Starfish Therapies

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?

October 3, 2012

Using the Ball vs the Platform Swing for Balance Reactions


As a therapist, we use the therapy ball a lot with our kids.  It helps them to work on balance reactions and postural control as well as provides vestibular input in a variety of directions.  The kids love it because usually we sing to them and bounce them and they may even forget they are working.  There are a few things to consider when using the ball though.  Generally you are holding onto the child in some way so they are being provided stability (most likely at the pelvis) which allows them to only concentrate on activating their core without having to figure out how to counterbalance at the pelvis.  In addition, usually kids are sitting with their feet hanging down in front of them so they are able to pull in their leg muscles to assist with activating their trunk muscles by using the overflow.  If they over recruit their muscles, they can generally push against your hands to give themselves extra support.  Finally (although I am sure there a quite a few more points that I didn’t bring up), if you are holding them at their pelvis or even their trunk, I can almost guarantee that you are helping them correct their posture in some way, shape or form.

Another alternative to use in conjunction or to switch it up is to utilize a platform swing.  You can have the child sit in ring sitting, tailor sitting, side sitting, etc in front of you and then you can move the swing forward, backwards, sideways or even diagonal (similar to the directions you can move the ball) and see how the child reacts.  This method is great because it can let the child practice sitting ‘independently’ (although with you close by) so they can practice using their pelvis to counterbalance their trunk reactions.  For example, if the swing moves to the right, the child needs to stop the movement towards the right by pushing their left hip down into the surface and use their trunk muscles to shift them back to midline.  In the beginning, especially with the side to side motions, kids have a hard time preparing their body for the movement and need help to not topple over.  I usually start with slow, small movements until they begin to get the hang of it and then I will increase the speed or the size of the movement.  By having their legs crossed in front of them they also have to work harder to isolate their trunk extensors and other trunk muscles.  If you have a kiddo with higher tone, they will attempt to push their legs into extension while trying to stabilize.

Now I know not everyone has access to a platform swing so what other tools or tricks have you used to work on balance reactions on a dynamic surface, without giving the kiddo stabilization?

May 21, 2012

Ideas for Helping Kids Develop Better Posture

Filed under: Developmental Milestones — Starfish Therapies @ 12:00 pm
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Posture is always an interesting topic.  As adults we are often trying to improve our posture because we have started discovering that poor posture can cause other problems like pain.  These are things we don’t think of when we are younger and don’t always think about for our kids.  Posture is something that can and should be worked on from when kids are little so that they can hopefully avoid long term problems as they get older.  I have to thank one of our readers for coming up with this idea!

Here are some tips and ideas for exercises/playing that can also work on posture:

  • Make sure kids hamstrings stay flexible.  Its a lot easier to keep them flexible than to stretch them later.  When hamstrings are tight it can tip our pelvis backwards so that it flattens our low back spine.  To help with keeping hamstrings flexible have kids avoid w-sitting and long periods of kneeling as these will both shorten the hamstrings.  They should sit in a variety of positions such as ‘criss cross’ or with their legs straight out in front of them.  Here are some different sitting positions.
  • Core strength is really important.  Some of my favorite ways to improve core strength for kids other than having them do sit ups are:
  1. Lots and lots of climbing.  Since its getting nicer out this should be easier because parks are lots of fun.  The more unstable the climbing surface the more they will have to work their stabilizers and abdominals.  I love climbing nets or climbing domes.  Even ladders work well for this.
  2. Animal walks are a lot of fun and really challenge the core.  Some of our favorites are bear walking (hands and feet) or crab walking or dog/cat walking (straight crawling).  You can have animal parades or animal races.  You can change the terrain by going over uneven surfaces such as cushions or you can go up and down hills.  You can make animal obstacle courses where they have to be the animal and go around cones, over obstacles and through tunnels.
  3. Use a therapy ball.  Have your kids sit on it and move it around in all directions with fast and slow motions.  Or have them bounce on it. Try to give as little stabilization as possible (try for just the legs) and make sure they aren’t using their hands to hold on.  If you can get them to engage their hands in play such as clapping or touching their head or reaching to the sky it automatically encourages more upright posture.  I will also have kids reach for items such as bean bags and then throw them for a target while sitting on the ball.
  • Try sitting on an unstable surface.  There are wedges or core discs that are out there that can provide the ability to wiggle while sitting and allow kids to keep their core active and engaged.  You need to try it out though because sometimes it can be too challenging and they will just sink into a slumped posture.  Also if you can make a sitting surface a little higher than normal so their feet still hit the ground it can encourage an upright posture more than sitting at 90/90.  Or if you have a therapy ball that they can sit on with their feet on the ground while watching tv or doing other things it really works to keep the core active.  You have to make sure that they are safe while doing this though.
  • Swinging at the park especially when they are self propelling naturally engages the postural muscles such as the scapular retractors and the abs. In addition they get some great vestibular input.
  • Bike riding is really fun and great for core strength and endurance.  If you really want to get the core working ride up slight inclines and hills, they will have to use their arms and abs to generate power from their legs.
  • Reaching in sitting will also encourage upright posture.  Have them sit in a variety of positions or on a variety of surfaces and play games where you make them reach up and in front or to the side.  Watch their posture to make sure they are engaging their core muscles.

