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Torticollis: Addressing the Full Body to Treat the Neck

The child in utero is curled up tight to fit in such a tight space.  If a baby’s neck is tilted, it is visually obvious to the parent and pediatrician.  If they have asymmetry elsewhere the observations may be more subtle.  It may be harder to put one arm in the onesie, the child may prefer to play with toys on one side, or the child may crawl with one leg dragging behind.  Read more

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Part 2: What Is the Neuro-Developmental Treatment (NDT) Approach?

NDT is a problem-solving approach used by physical therapists, occupational therapists, and speech and language pathologists to improve the abilities of child and adults with nervous system pathologies face during their daily lives. It is not a prescribed series of techniques, but a dynamic approach to planning and implementing treatment. Read more

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Torticollis: A Tearless Approach To Treatment

“I watched a remarkable, quiet, tearless session…that ended with his body and head in midline. No neck stretching!! No stretching of any kind!  It’s particularly appealing in that parents get to hug and hold their children and get changes…without imposing any demands.”
Billi Cusick’s PT, MS, COF

Torticollis is a term used when a baby tends to keep their head tilted or turned to one side. The most common type of torticollis in children in Congenital Muscular Torticollis. The head is positioned in various degrees of tilt to one side and then rotation to the opposite side.Evidence-Based Care Guideline for Management of Congenital Muscular Torticollis in children age 0 to 36 months describes the traditional approach to torticollis treatment, which includes stretching, positioning, and active movement on the weaker side.  The guideline does include assessing the full body, but treatment of these findings is not specifically recommended.  Traditionally, the therapist will assess the full body, but then treat the neck in isolation because this is the most visible and obvious problem area.

The TMR approach to torticollis addresses the body as a WHOLE.  Eliminate imbalances in the larger muscles to allow the tiny neck muscles to do their job spontaneously.  Its like a potted plant growing crooked.  We don’t stretch the leaves or the little stems.  We repot the roots so that the plant can grow straight.  Our visual and balance systems will automatically bring the head to the middle once we help balance out our roots, which in the body is the pelvis.

Some red flags that parents may notice outside of the head position or turning preference is that it may be harder to put one arm in the shirt when dressing, the baby always rolls to one side, or the baby learning to sit always falls in the same direction.  Some other signs are bottom scooting rather than crawling on hands and knees, cruising along the couch in only one direction, and walking with one foot turned out.

Parents are taught how to do positioning and play at home that comfortably releases the bodies restrictions. They are also taught how to monitor their child’s movement patterns over time, so that if asymmetries increase while a child is learning a new skill, they will know how to address it.

Curious if this tearless appropach may be best for you and your baby?  Call us to set up a screening at 908-543-4390.

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Tippy Toes and Normal Development

A Dad asked me today if it was okay that his almost 2 year-old was walking on her tiptoes. His 5 year-old daughter also walks on her toes, but she has cerebral palsy, and has gone through years of botox injections and wearing orthotics to help her to stand on flat feet and to maintain the flexibility of her calves.  Read more

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Dyspraxia: Conquering the Motor Challenges

Re-posted from OUR Journey Thru Autism

“I’m doing it! I’m doing it!” yells an exuberant 8 year-old boy as he rides away from me on his bike. This young boy has a diagnosis of autism spectrum disorder and dyspraxia and was so frightened to just sit on his bike with training wheels 4 months ago that he held on to me for dear life. Today he rides away from me on a two-wheeled bike on his own and tomorrow he will ride with his brother through the neighborhood. Read more

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Therapeutic Play With Playdough

Playdough can be a great tool to strengthen the hands and for imaginary play.  It can also be a great tool for increasing sensory awareness of the feet.  It can also be used to challenge balance in standing like in this video, or it can be done in sitting too.  Have fun trying it out!

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Learn To Move It, Move It

I just came from the house of an adorable 10 month old girl who I see through early intervention. She has been an amazing example of how quickly a child with an intact neurological system can learn new skills. This little girl had a rough start medically, but is now very healthy. With the medical concerns stabilized, her family was very concerned about her from a developmental perspective. When I started with her a couple of months ago she was barely sitting. Today she was crawling, cruising, and pulling to stand beautifully! She is now doing what other children her age are doing and is taking off. Read more

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“What Early Intervention Has Meant to My Family”

The following is an essay that a mom of one of my soon-to-be-discharged early intervention kiddos wrote for a contest through the NJ Early Intervention program. Not only did she win the contest (yay!), but it conveys to parents the hope that early intervention can bring to a family and the difference that therapy early on can make in a child’s life.

If I had to sum up in one word what The NJ Early Intervention System has meant to our family, its hope. When our youngest son Jonathan was born prematurely and soon after found to have hypotonia and both fine and gross motor delays we were so worried. What did this mean for his future? Would he ever catch up? What could we do to help him? So many concerns ran through our minds initially and then as we began our relationship with the early intervention program we began to find some answers and more importantly we began to find some hope. Read more

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Discussion on “Does Your Baby Have Autism?” by Teitelbaum and Teitelbaum

As a pediatric physical therapist specializing in developmental disabilities, I have worked with a lot of children with autism spectrum disorders (ASD) over the past 10 years. After several months of physical therapy, I frequently saw how related areas of development, such as communication and social skills, would improve after addressing their motor deficits. Read more