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Why Isn’t My Child Walking Yet?

As a follow up to last week’s blog, Signs that My Child Will Walk Soon, I present the next topic in my walking series, Why Isn’t My Child Walking?. As first birthdays come around, many anxious parents wonder, “why hasn’t my child taken his first steps?” First off, let me dispel the myth that babies will begin taking their first steps by their first birthday. The normal range for independent walking is 10-18 months, however most children begin walking around 14-15 months. Delayed walking skills may be due to decreased muscle strength, decreased confidence, or impaired balance. Read below for a description of signs of each and tips to help improve them.

 Reasons Your Child May Not Be Walking Yet:

  • Decreased Muscle Strength: Walking is a major milestone for children and requires a lot of lower extremitywhen will my child walk strength. This is why there are so many important precursors to walking, such as cruising and creeping on hands and knees. Children typically spend 1-4 months in each of these precursory milestones in order to build the strength necessary for walking. Encouraging your child to spend time in these gravity dependent positions will help build lower extremity strength.
  • Decreased Confidence: Often times children who have been cruising for significant periods of time without making the transition to independent stepping may have decreased confidence in their walking skills. Employing a towel or blanket that is held as a link between parent and child, can help build their confidence.
  • Impaired Balance: A child who shows difficulty with independent standing may have impaired balance and proprioception. Using heavier shoes that help give feet to the child that let them know where they are in space.
  • Other Medical Reasons: There may be an underlying medical condition preventing your achieving his gross motor milestones in an appropriate time frame If your child is not demonstrating signs that he will walk soon by 12 months of age, please contact your physician or come into North Shore Pediatric Therapy for a free physical therapy screen.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Gross Motor Skills and Dance

Dance has always been a fun and exciting recreational activity for children of all ages. Along with the enjoyment of dancing to upbeat music and the social experience, dance is also a great way to help develop your child’s gross motor skills. Read on for 4 aspects of your child’s motor skills that can be facilitated with dance lessons and performance of any style.

4 Gross Motor Benefits to Dance:

  1. Balance-Many dance moves incorporate balancing on one leg, standing with feet right next to each other or standing with one foot in front of the other. All of these positions are challenging for your child’s balance systems, which help to strengthen her balancing abilities.
  2. Coordination-While learning to dance, your child will begin by learning different dance moves and positions. Most positions involve different placement of all 4 limbs, which requires a lot of coordination. Also, once your child learns a dance routine with multiple dance positions sequenced together, she will need to coordinate the entire routine. Read more

The Benefits of Ride-On Toys

Today our guest blogger, Full Throttle Toys, Inc. owner Matt Westfallen, gives us the 411 on benefits of ride-on toys.

Around Chicagoland, summer is in full swing. Along with the extra hours of summer fun and sun comes the worry thatfull throttle our kids are losing the skills they acquired during the school year. Worksheets and flash cards will help, but there is another fun way to help kids with some of the “intangibles” of learning.

When used safely and properly, battery operated, ride-on toys have been proven to provide children with opportunities to practice many early learning skills that are rarely taught in school yet are vital for balanced growth.

Skills that Can Be Developed by Using Ride-On Toys:

  • Gross and Fine Motor Skills: Battery-operated, ride-on toys provide many ways to develop gross and fine motor skills. By operating the vehicle on various types of terrain, opening and closing doors or manipulating the dashboard, children will be using both fine motor skills and gross motor skills.
  • Exercise and Exploration: While playing with a ride-on vehicle toy, not only will children be burning calories, they’ll be outside exploring their world.
  • Sense of Balance: While operating ride-on toys, children will also develop an improved sense of balance. Children who have played with ride-on toys find it easier as they grow older to ride bikes, and to use roller blades and roller skates, because they have learned to distribute their weight while operating vehicles on various surfaces.
  • Spatial Play: It is also important to note that spatial play is stimulated when your children are out exploring the outdoors in a ride-on vehicle. This type of play will improve observation skills and stimulate their imaginations. Read more

Obstacle Courses are FUNctional!

