Starfish Therapies

March 5, 2017

Monkey Bars

Filed under: Developmental Milestones — Starfish Therapies @ 12:00 am
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We get a lot of kids who want to get better at monkey bars. Its something that their friends and classmates are doing with ease and they are struggling back at the first monkey bar, or having to have someone help them across.  Here are some ways we have found to help them:

  1. Get used to swinging/holding onto one bar. This could look like holding onto the first monkey bar and letting their feet swing once, twice, three times, or more.  Or have them hold onto an overhead bar for a count of X before they drop down to the support surface.  This gets their hands and arms used to gripping onto the bar and supporting their weight, as well as the feeling of having their feet unsupported
  2. Use a trapeze. We have a small trapeze that we let our kids swing on.  Some of them struggle with the core strength to pick their feet up off the ground to swing.  We have remedied that by putting the trapeze close to a wall and using a large therapy ball or peanut.  We have them hold onto the trapeze and help them get their feet onto the ball.  They then get to push off and swing back and forth as many times as they can.  They begin to start trying to get their own feet on the ball which supports their core strengthening.
  3. Knee walking or walking. We are lucky enough to be able to recreate monkey bars indoors and we have a treatment table that we can put under it.  We could also use a balance beam or any other elevated surface so that their feet are supported while they traverse the monkey bars.  We then have them work on reaching through with their hands so that only one hand goes onto each bar.  This lets them practice the coordinated movement of reaching through with their hands, and looking at the next bar, without the added strain of supporting their own body weight.
  4. Swing through. I know reaching through to the next bar so that only one hand is on a bar at a time may seem harder, but we have found it to help the kids we work with.  When they get two hands onto the same bar their tendency is to turn off their core.  This stops any momentum they have going and have to generate the energy all over again to move to the next bar.  By swinging through and only putting one hand on each bar they are working on the efficient use of momentum and keeping their core engaged which decreases the work on their hands and arms.
  5. Practice, practice, practice. Lots and lots of repetitions of all of these techniques as well as just going across the bars.

I don’t want you to think we forgot about core and upper extremity strengthening, because we didn’t.  We focus on those areas as well, but I limited this post to working on the actual monkey bars.

What are ways you have successfully worked on monkey bars with kids?

September 2, 2014

Accessible Beaches

Filed under: Uncategorized — Starfish Therapies @ 9:08 pm
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surf chair 1 surf chair 2

I was recently back in my home town in NJ and spent the day on the beach.  I was impressed as I saw multiple people being pushed down in ‘surf chairs’.  I thought it was great that so many families took the time to get chairs that would allow their loved ones to access the beach.  Imagine my surprise and delight when at the end of the day I was packing my stuff up and saw that these chairs were provided by the beach!  I went home and looked it up and not only does the beach provide them, but they are free of charge.  Its just recommended that you make a donation.

I would love to hear about other beaches in other parts of the country that have programs like this.

April 20, 2014

Sidewalk Chalk

Filed under: Developmental Milestones — Starfish Therapies @ 4:18 pm
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sidewalk chalk

With the weather getting nicer, you may be looking for some outdoor activities.  Sidewalk chalk is a great tool that is limited only by imagination. Just think of all the things you can do with it. Besides drawing pictures in your driveway, sidewalk chalk can be valuable tool when working on improving your child’s motor skills, the most obvious one being practicing their drawing and writing skills. But they can also strengthen their arms through weight bearing, work on their balance, learn to visually track, improve their jumping skills, and learn sequencing with a little help from this outdoor favorite. Here are a few ideas:

  1. Drawing on the ground – in order to draw on the ground, your child has to sit or lay on their belly on the ground. This means that they’ll likely be bearing weight on their non-dominate hand the entire time they are drawing and strengthening that arm. If you feeling adventurous try challenging them to draw with their non-dominate hand.
  2. Draw hopscotch on the ground – they can practice jumping together and apart in order to complete the hopscotch or hopping on one foot as their skills develop.
  3. Draw a “balance beam” on the ground – they can practice walking on the line without stepping off. If they get good at walking forward, try walking backwards or sideways. You can also try making a squiggly line.
  4. Draw a racetrack for them to ride their bike/trike, or sit and ride toy around – this will make them visually follow the line while riding in order to stay on track.
  5. If you get bored with all of these, try drawing an obstacle course and putting them all together – you can draw bases to hop between, a line to walk across, a hopscotch to jump through, and even hand and foot prints to do animal walks on.

