It’s Summer! Let’s Go Ride A Bike!

By: Josephine Hipolito, Physical Therapist

Summertime is approaching, and around this time, caregivers often ask me to work on bike riding with their kids as one of their goals. As an avid cyclist, it’s one of my favorite things to teach because of the joy and freedom children feel when they learn to ride. Let’s start with a few tips on teaching children bike riding.

Things to Consider When Starting

1. Determine whether the child knows how to pedal.  If they do, skip the next section and go to the balance section to work on the balance aspect of bike riding .
2.  Remember you don’t have to follow this step by step. It’s more of a guide to see where your child is in the bike riding process and then proceed.

 Teaching Children Pedaling:  

1. Start with teaching “Air Cycling.” Most kids don’t understand the concept of extending one leg while the opposite leg is relaxed if they have never pedaled before. Their usual instinct if you tell them to push with their legs is to have both legs push simultaneously, so they usually get stuck when on a tricycle.
   
2. To practice the motion of pedaling, place your hands at the bottom of their feet and tell them to push against it on their bent leg. Use a little resistance when you do this. On a tricycle, kids often stop pedaling and move backward when they encounter resistance, so you want them to get used to resistance.

3. Once they master air cycling, start them on a tricycle with a pedal block (a device that holds their feet on the pedals) or strap their feet on the pedals using an ace wrap or velcro straps. Children usually tend to over-push with their feet at first, so their feet slip off the pedals. Wrapping their feet will keep them on the pedals. You can also get commercially available pedal straps like this one.

4. Once they master the pedal block, take off the straps so they can learn to control their leg movement and keep their feet on the pedals.

5. Make sure they master pedaling with a tricycle so that it becomes second nature to them when they graduate to a bicycle.

Balance Bike Versus a Bike with Training Wheels 

I often tell families ready to progress their children from a tricycle to a bike, to start with a balance bike. A balance bike is simply a bike without pedals where children use their legs instead of pedals to move.

Skip the step of learning with training wheels because children can get dependent on leaning on them for balance. The Balance Bike enables the child to learn to find their center of balance on their own  

NOTE: Not everyone will be able to get a balance bike and a bike with training wheels, so I recommend taking the training wheels AND the pedals off of a bike to convert it to a balance bike. 

 Biking with Training Wheels

The problem with a bike with training wheels is the braking system.  They use coaster brakes which means pedaling backward to activate the brakes. 

Kids tend to start pedaling backward when they encounter resistance which activates the brakes. It’s always difficult for kids with motor planning issues to figure this out. That’s why you ensure they master the pedaling part of bike riding before moving on.

Keep an eye out for the following:  

1. Some kids tend to push with their legs while pulling on the handlebars, which causes the bikes to turn – as a PT, this signals to me that they need core strengthening 
2. Some kids will over push with their legs causing them to slip backward on the bike seat – I put a dycem (non-slip pad) or tie a theraband on the seat to prevent this .

 Tips to Use a Balance Bike 

1. Start with having the child walk with their legs while sitting on the saddle. See if they have the control to keep the bike from tipping or even recognize that the bike is tipped while they are riding it. They need to integrate this part. Children with body awareness issues will not even recognize that they are tilted when propelling a balance bike.
2. Watch out for kids who walk the bikes, but they are standing and not sitting on the seat. I sometimes use an ace wrap to secure their pelvis on the seat to prevent this 
3. Once they master keeping the bike upright, work on gliding .
4. Gliding – have them take three steps: 1, 2, 3, then bring their feet up to glide. Challenge them and ask them to see how far they can glide before they put their feet down.
5. I sometimes use floor markings like chalk on the surface to mark a certain point. Children can work on balancing better if they have a visual cue on how far to glide.
6. Once a child can glide for 10-20 feet consistently, I move them to a bike with two wheels (or put the pedals back on the bike).

