Did you know that cerebral palsy (CP) is the most common childhood movement disorder?
At Kid PT, our physical and occupational therapists work with many children impacted in different ways by cerebral palsy. One of our friends, Aidan, made this video several years ago to spread awareness on living with CP and how it impacts his daily life.
CP is a neurological disorder that affects movement, muscle tone, and motor skills. It is caused by damage to the developing brain during pregnancy, childbirth, or the early years of life.
It can affect people in different ways, and symptoms can range from mild to severe. Common symptoms include muscle stiffness or weakness, difficulty with coordination and balance, tremors, and problems with fine motor skills, such as writing or grasping objects.
CP is a lifelong condition that cannot be cured, but treatment and therapy can help individuals with CP manage their symptoms and improve their quality of life. That’s where physical therapy and occupational therapy can play an important role. The goal of therapy for CP is to improve mobility, whether it is to crawl, walk, run or use an assistive device, increased range of motion & flexibility to decrease contracture risk and improve muscle activation (tight muscles are harder to contract!), improve breath support for speaking, and improve gross and fine motor skills.
Many parents have shared that they’re just told to wait and see or just keep doing what they’re doing- whether that is early intervention or outpatient care. A frustration I have heard over and over again is that parents aren’t given their options. The reality is that there are so many different therapeutic approaches and options out there and different children will respond to different ones at different times. I didn’t say this was an easy route, but there is support along the way. One new resource is called www.turnto.health and is helping support parents researching their treatment options. Overall, therapy is an important part of the treatment and management of CP, and it can help individuals with the condition improve their quality of life and reach their full potential. It is key to develop a customized treatment plan that addresses their unique needs and goals.
Our therapists at Kid PT would like to share with you their top 3 therapy approaches that we use at Kid PT to spark change and support children on their journey!
http://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.png00jonikidpthttp://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.pngjonikidpt2023-03-11 13:29:092023-03-12 11:48:35Kid PT’s Top 5 Therapy Approaches to Help Children with Cerebral Palsy
Occupational therapy (OT) helps people of all ages to improve their ability to perform daily activities, also known as “occupations.”
What does this have to do with children then?
Well, what is the “occupation” of children? PLAY!
Occupational therapists (OTs) work with individuals who have conditions that affect their ability to perform activities of daily living, such as physical or cognitive disabilities, injuries, or illnesses. The goal of occupational therapy is to help individuals achieve independence and improve their quality of life. This may include activities such as dressing, bathing, eating, and using the toilet, as well as more complex tasks like work and leisure activities. Occupational therapists may also work with individuals to improve their fine motor skills, coordination, and balance.
In the pediatrics world, OTs work in a variety of settings, such as early intervention, outpatient clinics, and schools. They work with children with a variety of needs and diagnoses, including autism, hypotonia, sensory processing disorder, and genetic disorders.
Our occupational therapists at Kid PT work with children on a wide variety of ways.
Improving fine motor skills: Occupational therapists can work with children to improve their dexterity and hand-eye coordination, which can help with tasks such as writing, cutting with scissors, and buttoning clothing.
Enhancing gross motor skills: Occupational therapists can help children to develop their balance, coordination, and body awareness, which can improve their ability to participate in sports and other physical activities.
Addressing sensory processing issues: Some children may have difficulty processing sensory information, such as sounds, sights, or touch. Occupational therapists can help children to develop strategies to manage these sensory sensitivities and improve their ability to participate in daily activities.
Improving attention and focus: Occupational therapists can help children to develop the attention and focus needed for tasks such as reading, writing, and completing homework.
Adapting the environment: Occupational therapists can help children by adapting the environment to make it more accessible and comfortable for them, such as recommending adaptive equipment, or making suggestions for modifications to the child’s home or classroom.
Addressing developmental delays: Occupational therapy can help children who are experiencing developmental delays to catch up with their peers by providing interventions to improve their abilities to perform age-appropriate activities.
Addressing behavioral concerns: Occupational therapy can help children with behavioral concerns by addressing underlying difficulties with sensory processing, self-regulation, and motor planning.
