Starfish Therapies

July 2, 2017

Crossing Midline

twister yoga

Crossing midline is the ability for your hands, feet, and eyes to move across your body. Being able to cross midline is an important skill for children to develop as it is needed to complete everyday tasks such as, putting on shoes, reading, writing, and ball skills. Crossing midline includes visually tracking. Visually tracking includes your child’s ability to move their eyes across midline without moving their head, which is an important skill for reading. Being able to cross midline allows for your child’s brain to make connections from one side of their brain to the other. Children who have difficulties crossing midline typically do not have a dominant hand, may often lose their place while reading, and may have difficulties throwing and catching a ball.

Here are some fun activities that you can incorporate into your child’s playtime to encourage crossing midline:

  • Popping bubbles: Blow bubbles and encourage your child to reach across their body to pop the bubbles. Make sure that your child pops bubbles with both hands.
  • Drawing figure eights: You can have your child draw figure eights on a piece of paper or for some added fun have them draw figure eights in shaving cream
  • Bean bag games: Have your child reach across their body to grab a bean bag and then throw the bean bag at a target. Make sure your child is using both hands to grab bean bags.
  • Windmills: Have your child stand with their feet a bit wider than shoulder width, have them try to bring their opposite hand down to touch their opposite foot. Repeat this exercise 10 times on each side.
  • Play twister: This is a great game to encourage your child to reach across midline with both their hands and their feet.

May 29, 2017

Transitional Movements

2017-03-28 23.23.452017-03-28 23.23.502017-03-28 23.23.28

What are transitional movements you may wonder. They are when a kiddo moves from one position to another. This can look like rolling, getting in or out of sitting, getting in or out of quadruped, getting up into standing, getting back down to the floor from standing, and the list can go on and on.

For many kids learning to transition between positions comes easily to them. However, this isn’t the case for all kids. There are many reasons that some kids may have to ‘learn’ how to transition and move. Some of those reasons may include weakness, motor planning challenges, increased time in ‘positional equipment’, and many others.

Transitions are important because they help your child learn how to move. They begin to understand that they can explore on their own. They can increase their independence with exploration and expanding their curiosity.  It also helps them to learn more about their bodies as well as cause and effect. They learn to grade their movements and how to problem solve. They begin to understand and develop body awareness.

How can you help your kiddo develop and work on their transitional movements? Rather than pick them up and place them in a new position, help them to move into it. Another way is to set up the environment so that they are encouraged to explore. Here are a few ideas:

  • Rolling – Instead of picking your kiddo up and placing them on their belly, use a toy and get them engaged and then help them roll over onto their belly so that they can get to the toy. Even if you don’t have time to get them engaged, you can still help them to roll so that they start to learn there isn’t some magic force that moves them from one place to the next!
  • Sitting (from the belly or the back) – I’m probably going to start sounding like a broken record but the same ideas apply for all the areas I’m going to mention. Instead of picking your baby up and placing them in sitting, help them to get into the position on their own.
    • You can do this almost anytime you are changing their diaper, just help them to move into sitting before you pick them up rather than picking them up from a lying down position.
    • If they are already maintaining sitting independently you can also work on this from a sitting position. Have them lean over onto one arm and have a toy in front of them so that they have to push back up to get into sitting to reach for it.
    • When your kiddo is in a sitting position you can help them move into a lying down position. You can also have them try to do this by putting toys just a little further out of reach so they have to move from sitting onto their belly to get it.
  • Quadruped – This is similar to going from sitting to on the belly. If they are already sitting put your leg on one side of them and put a toy they like on the other side of your leg. Encourage for them to reach for the toy so they move over top of your leg (you may have to help them at first so they know what to do), keeping their legs on one side and their arms on the other. As they get stronger and willing to try the movement more you can take your leg out of the way. They may go all the way to their belly a few times but that’s the fun of trial and error and how they learn.
  • Standing – Again, it’s all about finding what engages your child. Use an elevated surface that they can pull up on (not too high but not too low) and place something they really want on top. Help them to figure out how to pull/push into standing so that they see they can get to the toy they want!