I probably have a ton of other ideas but this is a start.  What are some of your favorite ‘exercises’ for encouraging improved posture with kids?

February 9, 2012

What Does Low Tone Mean?

Muscle tone is the resting state of your muscles.  When a child has low muscle tone it means that they need to put a lot more energy into getting their muscles to turn on to do what they want them to do.  I often try to explain this to parents by describing that feeling when you finally get to sink into the couch or your favorite arm chair and relax and then someone calls you from the other room and you have to rev up the energy to get up.  Think about having to do that every time you move because that’s what it can be like for kiddos who have low tone.

Generally kiddos with low tone seem to be squishable because they melt right into you when you hug or hold them.  This is great for cuddling but if you are carrying a baby or kiddo around that is melting into you, it means they aren’t able to help support themselves in your arms so it can seem as if you are carrying a heavy weight around.  As their muscles get stronger they get better at activating them so that if you are carrying them, they can hold their own trunk up without having to lean on you.  Its amazing how much lighter this can make them feel!  (Another way to get the idea is if you are holding a kiddo by their hands to help them stand and they just decide to have spaghetti legs and you weren’t expecting it).

When I talk about strength being a challenge for kids with low tone I am talking about not just their ability to generate enough force to move their arm or their leg, but also their endurance and their ability to switch their muscles on and off.  These components all work together to produce movement.

I know that I talk about core strength a lot but for these kiddos its really important.  Just think if your trunk (core) was as stable as a slinky.  Do you think it would be easy to move your arms and legs, to do fine motor activities, to run and jump or even walk, to keep an upright posture in school to help with learning?  It would be challenging to do all of these things and so many more. That’s why when I work with kids with low tone I am often doing activities that will challenge the whole body but also focus on the core.  I also work to increase either how long they can do an activity (such as sitting on a ball for trunk control) or how many times they can do something (such as bridging) because this will help to increase the endurance of their muscles so they can stay working as long as they want them to.

Since it is harder to move and to activate their muscles, a lot of times they may need more practice, help and support, not to mention motivation to get moving! When they are little I do lots of tummy time to develop their butt muscles, anti-gravity trunk extensors, their head and neck muscles and their shoulder muscles.  The more interesting you can make the activity the longer you can get them to want to play in this position.  I do other activities as well, such as pull to sit to work on abs and head control (I make them work both going up and going down).  Going down is often easier (until you get close to the ground) because their muscles are already turned on so they just have to keep them on so they don’t ‘crash’ unlike going up where they have to turn their muscles on and its really hard when you are flat on the ground because you are fully working against gravity. I could go on all day and I might have to do another post just on activities!

Since these kiddos have to put out so much more energy to do things than a person with regular muscle tone, and the fact that we are constantly asking them to do more, don’t be surprised if they get tired easily.  For instance, it may not seem like it is that hard to sit in a chair to do work but if you think about all the energy they have to expend to keep their body up nice and straight its not surprising that they are tired.  When they are little they may need to nap more often, especially if they are doing therapy.  If you are in a mommy and me or a gymboree class you may notice that your kiddo needs to take breaks a little more frequently than the other kiddos.  This is normal for them.  However, you also want to remember the goal of working on their endurance so it doesn’t hurt to challenge them.  Just like when I am training for a race, 3 miles may be in my comfort zone but to get to the marathon I will have to challenge myself to run a little bit further than my comfort zone allows each day.