Obstacle courses can provide great opportunities for your child to gain multiple skills as well as challenge their performance in gross obstacle courseand fine motor activities. You can construct the course inside your home or outside in the playground. Collaborate with your child to create multiple steps that can incorporate household items, balls, pillows, toys, etc.

Below are 5 benefits of constructing obstacle courses at home and examples of steps you can include:

  1. Sequencing and Memory– Obstacle courses can teach your child to sequence a multi-step activity as well as challenge their memory by progressively increasing the demands of the activity. Start with writing down the steps of the obstacle course on a piece of paper or dry erase board and transition into memorizing the steps without writing down the sequence. In addition, you can increase the number of steps as your child’s sequencing and memory skills improve!
  2. Sensory Input– Within the course, you can incorporate various activities to provide multiple sensory inputs! Provide proprioceptive (deep pressure) input by having your child engage in heavy work. For example, make one step of the course to pull a heavy wagon from one location to the next, then have him or her unload the heavy items (rocks, books, toys, etc.) The obstacle course can include activities in all planes of vestibular movements, including linear (up and down), saggital (side to side) and rotary (spinning). To incorporate this input, have your child bounce on a “hippity hop” or an exercise ball while singing his or her favorite song for linear movement. When the song is complete, have them fall sideways onto pillows for saggital movement and/or have your child spin 10 times in a swing for rotary movement. To provide tactile (touch) sensory input, one step of the course could involve locating 10 items in a bucket of beans or sand.
  3. Strengthening and Balance– Multiple activities within the obstacle course can provide opportunities to build your child’s strength. An effective way to incorporate this is to have your child wheelbarrow walk, hop on one foot or perform a two-feet hop across the floor. In addition, your child can swing on a trapeze swing 5 times while holding up their knees to their chest or crawl over couch cushions to retrieve an object.
  4. Motor Planning– Obstacle courses provide a great opportunity for your child to improve motor planning by animal walking (bear, crab, bunny hop, etc.) as a transitional step to get from one location to the next or to deliver a puzzle piece to the puzzle.
  5. Bilateral Coordination– You can incorporate steps that challenge your child’s bilateral coordination by having him or her climb across 10 monkey bars, play catch by catching the ball 5 times or playing tug-a-war.

An obstacle course is a fun activity that doubles as a functional exercise to enhance your child’s motor and sensory skills. For more ideas, ask your occupational therapist!

Incorporating Balance into Your Child’s Before-School Routine

boy balancing on floorBalance, like many things, will only get better with practice and through challenging the balance systems. However, it can be hard to find time after school to work on balance activities when kids already have mountains of homework to keep up with. It can also be difficult to make balance exercises fun and enjoyable for kids.

In order to work on balance skills while saving time and keeping it interesting, here is a list of 5 balance activities that can easily be incorporated into your child’s before-school routine:

  1. Put pants, shoes, and socks on while standing up-This will require your child to stand on one leg while using her arms to don the clothing.
  2. Sit in ‘tall kneeling’ (sitting on knees with hips straight and knees kept at a 90 degree angle) while packing up the backpack-Sitting in the tall kneeling position narrows your child’s base of support, making it harder for her to maintain her balance. This posture also helps to strengthen her hip muscles, which are an important part of keeping her stable in positions that are challenging for her balance.
  3. Sit on a pillow while having breakfast-The pillow serves as an unstable surface, so your child will have to work hard to balance while sitting on it. This is a great way to work on core strength as well.
  4. Walk heel-to-toe on the way to the bus stop-Narrowing the base of support by walking heel to toe will challenge your child’s balance  and help improve her balance when she performs dynamic movements such as running or walking.
  5. Brush teeth with eyes closed-Vision is a big component of balancing, and when you close your eyes you are no longer able to rely on that sense to balance. Your body instead will have to use its vestibular and proprioceptive systems to keep steady.

