Monthly Archives: April 2016

Teaching Your Child How to Tie Their Shoes

By: Laura Bueche MOT OTR/L

Teaching your child how to tie shoes can be frustrating for parent and child. This tricky dressing task relies on a variety of different components to work together such as: fine motor skills, bilateral hand skills, visual perceptual skills, sequencing, and attention.

Here are some easy tips and tricks I’ve picked up over the years to help your child be more successful with this tricky self-help task.

 SET UP FOR SUCCESS

Practice Off the Foot

tie a shoe

It is much easier to learn how to tie a shoe when the shoe isn’t on your foot.  You can lace up an old shoe for your child to practice on, or you can make a “learning shoe” with cardboard or an egg carton.

Different Color Laces

Buy two pairs of laces of two different colors. This will help your child with the visual perception piece. She or he will be better able to see the laces and differentiate, and avoid a tangled mess.

Visual Check List

Print out the sequence pictures from this blog to make a flip-book and follow along as you teach. This can help your child sequence through the steps.

One or Two Steps at a Time

Learning all the steps at once can be overwhelming. Read your child’s motivation and/or frustration levels to know when to push forward and when to call it a day.

Don’t Rush

Set aside time to practice. Rushing out the door is NOT the time for learning. Set aside a time to work on shoe tying when you can go at a slow and stress free pace.

Ok great! Now you are set up and ready to learn the magic formula to teach your child how to tie their shoes…

MISS LAURA’S MAGIC FORMULA

  1. Hold the laces

shoe_1

2.  Make an “X”

shoe_2

3.  What lace is on top? (blue)

shoe_3

4.  Top Lace (blue) goes through the tunnel

shoe_4

5.  Pull Tightshoe_5

6.  Make a loop

Not too big… Not too small…Not too far away

shoe_7

    7.  Blue lace goes aroouuund town

shoe_8

     8.  Drop it!

shoe_9

    9.  Thumb pushes bunny through the hole

shoe_10

   10.  Grab both bunny earsbunny

           11.  Pull tightshoe_11jpg

DONE!!

Other Tips

Elastic shoelaces

Elastic shoelaces are great because they look just like regular laces and allow your child to slip on their sneakers without untying. This can be used as a great compensatory strategy or a temporary substitute while your child is in the process of leaning to tie shoes.

Hemiplegia

Here’s a resource for kids who need a one handed alternative.

Still having trouble?

Despite your best efforts, if your child is still having difficulty, perhaps it’s worth an occupational therapy screening or evaluation to determine if there is an underlying fine motor, visual motor, bilateral coordination, or visual perceptual problem. An occupational therapist will be able to adapt this shoe tying task to better fit your individual child’s needs.

Learn more about occupational therapy and other programs at eastersealsdfvr.org.

 

 

 

 

 

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Can your child benefit from Constraint-Induced Movement Therapy?

By: Emily Muzzy, Occupational Therapist

What is Constraint Induced Movement Therapy (CIMT)? 
Constraint-Induced Movement is a therapeutic approach for children with one sided weakness such as hemiplegia, brachial plexus or other unilateral impairment. CIMT was originally utilized in the adult rehabilitation setting to treat post-stroke patients.  However, it was found that children with one-sided involvement could also benefit from this type of treatment. Numerous research studies have shown that by restraining the unaffected limb and intensifying  use of the affected limb, pediatric constraint induced movement therapy produces major and sustained improvement in motor function in children.

Children with one-sided involvement often experience “learned non-use” of the affected side.  Forced use of the affected side helps to regenerate neural pathways back to the brain, increasing awareness of that side.  This leads to increased spontaneity of use of the arm and improved function.  The forced use is attained by the child wearing a constraint cast on his/her uninvolved arm for a period of time each day (preferably a minimum of two hours).  The cast is made by an Occupational Therapist and is removable.  When the cast is worn, this allows for mass practice of therapeutic activities with the involved arm.

What should a child hope to gain in an intensive program utilizing CIMT?

  • Typical goals of a CIMT program include improved quality of gross and fine motor skills and improved bilateral hand use for daily living tasks.
  • Family education will be provided on use of the cast at home, and home program activities will be provided to promote successful use of the involved arm and hand.
  • A skilled occupational therapist will help to develop specific functional goals for your child based on his/her specific needs.