TheraTogs or the Spio suit or even hip helpers are tools that can be helpful for kids with low tone to give them a little extra support in the core so that they can practice the skills they need to practice.  I also use a lot of tickling to remind a muscle to turn on and stay on.  Sometimes using a slightly unstable surface like a sitting disc or a therapy ball can also be a reminder to keep muscles on.  Since it is unstable its a lot harder to sink into the support like they would be able to in a nice firm chair.  Also using wedges (although I wish I could find these filled with sand in addition to the air filled ones) in a chair (tilted forward) can help to activate a child’s core for improved sitting as well.  What are other tools that have helped either kids you have worked with or your own child – I’m sure I’m leaving out a ton of ones I’ve thought of or used but I always love to hear new ideas!

You can download an informational handout of this information here!



January 31, 2012

Tummy Time – Its a Ball!

Ok, I am a big proponent of tummy time and I have discussed why I think its important in Tummy Time: The Cornerstone of Movement and Tummy Time: What’s the Big Deal.  I have also provided suggestions for ways to incorporate this in Strategies for Tummy Time.  I now have a new approach!  I am beginning to work on a video series for a set of ‘How To’s’ for parents who are looking for ways to help their kiddos work on their motor skills and milestones.  The first video is for tummy time and shows how to use a therapy ball to help your kiddo work on tummy time.

Now, its my first attempt at a video like this and I decided to leave in the natural dialogue between the mom and I because this is the way I talk when I am working with families and kiddos.  I added some text at the bottom of the screen to drive home some of the points but I thought I would also outline them here.

  • You can move the ball side to side to work on trunk reactions and weight shifting
  • Moving the kiddo back on the ball will take away some gravity and make it easier for them to push up and get trunk and neck extension
  • Moving the kiddo forward on the ball makes it harder because they have to work against gravity more
  • If you hold tighter to their hips and pelvis you provide more stability making it easier for them to have success with pushing up
  • If you hold looser at their hips (although make sure they are safe) you give less stability and make them figure out how to use their muscles to stabilize
  • Bouncing the ball can help to keep their muscles going longer to work on endurance
  • Moving the ball to one side can make it easier to lift the opposite arm for reaching
  • Slower movements allows them more time to react to the change in position
  • Faster movements are harder to react to and need a little more stability
  • If you hold the ball in one spot for slightly longer they get to work on the endurance of their postural muscles
  • Lastly, I mentioned this but have whatever interests them in front rather than to the side of them so that they are working their muscles evenly.  You can always move what interests them around so they work on weight shifting and head and neck turning but keeping it off to one side the whole time is not in their best interest!

Hopefully this video is helpful and my video skills will improve with practice!

January 27, 2012

More Great Songs for Therapy

After my last post on fun songs to use in therapy my coworkers suddenly started remembering songs that they frequently use in therapy so I thought I’d share some more ideas.

If You’re Happy and You Know It

This is a great song because you get to insert your own action.  You could pick skills that you are working on such as: jump up and down, stand on one foot, stand on tip tiptoes, jumping jacks, etc.  I also use it when we are on the ball and I am trying to keep the kiddo from using their hands to stabilize so I will often insert actions like:  clap your hands, reach to the ceiling, touch your ears, touch your head, reach to the sides, wiggle your fingers, touch your shoulders, say hooray (and reaching arms up overhead).

Hokey Pokey

Just by following the words of the song the kiddos get to work on motor planning and balance (and single leg stance for left and right foot).  To spice it up a bit you can have them jump (or hop on one foot) at the end instead of clapping.  You can also use the words ‘Touch the ground, stand back up, touch the ground and shake it all about’ to work on squats.  You could have the kids pretend they are dogs or cats and they can put their ‘paws’ and ‘tails’ in to work on crawling and balance in quadraped.  You can also just change animals for every turn so if they are frogs they hop in and hop out, or butterflies tip toe in and tip toe out.