As you noticed a lot of the concepts are the same. You want to make sure that their toys aren’t always right within their grasp, make them have to work a little to get to them. Don’t just pick them up and place them in a position, take a few extra seconds to ‘help’ them move to the new position. They begin to understand how to motor plan and problem solve so that they will begin to want to move and explore!

April 1, 2017

Today I Sat Up

IMG_3552

I love having friends and family who have little ones who are growing and moving through their milestones.  And I especially love when they say I can use their pictures and videos.

When I saw this video of this little one sitting up, I thought it was great. He is a fairly new sitter and you can see him working on exploring his movement. He shows rotation, and reaching outside his base of support, and coming back up to the middle, and propping for some extra support. As you can hear in the video, he found a new limit. He was able to reach a little further and return to the middle without falling down. But it was all the times of reaching and falling down that helped him to gain the skills to know his limits and to know what muscles he needed to turn on to keep himself from falling over.

As he feels more confident with his sitting he begins to release his degrees of freedom. So when he rotated to reach for something he was relaxing his trunk because he didn’t need to hold it rigid to stay upright. He is able to begin picking and choosing the muscles he needs to be successful, rather than turning them all on and having limited movement.

If you get a chance watch some little ones as they begin to master a new movement and you will see them slowly relax and be able to have fluid movement rather than tightening up all their muscles to try to maintain control.

March 12, 2017

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!

February 20, 2015

Doing Two Things at Once

cleaning7

Have you ever asked your child to walk while holding their glass of milk back to the table? “Dual tasking” or doing two things a once can sometimes be a difficult task and occasionally can lead to some spilled milk! Walking has been thought to be an automatic activity. However, recently studies have shown that walking actually requires attention and that people change their walking pattern when performing a dual task.

A study published in 2007 examined pre-school children ages 4 to 6 and their ability to perform easy and difficult dual tasks. They examined the changes in the children’s walking performance while walking normally, walking while performing a motor task (carrying a tray with or without marbles), and walking while completing a cognitive task (counting forwards or backwards). The results of this study show that in typically developing children walking is affected by carrying out a simultaneous task. Children need to create stability to carry out the dual task and therefore widened their stance, take shorter steps, spend more time with both feet on the ground and slow down their walking speed in order adjust to the task. This demonstrates that children have decreased walking efficiency and compromised balance while they carry out either a motor or cognitive task.

Walking while performing a concurrent task occurs commonly and frequently in a child’s every day life, for example walking while carrying a tray of food at school, walking a glass of milk back to the table or walking while answering a question. Teachers and parents should be aware of the cost and effort that it takes for a child to walk and perform these common tasks. This knowledge can help choose suitable activities that the child can successfully complete as well as prevent an accidental fall or spilled milk. Therefore, allow your child to walk slowly, safely and carefully the next time they are walking their glass full of milk back to the table!

Cherng RJ, Liang LY, Hwang IS, Chen JY. The effect of a concurrent task on the walking performance of preschool children. Gait Posture 2007;26:231-7.

November 21, 2014

Should You ‘Walk’ Babies?

Filed under: Developmental Milestones — Starfish Therapies @ 5:32 pm
Tags: , , , ,

beach walking

We have had some families bring this article, 9 Reasons Not to Walk Babies, to our attention.  It was generally a response to some of the things we were working on in therapy with their child, and confusion because this article to them seemed to be saying the exact opposite of what we are asking them to do.  I have to admit when I first read it I thought the author was completely wrong.  Then I took a step back and read it again.  What I realized was that the first time I read it, I was reading it with the bias of how it related to the specific child we were working with.  In actuality, what the author is promoting is independent exploration and development of the child.

I am a big proponent of allowing children the chance to independently explore and facilitate their own motor development as their bodies are ready.  Unfortunately, not all children are able to do this on their own and they need assistance with how to explore and move, and sometimes they help practicing and repeating skills, such as walking, so that they can master them.

