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- Dr.Joni Redlich PT,DPT
What does movement have to do with Autism, you ask? In short, EVERYTHING! Movement is the way we interact with our environment, one of the ways we make sense of all the information around us, and the way we turn our will into action! Even something that seems so based in the brain, like writing or typing our thoughts down, involves movement to actually get those thoughts onto paper or into a computer.
But what if the wiring in your brain telling your body to move a certain way wasn’t communicating that information effectively?
Or what if the information you were getting from your environment, like the sights or feelings around you were coming in as too bright, too sharp, or not clear enough?
What if you couldn’t necessarily tell where your body was in relation to your environment or where your legs and arms were while walking around?
It would be so much harder for you to get around without knocking into things, to react to your environment in the safest way, move the way you wanted, and keep your stress level down while doing all of these things, right?!
These are just some of the small or large mountains that a person with Autism needs to climb on a daily basis to feel like their normal selves and to engage with our crazy world. Movement can be overwhelming and difficult to coordinate or extra movements may be necessary to feel where their bodies are in space. With the many lenses we can look through from a therapy perspective, we often land on the tie between Autism and movement and want to discuss the connection and why children with Autism may be inclined to move more and to move in their own individual way.
Movement to meet sensory needs:
Movement that is Difficult to Coordinate:
Now add extra distractions of daily life to the Mix!
These are just some of the big reasons why movement can be tricky and discoordinated in autistic children and how it can impact os many areas of daily life, from getting dressed in the morning to social interaction. We know this is A LOT of information to take in, but this connection is an important one to make because when movement is hard, it makes coping with everyday life hard and stressful! If you feel like coordinating movement or movement with other daily tasks is sometimes tricky for your child, call (908) 543-4390 or visit our website at www.kidpt.com to schedule a FREE Discovery Visit today!
Extra reads:
As March is also Brain Injury Awareness Month, we will be discussing concussions. Did you know that concussions are actually mild traumatic brain injuries?
Let’s unpack what actually happens during a concussion.
First of all, a concussion can result from rapid movement such as whiplash, a direct blow to the head/ face/ neck, or indirectly by a significant blow elsewhere in the body that is transmitted to the head. These forces put stress on the brain cells and can cause microdamage. Whenever there is damage to a part of the body, the body responds with inflammation, changes in blood flow, and changes in tissue chemistry. While this body response can help assist healing, it requires a high demand of energy and also reduces the amount of energy and nutrients that the brain has access to due to changes in blood supply. This places the brain in a vulnerable state as the brain has limited resources to function as it heals.
Once the brain has experienced a concussion it is more vulnerable to repeated injury. Subsequent concussions often have longer lasting and more severe symptoms, so it is important to avoid environments and activities that could expose the child to a second concussion. Therefore, it is vital to reduce the demands on the brain to allow it to rest and heal and minimize the symptoms. A concussion can impact cognitive, physical, emotional, and proper sleep function.
Some symptoms of impaired Cognitive function include difficulty concentrating, reduced short term memory, feeling in a fog, and feeling slowed down. Physical symptoms of a concussion include headaches, dizziness, fatigue, nausea, sensitivity to light, balance impairments, ringing in the ears, and blurred vision. Emotional impacts include depression, irritability, and lack of interest in favorite activities. These symptoms impact many aspects of daily life like the ability to complete classroom assignments, withstand environments with bright lights, participate in sports and recreational activities, and complete daily tasks at home.
This is where Physical Therapists can help. We have expert understanding of the healing process of the body and have the tools to assess and treat the individual child’s impairments.
Below are Five Common Ways that we as physical therapists get our clients with concussions back to doing the things they love and the activities necessary for success at school and at home.
Educate On Strategies to Promote Rest and Healing
As mentioned above, there is a high energy demand on the brain after a concussion as it heals and there is less access to energy resources due to inflammation and blood vessel changes. This can last up to several weeks. It is vital to allow mental and physical rest so that the body’s resources can be used to attend to the damaged brain. Ways to promote rest are limiting screen time, schoolwork, and recreational activities. Once a child is ready to return to the classroom, there are strategies to adapt the environment to improve reading tolerance and participation in class with less onset of symptoms by using colored films, tinted eyewear, and incorporating a schedule for physical and mental rest throughout the day.