Steps to Help Children Ride a Standard Bike 

1. Work in a parking lot of a school or a park early in the morning so that it will be empty and there are no distractions – avoid the sidewalks or hallways because the child needs to worry about staying within the confines of the space (it can become too stressful for them).
2. Try to find a parking lot with a little downward incline to help them get a little momentum to balance.
3. Let your child walk the bike out to the parking lot while holding the handlebar. This way, they learn to handle the bike and how to motor plan to keep it balanced.
4. Work on pedaling forward first.  Worry about turns later.
5. Have a gait belt (or Dad’s belt) around their trunk, so you have something to grab onto when they are riding (if they are not using a bike with a parent’s handle).
6. Give them a little push to start them up – they will usually start slow because they are apprehensive but what children don’t realize yet is they need momentum to be able to balance.  
7. Give them frequent breaks, and maybe bring a snack, as bike riding can be stressful while learning. Let them know that they have to do 2-3 laps then they can take a break. Break for 1-2 mins, get a drink or snacks, then return to bike riding. Use a timer so they know break time is over when it rings. This way, they may be more cooperative when they know they have a break.
8. Once they master going straight, you can work on turning – put cones on each end of the parking lot and ask them to turn around the cones. This way, they can practice tight turns.
9. Once they master turning,  work on tighter areas (e.g. a hallway, sidewalk) to narrow their space.  
10. Once they master tight areas, work on going up inclines.

Biking From a Complete Stop  

1. Determine the child’s balance leg – it’s usually the first leg they put down when they stop.  
2. Once that’s determined, the balance leg is the leg that will stay on the ground and will be pushing to get the bike going.  The other leg goes on the pedal (pedal leg).  
3. Teach the child to position the pedal (pedal leg side) in front of their shin so they can easily put their foot on it.  
4. Ask them to have the balance leg push on the ground while the pedal leg is pushing down on the pedal to start the bike .

Cycling Benefits

I hope this blog has been helpful wherever your child is on their cycling journey! Teaching children to cycle has numerous benefits to their development, including improving motor skills, strength and balance. It’s also a fun exercise that can be enjoyed with a sibling or friend!

if you ever have concerns about your child’s mobility, strength, or motor skills, Easterseals DuPage & Fox Valley is here to help! Learn more about our physical therapy services by visiting:
https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.

We also invite your family to join our annual Bike for the Kids in Elgin!

Cyclists of all ages and abilities are welcome to ride distances ranging from 12 miles – 50 miles or join us in reaching a 100-mile goal throughout the summer on the Strava app. Adapted bikes and trailers are welcome. All ages and abilities are encouraged to participate.

We are excited to take this ride to the Fox River Trail and celebrate together at Festival Park in Elgin with food, refreshment, entertainment and more!

Learn more and register here: https://www.givegab.com/campaigns/bikeforthekids2022

Positioning and Mobility Clinic Overview

By: Allie Katsiris, PT, DPT

What Does the Mobility Clinic Do?

The Positioning and Mobility Clinic at Easterseals provides a comprehensive evaluation of a child’s adaptive equipment needs. It is a collaborative clinic consisting of a physical therapist (PT) and an assistive technology professional (ATP) from a durable medical equipment vendor. Of course, the child and their family members are also valued members of the team. The two vendors that attend clinics at Easterseals are Numotion and National Seating and Mobility. There are a lot of options for seating and mobility devices available on the market, so the PT and ATP will utilize their knowledge, experience, and expertise to recommend the most appropriate equipment for your child.

The Process

At the initial evaluation, the PT and ATP will complete a comprehensive evaluation of the child including assessment of posture, range of motion, functional mobility skills, home assessment, and child/caregiver goals. Recommended mobility equipment may include: adaptive strollers, manual wheelchairs, power wheelchairs, or power assist wheelchairs. The clinician will also assess the need for specialized car seats or adaptive bathing equipment.

Following the initial evaluation, the PT will write a letter of medical necessity for the device. This letter will be sent to the child’s physician to be reviewed and signed. The vendor will submit the order and the letter to this insurance company for approval. Once approved, the device is ordered then delivered to the child. The PT and ATP work closely upon delivery to ensure the child is positioned appropriately and that the family understands all features for safe and effective use of the device. We recommended yearly rechecks to ensure that the device continues to properly support the child.