I’m a Little Tea Pot

This is another fun song to use on the ball.  You can work on postural control while singing the song and then when you get to the ‘tip me over’ part you tip the kiddo backwards so they have to do a sit-up to get back up.

Old MacDonald

Great song for getting repetition of activities in.  If you are using an animal puzzle or play animals it works even better and the kids get to work on animal recognition because they get to select the animal that is on Old MacDonald’s Farm!  Usually we use this type of song for working on things like walking on a balance beam or going up and down the stairs.  Activities where they need lots and lots of repetition for mastery but may not be that exciting to do over and over again.

Winnie the Pooh

I only use the first lines from this song when it says ‘When I up,down,touch the ground it puts me in the mood.  Up, down, touch the ground in the mood for _____‘.  This can be a fun one to get a kiddo ready to do something.  You can have them squat up and down and then change what they are in the mood for.  It could be jumping, walking, running, crawling, spinning, etc.  (You just have to be okay if the rhyming is off!)  And it works even better if you do a big dramatic pause before you give the action!

More of Our Own!

  • Mr. Helper (to the tune of Frere Jacques) – Mr. Helper, Mr. Helper, – Hold, Hold, Hold, – Hold, Hold, Hold, – Hold the paper steady, – Hold the paper steady, – Helping hand, Helping hand.  Great Song to use when trying to teach a kiddo to use their secondary hand for stabilization or to ‘help’ with the task.
  • This is the Way We Wash Our Hands – I’ve adapted this one to go with gross motor tasks such as This is the way we (climb the stairs, jump around, skip along, stomp our feet, crawl away, run around, cross the bridge [for balance beam walking], bend our knees [squatting], walk on our toes, walk on our heels, etc).  Also lets the kids work on changing tasks because they have to switch what they are doing as the words in the song change!

January 18, 2012

Core = More Than Just Abs

I tend to be guilty of thinking of abs and core as being synonymous.  So I often have to remind myself that there is a lot more to the core than just those abdominal muscles that I’m personally awful about exercising (I definitely hate doing ab work).

So what is the core if its not just abs?

Your core pretty much encompasses from your neck to your hips.  This means it includes front, back and sides of your mid section.  It includes your shoulder and shoulder blade muscles.  It includes your gluts and other hip muscles.  Basically your core is the foundation that the rest of your movement occurs off of.  Think of it as the cornerstone of your body.

When kids work on their core aren’t trying to develop a six pack but rather improve the endurance and coordination of the muscles that fall within the core.  You don’t just want your child’s core to turn on when they want to do a sit up or a side bend, you want them to turn on so that your child can sit up straight throughout the day while they try to learn in school.  You want their core to work while they are trying to play or to eat.  If their core is strong they have better use of their hands and arms for fine motor skills and better use of their feet and legs for gross motor skills.

So, when working on core muscles, its not just about overall strength, its about their ability to stay turned on for long periods of time (endurance) or their ability to cooperate with the other muscles around them (coordination) as well as their ability to react to what is happening in a split second (help maintain balance/upright position).

Working on the individual muscle strength is important so don’t get rid of those sit ups or trunk extensions but its important to make sure you are working the core as a whole.

How you may ask?  Well here are some ideas:

  • Using a ball or core work is fun for the child and can work on the muscles activating together  and reacting quickly, as well as keeping them turned on for longer periods of time to build their endurance.  There are a lot of resources out there for ball work ideas and here are two, ‘Having a Ball with Core Muscles Strength‘, and ‘Therapy Ball Exercise Ideas
  • Having kids perform a plank and some variations are great ideas also – you can have them turn on their right or left side for a plank or face down.
  • Animal walking is a great way to develop dynamic cores strength as well as make it fun and work on kids imaginations!
  • Wheelbarrow walking
  • Climbing is a great way to also work on core muscles strength.  Anything from a climbing wall to a ladder to a climbing net to crawling up and stairs.  The more dynamic the surface (such as a net) the more challenge your core will get.  It also involves the hips and shoulders.  If your child needs lots of help then start with something really stable like crawling up stairs (also a great way to develop hip and glut strength).
  • The sit-n-spin is also a fun way to work on the trunk while having fun!
  • Here are some other fun suggestions for core exercises