Facilitate and Guide The Process to Return to Sports
Return to sport activities should be overseen and directed by an informed clinician in order to provide the right amount of rest vs challenge. The sporting environment has a high risk for a second and more severe concussion that can have lasting effects. Avoiding competitive sports and recreational activities is a good way to reduce the risk of repeated injury. Also, if a child is challenged too quickly, their symptoms may last longer as healing is delayed. On the other hand, it is important to provide the “just right” challenge to the young athlete to avoid unnecessary deconditioning. A physical therapist has the expertise to create a plan of care that provides the appropriate amount of progression to return the athlete to his/ her sport in the safest and most efficient manner possible.
Promote Sensory Integration
The normal function of the brain is interrupted with a concussion. This can impact how the brain interprets and integrates sensory information from the vestibular, auditory, visual, and proprioceptive systems. A typical brain automatically takes in all the information that your senses perceive, organizes it, and then helps you to respond appropriately. This complex process of integrating the sensory information provides the child with body awareness, understanding where they are positioned in space, postural control, regulation skills, depth perception, coordination of the eyes, and so much more all while they are simultaneously breathing, moving, multi-tasking, and processing a changing environment. When the brain connections that integrate the sensory information are delayed or interrupted, it can be disorienting and lead to visual and balance problems and sensitivities to varied sensory stimuli. A physical therapist will assess what sensory systems are impacted and will progress the interventions to return the child to unhindered play.
Address any Musculoskeletal Injuries Associated with the Concussion
Often the forces that cause a concussion also result in injury to the neck, spine, or other areas of the body. Sometimes injury and muscle tightness in the neck can even cause symptoms of headaches or dizziness and will benefit from therapeutic interventions to promote flexibility, stability, and strength to reduce these symptoms. Physical therapists are experts at identifying and treating these injuries alongside the concussion.
Restore Strength and Endurance
Since rest and lack of physical activity after a concussion is so important, most children will need to build back strength and cardiovascular endurance to return to the state they were before the concussion. Physical therapists are experts in exercise prescription and provide a plan of care to restore strength and endurance at a pace that meets the “Rest vs Challenge” criteria mentioned earlier.
This information is intended for educational purposes only. Please seek the advice from the medical team that manages your healthcare to manage your personal medical needs.
https://www.choosept.com/guide/physical-therapy-guide-concussion
There are so many reasons why the Spider Cage is a powerful therapeutic tool to integrate into your child’s physical therapy program. If you worry about your child not having all possible opportunities to develop new movement skills, you should try out the Spider Cage during a trial session at our office to see firsthand what your child can do!
Why is the Spider Cage so powerful? Let’s look at 7 reasons that the Spider Cage gives children access to developing new skills and abilities, by supporting them to increase strength, balance, motor control, endurance and sensory processing, all while having sooooo much fun. Remember, fun is really important when it comes to children- if they’re having fun, then they’re LEARNING! Let’s get into those 7 reasons now.
The Spider Cage is setup where the child wears a belt and the bungees connect to the belt. There are 8 bungees that can be attached to the belt with 2 on each corner.The child can be sitting, on hands and knees, standing, walking on a treadmill or moving between positions. The bungees in the Spider Cage provide support, but they’re also dynamic, so it is a different experience for a child that has been in a stander or a gait trainer. It is also different than having a parent or therapist helping. The child can try out new skills with just enough assist, but they are initiating the movement and responding to what worked and what didn’t work to learn from the experience.
In the video below, you can see the boy practicing standing up by himself without using his hands, which he can’t do outside of the Spider Cage. Over time the bungees can be lowered or only 4 bungees can be used to build more independence, which can then generalize to outside of the Spider Cage.
2. Confidence Building
Many children with movement delays or disabilities develop a learned helplessness from frequently experiencing things being difficult or impossible. Learned helplessness is when you have learned that you can’t do something, so you stop trying. It is an understandable reaction, but one we have to mindful of when guiding children to develop new skills and abilities. The Spider Cage is a fantastic tool for children to experience that they are capable of doing, with just the right support. This can be basic gross motor skills like sitting, standing and walking, or it can be more advanced skills, like hopping and balancing on dynamic surfaces.
The boy in the video initially needed hands on help to perform this motion. He didn’t try to initiate it on his own and needed help to complete the motion. After several times in the Spider Cage, he learned how to transition from hands and knees to standing with the help of the bungees alone. He was so proud of himself and this transferred to him helping more with transitions off the floor outside of the Spider Cage.