And don’t forget all the fun you can have washing your daily activates away so you can draw new ones tomorrow! What else have you done with sidewalk chalk?

November 30, 2012

Community Involvement with Physical Activity

Filed under: Developmental Milestones — Starfish Therapies @ 12:00 pm
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I’m home visiting my family for the holidays and discovered that our township had expanded their bike path.  I love it!  It creates a safe environment for families to ride their bikes, walk their dogs, rollerblade, or run.  In a day and age when sidewalks in neighborhoods are disappearing and its harder for kids to get outside and be active, its great to see that some communities are taking strides to create opportunities for families to be able to spend time outside.

It reminds me of the San Francisco peninsula which has a great bike path along the bay that I have spent many hours biking or running along while I have trained for a race!

I’d love to hear stories of other communities creating space for people to engage in exercise – please share!

November 27, 2012

Recipe for Playing Outside

Filed under: Developmental Milestones — Starfish Therapies @ 12:00 pm
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I had the fun the other day of spending the day with a friend from high school and her children.  We spent the day outside and the kids played the entire time without prompting from us and didn’t want to leave when it was time to go.  Looking back, here are some things that I think worked.

1.  Novel environment – We went to a place that they had never been before.  Therefore they were excited to explore and play on the ‘new’ things (even though I’m sure they have seen many playsets before).  I know finding a brand new environment isn’t always possible but look for ways to switch up where you go with the kids outside.  Maybe its even as simple as taking turns with friends and neighbors to have the kids play in their back yards.  Other people toys are always so much more exciting than their own.  If you have parks nearby try out a new one that you don’t usually go to.

2.  Appropriate toys – Since we had a large area that they could play in the kids brought their bikes.  They were so excited to ride out ahead of us and then circle back to see what was taking us so long (we also brought dogs along so they had fun making the dogs chase after them).  If you are going to an area that has paths, bring kids bikes or scooter.  If you are going to the beach, bring sand toys.  If you are going to be at a grassy area, bring some ball games and maybe even a kite.  Plan ahead for what may engage your child where you are going to be.

3.  Have a playmate – If your child has a friend or a sibling that is fairly close in age it makes it easier to engage in play.  We were lucky that my friends kids had fun hanging out with each other this day.  I think part of it is that we had the above two factors going for us as well!  We found that when one started to lag behind or complain of being tired, they often only needed a minute before they realized the other one was still having fun playing and they were being left out.

4.  Don’t try to have their answers for them – We didn’t try to dictate how they played.  We let them come up with ideas and just made sure they were safe.  We would take many breaks from the bike riding to explore the leaves, or throw rocks into the lake or even play on the play structures.  The ideas they came up with for fun things to do were great when they were given the opportunity to use their imagination.

I am sure there are many great factors that can encourage playing outside but these were ones that I came up with when I looked back over what made this outing so much fun for the kids and so successful in terms of encouraging outdoor play!

I would love to hear any ideas you have that work.

October 19, 2012

Some Fun Ideas for Encouraging Activity

I was browsing through the newest Family Fun magazine and I have to say I was quite impressed with the items they had that encouraged kids and families to be active.  Not only that, several of them also encouraged learning as well.  I thought I would share some of the activities in case you would like to try them, and I would love to hear any variations of these activities that you have tried!