Supporting children with special needs: Occupational therapy can help children with special needs such as autism, Down Syndrome and cerebral palsy to develop the skills they need to participate in daily activities and reach their full potential.
Kid PT’s occupational therapists, Disha and Nina, have an endless supply of creative solutions to improve all of the areas of a child’s sensory, motor and emotional development. We love to integrate children’s interests into their therapy sessions as well. An engaged child is a learning child!
Here are top 10 activities to bring occupational therapy activities home with you:
Remember, ask your child’s therapist for individual recommendations, but here is a good jumping off point for you!
Playdough is a fun and versatile material that can be used to improve fine motor skills in children. Children can use their fingers to squeeze, roll, and shape the playdough, which can help to improve their dexterity, hand-eye coordination, and strength in the fingers and hands. They can even experiment with squishing it with their feet and toes too!
2. Sensory bins:
Fill a container with cooked spaghetti, raw beans, or rice. Use cups to fill and empty, hide sea creatures in it, and have fun! This activity helps improve fine motor control, hand-eye coordination, and sensory processing.
Beading is a fun and engaging way to improve fine motor skills in children. Children can string beads of different shapes and sizes onto a string or pipe cleaner, which can help to improve their dexterity, hand-eye coordination, and strength in the fingers and hands.
4. Lego building:
Building with legos or any other small building blocks can be a great way to improve fine motor skills in children. It requires children to use their fingers to pick up small blocks and place them in the correct spot, which can help to improve their dexterity, hand-eye coordination, and strength in the fingers and hands.
5. Outdoor games:
Outdoor games such as tag, capture the flag, and soccer, which involve running, jumping, and coordination.
Swimming, which improves balance, coordination and endurance.
7. Obstacle courses:
Obstacle courses, which involve crawling, jumping, and climbing, and help to develop strength and coordination.
8. Pretend Play:
Dress up and role play, where children can act out different scenarios and characters using costumes and props.
Setting up a store, where children can pretend to be the cashier, customer, or salesperson, working on their math skills, social skills, and creativity.
9. Water Play:
Sand and water play, which can help children to develop their sense of touch and sense of proprioception (awareness of the position of their body in space)
Cooking and baking activities, which can help to develop children’s sense of smell, taste, and touch.
Remember to have fun, ask your child’s OT for advice on how to bring their therapy home into your daily routine!
Babies have just spent 9 months growing and developing in the womb, where they were just floating around!
As newborns, they are fully reliant on mom and dad to support where their bodies go and what they see, hear, touch and smell.
With practice, new experiences, and time, babies develop head control through a combination of increased muscle strength and coordination. As they grow, infants begin to control the movements of their head by strengthening the muscles in their neck, upper back, and throughout their bodies. They also learn to coordinate the movement of their head with their eyes, which allows them to fixate on objects and track movement. This stimulates the development of the vision system, which also develops as a result of movement experiences. Additionally, as babies spend time lying on their backs, lying on their stomachs, and even being carried, they have the opportunity to practice lifting and controlling their head movements.
When do babies hold their heads up by themselves?
Babies typically begin to hold their heads up by themselves around 3-4 months of age. This is a significant milestone in their development, as it indicates that they are gaining control over the muscles in their neck and upper back. However, it’s important to note that all babies develop at different rates, and some may start holding their heads up earlier or later than others. Some babies may be able to hold their heads up briefly as early as 2 months, while others may not be able to hold their heads up until they are 5 months old. It is important to also be mindful if a baby was born prematurely. We want to consider the skills of a baby who was born prematurely in comparison with their adjusted age and not just their chronological age.
It’s important to remember that skills will develop as babies have the opportunity to try out new skills. That means that babies need lots of time to experiment with movement! The best way to do that is on the floor on a blanket with both toys (consider black and white toys or cards for our youngest of babies) and also with us. Get down on the floor with baby to play and if there is a big brother or sister, have then get in on the action too. If you have barriers to getting down on the floor to play, you can do the same play activities on a couch where you can be sitting more comfortably.