Going back to the families that have asked about this article, the challenge was that due to busy lifestyles, other children, and ease of getting around, many of them were using carrying devices like carriers and strollers, or physically carrying or holding their child an overabundance of the time and not providing them the opportunity to explore their environment, thereby limiting their ability to figure out how their body works, trial certain movements, register the feedback, make adjustments and gradually refine their movement until they were masters of the skill.  This is the ideal way kids learn movement, opportunities to practice with trial and error.  By carrying their child everywhere, they were in fact putting the same constraints on their child as this article was attempting to steer them away from.  They weren’t allowing their child to develop at his own rate.

Its interesting that I have read two other posts that talk about the overuse of equipment in society today and how it limits children in this same way.  One was a guest post on our site about avoiding the ‘container shuffle‘, and the other was by Pink Oatmeal on baby items you don’t need.  This topic is also related to the Bumbo Chair.  Again its a convenience that can have specific benefits, but when its used to teach a child to sit before they are physiologically ready, it is not being used to the child’s benefit.  In that same way, when ‘walking’ your child is being used to teach your child to walk before they have even mastered standing, then it may be that they aren’t ready for it.

The best way you can support your child’s motor development is to give them plenty of floor time with the opportunity to explore.  Use yourself or engaging toys to motivate them to move.  If they are trying to move and getting frustrated its okay to give them a little boost, just make sure you are not always doing it for them, their is benefit to not succeeding every time, that’s how their bodies make refinements and adjustments so that they can become more efficient with their movements.

On a slightly different note, but on the same topic, for children who are already experiencing delays for one reason or another, and are engaged in therapies, the therapist may give you things to work on that are meant to support your child’s development because at that time, they are behind and they need that extra push.  If walking is one of them, its probably because your child needs your help in creating opportunities to practice the skill and learn from those trials, and they are not creating those opportunities for themselves.

 

November 11, 2014

Avoiding the ‘Container Shuffle’ with your Baby

Filed under: Developmental Milestones — Starfish Therapies @ 4:24 pm
Tags: , , , ,

movement exploration  IMG_1734  problem solving3

Guest post by: Nicole M Sergent, MPT

As a new parent, I was there. Giddy excitement over the news of a baby on the way followed by showering love from family and friends in the form of gift, and gifts, and more gifts. At the time I was touched (and am still forever grateful for their generosity) but shortly after the baby came I quickly fell into a routine many new moms do. As a physical therapist, I like to call it, “the container shuffle.”

“The container shuffle” goes something like this. Sleep (crib), eat (highchair), play (exercsaucer), calm down (bouncer seat), sleep (crib), eat (highchair), play (positioning seat), calm down (swing) etc. As a mother, I related to the thoughts many of my patients’ parents have. Everyone buys us all this stuff…and baby likes them and is happy…so why not use them? As a therapist, I’d like to tell you why.

I can’t tell you how many children I have assessed with general motor delays without significant medical histories or orthopedic or neurologic impairments. These babies are very stable in an upright static position. They often even sit really well, without ever rolling, crawling, creeping, kneeling, or standing. After I have carefully assessed to make sure, nothing more significant is going on, I’ll delicately share my diagnosis: CONTAINER SYNDROME.

I realize it is not rocket science but think of it this way. When a baby plays on the floor, he/she has the ability to wiggle, squirm, and move. Each tiny movement that may seem insignificant is actually exercise. They are beautiful diagonally directed movements. And they are needed. Because our moving transitions from one position to another (floor to sit, sit to stand), require that motion. How can we expect a baby to be able to move and explore if we always have them strapped in a container? Research tells us that babies who spend less time on their tummies on the floor, have delayed motor skills in the first year of life.

In addition to the ability to practice motor coordination, allowing a child to play outside of a “container,” has additional benefits. Play on a baby’s tummy, aids in digestion, assists with hand eye coordination, and promotes typical skeletal development. The hips have the ability to develop into a more stable, mature position and the skull, free from pressure from resting against a surface, has freedom to develop typically. Did you know that 20% of all infants now have plagiocephaly (flattened appearance of the head/face)? While free play time may not prevent all of those cases, I believe the increase in “container syndrome,” plays a significant role.