Home and Environmental Factors we Consider

There are many factors that are considered when deciding on a mobility device. In addition to evaluating postural alignment and medical history, the team will ask about your child’s current mobility skills and goals. We will consult with primary therapists as needed to best understand your child’s abilities, functional goals, and endurance level in order to best recommend a mobility device. The team will also ask about your child’s home and school environments. Some considerations include: whether your home has stairs, location of the child’s bedroom/bathroom, and width of doorways.

It is important that the child be able to utilize recommended equipment in all environments to promote his/her best alignment and independence. Another important factor in recommending a mobility device is how the child is transported. Do you drive a compact car or SUV? Do you have an adapted vehicle? Does your child ride the school bus? The answer to these questions will help guide to whether a folding or non-folding option and transit accessories are required. Due to insurance limitations and expectations that mobility equipment will last 5-10 years, it is important that all of these factors, growth, and future needs are considered in order for the equipment to support the child for years to come.

Quick facts about the various types of equipment:

Adaptive Strollers:

• Provide support for children who have decreased postural control, endurance, or safety in the community.
• They are typically lighter weight than wheelchairs and fold more easily.
• There are some limits to the customization of these devices.

Manual wheelchairs:

• Provide postural support for children who walk with limited endurance or who are unable to walk.
• A child can push/ move this device independently.
• There are folding and non-folding options.
• Can be customized to fit a child’s needs.

Tilt in Space wheelchairs:

• Provide postural support and can tilt backward for rest breaks or medical needs.
• Children are dependent on caregivers to propel the device.
• There are folding and non-folding options; although they tend to be bulkier than manual wheelchairs.
• Can be customized to fit a child’s needs.

Power wheelchairs:

• Provide postural support and power control
• Can be operated by the child.
• These are unable to fold so the family should consider home and car accessibility.
• Can be customized to fit a child’s needs.

How to Get Started

At Easterseals DuPage and Fox Valley, we appreciate the importance of providing children with a safe means of mobility. This allows children better access to their communities and increases overall participation with their family and peers. We also recognize that the equipment ordering process can be overwhelming, so we are here to support you and help your child obtain the equipment he/she needs to thrive! Please contact us to schedule an appointment: 630-282-2023 or click here to learn more.

18 Children’s Games to Stay Active Indoors

By: Laura Basi, PT, MPT

With the cold winter weather and limited ability to participate in many activities due to COVID-19, it can feel challenging to continue to find ways to keep children active. Fortunately, with a little creativity and imagination, there are many ways to help your children stay active indoors and have fun while you do!

I have listed the following activities and ideas to give you ideas as a starting point, but remember, some of the most engaging activities are when you place your own twist on them! Nearly all of these activities can be modified to fit your child’s unique needs, and don’t require buying extra toys or supplies. So don’t be afraid to change, break, or make your rules. You may even want to challenge your child to develop their own unique game or activities after taking inspiration from some of these existing ideas!

• The Floor is Lava
  There is an actual board game one can purchase with this name, but it’s easy to create your own game with household items. You can create a course across a room or even throughout the house to navigate that has a start and finish with the goal being that you cannot touch the floor (the lava) — creativity wins here. The game can easily be tailored to age/ability level (and parent tolerance for furniture climbing). Try using couch cushions, pillows, toys, and other objects that can be used to jump to and from safely!

• Simple Exercise Training Routine
  For elementary school aged kids who like to feel like they’re “training”, a good way to tackle a few exercises for building strength and endurance is by completing a number of reps that match the date.  For example, my son Will and I do jumping jacks, squats, sit ups and push ups every day…. 1 of each on the 1st of the month, and build up to 30/31 of each by the 30th/31st of the month…we break them up into smaller sets as the number gets high. Our goal is to complete them all in one day.

