Starfish Therapies

August 27, 2017

Squat, Stand, Tip Toes


One of our previous PT’s stopped by and brought us a 10 year birthday present (We had just celebrated our 10 year anniversary). She was so excited when she saw the Little People Stand and Play Rampway because she thought it would be great for kids to use to work on standing, squatting, transitions on and off the floor, and more. And yes, we have used the toy in the way we thought, although we’ve also found its good for tip toes as well! Sometimes we are inspired by a toy and sometimes we have an idea and find a toy that will help motivate. This happens to be one of those times that we were inspired by a toy!

As you can see in the picture, we set it up on a support surface so that the child would still have to get in to standing to reach the top. An added bonus was that she had to get up onto her tip toes to reach. To work on being all the way down on the floor transitions, you could have the car end up under the bench. They may try to reach in squatting, which also is good for them to do, but many times they will get onto their hands and knees or into sitting so they can reach a little easier. Then they have to practice the transition from the floor into standing. If they choose to stay in squatting they get to work on balance and stability while reaching outside their base of support.

What are some of your favorite toys for working on standing, squatting, and tip toes?


June 25, 2017

We Love Squigz!


Yes it’s true, we do. Not only do we love Squigz but the kids love them, which is probably part of the reason that they are at the top of the list for our therapists’ favorites. (and no, this is not a sponsored post)

Squigz are basically varied shape toys with suction cups on their ends. They stick to windows and mirrors and themselves. They are great motivators for kids because of their fun shapes and colors. We have used them to help motivate kids for all sorts of things such as:

  • Cruising – We set them up on the windows or mirror and have them move along the row pulling them off. We also will have them go from standing at a bench or other support surface to transition to the window or mirror to practice cruising between support surfaces.
  • Standing – You can practice transitioning sit to stand/stand to sit from a small chair or bench to the Squigz at the window. Also they like to stand there and pull them off which helps to work on standing tolerance and balance. The extra effort of pulling them off the window also provides perturbations to their balance.
  • Stairs – If you have a window or a mirror at the top of a stair case you can use them as motivation to crawl or walk up and down the stairs. Especially if you put a new one up every time they get back to the bottom!
  • Bilateral Coordination – This can happen when the kids are sticking the Squigz together, or pulling them apart, or using a stabilizing hand on the wall while they pull one off the window. You can get creative with having them reach up and down and across. You can also see how many they can stick together to make a chain!
  • Squatting – With your kiddo standing by the window, you can have the Squigz on the floor so they have to bend down to pick them up and put them on the window, or take them off the window and bend down to put them back in the container.

How do you use Squigz?

May 8, 2012

Ideas for Squatting

Filed under: Developmental Milestones — Starfish Therapies @ 3:33 pm
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In my previous post I talked about squatting.  Well here are some ideas for working on squatting with your kiddos.

  • Playing in Squatting: For kids that won’t go into that full or deep squat to play and immediately go into kneeling I try to find a toy or book that they are really interested in and then I get them into the deep squat position and hold them there while we play or read the book.  Depending on how uncomfortable they are in that position or how much they try to wiggle out of it will depend on how long hold it.  I try to start short and work our way up to longer bouts.  Ideally they will start to get more comfortable in this position and begin trying to play.  If they are really hard to get into the position, I will often have them sit right in front of me and then bend their knees so their feet are flat on the floor close to their bottom and then use my body to shift them forward onto their feet into the squatting position.  If anyone has other ideas for this one I would love to hear them!
  • Mini Squats:  A lot of times I use mini squats to begin teaching kids how to bend their knees to figure out how to squat down to pick something up off of the floor or to lower themselves to the floor.  I will usually start this one when they are still cruising along different support surfaces by placing toys they like just slightly out of their reach (not all the way to the floor) so they will have to begin reaching down for the toy.  Once they start that I begin to move the toy lower and lower until they are beginning to bend their knees slightly to pick the toy up.  To progress this you can use a toy shopping cart and put toys along the floor so they have to walk to pick up the toys.  If kids are comfortable enough they will begin to squat past the mini squat but some won’t.  By using the shopping cart or push toy they are able to get a little extra stability from their arms so that they don’t have to rely completely on their legs.
  • Mid Squat (90 degrees):  This one is the most challenging I think because by this point the kiddos will either go down onto their knees and then stand back up to get the toy they want or they will do a mini squat and just bend even more at the hips (which by the way is what most adults do and its bad for our backs as adults!).  One of the things I mentioned was getting kids comfortable with letting their legs move forward over their feet.  (1) We have a few wedges that we use at work and one of the things I’ve been doing is having them stand uphill on the wedge to play with something in standing whether its the sticky balls on the window, the easel or even the iPad that I’m holding in front of them.  If I can make it a toy they don’t get to hold onto for support even better.  Make sure their toes are pointing forward though and not out to the side so that they are getting input into their ankles in the correct position.  (2) One of the things I tried recently with a kiddo who wouldn’t squat all the way down was to have her stand on a small wedge and I put a ring toss in front of her on the floor.  She had to bend down to pick up the rings before she could throw them.  The combination of standing uphill, having the rings be below the level of her feet and I think the slightly unsteady surface (the wedge is a little bit squishy) all helped her to go into a mid squat each time she picked up the rings (on a flat surface she will only use a mini squat).  (3) Another thing we have used is having a toy in front of them that is flat on the floor like a puzzle and they have to stand up for the pieces but squat down to put them in the puzzle (opposite of what you would normally think to do) and because they have to concentrate they will try to hold the squat a little longer and go a little deeper.  (4) Another great idea is to have a chair where they sit with their knees bent to a 90 degree angle or even a little deeper.  Have them stand up to get a toy and then hold the toy in both hands while they try to sit down without ‘crashing’.  By holding the toy in two hands they are less likely to try to use their hands to help with sitting down.