3. Safety to Try Higher Level Balance Skills
Children will limit attempts at new skills if they know their body isn’t going to be able to do it reliably and safely. Knowing they can’t fall, the Spider Cage gives the opportunity to try all sorts of challenging balance tasks without the risk of falling and hurting yourself. This way, the kids can work on those advanced skills, flood their brains with novelty and develop more advanced movement control.
In the video below, she challenges herself to move from standing to half kneel while standing on a bolster that rolls side to side. What a challenging task! This would be a risky thing to try holding maybe a trapeze overhead and would have allowed her to rely mostly on her arms, instead of her hips. Doing this activity in the Spider Cage let her work on a high level of hip and balance control and no rely on her arms for help.
4. Sensational Sensations
As we said before, the Spider Cage is a DYNAMIC place to be! The bungees provide resistance and assist to movement, giving intense proprioceptive/deep pressure input to the children’s bodies. All of the movement is very stimulating to the vestibular system in the inner ear as well. The Spider Cage is a great place to put together the postural system with the eyes, vestibular (inner ear), and proprioceptive (information from joints and muscles) to work on improving body awareness and regulation skills.
In this video you will see a boy doing intense jumping, having a BLAST, and regulating his system to do focussed work afterwards!
5. Hands Free Movement
Children who use crutches or walkers for mobility are always using their hands to help manage the rest of their bodies. The problem is that they then become limited in using their hands for other activities, such as carrying something, and they rely on using their arms to initiate movement, rather than using the pelvis, the cornerstone and powerhouse of our bodies.
In this video you’ll se a boy playing basketball where he typically needs a person to help or his hands on an assistive device to be able to do an activity like this.
6. Speed & Power
The Spider Cage gives the support a child needs to be able to work on moving at increased speeds than they could do outside of the cage. It also lets them work on their power with jumping and leaping. The dynamic assist on the bungees give greater access to new skills while decreasing risk of falls at the same time. This allows motor control, strength and endurance to build to support the use of increased power and speed outside of the cage in the future.
In this video, the boy walks 2mph, when he usually walks at a slow pace with crutches, he’s able to explore increased speed. You can see how proud he is at his acomplishment!
7. Play
Play is how babies and children learn! Play in the Spider Cage gives access to children with a limited play repertoire to develop more advanced play skills. Children can jump, kick a ball, throw a ball, and knock down towers. There are so many games children with limited play skills can try out in the Spider Cage!
In the first video below, the boy initially needed assistance from the therapist to stop on the target. With practice he was doing it all on his own and laughing so hard each time!
In the second video, we used the Spider Cage in a completely different way to make a ninja obstacle course with the bungees! The boy is working on his midrange postural control to move over and under while trying not to touch the bungees.
In the 3rd video the boy is playing t-ball! He has the opportunity to be hands free using the support of the bungees to play the game!
Participation in the arts are a way for someone to express themselves. It creates a window into the soul and an escape all in one. Some turn to painting, drawing, music, drama, or dancing to find their sense of self or to relieve stress after a long day, and this is no different for kids and adults with Cerebral Palsy (CP). Taking part in the arts is a wonderful thing for children with CP to do, no matter their level of disability, and here’s why!
Self Expression Without Limits
The arts allow for a place to explore what you are thinking or feeling. Whether you are verbal or non-verbal, participation in an art form is a way to get your feelings out! Society often tries to put us in boxes that may make us feel limited. But when you are creating art, you get to make the rules. Bend the rules to work for you
Adaptability
With the free form nature of many arts programs there are no rules that have to be adjusted to make it work for your body. If your dancing includes, moving your head side to side to make your wheelchair turn to the right and the left, do it! If you need something to secure a paint brush to one of your hands or to your head to paint your beautiful picture, why not! It’s your masterpiece, so the environment can be set up to make creating your art that much easier.
Community OR Solitary Art
Many arts are performed in a group setting for those who love being social, like Drama. You can find your Drama, Dance, or Visual Arts community if that floats your boat. BUT the cool thing about the arts is many forms don’t have to be done in a group, they can be done alone too if you’d prefer to work that way.
