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?

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?

I Won’t Stand for That! (unless I learn how)

Learning to pull to stand can come naturally for some kids, and for others it can require a bit of work. This video is one where it came naturally (please note the emerging balance reactions at the end of the video – I love to see kids getting to experiment with this). As he was learning to crawl and explore he naturally began experimenting with pushing or pulling up to stand. This may have started with your legs, a coffee table, an oversized bin, the couch, or a chair. Basically anything that is off the ground and their hands can reach. When they get to it, their natural curiosity has them try to see what’s up there, or what’s on the other side. They become successful at it when the ability of their muscles matches their curiosity!

For those kids that require a little more help, here are some ideas you can try:

• Sit to Stand – If your child can already sit independently, have them sit on a small stool really close to the couch or an activity table or a chair. Have a preferred toy or activity on the support surface. Help them to put their hands on the support surface and move into standing. Let them play for a bit and then bring them back down into sitting and repeat again. This helps them to strengthen their leg muscles, as well as learn that if they move into the new position, there might be something they like there!
• Playing at Support Surfaces of Various Heights – When your child can crawl, or even kneel, create an environment where they have different heights to explore on. This could be the couch, the coffee table, an activity table, an overturned storage bin, a foot stool, etc. Put toys or activities that are motivating to the them on the support surfaces, and be there to engage as well. They may begin to experiment with pushing or pulling up onto extended legs. You can also line them up near each other. For instance, have the activity table touching the couch and a little bit away have an overturned bin touching the couch so that you have made a U of activities at various heights. Let them start at the lowest height and then make them aware of the activities or toys at the higher height. They can use the lower height to help them problem solve how to reach the higher height. This can also help them learn how to lower back down to the ground because they may want to get back to the toy or activity at the lower height again.
• Crawling Over Obstacles – Learning to crawl over obstacles helps kids to develop their total body strength as well as have to problem solve how to get to where they want. This can involve pushing up onto extended legs before they go over the obstacle, or even just crawling right over. It engages their curiosity about what is ‘on the other side’ and if you use toys that are motivating, they can crawl back and forth along the same obstacle path for many repetitions! Use your legs, couch pillows, piles of blankets or towels, small upside down storage containers, etc.
• Manual Assistance – And sometimes you just have to give them the extra support and take them through the motions. So if you are at a support surface, and they are on their knees with their hands on the surface, help them bring one leg forward so their foot is resting on the floor (half kneel) and then give them a little boost at the hips to go all the way up into standing. Take turns with which side you help them with so they get to develop strength in both legs, as well as so that each leg learns that it can push without the other leg right next to it!

What are other ways you have taught kids to pull to stand?

What does High Tone mean?

I wrote a post a while back describing low tone so I thought I would try to do the same with high tone.  Tone is the resting state of your muscles.   When someone has high tone it means that their muscles are getting more input than is necessary, even when they are at rest.  Where kids with low tone tend to melt into you, these kids tend to be on the ‘stiffer’ side.  One thing I often hear from parents is that their child likes to stand all the time (even before standing is a milestone they should be hitting) and they don’t like to sit. (PS- for these kids it is not better to put them in an exersaucer alot because it doesn’t help them learn how to use their muscles differently)  This is because it is easier for their muscles to work all together.  When they are standing they are able to use extension all together, they can keep all of their muscles turned on at the same time.  When they are sitting they are asking their muscles to do different things.  They need to keep their trunk muscles turned on without turning on their gluts (tush muscles) at the same time.

Many people think that kids with higher tone are stronger because they are able to keep their muscles turned on.  This is a common misconception and these kiddos often have the same amount of weakness as kids with low tone.  The just look strong when they are able to do a task like standing when all their muscles are on.  If you ask them to sit or go onto hands and knees they often have a more challenging time because they have to isolate their muscles to have them do different things.  When a child goes onto hands and knees they need to keep their head, neck and trunk extensor muscles turned on but they need to relax their gluts/hip extensor muscles so that they can bend at the hips and again at the knees.  Often they will hold this position for a short period of time before they turn their gluts back on and come up into high kneeling.  This is because its easier for them to maintain head, neck and trunk extension with hip extension then it is to have hip flexion with their head, neck and trunk being extended.  Just like in sitting they need to keep their trunk upright while keeping their legs bent at their hips and knees.

Its important to remember that these kids need to strengthen individual muscles so that they become more efficient at isolating out movement and don’t need to rely on using all their muscles doing the same thing at the same time.  The earlier they start developing isolated muscle strength the easier it will be as they progress through their milestones where they need to be able to use each  muscle differently.  In addition, as they grow or have growth spurts you may see some ‘stiffness’ return because their muscles have just been stretched and need to adapt to the new length.  Maintaining isolated strengthening will help your child to move through these growth spurts with increased ease.

I know this is a hard topic to explain so I hope I made it a little more understandable for you.  Please don’t hesitate to ask any questions that this may have raised and I will do my best to answer.