• Have a Dance Party
  Put on a favorite song and dance/move any way you like to — this appeals to all ages because the kids can choose the songs. To get increased time out of this activity, try setting a timer and announce the family will be dancing for a set amount of time or a certain number of songs- perhaps one song per family member so that everyone gets to choose one. Make it even more fun by hanging up lights (a string of holiday lights works excellent) and otherwise darkening the dance party’s room.

• Play Freeze Dance
  For younger children or those with limited endurance, play Freeze Dance. Parents can pause the song at random, at which time everyone dancing must stop in place. Kids 10 and under will find it funny to freeze in silly poses (or see their parents do so!), and the pausing will allow a brief rest break for those that need it. As a bonus, freeze dance works on pairing movement with listening skills and practicing starting/stopping on cue, something that kids with coordination disorders may need extra practice with.

• Movement and Action Songs
  For preschoolers, many movement songs can be found on the web. This list here from Preschool Inspirations has many good ones. In addition, on youtube, I like Freeze Dance (The Kiboomers) and Listen and Move (TheKidsCartoons) because they prompt kids to vary their movement (i.e., dance, hop, skip, twirl, tiptoe, gallop, etc.).

The Best Movement and Action Songs for Children

• DIY Stationary Bike
  For kids who need to practice pedaling for bike riding or for active kids who need to move, a bike with training wheels can be brought inside and transformed into a stationary bicycle. Modify the bike to become stationary by placing the front wheel on a towel and training wheels propped inside a pair of shoes to lift the back wheel enough that it will spin when the child pedals.

• Keep the Balloon Up
  Keep the balloon off the floor gets everyone active and can be played solo or as a whole family – for families who enjoy some competition, hang string or yarn across the room as a “net” and play volleyball with the balloon.

• Board Games
  Family Board Games that get you moving: Twister, Hullabaloo, Pancake Pile-Up, Floor is Lava

• Minute to Win it
  Minute to Win It games are various 60 second challenge games based off the international game show of the same name. The games are engaging and practical because they all utilize everyday objects you probably already have around the house. A quick internet search will result in hundreds of ideas and you can also easily make up your own games for more fun. https://www.familyeducation.com/family-games/our-favorite-minute-to-win-it-games-for-kids

• Prone Scooter Board
  For those with a skateboard, clean off the wheels and bring it inside to use as a prone scooter board — have your child lie on the board on their stomach and challenge them to get across the room only using their arms.

• Build a Fort
  This one is a classic for a reason. Kids love the process of building forts! This activity encourages creativity and problem solving as kids figure out what materials to use and how to keep the fort from falling apart. Make sure your child takes the lead and participates in the building so that they are lifting, pushing, and pulling pillows, cushions, furniture, blankets, etc., to help create the fort. Modify your level of involvement based on your child’s age and abilities. Just make sure to challenge them to be creative and be active!

• Build an Obstacle Course
  Younger children might enjoy turning this into a pretend game of animals in which the course is their animal home. Older children might enjoy acting like ninja warriors on their obstacle course. Be creative and incorporate lots of variety (climbing under, climbing over, jumping down, jumping over, crawling, reaching). Painters tape works great to place lines for walking or jumping over without damaging floors. Use sturdy furniture or objects for stepping/jumping from one area to another.

• Create a Cocoon
  For kids who like/need deep pressure input or those who just enjoy pretend play, spread out a bedsheet or beach towel and have the child lie down along one edge as a caterpillar – the child can grasp the edge, or parents can tuck the edge between child’s arm and torso. The child then rolls themselves up in the sheet/towel, turning into a tight “cocoon” with only their head sticking out – they can push against the sides of the towel, imagining they are growing their wings. When ready, they roll in the reverse direction to unroll the sheet/towel and burst out as a new butterfly. This activity can be done on its own or incorporated into other “animal walks.” These walks could include:
  • Bear walking (walking on hands, feet, belly, and face down).
  • Bunny hopping (small jumps).
  • Frog jumps (big hops).
  • Crab walking (walking on hands and feet, belly and face up).

