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Important Gross Motor Milestone: Jumping

Sometime between the 18th and 24th month, children start learning to jump. Eager parents often ask when to expect their child to jump with both feet off the ground. The simple answer is, every child is different. Of course, we as physical therapists and developmental experts will become concerned if a child is still making no attempts to jump by 2.5 to 3 years. However, what parents should know is that there are many reasons a child could be delayed on a particular gross motor milestone.

Usually, after 6 months of walking independently and participating in typical play (such as climbing on/off furniture, walking up and down stairs with help, and running on various surfaces) a child will have developed the strength and balance needed to jump without falling. When she first starts jumping, she might push off with one foot only and jump down from a low step without help.  By 2 years, a typically developing child can most likely jump forward 3-4 inches while maintaining her balance, with both feet.  She should also be able to bend her knees, with feet together, and propel herself upwards to try to touch something up high.

When to seek physical therapy interventions:

Around 2.5 years of age, if your child continues to show difficulty with jumping and shows any of the following, it is best to bring her into physical therapy so we can check out her alignment, strength and balance, and give her strengthening exercises as needed.

  • Asymmetrical jumping: A typically developing child does not show side-preference until preschool age. If you notice your child always pushing off and landing with one side, seems to drag one side or hold it stiffly, or if one side barely participates in the initiation of jumping, it’s good to mention it to your doctor at her 24 months check-up.
  • No power during push-off: If your child prepares to jump by initiating a squat but then her feet barely leave the floor, her leg muscles may not be strong enough yet to fully propel her weight forwards or upwards.  Or, she might not know how to best coordinate the beginning and end of the activity. If she prefers to step off a low surface or step over an obstacle instead of jumping, she is showing weakness in her legs, especially her thigh and hip muscles.
  • Frequent falls: If she crumbles to the floor or if her knees buckle every time she lands from a jump, or if she falls on purpose when trying to jump, your child may be showing that her body is just not ready for this milestone.
  • Increased anxiety or behavioral resistance to the task: Does your 3 year old hesitate with apprehension, ask to be picked up, or ask for a hand any time she’s encouraged to jump down or over something on the ground? Does she throw a tantrum or flops to the ground if you don’t help her?

All of the above could mean something is keeping a child from jumping. There could be a visual discrepancy or a depth perception issue that can be addressed with occupational therapy, an anxiety/comfort matter that can be addressed by social work, or a deeper issue that can only be attended to after a thorough evaluation by a developmental expert.

10 Signs at School Suggesting a Student May Benefit from Physical Therapy

Children develop and improve their gross motor skills significantly during their early school years, between three and ten years of age. A lot of gross motor development occurs at school while playing at recess or doing activities in gym class. School offers the opportunity to recognize if a child needs extra assistance from a physical therapist in expanding or improving their gross motor skills.

Physical therapist treats child

Here are some tips for teachers that will help determine if a child would benefit from physical therapy:

  1. The child prefers to sit and play instead of run or participate in gross motor activities during recess or gym class.
  2. The child has difficulty jumping, skipping, or galloping when compared to their peers.
  3. The child has an atypical gait pattern (for example, they walk on their toes or they are “knock-kneed”)
  4. The child prefers to w-sit (with their knees bent, feet by their bottom, and bottom on the floor) instead of crossed-legged on the floor.
  5. The child frequently trips, falls, or bumps into objects.
  6. When walking up and down the stairs, the child does not alternate their feet, instead placing both feet on each step.
  7. The child is unable to kick a soccer ball.
  8. The child is unable to catch or throw a playground ball.
  9. The child runs significantly slower than his peers or has difficulty running for more than one minute.
  10. The child complains of pain or tightness in their ankles, knees, hips, or back.

If you see any of these characteristics in children at school, they may benefit from a physical therapy evaluation. Without fully developed gross motor skills, a child is going to have difficulties keeping up with their peers during recess or gym class. It will also affect their ability to participate in gross motor games and sports. Also, it is important to note that many children will exhibit the above behaviors and may or may not require physical therapy (PT) intervention therefore it is important to consult with a PT first.

