Starfish Therapies

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.

What are some of your favorite activities with a hula hoop?

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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.

January 29, 2014

Spider Web Activity

IMG_3226 IMG_3194 IMG_3195 IMG_3196

One of our PT’s used this great game around Halloween time (I know, I’m a little late publishing it but better late than never)!  The idea came from ‘No Time for Flash Cards’.  The object is to walk along the tape lines and pick up all the spiders that are in the ‘web’.  Not only did the kids love playing this game but it also worked on some great skills such as:

  • Balance and Body Awareness – by having to keep their feet on the tape lines they are working on maintaining balance with a significantly narrowed base of support and maintaining awareness of where their feet are.  (For kids who can’t manage that small of a line you could have them either keep one foot on the line or double up the tape lines to make them wider)
  • Squatting – when the kids reach an area that has a spider they will have to stay on the line, squat down (while maintaining their balance), reach for the spider and then return to standing.  For kids that need some extra help you could put the spiders closer to the lines so they don’t have to reach as far.  You could also use bean bags if kids don’t have the fine motor dexterity to pick up the small spiders (to change it up some you could give them tweezers or clothespins to try to pick the small spiders up with).  You could also put the spiders on step stools so that kids don’t have to squat as far down if they are still working on this skill.
  • Motor Planning/Executive Functioning – the kiddo has to figure out how to get to each spider (by walking the lines of the spider web) which involves planning out their path.  They also need to work on once they are there how they stay on the line while still picking up the spider.

Who else has done an activity similar to this one?

August 20, 2013

Pipe Cleaner and Wikki Stick People

Filed under: Developmental Milestones — Starfish Therapies @ 3:48 pm
Tags: , , , ,
Wikki Stick People

Wikki Stick People

Pipe Cleaner Person

Pipe Cleaner Person

Kids can have fun creating people out of a ton of different materials.  Two of the materials we use are pipe cleaners and wikki sticks.
Areas it works on:
Fine Motor Dexterity: This activity incorporates a lot of pincer grasping and finger isolation in order to push the wikki sticks onto the white board and to twist the pipe cleaners together. Kids also needs bilateral hand use in order to twist the pipe cleaners together and stick the wikki sticks together. In addition, they can work on snipping with scissors to cut the wikki sticks and pipe cleaners to the appropriate length.
  • Alternative Ideas: If the kids are having a lot of difficulty in placing the pipe cleaners or wikki sticks, you can still work on finger isolation by placing them for them and then having them trace them with their index finger, so they are still attending to placement and shapes and working on pointing their finger. 
Body Awareness: Some kids are still working on learning where their body parts are and how they relate to the space around them. Working on visuals of the body can be a way to work on this and to have them be aware of things such as arms and legs come out of the body and not the head!
  • Alternative Ideas: You can play directional and movement games when placing the body part to make it more interactive. The kids have to place the arms and then raise their arms in the air, or they have to make a head and then turn their head side to side, to name a few options.
Visual Copying: You as the therapist, parent, etc. can build the person and see if the child can duplicate what you created allowing them to working on visual processing skills and eye-hand coordination.
  •  Alternative Ideas:  You can grade this activity to make it easier or harder for them.  This can be done by:  complete the person one step at a time in order to make sequencing easier for them or complete multiple steps and judge from their motor planning/sequencing skills whether the task needs to be graded up or down. 

How have you worked on these concepts?  What other items have you used for creating people?

August 9, 2013

The Un-Block

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

unblock

When we went to the American Occupational Therapy Association (AOTA) conference this year we saw this great toy that one of the vendors was selling.  It’s called the Un-Block.  I of course had to get it because I love any type of building toy and thought it looked like such a novel idea.  (Since I’m a PT, I was crossing my fingers that the OT’s would be able to use it.)  Luckily our OT’s have been using this toy and were able to give me some feedback on what they were using it for.

The biggest thing they said kids had a challenge with was motor planning how to connect the pieces.  Because it is a precise fit and the pieces slide together, many kids found this challenging and required hand over hand assist while working on the motor planning.  A lot of times they just wanted to snap them together (similar to legos) but they won’t connect that way.

Another challenge was lining the pieces up together in order to slide.  Currently the pieces are all the same color so it requires increased use of the visual system to get accurate alignment as well as precision.  Several kids would get it close and then keep attempting in the same spot, so they required assistance to problem solve and make adjustments so that the pieces would fit together.  We talked about that it would be great if the blocks were different colors or had the interlocking parts defined out by a color/boundary.  This is easy enough to add on your own if you think your kids would benefit from this.

This toy also allows kids to work on their grasps, such as the three jaw chuck or pincer grasp, when picking up the pieces and manipulating them such that they fit together.  In addition, the get to work on fine motor control, precision and coordination.

Lastly, they get to have fun with their imagination and build things!

While talking about the pieces being different colors we were also brainstorming that kids could do patterning, or create additional designs, or just get the visual assist that may be needed.

Have any of you played with this toy?  If so, how are you using it?

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