Top 3 positions that are helpful for babies to strengthen their necks
Here are our Kid PT top 3 positions that can be helpful for babies to strengthen their necks:
Tummy time: Lying on the stomach while supervised is one of the best ways for babies to strengthen the muscles in their neck and upper back. Think tummy down time though! Baby can be tummy down while being carried on your shoulder, on your lap, or on your chest. Tummy time does not have to be flat on the floor, especially during the first couple of months when maybe will have more success doing it on an inclined position.Tummy down positioning should start day one, but don’t stress about how it is done!
Side-lying position: Lying on their side with their head supported can also help babies to strengthen their neck muscles, especially when they start to lift their head and shoulders. Lying on their sides will also stimulate rolling to either their backs and bellies. This gives babies the experience that they can move their bodies, which leads to them trying to make it happen again and again! When babies roll they are practicing controlling their necks in 3D positions to master head control in all planes.
Playing on their backs: Although there is a lot of emphasis on tummy time, playing on their backs is also good for babies. This is not the same as playing in a bouncer, car seat, or other semi-reclined seat. Many of these semi-reclined seats limit head movement and block exploration. Playing on the floor on their backs like in the photo below is fantastic for the development of head control. You want to see the baby turning their head side to side, reaching for things, and moving their arms and legs in this position.
Sitting on your lap: When babies are sitting on a loved ones lap, they are looking around at their environment or looking at their loved one cooing away. They are learning how to respond to movements to keep their head steady in one position as we rock and bounce during play.
Carrying baby: Baby wearing or carrying your baby can also be helpful for the development of head control. When you are holding or wearing your baby and moving through space, the baby senses the movement and turns their muscles on in response. It’s a win-win for being close to you and getting stronger at the same time.
When should I get help if my baby isn’t holding their head up?
If your baby is struggling to hold their head up during tummy time or prefers to look in one direction, it is best to seek out professional advice. At Kid PT, Dr. Joni always tells parents that when they come in for a free screening they will either learn how to help their child or they will get piece of mind that everything is ok. There is nothing to lose!
To learn more about the developmental process in the first year and understand what to expect as your little one learns to move, check out Dr. Joni’s free guide, The 6 Keys to Gross Motor Development In the First Year. The goal of this guide is to help parents find out when their baby just needs more time and when their baby may need some help to meet their milestones!
If your worries about your baby’s development are keeping you up at night (and we know how precious sleep is right now!), then we would like to invite you to come in for a Discovery Visit to meet with one of Kid PT’s physical therapists. At a Discovery Visit, we will talk about your concerns and make a look at your baby’s movement skills.
Do you want to learn more about pediatric physical therapy and what it is. You can read more about it here. I know as a parent it can scary to take your baby to a new medical appointment. Rest assured that our visits are generally filled with smiles, giggles, and play. Babies have no idea they’re “working”, but just know they’re having fun. In fact, one of our top values at Kid PT is for the therapeutic process to be not just effective from a movement perspective, but for it to be as easy and positive as can be along the journey.
If you have any questions, we are here for you. You can call us at (908) 543-4390 or email Dr. Joni directly at email@example.com.
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We all know by now that we should be eating at least five servings of fruits and vegetables each day. But knowing and doing are two different things, aren’t they? Sometimes it is just not easy to get them all in there. We are constantly tempted to fill up on convenience and junk food. If your family is anything like mine, they’d much rather fill up on a bag of chips or a bowl of rice or pasta instead of trying an apple or a plate of steamed broccoli. A little creativity and preparation can go a long way though! Here are a few ideas to “sneak” some extra vegetables and fruits in your family’s diet.
1. Start the day with a breakfast smoothie. All you have to do is throw some fruits, low-fat yogurt and ice in a blender. You may also want to add a scoop of protein powder in there for good measure. Just blend for a few seconds and you have the perfect breakfast ready to go. I like to sip mine in a thermal cup on the way to work. To make it even more appealing for your kids, use some frozen yogurt or a scoop of ice cream in the smoothie. They won’t believe that you are letting them have ice cream for breakfast.
2. Dried fruit makes an excellent snack any time of the day. Add some small cartons of raisins to your child’s lunch box, pack some yogurt-covered raisins in your husband’s briefcase and keep some trail mix sitting around for snacking. You can also add dried fruit to oatmeal and cereal in the morning. My family loves banana chips in their breakfast cereal.