1.  The first one (on page 36 of the November 2012 issue) is simple, it involves using a therapy ball for fitness.  They recommend a 45 cm ball but you want to make sure it is the right size so that if your child is sitting on it their hips and knees are bent to approximately 90 degrees.  The fuller the ball is the harder it is to balance.  They then go on to show exercises that work on core and leg strength.  They give them great names such as ‘On top of the world’, ‘Do you know squat’, and ‘Hand walking the plank’.  On top of the world has your child sit on the ball and lift one leg a few inches off the floor for 10 seconds while holding their balance and then switch.  This will work on your child’s balance and core strength.  Do you know squat has them do a squat while holding the ball against a wall with their back.  Have them try to hold the squat for as long as they can.  This will work on their core and leg strength.  The last one, Hand walking the plank has them lie on their stomach on the ball and walk their hands out as far as they can in front of them while maintaining their balance on the ball and then walk them back in.  This will also strengthen the core and their arms.  What other ball exercises do your kids do?  I know I sit on the ball while I watch tv so at least I am doing something healthy while my brain takes a vacation!

2.  In the spirit of Thanksgiving they introduced the idea of 21 Turkeys on page 33.  This game has people line up across from each other and throw a football back and forth (you can use little footballs or other balls for smaller kids).  If they can throw it right to their chest so its an easy catch they get 2 points.  If they have to reach for it or move to catch it, they get 2 point and if they miss its 0 points.  This will also allow the kids to work on adding and counting as well as throwing and catching.

3.  On page 40 they describe calculator hopscotch.  I love this idea.  Set up a calculator with sidewalk chalk (see photo) and you can play a few different ways.  You can have one person pick out a math problem by hopping from square to square and the other person jump on the answer (depending on your kiddo’s math ability you may want to just practice hopping on a number or recognizing how many of something there are and then jumping on the number).  You can also toss a stone onto a number and then in one minute come up with as many equations as you can that equal that number.  Or you can do the last one as a group activity and see how many equations you can find before moving on to the next answer.

4.  A great relay race on page 55 has you divide into teams and each team gets a bag of plain popcorn.  The first runner puts a cup attached to a rubber band around their shoe so the cup sits on top of their shoe.  Fill them with popcorn and then cross to the opposite side of the room/yard and empty the cup into the box.  Go back and pass the cup to the next team mate.  Continue this until the bag of popcorn is gone!
Has anyone played these games or do you have any other variations?

May 23, 2012

Water Squirt Toys – Some Colorful Ideas!

image retrieved from:

With the weather getting nicer and nicer, I love to come up with ideas that can be done outside.  One of our OT’s actually thought of this idea and I loved it (and added a few twists).

There are a plethora of squirt toys out there for kids and one of the great things is that they really work on hand strengthening.  You can use squirt bottles, water guns, and those little toys that suck up water and you squeeze them and water shoots out of their ‘mouth’ (sorry, no idea what they are called), to name a few.  As fun as this can be you can add some twists to it by using colored water (with food coloring added in or washable paint added to the water) and the opportunities are endless!

The first idea I had was making targets and seeing how accurate kids could be by trying to hit the center of the target or even certain pictures on the target (by using white paper the colored water will show up).  You can use the different squirt toys and see which can generate the longest stream by measuring how far away the kids can stand and still hit the paper.  This is great work for visual attention and hand-eye coordination.  You could even play around with if they are more accurate standing up, sitting down, kneeling, standing on one foot, etc.

Another idea would be to play ‘tag’ with the squirt bottles and each kiddo gets one filled with a specific color (of washable color) and they all wear white t-shirts.  You can make it a small playing area or a large playing area.  You can make teams of one color or have it all individual.  See who can get the most hits on the t-shirt while the kids run around.  This generates activity, awareness of other kids in their surrounding area, hand-eye coordination, visual attention and hand strengthening to name a few things.

You could even create an adventure with an outdoor obstacle course and have it be a scavenger hunt where they have to go through the course and squirt certain pictures as they go.  For instance have a picture of a star or a circle or a leaf and they get points for each one they are able to squirt.

What are some other ideas you have used for outdoor fun with squirt toys?