• Cosmic Kids Yoga
  For kids who enjoy following along with a story, Cosmic Kids Yoga on YouTube and Amazon (free and subscription based options) is an excellent resource with a LOT of variety in length of time and story content. I recommend this program for children 3 to 8-years-old range who have difficulties with strength, postural control, balance, coordination and motor planning.  

• Create a Dance/Gymnastics Routine
  Creating a routine can be done solo or works excellent with a sibling set. For extra fun, add in performance clothes, create a “stage” and encourage your kids to put on their show.

• Spray Bottle Activities
  For hand strengthening, let kids play with spray bottles and squeeze bottles (could finger paint on the shower wall and then let them spray it off and then wipe it down or spray/squeeze water into cups). You can find countless spray bottle activities here.

• Stuffed Animal Bowling
  Set up stuffed animals in a circle around your child and specify which animal the child should knock down. The child will need to turn their body and roll ball to knock down and stuffed animal. A great toddler movement activity!

• Row, Row, Row Your Boat
  Child sits in a laundry basket, and caregiver will push the basket or tilt it side to side like they are on a boat. You can do it to the tune of Row, Row, Row, Your Boat or other songs.

I hope these ideas have helped you think of fun activities and games to keep children occupied and active in these unusual times. Remember that with a little creativity and imagination, the possibilities are endless! For more information on physical therapy services at Easterseals, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.html.

Remote Learning Seating Tips

By Laura Donatello, Physical Therapist and Positioning & Mobility Clinic Coordinator

As school districts return to remote instruction (many for the rest of the school year), the learning environment at home should be revisited. As an observer of your child’s school day you may notice when he/she needs a break or help focusing. Their seating position has a large impact on their ability to focus! You may have to experiment with seating positions to find the best productive space for their child.

Ideally, you want to help create a workspace conducive to good posture and free of distractions. The pictures below demonstrates what good posture looks like in an at-home learning environment. As you can see, there are multiple ways to position an at-home learning environment!

Seating Positions

1. Laying in prone on your stomach is a great way stretch your trunk and hips after sitting in a chair. You can put a small pillow or rolled up towel under your feet to relax your back.

2. Sitting on a peanut ball is another great alternative to sitting in a chair. The ball will provide proprioceptive feedback to assist with increasing arousal levels. Be sure your child’s feet are flat on the floor. It might be easier for your child’s feet to touch the floor with a peanut ball versus a round exercise ball because of the shape. Put something under the computer to be at eye level. A physical therapist can help identify the right size ball for your child. Also, a general tip is to measure the distance from the child’s armpit to the middle finger tip. This measurement will give you a decent estimate of what the diameter of your ball should be.

3. Tall kneel and half kneel are different floor positions which can be balance challengers. Encourage your child to keep their stomach away from the support surface. You could use a small towel or move the desk slightly away from their trunk to strengthen their core!

4. Using the wall is an easy tactile cue to encourage your child to sit with a flat back. If you do not have a small bench you can use a box. Your child can sit in pretzel style sitting while using the wall as support.

5. If you have an adult size desk chair, position blankets to make it child size! Watch for a couple minutes to see if your child is comfortable. If you notice your child leaning to the side, you can also put a rolled-up towel or blanket by their hip. Make sure their feet are supported with hips and knees at a 90 degree angle. If you notice your child leaning back, you might need another blanket behind their back. If you notice their trunk starts to come past their hips, you might need to take a blanket away. If their knees are higher than their hips, the support surface under their feet might be too big. If their knees are lower than their hips, you might need a higher footrest.

In this picture the height of the desk is set as if Henry were talking to his teacher and looking at the camera. If your child is watching something on the screen, you would need something else under the computer such as a thin box to keep their eyes level.

6. Another example of what a blanket can do for posture! In this example the blanket is rolled long ways and wrapped around Henry’s back to provide total trunk support.

