping’ on it and making the rocket fly. She even got good at putting the rocket back on the launcher (ok, she needed some help but she knew that it needed to line up).
For some kids, doing a novel activity is enough to get them to practice because they want to keep doing the new thing, especially when there is a ‘reward’ at the end (i.e. the rocket flying off the launcher). With tasks that aren’t as novel look for ways to change it up and make it fun. For instance, with stairs practice at the park or in the house or make little steps (using stools) that are a path they have to follow throughout the house. Change it up and add some fun and you’d be surprised at how quickly kids will engage!
We decided the ladder was the best for our needs based on the packing that was occurring and he tolerated me taking a picture as well as the video so I couldn’t complain when it was slightly blurry!
So I spent part of the week in San Diego helping my friend and her family pack to move across the country. While there I spent some time with my ‘nephew’ because she has mentioned that he can struggle with running sometimes. We’ve talked about the fact that he’s a toe walker and that his calves and hamstrings are extremely tight but its hard to give out advice over the phone, and even harder for ‘mom’ to motivate him.
I already had some ideas but I watched him for a few days to see what I thought and then on my last day, I asked him if he wanted some help with his stretches and some exercises to help him possibly run faster on the football field. He agreed so we had an impromptu work out. I gave him 3 simple stretches for his hamstrings and calves that he can easily do while watching tv and I didn’t make them very time consuming or requiring a lot of contortions. I had him try them out and decide if it was something he could ‘easily’ do. He agreed.
Next we went into the backyard (mainly so we could have some space since their house was in the midst of being packed up) and we practiced jumping and bounding. I showed him the exercise and then he tried it. Of course he did it really fast (the way he would normally) and then I asked him if he would try going slow and concentrating on each jump/hop/bound and pausing between each one so he could really make his toes into ‘jet rockets’. When he did, he felt and saw the difference between how high he could jump/hop and how far he could bound. I asked him if he knew why and he said its because he was thinking about it so he was able to make his muscles work the way he wanted. I asked him what happened if he kept practicing it while thinking about it – and he (without prompting) said eventually he would be able to do it without thinking about it! I loved that he got the concept!
Now, I know that he’s a 10 1/2 year old boy that would rather be watching tv or playing DS but he was genuinely interested in running faster during football practice and during the game. When I asked if he wanted me to make him a chart, pictures or a movie, he picked a movie so we filmed him doing his exercises with the explanations and then I worked my magic with iMovie and made his own personalized exercise movie.
Do I think he will do it every day? Probably not but he had some choices with the exercises as well as with the delivery of the exercises. He also got to ask questions about why we were doing them and how practice would make it easier. He even got to see that when we went back to make the movie, the bounding and jumping were harder because his muscles were tired. He could relate it to learning how to play football and the time he puts in on the practice field, so that by doing these it will get easier and he will start to see results.
Now, I’ll have to check back in a month or two to see how diligent he has been but my fingers are crossed!
What ideas have you used?
I love to find new and creative ways to get kids to do activities that may not always be their favorite, and to get them to do multiple repetitions of it. We came up with a new game based on BINGO. Instead of letters we used numbers on both the column and row labels. This way the kids could roll two dice and find out their activity. One die would correspond to the column labels and one die would correspond to the row labels. Then you would follow the row and column until they met and figure out the activity. Our pictures show a pre-made one for activities our OT is working on with a kiddo. You could also use it for handwriting and put letters or numbers in the boxes. You can pretty much get creative with what you want to work on and put into the boxes. Once a box has been used you can have the kiddo cover it up (either by writing on it or using a bingo chip or a torn piece of paper, etc). When the kiddo gets 6 in a row (as seen in the second picture) they can stop the activity.
You can modify this almost anyway you want to, whether its the activities in the boxes or the way you label the columns and rows. Its just another idea for a novel approach to getting kiddos to do the activities you want them to do! You can also do it on a white board so that you can make it reusable or you can laminate some pre-made ones so that you can have them ready to go.
Has anyone tried something like this?
image retrieved from: http://www.oscarpistorius.com/
I was one of the many who were inspired by Oscar Pistorius during the Summer Olympic Games just recently. I have seen several blog posts by others who were inspired as well. He helped to provide hope to people that they too may not be seen as different and that they can strive for something that may not be the norm at this point and time.