May 22, 2012

Gross Motor Ideas for the Park

Now that nice weather is upon us its time to get outside and play with the kids!  Parks are a great place for kids to effectively ‘burn off’ their energy while working on gross motor skills and socialization.  Here are some of the great things about parks:

  • There are other kids around to play with.  They may not even know them but if they are sitting next to each other playing in the sand conversations can start up and they make a new friend.  For kids that need to practice social skills there are lots of opportunities to encourage play and socializing.
  • Kids can climb.  There are climbing opportunities for kids of almost every level.  There are usually changes in height on the ground that little ones can practice climbing up and down.  The stairs that go up and down the play structures offer opportunities for walking or crawling up and down stairs.  Ladders come in all shapes and sizes with different patterns that offer opportunities for motor planning and problem solving.  Also they let kids work on climbing down which can offer its own challenges.  Lastly there are usually climbing walls, fake climbing rocks, chain link nets to climb or arches to go up.
  • Lots of different surfaces to walk or run on to practice balance.  Sand, grass, tan bark, wiggly bridges are just a few of the surfaces that can provide opportunities for challenging balance.  If you take kids shoes off these same surfaces provide great sensory input opportunities.
  • Slides can work on core when kids are learning to go down sitting up, they provide vestibular input, work on depth perception and awareness of height as well as different sensory input depending on if it is straight, curved, steep, in a tunnel, etc.  And if its okay at the park kids can practice climbing up slides (one of my favorite things to do when I was little).
  • Swings are a great place to get vestibular input as well as work on head and trunk control.  If kids are old enough to start self propelling its also a great core workout and opportunity for motor planning and coordinated movement as they figure out how to lean back and bring their legs up and then pull themselves forward while bending their knees all while timing it with the movement of the swing.  Another one of my favorite activities as a kid was to see how high I could swing and then jump off.  We had contests to see who could go the furthest!  You may want to have them practice that on a smaller scale first.
  • Lots of space can be found at parks which is great for running races, games of tag, riding bikes, throwing and catching balls, soccer, frisbees, kites.  All of these activities are great for gross motor development.
  • I also forgot the little ride on toys that bounce back and forth which are fun and provide sensory input as well as problem solving for climbing on and off, and core strength to keep it moving!
  • I almost forgot monkey bars.  This is great for upper extremity and core strength.  You can practice having kids hold on to one bar with both hands or stagger their hands across two different bars.  Make sure you change which hand they are leading with.  And, you can help them learn to traverse the monkey bars.  A great way to work on visual attention with a task as well.

What are some of your favorite activities to do at the park?

February 24, 2012



Since I just took an extended holiday weekend and went skiing, I for some reason couldn’t turn off my PT brain and I found myself analyzing what I was doing (other than falling) as I made my way down the slopes.

I can tell you right off the bat that your quads get an amazing work out.  Not only were they burning as I was going down the slopes but they are still sore and I can feel them every time I stand up or go up and down the stairs.

My other sore muscles are my calves and that’s because being on skis encourages you to shift your weight forward so your calves are working to keep you from falling flat on your face.  This is the same way your calves (and quads) are used when you go down the stairs, they slowly elongate to keep you from falling.

When you are shifted forward on your skis going down hill you could stay in that one position but I can pretty much guarantee you will go speeding straight down the mountain.  In order to control your speed you need to weight shift from side to side as well as turn your skis slightly (or drastically) back and forth.  This is great practice for weight shifting which is important for walking.

When you are shifting forward and side to side, you need to keep your head and trunk upright and looking down the hill which helps to develop righting reactions as well as trunk rotation (for when you turn your skis side to side).

By looking down the hill or to your next target (especially if you are doing moguls) you get to work on maintaining visual focus despite other things going on around you.  You also get to anticipate what you are going to do next and work on your anticipatory balance reactions.

And believe me, skiing will work on your balance all around!

There are plenty of other things that go into skiing but that is the basic breakdown.