Foam Roller Stretch

This exercise is one of the best activities you and your child can do after a long day at the computer! Grab a foam roller or roll up 1-2 towels. Lay on your back with your arms stretched out, your palms facing up, and your feet flat on the ground. Keeping your arms on the ground, bring your hands in line with your shoulders. If you notice your back start to arch bring your hands down. Stay here for the length of 1 song per day to stretch your pectoralis muscles!

A special thank you to Henry for being our model!

Alternate Seating Options & Focus Ideas

Occupational Therapist, Laura Harmasch, OTR/L, shares some additional strategies to help children who need extra help focusing! Headphones help and our recent blog post, covers how to help children with hearing aids use headphones and hear the best during remote learning sessions. Also creating a space with a trifold display board around the computer can help some children if they are easily distracted, have siblings playing or learning nearby to tune out all the other “noise” or activity around them.

Wobble stools may provide a good option for children who like to move around some when learning or working on assignments. I only recommend wobble stools or balls for kids with good trunk strength. Children with low muscle tone will fatigue too quickly using them, which may further limit their attention. A sit and move cushion is also a good option for children who need movement and have good trunk strength.

• 

• 

Additional Resources

Caring for a child during this pandemic is difficult, and it can be hard to know the proper supports for child development. Read our resources, find support and more here: https://www.easterseals.com/dfv/explore-resources/for-caregivers/covid-19.html.

Also if you need assistance documenting your child’s learning progress or needs, Matt Cohen and Associates, a law firm specializing in special education, disability rights, and school-related issues, provided a number of resources on our blog here.

Growing A Family’s Health

By: Laura Basi, PT, MPT

Physical fitness is important for everyone, including children and adolescents with developmental disabilities.  Running is a great weight-bearing aerobic activity. It promotes cardiovascular and respiratory endurance, bone health, lower extremity strength and endurance, symmetry of movement in both upper and lower extremities, and emotional regulation.  Wheelchair racing promotes cardiovascular and respiratory endurance, upper extremity strength and endurance, and upper body symmetry.  These are all areas that children with developmental delays and disabilities can improve on. 

“Gross motor skills like jumping and running, and object control skills like throwing and catching, are the building blocks upon which more complex physical activity can be learned as children grow, so the sooner kids work on being active, the better.” From parents modeling physical activity help kids with developmental disabilities improve motor skills).

Our community program, Hustle for Your Health, helps children reach their fitness goals. Each week includes an outdoor aerobic activity in the form of running and walking or wheelchair propulsion, basic strengthening exercises, and stretching to cool-down. At the end of the program, children will be prepared to complete our Run for the Kids: Superhero Hustle to run or walk a 5k distance and are encouraged to participate in other local races too.

I have heard from countless families that are amazed at their child’s commitment to health during and after the 10-week program. Below, I share some tips to help all children grow their enthusiasm for wellness.

Growing a Child’s Love of Physical Fitness

1. Make it fun. Choose activities your kids like. Some kids enjoy walking, running, and biking, but others may get more out of obstacle courses, climbing trees, hopscotch, rollerblading, dancing or a game of kickball in the yard.  The goal is to promote a love of movement.
2. Variety is the spice of life. To prevent boredom, change things up. Tour the neighborhood using different modes of transport – walking, scootering, biking, skating; you can even make a walk feel different by bringing a ball to dribble while walking or by challenging your child to run to the next tree, skip to the next fire hydrant, leap across the next driveway, etc.
3. When building endurance, add in activities for “active rest.” Lengthen a jog or a bike ride by bringing along a frisbee so that you can take a break in the middle of your run/ride to toss a frisbee before heading back home. Your child will have maintained being active for a longer period of time and be able to handle a longer distance with a built-in break.
4. Stuck inside?  Get your body moving by:
   • Making up a dance routine.
   • Setting up an indoor obstacle course
   • Creating movement themed minute challenges. How many times can you…. in a minute? 
     • I.E: Run up and down the stairs, do sit-ups, do jumping jacks, push a basket of laundry across a room, run laps throughout your house.