I also mentioned that your core involves shoulders and hips.  This is important to remember because if your child doesn’t have muscles that can stabilize their shoulder blade it makes using their arms a lot harder.  Can you imagine trying to form your letters correctly when handwriting if your shoulder area wasn’t strong?  Any of the exercises that are listed above that involve weight bearing through the hands and arms will work on shoulder girdle stability such as:  wheelbarrow walking, crawling, bear walking, push ups, and plank.  In addition here are some other gross motor ideas that can strengthen the core and have a direct effect on handwriting and fine motor skills.  Another idea is to have the kiddo use some thera-band and try to pull you up by pulling on the thera-band and pulling their arms back.  They think its hysterical that you are ‘stuck’ and need help!

Lastly, a lot of times when I am working on posture with a kiddo or having them sit on a ball they tend to slouch from their shoulders all the way to their hips.  There can be a few reasons for this such as weakness or tight hamstrings but the reason I want to look at is challenges with coordinating the trunk muscles so that they can tilt their pelvis forward and get that nice straight posture that helps with learning and attention.  If you spend just a little bit of time working on this with kids they start to pick it up pretty quickly.  If it gets overlooked, it can contribute to tight hamstrings and ongoing poor posture that is harder to correct as they get older.

What I generally do to teach coordination of the trunk muscles for an anterior pelvic tilt is I work on reaching with the kiddo.  The easiest is to have the child sitting on a firm surface (or even a slightly downhill surface) on the floor or a chair.  If you have two people its even easier.  Find things they want to reach for whether its toys or an ipad app and hold it in front and above them.  If you stabilize their hips while they are reaching (with both hands) and give them some cues at their low back they will start to tilt their pelvis forward while reaching.  Its important for them to reach using both hands in the beginning while they are working on getting the coordination of their flexors and extensors so that they stay symmetrical.  Also watch for if they keep their chin tucked or if they really extend their head and neck to try to stabilize.  I usually remind them to put their chin down and use their eyes to look up.  Once they get the coordination down you can start to challenge them by having them reach off to one side or add a dynamic surface such as a therapy ball, disc or peanut.

What are other ideas you use for core muscle control and upright posture?

January 16, 2012

Great Songs for Therapy

I think that most people who work with kids have discovered that songs are an amazing tool to support play and therapy.  We use songs all the time, sometimes they are well known songs and sometimes they are made up songs.  I think my favorite part is adding parts to songs that already exist.  For example my bus from ‘Wheels on the Bus’ has an eclectic assortment of riders.  Sometimes the songs are great just to keep the child engaged and entertained and sometimes they can support the skill you are working on.  I especially love songs that have multiple verses sorted by numbers or characters because it can help maintain the repetition so the kiddo gets more practice.  I am not a singer and have never even attempted to be, in fact my parents and brothers cringe whenever they hear me start to sing but luckily the kids I work with aren’t as picky about the voice, they just love the song!

The Pirate Song

This new favorite song of ours.  One of my coworkers started using it and we have all picked it up.  Its great for ball or balance board work.  Its especially great if you add a dramatic pause after the line ‘the captain said to me…’ because the kids love the anticipation of what comes next and it usually results in a great giggle!  I love it because I can switch it up.  I can move the child slowly on the ball during parts of the songs, I can hold them for slightly longer so they have to work on various trunk muscles, and then I can speed it up when it comes to ‘We’ll go this way and that way and forwards and backwards’.  I mean the song helps you out with trunk control right in the verse!  I usually add in some bouncing too.  Its great for the kids to come up with items that rhyme with the numbers and to pick up the vocals at different parts.  Definitely 2 thumbs up for this song from us and our kiddos!

The Ants Go Marching

This is a great one for working on walking or crawling or knee walking or wheelbarrow walking.  I loved it when I used to do treadmill training with the kiddos.  I don’t have access to a treadmill anymore but I still use it when I am gait training a kiddo using an assistive device or where I have to manually help them.  It provides a nice steady rhythm to go with walking and it engages the kiddos while they work on a harder skill.  I also use this for ball work as well because the kids love to bounce during the ‘boom, boom, boom’ part!