Who is appropriate for constraint therapy?

  • Typically, children with a diagnosis of hemiplegia, cerebral palsy or brachial plexus injury (though any child with one-sided involvement could be considered).
  • This is generally used with children from 18 months to 10 years of age.  Younger children have a more plastic neurological system and greater gains may be seen with them than with older children.

CIMT

After finishing a session of CIMT, one parent couldn’t believe her child’s progress after four weeks of therapy.

My child’s time in constraint camp improved his fine motor skills and he had fun while doing it!  He will always use his right side, but by putting on the cast, it strengthened his weak side and now he uses it more to support activities.

What does a session of constraint therapy look like?

  • At this center, a child is seen for 4 weeks of intensive therapy, 3 times per week.  Each session lasts 2 hours per day.  The fourth week focuses on bilateral training without use of the constraint cast in order to practice functional activities with both hands.
  • The therapy sessions of the CIMT program offered at this center should look like FUN!  We work hard to provide a variety of play-based activities that promote repeated use of the affected limb.
  • Messy tactile play is used to promote increased awareness.  Activities like giving farm animals a bath in shaving cream, building sand castles, and finding play bugs in dirt are just some examples of the way kids can get messy with their involved hands.
  • Activities to promote shoulder strengthening are incorporated through climbing over obstacle courses with ladders, slides, and tunnels.
  • A variety of grasp and release activities are used.  Use of the “just right” size of objects is needed so the child can be successful.cimt2
  • Activities on a vertical surface such as finger painting on the wall are beneficial for getting shoulder movement along with wrist and finger extension.
  • The child will be constantly engaged in activities that will require use of his/her affected arm.

Two sessions of CIMT are offered this summer as part of our Community Based Therapy Programs.  For more information on registering, contact our Intake Coordinator at 630.261.6287. Check out the additional Community Based Therapy programs like Aquatic Therapy, Fun with Food and social skills programs  here.

Childhood Apraxia of Speech: Signs and Symptoms

By: Jennifer Tripoli M.S, CCC-SLP

You may have heard the term “apraxia” before but wondered, what exactly does this mean? According to the American Speech Language Hearing Association (ASHA),

“Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.”

Childhood Apraxia of Speech (CAS) is not a black and white diagnosis and can be difficult for speech language pathologists to diagnose especially in very young children (under the age of 2). Children with CAS may have coexisting conditions such as Down Syndrome, Cerebral Palsy, or some other neurological disease. Some children with CAS though do not have any other known neurological deficit.

Children with CAS may present the following key characteristics:

  • Limited vowels produced, lack of differentiation between vowels, and/or vowel distortions
  • Inconsistency or variability in productions
  • Groping of oral structures or physical struggle to produce sounds
  • More difficulty with multisyllabic words or more complex productions (longer phrases/sentences)
  • Difficulty with imitation, better productions observed with spontaneous, learned, or automatic productions
  • Choppy or monotone speech (equal stress patterns on multisyllabic words)
  • Slow rate of speech
  • Difficulty with non-speech oral movements such as sticking tongue out, pursing lips, etc. (oral apraxia)

Listed below are other common signs present in children with CAS, though are not exclusive to CAS:Baby nico on swing

  • Decreased babbling or vocal play as an infant
  • Lack of imitation skills in infancy
  • Delayed speech production or expressive language skills
  • Poor speech intelligibility (ability to be understood)
  • Decreased sound inventory for his/her age
  • Words used once and never used again

Children with CAS may not present with all of the above characteristics. There is currently no “rule” regarding how many characteristics a child must have to qualify for a CAS diagnosis.  If your child presents any of the above key characteristics, an evaluation by a speech language pathologist who specializes in CAS is recommended in order to differentially diagnosis your child.  Children with the above characteristics may present CAS or another speech sound disorder.

Visit Easter Seals DuPage & Fox Valley at EasterSealsDFVR.org to learn more about speech-language services and evaluation. And to learn more about CAS and access parent friendly resources, visit Apraxia Kids.