3. Add some fruits and vegetables to your family’s sandwiches. You can add some banana, sliced apples or strawberry slices to a peanut butter sandwich. Top a turkey sandwich with lettuce, tomato, cucumber and anything else they will eat. You can even make a sub shop style vegetable sandwich by combining several different vegetables with some mayonnaise and cheese on bread.
4. Have a salad bar at dinner. Set out a variety of chopped vegetables, some cheese and croutons as well as several choices of salad dressing along with the lettuce and let everybody create their own perfect salad.
5. Let them drink their fruits and vegetables. Keep an assortment of fruit and vegetable juices in the fridge and encourage everyone to drink them as a snack. Get creative. You could start “family cocktail hour” by pouring everybody a glass of his or her favorite juice over ice. Add some straws, cocktail umbrellas and sit together to talk about how everybody’s day went.
6. Try this for dessert. Put a small scoop of ice cream or frozen yogurt in a bowl and top it with lots of fresh or frozen fruit.
7. Offer fruits and vegetables as snacks. You can cut apples into slices and top them with peanut butter or cheese. Cube cheese and serve with grapes. Cut up some fresh veggies and serve them with ranch dip. And of course there’s ants on a log. Spread some cream cheese or peanut butter on the inside of a stick of celery and sprinkle raisins on it (wow, fruit and vegetable in one snack).
8. Try some new fruits and vegetables. Pick something exotic to get your family’s curiosity. With a little luck their curiosity will outweigh their initial apprehension to trying something new. You could try artichokes, plantains, papaya, mango, star fruit, or anything else you can find in the produce department of your local store.
9. Make a pot of vegetable soup or a stew that’s heavy on veggies and easy on the meat. Both of these make some great comfort food when the weather gets cold.
10. Start “My Veggie Day”. Each family member gets to pick a vegetable one day of the week.
Incorporate a few of these ideas and you will have everyone in your family eating more fruits and vegetables in no time!
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Did you know that less than 25% of people keep their goals past the month of January?
So what does this mean for the rest of the 75% of the population?
Does that mean that we’re all unrealistic in our expectations…
…not disciplined enough,
…not motivated for the right reasons,
…unwilling to make the “right” sacrifices,
…or just plain lazy?
We need to stop that negative self talk NOW!!!
We may be easily tempted into accepting these explanations of our “failure” as truth. Especially since social media is constantly screaming how we are not enough without this product, that body, or those fad diets or trends.
Maybe the fact that the majority of the population is unable to follow through with their resolutions, speaks more to the ineffectiveness of resolutions rather than us. Maybe the concept of resolutions does not align with how we as humans are typically wired. Keeping goals and following through is a hard task for anyone, so what can you do to make this process easier? We encourage you to instead establish small changes in your ROUTINE rather than resolutions. How is establishing a routine different? Below are 5 tips to making realistic routine changes that will help you reach your goals.
This is so important to avoid burnout. If your goal is to exercise consistently, refrain from initially making a goal that reflects your ideal frequency, duration, and intensity. Instead, start with small increments of an exercise or activity that will slowly get you to that goal. This could include walking in the morning or after you get home from work, performing a short yoga flow routine on youtube, or even doing pushups before you get ready for work. The important part is that it starts to become your routine and then you can always progress the amount of time and intensity of the activity as it becomes an automatic part of your day.
Ban the Barriers
Barriers are anything that block you from performing your intended task. Some examples of barriers are relying on the presence of another individual to complete the task, only exercising in a gym, and only doing an act of self care when everyone around you is content and happy. The more steps or conditions needed to complete a task, the less likely you are to follow through. There is not a problem with performing your routine with other people or going to the gym to exercise, but always have a back up plan and follow through even if the conditions aren’t ideal.
Combine it with something that gives you joy. This will be different for each individual person. This may be listening to a beloved audiobook or podcast, sharing the activity with a family member or friend, or making sure to give yourself a reasonable reward each time you perform the task. Even if the actual task is daunting and overwhelming, you will still have something to look forward to, which will help to reduce your avoidance of following through.
