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Toe Walkers Part 2: When You Should Seek Help | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist discusses the intervention needed for a toe walking child.  For more on Toe walking, read this blog.

To Watch Part 1 of the Toe Walking Webisode, click here.

In this video you will learn:

  • How soon a toddler needs therapy intervention for toe walking
  • What is the maximum age  a child should stop toe walking

 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. I’m stranding here today with pediatric physical therapist, Colleen Kearns. Colleen, when it comes to toe walking, when is intervention needed?

Colleen: Well, when it comes to toe walking, the earlier the intervention, the better, because toe walking can become such a strong habit in children. The longer that they do toe walk, the harder it is to break that habit. And then, also I mentioned before, when the muscles do become shorter, the more the child’s toe walking, the shorter the muscles will become. And then the longer that it goes, the harder it’s going to be to reverse that. So, if the child is over 2 years old and walking on the toes over 50% of the time, so the majority of the time that they’re walking, then it’s time to seek intervention.

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

Toe Walkers Part 1: What are Reasons Children Toe Walk | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist explains why children may walk on their toes.

Learn more from this blog called “Is Toe Walking Normal?”

In this video you will learn:

  • How sensory input is related to toe walking
  • What is muscular dystrophy
  • What is idiopathic toe walking

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 today with Colleen Kearns, a Pediatric Physical Therapist. Colleen, can you give our viewers an explanation of why some children toe walk?

Colleen: Of course, Robyn. There are three main reasons why children may toe walk. The first one is related to sensory issues. Some children may actually be hypersensitive to certain textures on the floors that they are walking on, and the surfaces that they are walking on. So if that occurs, they may be more prone to walk on their toes to avoid those uncomfortable textures.

On the other hand, they may also be seeking extrasensory input. Maybe, some kids need a little bit more of the sensory input, and by walking on their toes they are locking their ankles and knees, and by doing that, they are actually getting more input from their joints. So that’s also why children with autism will walk on their toes, to get that extrasensory input.

The second main reason that children toe walk is due to an underlying diagnosis. Muscular dystrophy is a big one. That’s a genetic disorder where the muscle tissue is destroyed and it’s actually replaced by fat, and the calf muscles are often the first ones to be involved with that. So children with muscular dystrophy will toe walk in an effort to stabilize, due to the decreased strength. Any condition that results in an abnormal increase in muscle tone will also result in toe walking. A common one with that would be cerebral palsy.

The third reason why kids may toe walk is actually unknown. Some children, who don’t have an underlying diagnosis and don’t have sensory issues, just prefer to walk on their toes, and that’s what we call idiopathic toe walking, which means we just don’t know. Unfortunately, they can get into a very strong habit of doing it, and when they do that it results in a shortening of the muscles in their calf, and that actually makes it harder for the child to be able to get their foot flat on the ground. And when that happens, it’s kind of like a vicious cycle. They are more likely to be walking on their toes because they have a strong habit, then their muscles get shorter, then it’s harder for them to walk on their flat feet, so then they are even more prone to walking on their toes.

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.

How to have a just right ‘Engine Level’

As I discussed in my previous blog, a child’s body is typically functioning at one of three ‘Engine Levels’.   Ideally, the goal is to be at the ‘just right’ level, in which your child can accomplish the most and focus on the task at hand. It is important to remember that each child’s ‘Engine Level’ runs differently, and is affected differently.  Therefore, different strategies work differently for each child.

Here are a few strategies which might help your child to reach a just right level:Little boy practicing a yoga position

  • Listen to calming/quiet music
  • Get a drink of cold water/drinking through a straw (e.g. water bottle)
  • Chew gum or a crunchy/chewy snack
  • Take a walk, or get a breath of fresh air
  • Excuse herself to the restroom
  • Exercise/heavy work
  • A big bear hug/joint compressions
  • Yoga breaths (e.g. inhale through nose as long as she can, exhale through mouth like blowing out birthday candles)
  • Rub a small amount of lotion or scented hand sanitizer onto hands (massaging lotion into her skin can be calming, and a nice scent can help to ‘wake-up’ or ‘calm’ her body)

Try the strategies above, and note whether or not they help your child’s mind and body to feel more organized and ready to take on the tasks expected of her.  By incorporating this ‘Engine Level’ lingo into your child’s vocabulary on a daily basis, your child will ideally be able to better understand how her body is feeling, and what she can do when she’s feeling “off” or over/under aroused.  Please reach out to your child’s therapist with any further questions as to how this program can be incorporated into your family’s routine.

Reference: Williams, Mary Sue and Shellenberger, Sherry. (1996,) “How Does Your Engine Run?:  A Leader’s Guide to The Alert Program for Self-Regulation”.  Therapy Works, Inc.

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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.

Tips on How to Get your Child to Walk

Children generally learn to walk on their own; however, some children need a little bit of assistance in order to take those first few steps. Below are some ideas on how to help encourage your little one to take those first few steps.

Tips To Encourage Your Toddler To Walk

  • Make sure that your child has plenty of ‘floor time’ so that they can use their bodies to explore their environment around them. Children that sit in bumbo seats, car seats or jumpers often are more delayed in their gross motor skills baby walkingbecause they rely on ‘containers’ to support them and their posture muscles do not have to work hard to support them. Pack-and-Plays and other play pens are great and safe place for your children to play in if you need some time to make dinner, fold laundry, etc.
  • When first assisting your child to walk, hold them higher on their trunk, like at their rib cage. As your child becomes more upright and stable, hold your child lower at their hips so they can use their core muscles to help their stability. Holding your child’s fingers above them can encourage a forward base of support and can lead to early toe-walking.
  • When a child is cruising at a coffee table, stand behind them so that they have to rotate their trunk away from the table. This will also help them lessen their support as they may take a hand off the table and stand more independently.
  • When your child is standing supported at the couch or coffee table, place a toy at their knee level and encourage them to squat down to get the toy. Repetitive squats will help strengthen their hip muscles and help them gain more stability on their feet.
  • Use a motivator, such as a puff , small snack, or favorite toy to motivate the child to walk to you. Stand just a few feet away from them on a carpeted surface so that they have plenty of support and traction.
  • When the child is inside, have the child just in a diaper when taking early steps. Bulky, winter clothing may be cumbersome and we want the hips and feet to move freely when learning a new gross motor milestone, such as walking.

Most children learn to walk independently between 10 and 15 months. If you or your pediatrician is concerned about your child’s development, feel free to contact a physical therapist at North Shore Pediatric Therapy for an evaluation.

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