Confidence Booster
For many kids and adults, taking part in the creation of something beautiful, or something they made themselves, is a huge confidence booster. When the right adaptations are in place to support each child or adult, either with motor or intellectual considerations, the child can make something by themselves (or with a little bit of teamwork if needed) and feel proud of themselves for doing so!
Types of Art
Visual Arts
Dance
Drama
Music
But where is there to go in NJ for my child with CP to participate in the arts? Check out these links to find out more!
Dance:
http://kayelynndance.com/chance-to-dance/
http://www.danceinnovations.org/dipf
http://kayelynndance.com/chance-to-dance/
http://www.danceinnovations.org/dipf
Theater:
https://papermill.org/access-for-all
Art:
Music:
https://www.theconnectiononline.org/com
References:
https://www.cerebralpalsy.org/information/activities/arts
Children with cerebral palsy (CP) undergo intervention throughout their lives. They often receive physical therapy, occupational therapy, and speech therapy for many years in the home, school and clinic settings. Parents are often presented with lots of opinions as to therapy options, medical interventions like botox and baclofen, bracing options, and surgical procedures, such as selective dorsal rhizotomy and lengthening procedures.
Although it is a lot to navigate, parents, you need to know that you are the experts in your children, there is not doubt about that. Many parents will tell me that they feel like they are left to manage their child’s care in a world that speaks a different language that are all giving different opinions. This is not easy! That’s why when we provide care for our families, our goal is to help you manage the big picture and not only provide your child’s therapy. We’re here to support you, guide you, and connect you with resources every step of the way.
In the therapy world, there are so many different treatment approaches out there and often they are filled with big promises. This can add to the challenge of navigating the best care for your child. We know that you want the best for your child and we want to empower you to trust your gut, combined with learning as much as you can, to find the best match of services for your child.
TMR is a treatment approach that can be powerful for children with CP. Rather than tell you so, or even show you someone else’s child, I invite you to come in for a Discovery Visit at our practice to learn how TMR can help your child. TMR is integrated into our intensive therapy programs as well as our weekly sessions. It is an approach that is easily accessible for you to do at home in between sessions, which is a big piece of why it is so powerful- your repetition at home adds on to changes that are made in therapy sessions, stacking up to powerful changes in your child’s ability to breath, balance and move.
There is a reason families from around the world, from South Korea to Saudi Arabia, to throughout the United States, from NY, Virginia and Texas, have worked with us to learn how to use TMR to help their children breakthrough limits and open up new worlds of possibility.
Whether you’re curious or skeptical, we want to talk to you and share with you the future of pediatric therapy with children with CP and other movement disorders! Email us anytime at info@kidpt.com or call/text us at 908-543-4390.
February is American Heart Month! Along with AHM, it is also Congenital Heart Defect Awareness Week from February 7th to February 14th! Many people don’t know, but children with Congenital Heart Defects (CHDs) often have to have surgery to correct the way their heart is working within their first year of life. Sometimes, depending on the severity, children with CHDs need multiple surgeries spanning from a couple of months after birth to their toddler years. Many of these surgeries cause children to stay immobile as they recover, which is necessary, but often limits their overall motor development. As most surgeries are performed within the child’s first year of life, these children can become delayed in crucial developmental milestones that would be occurring at this time.
This causes these kiddos to have to play a lot of catch up as they grow and develop as older infants, toddlers, in grade school, and beyond. Understandably, if you are a parent of a child with a CHD, you may have felt overwhelmed when your child was going through struggles and surgeries. We have heard from our parents, many are just so relieved when their child begins to recover from surgery, and starts to move around and play again.
Often, physical therapy for children with CHD’s is crucial to make up for lost time, improve gross motor skills, and catch them up to where they have the potential to be! Sometimes the importance of physical therapy is overlooked as they have other medical based needs to meet, but their success with movement is also very important to their success in life, in play, and in school later on!
Having children with a history of a CHD screened by a physical therapist, and if appropriate started in physical therapy services is important to do ASAP. If you have a child who recently had surgery and still has mobility restrictions, check with their heart surgeon to see if it is okay to start PT, and they will give you the go ahead when they think your child is ready and cleared to move.