I once attended a continuing education lecture, where the OT speaking suggested that infants should spend 80% of waking hours on the floor. As a therapist, I could see the benefit of this time well spent. As a mother, I felt myself slumping with guilt. My daughters did not spend that much time on their tummies, especially my youngest that had severe acid reflux. A practical balance must exist for families. And while I realize “containers” are helpful with a fussy baby and so that one can actually shower, I recommend promoting floor time throughout the day. I tell the parents of my patients, “If you find yourself going to put your baby down, choose the floor or pack-n-lay first.”

Many of those children I have evaluated that had delays with mobility and transition skills that I felt came from “container syndrome,” ended up catching up to typically expected gross motor milestones in just a few short weeks by allowing more free play time on the floor. It can be argued that it is not rocket science. My mother (and yours) might argue it is common sense and “what we did with you.” But in a commercialized world where more = better, maybe we do need a dash of common sense to help keep our infants happy and healthy as they develop and grow.

Nicole M. Sergent, MPT is a pediatric physical therapist and co-owner of Milestones & Miracles, LLC. She co-authored a unique developmental tool for therapists and parents that pairs detailed development with interactive play skills, called 1-2-3 Just Play With Me. It is available in digital and print and can be found at www.milestonesandmiracles.com, Amazon.com, and select retailers. Follow Milestones and Miracles online for developmental support & fun

 

 

May 30, 2014

Favorite Summer Toy: Hula Hoops (Blog Hop and Giveaway)

Filed under: Developmental Milestones — Starfish Therapies @ 12:41 pm
Tags: , , , ,

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Hula hoops are a great summer time (or anytime) toy.  Now don’t automatically assume it means you need to know how to ‘hula hoop’ in order to play with them.  I’ll be the first to admit that I’m terrible at ‘hula hooping’ however there are a ton of other ways to have fun with them.

Hula Hoop Paths

Movement Through Space – If you get a few hula hoops you can line them up in a row and you can practice locomotor skills through them.  Start simple by having kids walk through each one.  Next can be running through them.  Add in some jumping and hopping as well.  To get more complicated you can create movement patterns similar to hopscotch where they have to jump in one then hop in the next one or skip hoops as they run through them.  You can also do side stepping and leaping.  I like this activity because it works on movement through space with the child being aware of their path.  They also have to coordinate their movements while remembering a pattern/instructions.  If you have enough hoops and kids, you can even make it into a relay race!

Visual Motor – Hula Hoops also make great targets.  You can set them on the ground and use it as a visual for bouncing a ball in.  This could be done by yourself with dribbling skills, or using a tennis ball to practice bouncing and catching.  It can also be used with a partner for bounce passes and having to bounce the ball in the hoop before your partner gets it and bounces it back.  You can keep score for how many times you each get it in the hoop!  Also, you can use it as a throwing target.  If you have a tree you can hang it from a branch and practice throwing balls through it or being really tricky and getting a frisbee through it (my frisbee skills are about as advanced as my hula hoop skills)!  If you don’t have a tree you could prop it up against a support or leave it flat on the ground and try to throw or toss an object into or through it.  If you are leaving it on the ground you could use chalk and add rings inside of it and try to toss bean bags in.  Each chalk circle could have a set number of points and you could see how many points you get (similar to darts or ski ball).

Body Awareness – Some other fun ideas to use a hula hoop for are as a jump rope and as an actual hula hoop.  For jump roping (yes, even adults can still do it – I tried it today) you hold onto one edge of the hula hoop and swing rotate it so it swings over your head and then you jump through as it comes back down to your feet.  Similar to a jump rope you have to be aware of where your body is as well as rhythm and coordination but with the hula hoop its a closed loop so you have to know where your head is as well as your feet.  For actual hula hooping (is that even a word?) you can do the traditional version around your waist/hips but you can also experiment with other body parts such as arms, legs and even your neck.  It allows kids to know where the parts of their body are and focus on how they are moving and controlling that one area such that it is isolated to get the movement they want.  What’s great about the hula hoop is they are getting immediate feedback.