Pair it with activities already in your routine. Take advantage of all the routines you have already established throughout your day. By coupling your new activity with something you already automatically do in your day, it will boost your ability to follow through. An example of this is if your goal is to spend more time with your child, perform fun activities at a consistent time in your day that you are already with your child. For example, have an ice cream date or do a puzzle or play on the playground with your child after driving them home from school, after dinner, or before the bedtime routine.
Make It Sustainable
If you intend on making lifestyle changes that last longer than a few months or a year, then it has to be reasonably sustainable. It is important to choose goals that allow you to function in a normal daily routine without significant stress and sacrifice as this can be unhealthy for your body. Make sure to allow yourself a balance of productivity, connection with loved ones, adventure, self care, and rest.
If you’ve already ditched the resolution, its not too late to make a change. Think new routines, not resolutions and try some of the above tips to put them into action!
http://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.png00jonikidpthttp://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.pngjonikidpt2023-01-02 12:45:262023-01-02 12:45:295 Top Tips to Bringing Your Best Game to 2023
http://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.png00jonikidpthttp://jonikidpt.wpengine.com/wp-content/uploads/2015/11/kidpt.pngjonikidpt2022-12-26 12:06:442022-12-26 12:06:46The Top 3 Reasons Why Children with Low Tone Don’t Get Stronger
Let’s start out by saying THANK YOU, WE ARE GRATEFUL FOR YOU!
Wait, did we say the same thing twice?
No, there is actually a difference in thanks and gratitude!
You say “thank you” to others daily, for stuff ranging from getting your Starbucks handed over the counter to someone holding a door open for you when your hands are full. But, are you aware of the difference between being “thankful” versus being “grateful”?
Kid PT wants to show you that difference and give you 10 ways that gratitude can enhance your life.
Thanksgiving- An American Tradition
Halloween is in our rearview mirror and we are marching toward the major holiday season, starting with Thanksgiving. If you grew up in the US, you learned about the Pilgrims journey and their difficult conditions during travel and after arrival on what would become United States soil. You heard how the Native American people provided invaluable assistance in learning to survive the harsh, unfamiliar landscape, culminating in the celebration of what we have come to know as Thanksgiving, The majority of you in the US today, don’t live life pitted against the elements, wild animals, and the challenge of depending on only the food you grow for sustenance, thank goodness. It is easy to imagine how those desperate first settlers were incredibly excited when the skills they were taught began to show good results, like food growing!
But, were they only THANKFUL, or were they also truly GRATEFUL?
The Difference between Thankful and Grateful
You (and many of us) were probably taught that when we say “Thank You” to someone, we were showing gratitude. Somewhere along the way, the words became used interchangeably when they aren’t. According to psychmc.com, “Thankfulness involves how we feel in the moment, and like all feelings, eventually, it fades. Thankfulness is a temporary emotional response to a temporary circumstance.” Of course, being thankful when something good or positive happens is a beautiful response! It is just not the same as being grateful for something in your life or world. Again psychmc.com gives a perfect description of the difference,
“Where thankfulness is an emotion, gratitude is an attitude of appreciation under any circumstance.”
Gratitude involves being thankful, but it is more than that. Gratitude means expressing thankfulness and being appreciative of life daily even when nothing exciting happens.” In other words, being grateful or having gratitude is a choice you make to practice for yourself, to be content with your own life (physically and mentally),even if you aren’t always happy or some negative things happen. Thankfulness will fade when the excitement is over, whereas gratitude will remain with you, and provide a more durable satisfaction and sense of wellness.
Gratitude Can Improve Well-Being
According to a 2018 study from the University of California Berkeley, “Research suggests that gratitude may be associated with many benefits for individuals, including better physical and psychological health, increased happiness and life satisfaction, decreased materialism, and more.”
The study states that “Gratitude is also important to forming and maintaining social relationships.” When you engage with someone and express gratitude for them, they are in turn more likely to express gratitude in return. The expression of gratitude is what helps us form new relationships and strengthen our current ones. Various studies have shown the positive effect of relationships on our emotional well-being, and it is one more added benefit of practicing gratitude.