Now, when kids (or adults) first start out they learn how to maneuver with skis on their feet.  I remember practicing with a kiddo who was going to go skiing for the first time.  We were practicing on dry land so that she would have some idea of what to expect and thereby feel more comfortable with this new activity.  We practiced moving our feet from ‘pizza’ (pointing inwards) to ‘french fries’ pointing straight ahead. I would give the command and she would react.  This gave her the opportunity to work on reaction time, motor planning and coordination.  Lastly we practiced falling.  The main purpose for that was so that when she fell she wouldn’t get discouraged and would stand up and ‘brush it off’ or ‘shake it off’.  I was so excited to hear that her first skiing opportunity was not only a success but she wanted to do it again!  Ski school is a great chance for your kids to learn with their peers and work on social skills while they all learn a new activity.

For kids that have more involved needs there are some amazing adaptive skiing programs out there.  This family talks about their discovery of skiing and the upside of going downhill!  I also work with a kiddo who participates in adaptive skiing and he loves it.  The smile he gets on his face when you ask him about it says all you need to know about the benefits of this activity that is ‘typical’ among his peers.  Here are some of the adaptive ski programs I know about but please feel free to add to the list.

February 16, 2012

Stomp Rocket – Oh the Possibilities!

The stomp rocket is one of my favorite toys to use in therapy.  Initially we started using it to encourage standing on one leg, but over the years we have come up with a plethora of ways to create therapy uses for it!  Some of them are listed below:

Single Leg Stance – In order to step on the stomp rocket the kiddo will ideally have to pick up one of their feet while the other one stays on the ground.  Because they have to pick it up higher than they would for taking a step during walking, they leave their foot in the air for a little longer, also allowing them to get a better stomp!  Once our kids master the ‘stomp’ part we will have them hold it for a count of (pick a time) so that they have to start balancing on one foot.

Weight Shifting – Again, in order to pick their foot up to stomp on the toy, the kiddo needs to shift their weight onto their standing leg.  Because they have to pick the foot up a little higher to clear the ‘stomp’ part its harder for them to do a partial weight shift.

Force Production/Regulation – Whether they are using the stomp rocket with their hands or their feet, they need to generate enough force (in a timely manner) to propel the rocket off the end of the stand.  Some kids have no problem with this, however, some kids will take tentative steps or allow gravity to pull their foot down which doesn’t allow the proper pressure to generate for shooting the rocket off!  A trick to give them some success in the beginning is to only put the rocket part way down so that less force is required to propel it into the air.

Visual Tracking – When kids first start to use the stomp rocket they often can’t attend to what they are doing and then watch the rocket go into the air.  A lot of times they miss the actual rocket flying through the air.  Because its fun to watch and the kids are motivated they will pretty quickly start to figure out (with some help from you) that they need to also pay attention to where the rocket is flying through the air.  If you have them retrieve the rocket as well, it helps if they know where it has landed!

Sensory Input – We had a kiddo the other week who was loving the stomp rocket.  He wanted to do it over and over again.  His mom was amazed because he has really tactile sensitive feet, and he was doing this activity in bare feet.  With that in mind, we adapted the stomp rocket to add different textures to it so that he would get input from different textures to the bottom of his feet while doing an activity that he really liked.  Also, we changed the surface the stomp rocket was resting on.  We put it a few steps into a grassy area so that he had to walk a step or two on the grass to get to it.  You could easily make walkways of different sensory material as well as the overlays of sensory material to decrease tactile sensitivity or just to increase tactile input (can be used on hands and feet).  Here are some ideas for sensory input to incorporate!

Jumping – Kids can practice jumping onto the stomp rocket to get a more powerful flight.  It allows them to work on jumping forward, up and to a target (all of which can be challenging when done purposefully).

Hand Use – You can work on hand strength by having a kiddo squeeze the bulb in their hand to make the rocket go.  You can also work on using an open hand by having the kiddo activate the stomp rocket by having to use a flat hand.  They can crawl to it or bear walk to it or just sit and use a flat hand.  You can also use this activity for upper extremity weight bearing and weight shifting.

Target Practice – You can also set up a target to try to aim the stomp rocket at and see if you can hit the target, whether with the rocket starting from the floor or the child holding it and pointing it at the target.

One more thing – they also make a bubble stomp rocket which should provide tons of motivation and other ideas such as finger isolation to pop the bubbles and running to chase them!

What are some of the things you have used the stomp rocket for?

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