The Wheels on the Bus

This is a classic favorite.  Depending on what I am doing or how long I want the activity to last I add in my own verses.  I’ll share a few of mine but feel free to make up your own.  I was trying to keep a kiddo entertained and she loves Disney characters so while we were slowly commando crawling across the floor I pulled every Disney character out of my memory and added them as riders onto the bus.  Let your creativity and imagination run wild and I bet your kiddos will love it!  See who they come up with too, you might be surprised!

  • The parrot on the bus says ‘Polly want a cracker’
  • The pirate on the bus says ‘walk the plank’
  • The baker on the bus says ‘have some cake’
  • The genie on the bus says ‘your wish is my command’
  • The butterfly on the bus says ‘flutter, flutter, flutter’
  • The Winnie the Pooh on the bus says ‘where’s my hunny’
  • The ballerina on the bus says ‘twirl, twirl, twirl’
  • The Dorothy on the bus says ‘there’s no place like home’
  • Use animals too and have them make whatever sound you usually have them make

Ok, I think you get the idea.  We’ve also adapted it for bike riding so it can be the wheels on the bike.  This way the feet can ‘pedal, pedal, pedal’ and the hand can ‘steer, steer, steer’.  Hope you enjoy the adaptations as much as we do!

Ten Little Monkeys

Another favorite that can be used for gross motor play or for ball work again.  It can be used while working on jumping on the trampoline or across the floor.  My favorite line is the last one when there are no monkeys jumping on the bed and when mom calls the doctor the doctor says ‘put those monkeys back in bed’! (see Kids Games – New Twists on Old Favorites for a gross motor idea for this song)

Where is Thumbkin

We use this one on the ball to keep a kiddos hands occupied with a task or just sitting down and working on posture or from a fine motor standpoint, working on finger isolation or imitation.  Its a fun one!

Creating My Own Version

I have a kiddo who I work with whose mom is amazing at coming up with lyrics to well known tunes or just making up her own tune.  Her child responds really well to songs and will do any activity if there is a song to it.  Well I have been able to practice a bit with this and I’m not nearly as talented as her but I’m getting better with practice (well at least the kiddos don’t mind my attempts, my coworkers continue to giggle at me)!  Here are a few that I have added in to work on the skills we are doing (I will try to keep it to tunes that are already in existance):

  • Five Little Ducks – We are working on climbing a climbing net and to get multiple repetitions involved we are putting bean bag animals at the top for the kiddo to rescue.  On the way up we use the words: ‘5 little friends went out to play, up the net and far away, (kiddo’s name) said ‘hey where are you?  I’m coming to rescue you’, up the net he went to them, left foot right foot and two hands.‘  (If it takes him longer than this to get to the top I have to get creative so it changes on a weekly basis)  On the way down we sing: ‘down the net he went once more, left foot right foot to the floor, over and over he climbed back down, until his feet were on the ground.‘ (same deal for if it takes him longer).  We then repeat with one less friend for the next time.
  • Farmer in the Dell – Ok, I had to get really creative on this one because we were working on standing from the ground using a half kneel (not something any kid really wants to practice over and over).  Since I was using a farm puzzle to help with the repetions, I adapted Farmer in the Dell to the following words: ‘There’s a (kiddo’s name) on the ground, there’s a (name) on the ground, hi ho the dairy oh, there’s a (name) on the ground.’  Next verses I will just give the first line, hopefully you get the idea: ‘(name) takes a sheep (or whatever animal piece you want them to pick up)‘ next verse ‘There’s a (name) on his knees‘ next verse ‘And, (name) stands up‘.  Hopefully you could follow that, believe me I’m a novice at this song writing stuff!

I’d love to hear any of your favorite songs to use.  I generally use any song that has lots of verses from the pre-existing kids songs but I also would love to hear any creative adaptations!

December 31, 2011

Top 10 Blog Posts of 2011

I love Top 10 lists!  Here is this years list of Top 10 Blog Posts:

10.  Core Muscles:  Building a Solid Foundation

9.  No Kid Left Inside – Benefits of Outdoor Play

8.  Having a Ball With Core Muscle Strength

7.  Gross Motor Development vs. Fine Motor Development

6.  Standing Straight and Tall

5.  A Glossary of Sitting

4.  Let’s Play!

3.  What is Protective Extension?

2.  Why is W-Sitting a Four Letter Word?

And the most read blog post by a landslide:

1.  Torticollis:  What Is It?

Thanks for everyone who reads and I look forward to the next year!