We understand how scary it can be to encourage your child to move and play after hearing so much “don’t do this” or “no they can’t do that right now” that typically comes right before and after surgery. If you aren’t sure where to start, let us PTs help you! We know how to encourage the development of new motor skills and play while keeping in mind any restrictions that your child still has, to help them be the best that they can be while making sure they stay as safe as they can be. The best part is, we can coach you how to do similar activities at home so that you know how to keep your child safe, but help them grow while they play at home.
Basically, we are here to be your teammate, parents! We know the road you have traveled with your child has been tough, and you may or may not have some more road left to go. But regardless of the difficulty of the journey, we are here to support you and your child along the way to make life easier for you and to help your child achieve all the motor skills they are capable of (while having fun)!
Reference:
Sprong, M. C., Broeders, W., van der Net, J., Breur, J. M., de Vries, L. S., Slieker, M. G., & van Brussel, M. (2021). Motor developmental delay after cardiac surgery in children with a critical congenital heart defect: A systematic literature review and meta-analysis.
If you are a parent of a special needs child, you have learned to be very patient when it comes to your child’s progress in therapy programs and how to embrace the baby step milestones along the way. In this video, I will share with you how I had to develop patience too as a young professional, and how I was able to move on from it over a decade ago.
What does that have to do with TMR? Well, when I starting using TMR, I started seeing immediate changes in children’s bodies. What I would have seen change in 6 months, I could see change in 6 visits. In fact each visit had a change I could put my finger on.
Total Motion Release, or TMR, is an approach the physical therapy that the therapists at KidPT apply to all of their sessions. If you’re a current client, you may ask yourself, why have’t I heard of this before? Just like all of the approaches we integrate into our sessions, we don’t usually name them, because they’re all under the lens of pediatric physical therapy and regardless of how we get there, our #1 focus is always your goals and not how we get there.
If your home program involves holding your baby in different twist or crunch positions, or for an older child, playing or sitting in a twist position, you’ve been doing TMR! If your wondering why we’re always asking your child to work their easier side really really hard, this will explain why!
So what is it? As TMR has spread around the world, from here to Australia to India, many therapists and the families they work with have experienced the impact TMR can have on changing how the body moves. And how those changes can come FAST!
As one of just a few Certified TMR- Tots & Teens therapists, I wanted to share a video series on TMR, what it is, how it is used, and how it can spark change in children and adults with various movement challenges. This video is a general video on TMR for pediatrics. The following videos will share with you how TMR is applied with different diagnoses and disabilities.
Do you have a question? Post it below!
Happy Valentine’s Day 2022! This year let’s use Valentine’s Day as a day (5 minutes, 1 hour, whatever you got!!!) to give yourself some LOVE!!!
We know parents are busier than every before and life continues to be unpredictable and filled with curve balls. That’s why we’re here to remind to to practice some self-care for show yourself some love.
Here are some ideas for you! See what speaks to you and try to squeak one into your day this Monday.
I hope this list got you brainstorming about a small part of your day that can be focused on YOU. You are worth it and some self love will help you be your best self for your family too!
The winter olympic games have begun. It is amazing to see what the human body can achieve with consistent hard work and dedication. If you are like us and enjoy watching the games as a family, here are some ideas to bring the winter games to your very own living room and keep your kiddos active.
Ice Skating
Have your child practice their speed skating or figure skating skills with this fun indoor activity. Have your child skate around the house with each foot on a paper plate or a furniture slider or in tissue boxes. Have them practice their twists, turns, and spins.
Bobsledding
Don’t throw away that amazon box. Have your child decorate their very own bobsled. Once they have produced a personalized sled, they can sit in the box and weight shift side to side as though they pretend they are racing down a winding track. Turn this into fun “heavy work” by having your children take turns pushing the other child in the box across the floor. Heavy work can be organizing for both the sensory and emotional regulation systems. Don’t have an empty cardboard box? Use a laundry basket instead.
Skiing
Take out those furniture gliders again and have your child stand with one foot on each glider. Have them propel themselves forward with sliding their feet and using 2 pool noodles. You can even set up cones that they have to skate around or go in and out.
Snowboarding
Place a pillow or wobble board on the floor and have your child assume the snowboarding position and have them rock back and forth and even touch their hand to the ground as if they are gliding down a snowy slope. Enhance the experience by playing a YouTube video in the perspective of someone snowboarding down a mountain
Watch some of the Olympic sports with your children and see what creative ideas they come up with to imitate the sports at home!
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.
Start Small
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
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
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!