Hopefully some of these ideas are helpful and use different variations of them.  Part of a toy on the ground and part up higher are usually a good way to get lots of reps of squatting (You could use the marble and pool tube idea from a few posts ago).  Also trying to put the toy below the level of the feet so having them stand on a slight height will encourage them to bend more so they can reach further.  Having them stand on a slightly unstable surface like a couch pillow or high density foam or balance disc (if they are stable enough) will also encourage squatting more than bending at the hips because if they bend too far forward they may feel like they are going to lose their balance.  I would love to hear ideas that other people have used!

May 7, 2012

Squats (not just the dreaded gym exercise)

Filed under: Developmental Milestones — Starfish Therapies @ 4:04 pm
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Squatting is when a child (or adult) bends their knees to lower themselves closer to the ground.  In the case of kids this is usually for a functional purpose such as to pick something up from the floor or to play on the floor.  Now, I bet you never realized that there are variations on squatting, well there are!  I’m not sure of all the technical names for the squats so I’ll give you the ones we tend to use.  There’s the mini squat, the mid squat and the full squat.  The mini squat is when a kiddo just bends their knees a little bit and a full squat is when they go all the way down to the floor (and usually play in this position).  The mid squat is the hardest for kids who have weakness because it requires the most control.  Its when they bend their knees to about mid range (~90 degrees). (Kids who are tight in their ankles will generally avoid playing in a full squat and will go right into kneeling rather than stay on their feet)

When I talk about control I am referring to eccentric muscle control.  The opposite is concentric.  When you stand up and straighten your knees you are using concentric and your muscles are generating power to help lift you into a standing position.  When you are squatting down and bending your knees you are using eccentric and your muscles are slowly lengthening to help you maintain the position you want to be in.  They have to grade it just enough to let you lower but not too much so you don’t just collapse to the floor.  If they don’t feel like they have enough strength to maintain that control they will avoid the mid position because its the hardest (gravity gets to have the biggest pull on them at this range as well).

Usually the muscle I am referring to is the quadriceps muscle (the thigh muscle), however the calves can play just as big a role.  I have found that if kids don’t have control in their calf muscles they don’t like to let their leg move across their foot (because it requires control).  In order to go into a mid squat they need to let their leg move forward over their foot.  If their calf isn’t comfortable with this is will often go into an overactive ankle reaction.  An ankle reaction is one of the balance reactions that helps to keep us upright.  When the calf feels the leg start to move over the foot it will get nervous that we are about to fall so it will turn the calves on concentrically to stop that leg from moving forward.  Well this makes it awful hard to squat!  Ankle reactions are great for balance but we want to make sure they are turning on and off at the right time.

Now that I’ve given you all this information on squatting, what are you supposed to do about it?  Well start by paying attention to your kids and see if they use all three positions or if they avoid one or two of them.  In terms of ideas for encouraging squatting in all positions?  Well that will be a topic for another post this week!

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