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Ways to Improve Core Strength at the Playground

As the weather is becoming nicer, you are most likely spending more time outside and at your neighborhood parks. If your child is working on improving their core strength in their therapy sessions and at home, this can also be carried over while playing on a playground.Child swinging in the playground

The following activities can be completed to improve your child’s core strength:

  • Climbing ladders
  • Completing monkey bars
  • Pumping themselves on the swing or pushing another friend or sibling on the swing
  • Going down the slide in a “V” position
  • Jumping off surfaces of varying heights with two feet together
  • Create an obstacle course throughout the playground
  • Crawling through tunnels, under things , and over things
  • Running on different surfaces (sand, wood chips, grass, sidewalks, uneven bridges)

Hopefully these activities will add some variety into the home exercise program your child is currently doing.

Happy Exercising!

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5 Swings Used in your Child’s Therapy Sessions

Oftentimes, parents probably wonder ‘what makes the swings and equipment at my child’s therapy different than the swings at the  playground’?  The answer is that each of the swings used in the therapy gym are able to be used in a much safer and controlled Little girl sleeping in hammockenvironment, as the therapists are able to place mats and pillows under and around the swings, and the therapist can therefore challenge how the child engages in the activity and moves and manipulates his body (e.g. hanging underneath the barrel swing).  Similarly, the swings used in the therapy gym are able to be hung on a rotating hook to allow the child and the swing to move in a variety of planes and directions, providing the child with a greater amount of vestibular and proprioceptive input.

Below are explanations of 5 of the swings therapists use throughout your child’s therapy sessions to help best understand the benefits of using the therapy equipment

  1. Superman swing: The superman swing is also referred to as our prone extension swing, meaning that the child is lying in a prone position (on his belly with his arms and legs extended). The superman swing is suspended high enough off of the floor so that the child has to weight bear through his upper body (shoulders, arms, hands). We often refer to this position as using his ‘wheelbarrow’ arms. This position helps to improve upper body strength, neck strength, trunk control, and multi-tasking/motor planning, as the child is typically playing some sort of board game or activity while maintaining this prone extension position in the swing. As the child gets stronger, he shoots to remain in the swing for longer and longer durations.
  2. Cuddle swing: The cuddle swing is mostly used for self-regulation and calming, as it mimics a hammock, in that it completely surrounds, engulfs, and molds to the child’s body. While in the swing children often feel extremely secure and at ease as the swing provides them with a squeezing sensation- much like a big bear hug from mom or dad. The cuddle swing can provide the child with slow rhythmic movement, which can be very relaxing for a child, especially when he is feeling anxious or when his body is moving too quickly. The cuddle swing can also provide a child with more intense vestibular input, as the child can be spun in circles, when he is seeking more fast-paced input.
  3. Rainbow swing: The rainbow swing looks exactly how it sounds, as it has 4 different colored layers, which the child can crawl in and out of. The rainbow swing provides a rhythmic motion when the child lies on his back or stomach in one position, while the therapist swings him back and forth. Similarly, the child can start at one end of the swing and crawl through like a resistive suspended tunnel, until he reaches the other end and can crash out onto a pile of pillows. This serves as a heavy work activity and can ideally help to increase his attention and body awareness.
  4. Frog swing: The frog swing looks exactly like a playground swing, in which a child needs to pump his legs or be pushed by a therapist to get his momentum going. Typically, the child is instructed to listen for a ‘magic word’ before jumping off of the swing to crash into a pile of large floor pillows (e.g. ready, set, and ‘go’). This activity helps to work on following directions and motor planning, as the child must figure out how to get his body off of the swing at the correct timing to land on the pillows.
  5. T-swing: The t-swing looks like an upside down letter “T”, and may also be referred to as a barrel swing. The child is required to wrap his arms and legs around the barrel like a koala bear and hold on as tight as he can while the therapist is pushing and swinging him. This swing helps to work on entire body strengthening and endurance, and it also requires motor planning and body awareness in order to assume the correct position initially to get onto the swing.

As therapists, we find that the swings listed above are extremely motivating for our clients to use, and serve many distinct purposes; as such, equipment truly helps us to better reach our client’s goals (e.g. following directions; attention; body awareness; self-regulation).  The swings are also a great reward for clients to work towards throughout a therapy session, as they see all of the other children playing on them, and they want to partake in the fun too.  Feel free to ask your child’s therapist if you can come-in and peak at the therapy gym during your child’s session to help you to best understand the treatment process.