It is going to be important to supervise your child when beginning these balance activities, as they may be hard at first. If you have significant concerns about your child’s balance with daily activities or if you have balance-related safety concerns, you can contact an occupational or physical therapist at North Shore Pediatric Therapy. To find out more about the vestibular system read our blog To find out more about the proprioceptive system read our blog

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How Does Play Help Meet a Child’s Therapy Goals?

Occupational therapists often use play as a means of helping achieve our clients’ goals. Many times, it may not look like our sessions are working on your child’s areas of need; however, when we are working with children, we often try to adapt play activities in order to help your child meet his goals. Play is a very motivating activity for a child to engage in with the therapist and work on some of his goals. Play may also mask the fact that children are working on a difficult skill by introducing fun into the activity. For example, if one of the child’s goals is to improve his handwriting skills, you could play a game that involves writing, such as Boggle, Scattergories, or crossword puzzles.

Therapist and child at Gym

Here are some play activities that OT’s use to help your child meet his goals:

  1. If your child needs to work on balance and coordination, we may play basketball while standing on top of a bosu ball (imagine standing on the rounded part of a ball cut in half).
  2. A child who needs to work on core and upper extremity strength could meet these goals by playing a game while lying on his stomach over a therapy ball, while balancing with his arms on the ground.
  3. In order to improve self-regulation for a child who has sensory concerns, we may start our session by playing on the gym equipment in order to help regulate his nervous system.
  4. To work on bilateral coordination and fine motor skills with a child who does not like drawing, we often use play-doh and have him trace shapes and cut them out with scissors.
  5. Another way to work on gross motor coordination is to practice climbing a rock wall, climbing a ladder, or swinging on the monkey bars.

Sometimes, however, it may be difficult to adapt the activity and make it fun for the child. In this case, the therapist may have the child participate in an activity to work on the skills he needs to improve, but use a play activity as a reward.  From the first example in which the child’s goal is to improve handwriting, the child may still not want to play the games that involve handwriting. Then, the therapist may tell the child that after handwriting, he can do an activity of his choice.

Hopefully, this blog provides a bit more insight into the therapist’s mindset while working with your child. The therapist is constantly thinking and problem solving about how to make an activity therapeutic and how to make it easier or harder based on the child’s ability to succeed at the tasks. If the therapist is successful, the child will not even realize the activities are working on their areas of need and will want to come to therapy every session!

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Ways to Encourage a Baby to Sit Up | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist will show us helpful ways to encourage a baby to sit up independently.

Read about useful tips to get your baby to roll

In this video you will learn:

  • How old your baby should be to sit up
  • Strategies to support your baby as they sit up

Video transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide
experience and innovation to maximize your child’s
potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host Robyn
Ackerman, and I’m here today with Leida Van Oss, a
Pediatric Physical Therapist. Leida, can you tell us a
couple tips on how to get a child to start sitting up
independently?

Leida: Sure. So the first stage of sitting should be done by four
months of age, and this is called prop sitting. This is
when they support themselves on their own. So you want to
put a toy down by their feet, and then tilt them forward so
that they put their hands on the ground, and then that
should encourage them to support themselves on their hands.
She’s older than four months, so she doesn’t want to do it.

But then the next stage is this kind of sitting, where they
want to bring up their hands, and sit by themselves
independently. So if they’re not quite wanting to do that
yet, you can take their toy – there we go – and lift it up
in front of them, so that they want to look up and raise
their arms up. This will activate the core and back
muscles, which will help bring up their head and do more of
an independent sitting.

You want to make sure that you keep a hand behind their
body, so that in case they topple backwards, you can catch
them really quickly. Then, the last mature stage of sitting
are things like rotating and reaching out if they need some
support. So, again, you can use toys to have them turn to
the side or reach up, or reach far [inaudible 00:01:37].
Those are all things that are going to help encourage more
mature sitting skills.

Robyn: All right. Well, thank you so much, and thank you to our
viewers, and remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational
programming. To subscribe to our broadcast, read our blogs,
or learn more, visit our website at learnmore.me. That’s
learnmore.me.