My favorite inspirational story surrounding this amazing athlete is that he has become a role model for one of the boys I work with and have talked about often in my blog posts. He is a 7 year old with spastic quadriplegia cerebral palsy and he is learning how to walk without his canes. This is an amazing feat because of the amount of energy it takes for him to take each step and maintain his balance. Motivation has been a challenge because who as an almost 8 year old wants to work that hard every day to learn how to walk? Well he saw Oscar Pistorius run in the Olympics and has decided he wants to be like him. He has found his inspiration and motivation to help him take each step. Don’t get me wrong, he still has his moments of whining but he has an internal motivation that we have sought to provide for him and have not always been successful.
The other similarity in this story is that the little boy I work with, just like Oscar, has never once seen himself as disabled….
Who are your kids role models and inspirations?
image retrieved from: tvteachervideos.com
I just wanted to share another great handwriting tool for people to put into their bag of tricks. Sarah, one of our OT’s reviewed The TV Teacher for PediaStaff in this post. Just like in her review of Callirobics she talks about it in relation to a kiddo she was working with and give her perspective on ways the program can be beneficial for various kids as well as things to watch out for.
Has anyone else used this program? What are other programs or tools you use?
Well I am almost 3 weeks status post my hip surgery and I am swamped in my home exercise program. This post surgery protocol is almost a full time job. I am lucky that I am able to devote the time to completing it because I’m not able to do patient care currently and my admin work allows for flexible hours. I don’t know how I would complete it without this luxury of a flexible work schedule. As a PT I understand a lot of what they want me to do but even still I needed to create a chart (see photo above) so that I could understand and follow the complex information they gave me and make sure I completed the correct exercises and progressed them appropriately each week. Again, a bit ridiculous I think.
I know that as a PT I have given many home exercise programs, or suggestions of things for families to work on with their children. I try to make sure that I also provide them with ways to fit it into their lifestyle because a home exercise program is only good if it is completed. It doesn’t matter if I have created the doctoral dissertation of all home exercise programs because if it doesn’t get done its just a waste of paper and time. I contributed to another blog where I talked about my thoughts on home exercise programs and how to make them effective for families. I thought I would take a moment and make some suggestions now based on my new found personal experience. My thoughts are still the same but I have found some ideas for maybe making sure it gets completed.
- Figure out how much time you can devote to physical therapy exercises each day or week and share it with your therapist so they can help to select the priority for exercises/activities you should focus on
- Let your therapist know what your other therapies are giving you for ‘homework’ because there may be overlap and you can ‘kill 2 birds with 1 stone’
- As ridiculous as it sounds make a chart for each week so you can check things off. Put the chart in a place where you will see it so it will be a reminder of what you need to do. (I love charts and lists because I love checking and crossing off) For older kids you can use sticker charts so they buy into practicing the things they need to work on. I talk about ways to motivate kids in another blog post I did.
- Make it a part of your day as best as you can. There are many things that therapists give you to work on that can easily be incorporated into your daily routine. In my case, in a few weeks I am going to need to start standing on one leg (my surgical leg) and what I will do is stand on one foot while brushing my teeth, doing the dishes and other opportunities like that. Ask your therapist for ways you can include their exercises into day to day activities, usually they’ll surprise you with what they can come up with.
- Ask why. I know for myself I am more likely to do something if I understand why I am doing it. Believe me, I woke up this morning and didn’t want to do my exercises. I gave myself a figurative kick in the behind and reminded myself that I had this surgery for a reason and I wanted it to be a success and that these exercises were getting me one step closer to having a hip that worked correctly again. If you aren’t sure why your therapist is suggesting an exercise or an activity as them why they are recommending it, we usually have a good reason for the things we do and its good to make us explain it every once in a while!
I would love to hear other suggestions people have for making home exercise programs compliance more likely whether you are a therapist or a parent or a patient yourself. I love new ideas and maybe even some motivation for myself! (Luckily I have had the Olympics to keep me occupied during this time and provide motivation for doing my exercises as well)