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The Benefits of Increasing Therapy Over the Summer

Summer is the time of the year when children engage in more free play and physical activity. Therefore, summer is the perfect time of the year to improve upon skills that children need in order to be active, successful, and independent children!Little girl jumping a rope

Here are some of the best reasons to consider starting therapy or increasing the number of therapy sessions for your child over the summer:

Maintain and improve skills for school – Since school is out for the summer, it is important that children do not lose the fine motor, problem-solving, planning, and organizational skills (and more) that are necessary to be productive students at school. Although summertime is a great time to provide opportunity for free play, it may create academic issues for your child once school starts back up if he or she does not engage in challenging tasks  during their 3 month break from school.

Practice physical activities, such as bike riding, climbing, and jumping rope – During the summer, children are often playing outside for hours on end. It may become noticeable that your child is not keeping up with their peers. Activities with which you may notice some difficulty are often when children have to coordinate their arms and legs, such as jumping jacks, climbing the jungle gym, and learning to ride a 2-wheeler. By participating in therapy over the summer, therapists can address these specific concerns in order to help your child stay up to speed with their friends while performing these activities.

More availability over the summer – Since your children are out of school for the summer, they may have a lot more time and availability during the day to participate in more therapy. Summer camp and extra-curricular activities often only take up part of the day, so there may be more times you are available to schedule therapy appointments. Furthermore, although camp and extra-curricular activities are great options for staying active, they do not necessarily offer the same therapeutic benefits as therapy.

Provides structure to their day– Oftentimes, summer can be a season of unstructured play time in which children can do anything they would like. Sometimes the choices are so overwhelming that this can often lead to hours of playing video games, watching TV, and other sedentary activities. Therapy can provide structure to your child’s day to make them feel like they are being productive by spending their time doing valuable tasks.

Opportunity for peer interaction outside of school – Once school is over for the summer, some children may only spend their time with the same friends every day. Therapy sessions can provide the opportunity to make more friends in the clinic and learn how to engage in social situations with other people.

These are just a few of the many benefits that therapy can provide to your child over the summer! By making your child more actively engaged in goal-directed activities, you are setting your child up to be productive students the following school year and active children during the summer!

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Differences and Similarities Between Occupational and Physical Therapy | Pediatric Therapy Tv

In today’s Webisode, a pediatric occupational therapist explains ways to distinguish between occupational and physical therapy and how they are similar.

In this video you will learn:

  • To determine the differences between physical and occupational therapy
  • How the two disciplines are alike
  • What types of therapies are used for the different disciplines

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 standing here with Lindsay Miller, a Pediatric
Occupational Therapist. Lindsay, people are often confused between physical
therapy and occupational therapy. Can you explain with the differences and
similarities are between OT and PT?

Lindsay: Sure. With occupational therapy, we usually work on independence
with self-care skills, and these are skills like dressing and bathing. We
also work a lot on fine motor skills as well. So that’s any sort of
movement using your hands and fingers like writing, coloring, using
scissors, using a fork and knife, those types of things. Traditionally,
physical therapists work on mobility, so that’s walking, running, jumping,
and other gross motor tasks that use the larger muscles of the body. In the
pediatric realm, occupational therapists also work on executive functioning
skills, so those are our thinking skills and our thinking processes, and we
also work on sensory processing as well, so that’s how children react
emotionally and behaviorally to their environment and their surroundings.
In the pediatric world, physical therapists also work a lot on mobility
again and also gross motor development. So that’s, can your child crawl and
can they get themself up into standing and those sorts of things.

Some of the similarities are that occupational and physical therapy both
can look at muscle strength, flexibility, range of motion, and muscle tone,
but the biggest difference is really how we look at those things and in
what context. So occupational therapists look at those muscle strength and
flexibility and those types of things and how they affect functioning and
daily life whereas physical therapists look at those things and how it
affects mobility and gross motor skills. So overall, there is some overlap
between occupational and physical therapy, but the biggest difference is
really how they look at it in terms of functioning.

Robyn: All right. Thank you so much, Lindsay, 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.