10 Ways Gratitude can enhance your life
Scientists have started studying the effects of practices lie positive thinking and gratitude, only in recent years. According to https://www.montereybayparent.com, the world’s leading scientific expert on gratitude is Dr. Robert Emmons. This “gratitude guru” conducted studies involving gratitude journals and found that when people regularly practice gratitude, they experience the following notable psychological, physical, and interpersonal benefits:
Feel better about their lives overall
Experience higher levels of positive emotions like optimism, enthusiasm, love, and happiness
Are kinder and more generous to others
Have fewer physical problems including pain
Exercise more regularly and eat healthier
Visit the doctor more regularly for checkups
Feel less stressed
Able to cope with stress more effectively and recover more quickly from stressful situations
Live longer–on average, being thankful adds 7 years to our lives!
Wow, I know I’d like to experience those benefits- how about you?
The article goes on to say that this process of expressing gratitude works by interrupting the cycle of negative, down or upset thoughts. The beauty of this process is you can do it anytime, anywhere, no special equipment or skills required, While some people love to write in a beautiful journal with a fancy pen, others find typing or dictating a list into their phone gratifying, while still others feel most comfortable reciting a gratitude list or prayer (aloud or silently). This is a practice that can be shared with loved ones, friends, or children, or used as a time for quiet reflective meditation.
No one size fits all for a gratitude practice, except that it can make EVERYONE feel better.
Kid PT Staff Gratitude Statements
In the spirit of gratitude, the Kid PT Staff wanted to share our expressions of gratitude with you.
Kelley (Admin): I am so grateful for my wonderful family and the amazing people I work with! 👨👩👧👧❤️
Disha (OT): I’m grateful for my family and my dog ! 🙋♀️🐶
Mima (PT): I am grateful for my family, good health and my amazing life!! 👩🦱🏆
Wendy (OT): I am grateful for the love I feel each day from my family and friends and for the beauty of this fall season. Isn’t it just gorgeous? 🧡🍁
Joni (PT/Director): I’m grateful for my family and my health. I’m also so grateful for my Kid PT family!!! 🚶♀️🥰
Ali (PT): I am grateful for any time I get to spend with my family and close friends and for any time I get to spend in the outdoors because spending time with people I love and in nature makes me happy! 😀
Kat (PT): I am grateful:that I am married to my best friend and that I have a wonderful family. Additionally, I’m grateful for the beautiful outdoors. 🌳👩🏻❤️👨🏻
Nina (OT): I’m grateful for community and I’m grateful for being surrounded and supported by loved ones! 💞🤲🏻
Melanie (Marketing): I’m grateful for all the people I love, especially my kids. Plus, gratitude for music, reading and theatre making the world a brighter, more positive place to live! 🎭🎶📚
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Halloween is coming! And it’s time to get in shape for the big day. Lugging all that candy around from house to house is harder work than you think! 💪
Here are five spooky, Halloween-themed 🎃 exercises you can do at home, at the park, or on your trick-or-treat haunts to get you in the SPOOKY spirit:
The Zombie Twist
A simple exercise where you stand with your feet shoulder-width apart and arms out in front of you. Then twist your arms from side to side and say “BRRRRAAAIIIINNNSSS” like a zombie!
The Soaring Pumpkin
This is a great way to work on your core strength while getting into the spirit of Halloween—lie on your back and lift your arms, head, and legs off the ground. Grab a pumpkin and hold it between your hands and feet (make sure it isn’t too big or heavy). Now lower the pumpkin toward your tummy and then push it back up into the sky to make it SOAR!
The Stingy Spider Squat
This exercise will help you strengthen all those leg muscles we use when we’re running from vampires or other spooky creatures. Start in standing with your feet hip distance apart. Then squat down as if you were trying to hide from something scary, and repeat! Make sure your arms are stretched out too so you really look like a leggy, crawly spider!
Jump up and down as if trying to scare someone into giving you candy. Don’t forget to get your monster claws out, and get creative with your jumps! If you want to be a monster that jumps on one foot, jumps while spinning, or jumps like a frog, then do it!
Bat Wing Swing
Make sure you are in a big open space for this one! First, put your arms out to the side while standing, like you have two wings. Next, dip one wing down, and one wing up in the air, so that your arms are in a diagonal. Now run 10 steps flying forward to the right side THEN 10 steps running toward the left side. You can also start screeching like a bat for some extra Halloween flare.