Breakfast for a Better Kid and Day!

Breakfast often gets skipped in the haste of the typical morning. Mom and dad are getting themselves ready, getting the kids ready, and tying up loose ends around the house. Many people report not having an appetite in the morning. Often, this is caused by over-eating in the later part of the day. family breakfastKids will model their parents, so think about what example you may be setting for your kids. In any case, the fact is, this morning a lot of kids woke up late and got breakfast at a fast food drive thru or ate nothing at all.

Studies show that kids who eat breakfast do better on tests in school. Nourishment in the morning provides brain fuel needed for concentration and energy. Even behavior and general attitude is better. Have you been around a hungry, tired kid lately? Not so fun and probably not the kid who’s skipping to the head of the class, so to speak.

Not only do kids who eat breakfast do better in school, but kids who eat breakfast tend to have healthier BMIs. It’s hard to say exactly why this is, but likely it has at least something to do with kids having less energy during the day to be active, and then over-eating later in the day. Eating in a balanced way throughout the day will prevent over-eating later, and leave room for a good appetite in the morning.

Here are some tips for a breakfast for a better kid:

  1. Change your morning so that breakfast is a requirement. Would you let your kids go to school in their pajamas? Just like getting dressed is a morning requirement, eating breakfast should be too. Carve that time into the morning, for yourself and your kids. Remember you are the most important role model in shaping their eating habits.
  2. Make breakfast count. Breakfast is just as important as lunch or dinner in terms of creating a complete, healthy meal. Strive for the healthy plate model at breakfast, which is to include whole grains, a protein source, and plenty of fruits and veggies. Vegetables are not typically the stars of the breakfast show, but try things like homemade hash browns or omelets with a variety of veggies. Potato pancakes are usually a hit if you have time to make them.
  3. Something is better than nothing. I would really recommend avoiding the fast food drive thru breakfast. Usually this isn’t going to be the healthiest food, but also, eating on the run results in poor digestion and tummy aches.If on occasion, you are late and have to do breakfast in the car, try a trail mix with dried fruit, nuts, and cereal. Another option would be a Clif ™ bar or Larabar ™ with a string cheese.
  4. Use the weekend to make breakfast a special meal for your family. The weekend breakfast can be such a fun family (and friends) tradition. Eating breakfast at home gives kids another chance to have a family meal at the table, which builds good habits, communication skills, and relationships. Breakfast foods tend to be popular with kids, and can be made with a healthy spin.

Examples of a Better Breakfast for Children:

  • Multigrain pancakes with blueberries and scrambled eggs. Try a maple-agave syrup blend (it’s less expensive than 100% maple syrup but still contains whole ingredients instead of high fructose corn syrup). Another healthy topping is homemade strawberry-rhubarb syrup which you can make by simmering chopped rhubarb and strawberries with a few tablespoons of water.
  • Granola, fruit, and yogurt parfait. Make it seasonal by stirring in pumpkin spice granola or farmers market fruit. Make it a winner by setting bowls of yogurt at the kids’ places at the table, and allow them to pick from an array of mix-ins on the table that they can spoon in themselves.
  • Organic bacon or sausage, whole grain English muffin spread with fruit preserves.
  • Whole grain toast, egg scramble or omelet with any of the following: chopped peppers, spinach, broccoli, peas, mushrooms, onions, tomatoes virtually any vegetable, black beans, cheese.
  • Oatmeal, berries, and nut butter mixed in. Top with homemade coconut whipped cream, which can be made by whipping canned coconut milk with beaters on high until foaming and thick.

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Low Muscle Tone Revealed

Muscle tone refers to the muscle’s ability to sustain a contraction. It is different than muscle strength, which refers the muscles’ power. A child with low muscle tone is often observed to sit with a slouched posture, may have difficulty holding their head upright when sitting at a desk and may be observed to prop their head up with their hand. Mother and child with balance ballOther observations include having difficulty sitting for extended periods of time, particularly without back support or w-sitting, where the legs are splayed out to the side in the shape of a ‘w’ when sitting on the ground.