September 28, 2011

W-Sitting Revisited

I have decided to post again regarding one of my more controversial topics: w-sitting. W-sitting is a very natural form of floor sitting just like tailor (crisscross cross applesauce) sitting, ring sitting, side sitting, long sitting, and kneeling. All of these positions can be assumed and transitioned out of. In fact I discussed the beauty of movement variability in the development of movement in my previous post.  I was re-inspired to post about w-sitting because of this article I read on the most recent PawPrint Newsletter.  I am going to paste the article in its entire form since I believe Why reinvent the wheel!  She said it great!

The W’s of W-SittingDeanna Maciole

Deanna Macioce, MS, OTR/L

We have all seen those toddlers who are playing with cars or dolls in the common position of “W-sitting”.  And since we see it so often in young children, we may not see it as worrisome, however for many children if left unaddressed long-term “w-sitting” could lead to some overall developmental issues.  With that said, this month’s focus is not to alarm, but to increase an awareness while providing some useful and tactical information for parents, teachers and therapists of the many children who find the position of “w-sitting” comfortable.

Although this is a common position to find a toddler sitting in, it comes with many implications of why it is not good.   For those children who move in and out of the position for short periods of time, it can be looked upon as just a typical playing position that the child will outgrow.  However, for many of the children we see in the therapy world, it can have a greater effect on a child’s overall development  “W-sitting” inhibits exploration, does not allow for proper strengthening of the trunk, and keeps children confined to play only in midline. Effects of long-term “w-sitting” include hamstring tightness and tibial torsion and even hip dislocation. In addition, because it inhibits trunk rotation it also causes overall decreased balance and trunk control.  The lack of trunk mobility causes children who utilize this position on a regular basis the inability to cross midline and explore as much during play.

One of the most common reasons children hang out in this position is low tone.  Early on when children begin to crawl, you often find them stopping in the “w” position regardless of tone issues because they require a wider base of support at this stage.  However, as they get stronger, you should be able to see them transition into a proper ring sitting position with ease.  For the children who present with lower tone, they still require a wider base of support and will utilize a “w” due to ease, comfort, and stability.  In addition, many of the children who do “w-sit” also present with tighter hamstrings, making it difficult and uncomfortable to sit in long sitting, “crisscross applesauce”, or ring sitting.

Ways to naturally work on correcting this it to utilize a toddler chair for sitting activities as much as possible, encouraging a 90-degree position of the hips and knees. When using larger chairs where the child’s feet do not touch the ground, the use of a stool will help obtain this position.  Many children will be able to correct this position with verbal cuing, so you may often hear a parent, teacher or therapist use the phrase, “fix your legs” to cue the child to choose a different sitting position.

Ultimately, to help children move out of this position, choosing activities that strengthen the trunk and improve overall stability are beneficial.  Those would include things such as the use of an exercise ball, yoga, and balance activities.

Exercise/therapy ball activities are great for trunk strengthening; from performing activities while sitting on the ball that encourage trunk rotation to using the ball for completing sit-ups, these are excellent ways to engage trunk muscles and work on balance.  Activities performed in high kneel, such as drawing on a draw erase board or completing a bean bag target throw activity will also nicely engage that trunk muscles for strengthening.  In addition, using a balance board for activities in sitting, such as completing a puzzle, or standing to play catch or Zoomball will also achieve this.  Kid yoga programs, including Yogarilla from Super Duper are a fun way to introduce children to the overall core strengthening and attention improving art of yoga.

For those low tone children with tight hamstrings, performing leg stretches or utilizing target toss activities with obtaining bean bags from the floor or low stool with straight legs will help to loosen up the muscles.  In turn, you find children are able to maintain the position of “criss-cross applesauce” with more ease.

Therefore, although “w-sitting” is very common among all children, similar to nail biting, it is one of those habits that if addressed early can really making a difference in overall development, especially for children with lower tone.

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