Some other fun ideas:

  • Team work activities where you have two or more people in the hula hoop and they have to move across space together (similar to a three legged race).  You can make the trek as complicated or simple as you want.  To add to the difficulty level you can blindfold all but one of the people so they really have to work as a team.
  • Hula hoop rolling.  You can place the hula hoop on its edge and see how far you can roll it, or who can roll it the furthest.  You can also draw chalk lines and try to keep it rolling on the line for as long as possible.
  • Extra large ring toss is always fun.  If you have stumps or other outdoor items that work well as a post you can try to use the hula hoop as a ring to get around it.

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March 5, 2014

Muscle Memory and Movement

Filed under: Developmental Milestones — Starfish Therapies @ 7:00 am
Tags: , , , ,

skiing

I recently spent a week skiing after almost two years off.  And while I wouldn’t say I was a superstar, I was amazed at how easily the movements came, and how little thought had to go into me successfully completing the basics of skiing.  At some point and time, my body had committed the movements to it muscle memory.  Now, add massive amounts of fresh powder and I was glad for that muscle memory because powder is not my strong point (I learned to ski on the east coast) so I had to think about how to build on the basics so that I could successfully get down the mountain.

How is this pertinent?  Well when your child is learning a new movement they practice it over and over so that their body can commit the movement to its muscle memory.  Once this happens, its an automatic movement and you can start adding in variations to the movement.  For instance, a baby learning to crawl will practice on flat ground over and over until they are the crawling masters.  Once they get that down they can start experimenting with crawling on different surfaces, such as cushions, or crawling over obstacles, or up stairs.  These variations will be more work for them because they have to expand on their movement bank and think about how to be successful.  Eventually with practice these will become automatic as well.

When muscle memory happens, a person can go a while without doing a skill and when they try it again, they will need to practice a bit but it will come back that much faster than if they were learning it for the first time.  I know when I teach someone to use crutches, it is that much easier for a person who has used them before.  This is an example of a skill that isn’t used every day but once its learned, it comes back that much faster when the skill is needed again.

So, the premise of this is repetition is important when kids are learning new skills because they are committing the movement to their muscle memory so that they can expand on that movement and continue to progress to higher level skills.  So the next time you wonder why your child who is just learning a skill does it over and over again, its because they are committing it muscle memory.  For kids that need extra help to learn movements its essential that repetitions are built in to their learning.

 

February 19, 2014

Doing Two Things At Once

ring toss

Have you ever asked your child to walk while holding their glass of milk back to the table? “Dual tasking” or doing two things a once can sometimes be a difficult task and occasionally can lead to some spilled milk! Walking has been thought to be an automatic activity. However, recently studies have shown that walking actually requires attention and that people change their walking pattern when performing a dual task.

A study published in 2007 examined pre-school children ages 4 to 6 and their ability to perform easy and difficult dual tasks. They examined the changes in the children’s walking performance while walking normally, walking while performing a motor task (carrying a tray with or without marbles), and walking while completing a cognitive task (counting forwards or backwards). The results of this study show that in typically developing children walking is affected by carrying out a simultaneous task. Children need to create stability to carry out the dual task and therefore widened their stance, take shorter steps, spend more time with both feet on the ground and slow down their walking speed in order adjust to the task. This demonstrates that children have decreased walking efficiency and compromised balance while they carry out either a motor or cognitive task.

Walking while performing a concurrent task occurs commonly and frequently in a child’s every day life, for example walking while carrying a tray of food at school, walking a glass of milk back to the table or walking while answering a question. Teachers and parents should be aware of the cost and effort that it takes for a child to walk and perform these common tasks. This knowledge can help choose suitable activities that the child can successfully complete as well as prevent an accidental fall or spilled milk. Therefore, allow your child to walk slowly, safely and carefully the next time they are walking their glass full of milk back to the table!

 

 

Cherng RJ, Liang LY, Hwang IS, Chen JY. The effect of a concurrent task on the walking performance of preschool children. Gait Posture 2007;26:231-7.

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