Muscle tone cannot actually be changed, though through occupational or physical therapy, muscles will become stronger and compensate for the low muscle tone to help support your child through his/her daily tasks.

Here are five activities to help address strength, endurance and low muscle tone at home and in the community:

  1. At the park, have your child lie on his belly on the slide and pull himself up the slide using only his arms.
  2. Complete yoga poses that work on balance and core strength, like down dog or plank.
  3. Using a weighted ball or BOSU ball, have your child lift the ball overhead with both arms, lower it to the floor and balance his hands on the ball while he jumps his feet backwards into a plank position. Repeat these steps 10 times.
  4. Have your child lie on his back on the floor. With his legs raised off the floor and knees bent, have him weave a ball between his legs.
  5. Encourage your child to use the monkey bars or hang from the zip-line when at the park.

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How to Teach your Child with Sensory Processing Difficulties How to Ride a Bike

Learning to ride a bike can be a scary and overwhelming adventure for both the parents and the child involved!  There are many components required for bike riding, such as motor planning, body awareness, trunk control, balance, self-confidence, following directions, safety awareness, timing, and sequencing.  However, one of the best things about bike riding is that the child is typically very motivated and excited to do it, as he sees his friends or other children in the neighborhood doing so already.

SPD Child riding a bike

Below are several strategies on how to get started:

  • Practice lots of balance activities:  balance is a huge part of bike riding; therefore, it is important to strengthen these skills by challenging your child’s ability to maintain various positions including standing on one leg, sustaining yoga poses, walking across balance beams, or kneeling on an unstable surface such as the bosu ball.
  • Incorporate a variety of activities with wheels:  while being able to ride a bike independently might be the ultimate goal, it is beneficial to incorporate other similar skill sets into your child’s play experience.  This will help you and your child to take the emphasis off of the fact that he does not know how to ride a bike and help to focus on the excitement of trying new things (e.g. scooter, skate board, tricycle, roller skates, etc.).  Similarly, your child might really excel at one of these activities, in which this activity can then be used as a confidence booster when the child has already mastered it.
  • Practice inside:  have your child practice simply balancing on the bike/sitting on the bike in a safe environment, such as inside (e.g. basement or playroom/living room if appropriate).  Place large pillows/beanbags next to the bike so the child feels secure, and if he falls, he will crash into the pillows.
  • Involve different family members/friends:  bike riding can be a very complex task; therefore, it can be extremely beneficial to involve different family members/friends to help with the process. Different people have different strategies and ways of motivating and sometimes one strategy will really hit home for your child.  Similarly, then the same parent and child won’t get so frustrated with one another.
  • Visual schedule:  help your child to make a visual schedule/calendar to illustrate when the child will start practicing and what skill he will work on each day (e.g. getting onto bike; peddling with both legs; ride to the corner etc); then the child can put an “x” or a sticker on the chart when he completes a day of practice, or practices a skill etc.  Visual schedules can be motivating for the child, and provide structure.
  • Take the pedals off:  taking the pedals off of the bike helps initially with learning the feel of the bike/balance. Take the bike to a small hill and have the child ride down without the pedals, this provides an introduction to moving and balancing on the bike without needing the coordination to pedal.

Learning a novel activity can be intimidating for a child, as it is a totally new experience and requires a significant amount of following directions and motor planning.  Similarly, teaching  novel activities can be nerve wracking for the parents, especially if it is a skill they have not taught before, like bike riding.  As parents, it is important to keep in mind that every child learns differently and requires different levels of support when learning a new skill.  Make sure to constantly praise your child during this challenging activity, even if it seems like the tiniest accomplishment (e.g. buckling bike helmet independently; putting kickstand down independently).  As always, feel free to talk with an occupational therapist or physical therapist if you need more individualized strategies or have other gross motor concerns for your child.

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