WOW! Now you’re looking and feeling EXTRA SPOOKY! We hope you and your family enjoyed grooving your way through these Halloweeny moves. Have a HAPPY HALLOWEEN!
October is Spina Bifida Awareness Month and for it we wanted to share with you one of the recent advances in rehabilitation for children with spina bifida. On of our physical therapists, Dr. Kat has received training in this new approach and is now using it with our Kid PT families.
First, let’s talk Spina Bifida.
Spina bifida is a birth defect that occurs during the first month of pregnancy when the spinal column does not close properly, resulting in an open lesion on the skin. There are different types of spina bifida, but all can cause varying degrees of paralysis, loss of sensation and sometimes bladder and bowel problems. The severity depends on where the lesion is located on the spine and how much damage was caused to nerves as a result of it.
Spina bifida can be treated with surgery, even before the baby is born. These surgical repair advancements have improved outcomes for children with Spina Bifida. Physical therapy typically begins very early in life. Parents are taught stretching and positioning routines to maximize flexibility and play strategies to maximize function. Skin protection is also very important due to the lack of sensation and position sense.
Electrical stimulation has been used for many years for a variety of purposes. It is a safe non-invasive therapeutic intervention that can impact many different systems of the body, including circulation, sensation and muscle strength. Back in graduate school over 20 years ago I was involved with an research study using neuromuscular electrical stimulation for children with cerebral palsy and it showed great effectiveness.
Many people are familiar with TENS or interferential electrical stimulation from their own physical therapy experiences for pain problems. It is a similar set up doing neuromuscular electrical stimulation, functional electrical stimulation and spinal stimulation where you have two electrodes on the body and they connect to wires on the device.
Originally, Gerti Motavalli, a PT who was investigating using electrical stimulation to increase muscle activity with babies with Spina Bifida, she was focussed on direct activation of the muscles, as is more typical with the application. What she found was even more dramatic improvement doing spinal stimulation vs. only muscle specific. Babies improved their sensation and movement abilities at a much quicker pace than was typical. Her publication on the first search study can be found here. Spinal stimulation uses electrical pulses sent through wires placed around the spine into nerves in the lower back. It helps restore nerve signals that have lost their ability to travel down the body as a result of spinal cord damage or abnormalities. The exact way that spinal stimulation works is not completely understood; however it has been shown to improve sensation and motor skills at a faster rate than is typically expected. Since initiating this work, Gerti has used her protocols on children from babies to 13 year old and is now working with families from all over the world as well as teaching other physical therapists how to apply the concepts.
Since we already use electrical stimulation at Kid PT and we own multiple electrical stimulation units that are considered the gold standard for safety with children, we naturally wanted to learn how to apply these findings in the practice. Let’s talk a little bit more about the areas that spinal stimulation can impact a child with Spina Bifida.
The spinal cord provides protective sensation—the ability to feel pain and temperature changes—to the body. This sensory information is relayed through the dorsal root ganglia (DRG) and transmitted through dorsal column pathways to the brain. In children with spina bifida, there can be significant damage to these structures, resulting in reduced protective sensation.
If you don’t feel the bottom of your foot, for example, you wouldn’t know if you’re standing on soft grass or on a thorn. That places your skin at risk for injury and limits your ability to stop an injury like that from happening over and over again.
Spinal stimulation has been shown to increase sensory awareness more rapidly than other treatment approaches used in the past. This has the potential to make a powerful impact on a child’s daily life.
Proprioception is the ability to sense where your body parts are relative to each other and how they move in space (e.g., when you put your hand behind your back). Loss of proprioception can lead to difficulties with balance, coordination, and gait. Imagine trying to place your foot down flat on the floor if you don’t feel where your foot is. You would need to look down every time you take a step to know where to place it. Improving the sensory information moving from the body to the brain can improve a person’s proprioceptive sense.
Circulation of the vascular and lymphatic systems are greatly impacted by movement as well as nerve innervation. If you always have cold feet life me, imagine how much colder they would be if you didn’t have the motor control to move your ankles all day long. I know mine would be icebergs! Spinal stimulation has the potential to improve circulation by increasing nerve conduction to the vascular system.
Spinal stimulation has the potential to increase muscle activity, which can improve endurance of postural muscles, symmetry between limbs, and promote improved alignment of the body. Stimulating the nerves that cause the muscles to contract can improve motor control, strength and endurance of the body. Improving symmetry of the body, including the hips and the trunk, can decrease the risk of scoliosis and hip joint issues, as well as support improved functional mobility.
To see many video samples of how spinal stimulation is done and to watch videos of changes over time of children of different ages, check out Gerti’s Facebook or Instagram pages. To learn more about Electrical Stimulation and how it can help your child reach out to us for a phone consult or to schedule a free screening.
Reach out to as at firstname.lastname@example.org or call/text 908-543-4390.
Science keeps growing, we all keep learning, and the future is bright!
“My baby won’t move out of sitting! She just wants to sit and play and gets mad if we lie her down to play!”
Learning to Sit
It’s an exciting moment when your baby starts sitting all by themselves. At some point between 5-8 months babies developing typically will gain the postural control to sit hands free and play with toys.
It’s a huge milestone and a big one to celebrate!
Here’s a photo of the first time my daughter, Rebekah, sat by herself. She sat just long enough for me to snap a quick pic!
You can see how tentative she looks here!
Rebekah is using her hands to help her balance here.
She’s not quite ready to sit and play with toys with both hands, watch the dog running back and forth, or reach for something.
Perhaps a big giggle would knock her over at this point!
This is a great time to play in sitting with a little support, such as in a laundry basket or a box.
The more filled the basket, the easier it will be to balance. For more challenge, try wiggling the laundry basket or give your baby a ride moving the basket back and forth.
You can also use large toys where your baby can use one hand to balance and the other to like this one.
Many of the push toys have a side to play on- park it against a wall of the couch so it won’t move and your baby can sit and play with it.
A big toy that fits in between your babies legs in ring sit so they balance with their hands on the toy, rather than hands on the floor can help sitting balance get better and better.
When babies become more experienced sitters, they can look in all directions without it impacting their balance, they can play with toys with both hands and they can reach in all directions.
This is when you’ll see your baby experimenting with banging toys together and using both hands to manipulate their toys.
Once we’ve mastered the sitting milestone, now what?
In sitting, we want to see your baby shift their weight forward and back, left and right, while they’re playing in sitting.
They will learn this naturally during play.
While they’re shifting their weight to each side to get the things they want, your baby will learn to move from a ring sit position like above to other positions, such as ring sit to side sit.
Babies will also move from sitting down to their bellies too.
Here are some examples of playing in sitting that leads to next steps and moving in and out of sitting:
This give babies the opportunities to practice moving between positions from sitting to belly and from sitting to hands and knees.
All of this movement out of sitting creates separation from the babies’ lower legs, hips, and core, building flexibility and postural control.
This is getting the baby ready for all of the milestones that come next!
The stage is being set for crawling and walking!
What are happy sitters?
Happy sitters are babies who achieve the exciting sitting milestone that we’re chatting about, but then they bask in the glory of sitting and don’t keep moving along in the developmental process.
Our therapists at Kid PT see this all the time.
These babies figure out how to communicate to their parents to place them in sitting. These babies will pull toys towards them using a blanket and will have siblings bring them the things they want. They are so smart and problem ways to keep things in their comfort zone!
We call these babies “happy sitters” because they’re happy sitting there, but aren’t happy exploring other ways to move.
Although learning to sit by themselves is fantastic, it should happen alongside:
Moving in circles on their bellies
Moving from sitting to bellies
Moving from ring sit to other sitting positions
If your baby is sitting all by themselves, but they aren’t doing the other movements listed above, your baby may be a happy sitter.
What happens if you don’t intervene?
The longer you wait, the harder it is to promote more movement.
Variety of movement is one of the big keys in motor development.
If you are worried that your baby may be a happy sitter, come in for a free screening with one of our physical therapists and we can give you tips to get your baby out of this phase and onto moving and exploring their world!