Growing your child’s fitness and love for activities like running, biking or yoga, has a positive impact on their overall body health but also improves attention, mood and more. But one of the biggest factors in growing a child’s fitness was parent modeling according to a recent study published in the Disability and Health Journal. Caregivers and parents that model physical activity helped encourage their children to be active and created a supportive environment for children with developmental delays and disabilities. The study also mentions that starting this early, around preschool age, takes advantage of the fact that younger children are already spending significant time watching and copying parents.

During the State of Illinois’ stay-at-home order, children have more opportunities to spend time with their caregivers and model their activities. There are plenty of fitness activities the family can do together. Our annual Run for the Kids: Superhero Hustle helps many children at Easterseals make a goal to cross the finish line with their first independent steps, with a walker, or after reaching a new distance. Their goals help inspire other family members to join in their training and reach new levels of health. The new Superhero Hustle date is August 1, which gives participants three months to work on a new wellness goal.

Our goal is to help you reach yours! Set your intention for the next 3 months. What will your family accomplish by August 1? Will you run a 5K for the first time? Do 100 jumping jacks? Start each day with mindfulness and yoga? Tell us! To get started: 

1. Register today at eastersealsdfvr.org/runforthekids.
2. Set your wellness and fundraising goals.
3. Share your progress with family and friends and encourage their support
4. Make plans to “cross the finish line” on August 1 

One of my personal goals as a physical therapist for children with developmental delays and disabilities is to not only help improve their physical health but the entire families. Our Run for the Kids and Bike for the Kids events are opportunities to grow our family’s fitness with a very supportive community group.

Tele-therapy at Easterseals

By: Valerie Heneghan, M.A., CCC-SLP/L, Director of Speech-Language, Feeding, and Assistive Technology

Tele-therapy for All! 

Easterseals DuPage & Fox Valley has been at the forefront of serving children and their families in a way that meets their current needs through clinical expertise, a team-based approach and integrating technology to ensure maximum independence. As an organization, we have been offering tele-therapy opportunities for the past 10 years as a service delivery model to those it would serve optimally (i.e., a generalization of skills to home environment, transportation issues, medically fragile or at-risk health, to accommodate busy schedules, etc.). 

In response to COVID-19, all 87 therapists were trained to transition to tele-therapy services within two days with support from experienced tele-therapists within the agency.  

How Does Tele-Therapy Work? 

Once evaluated to determine eligibility for skilled therapy services, your therapist would follow up to plan your child’s tele-therapy session and schedule a time to meet. They will work with you to review treatment plans and establish your priorities. 

Laptops or desktop computers are preferred for best overall experience. But tablets, iPhones and Android phones can work too as long as the device has a working microphone and camera. A stable internet connection is needed via a hard-line/Ethernet cord, WiFi or using your cellular plan (your standard data rates may apply). Screen sharing is available to increase participation, engagement and utilization of resources throughout the session. 

Tips for Making the Most out of Online Therapy

1. Get comfortable with the technology: Immerse yourself in the platform you are using. There are often a lot of features available such as audio adjustments and visual displays, screen sharing, chat features, etc. The more comfortable you are with these features the easier it may be to modify or troubleshoot if a technical problem occurs.
   
2. Make a plan: Plan out a time and a designated space in your home that would work best for your child. Have the computer, phone or other device propped up on books or a stand that has a wide view of the room. If possible, the therapy time should be away from other family members or pets. Work with your therapist ahead of time to prepare a few materials or resources like balls, pillows, mats, or games. 
   • Ex: For a young child, find a space where the child can sit comfortably to view the screen but also has space nearby for movement breaks. Bring your child’s favorite toy to show to their therapist and board game to keep their engagement with the parent between exercises. 
3. Be flexible: When plan A doesn’t go accordingly, be willing to change course.  
   • Take the child’s lead and adapt as necessary. Let the therapist guide you in facilitating therapy strategies through real-life reactions and experiences. 
   • Use items in your home to replicate therapy equipment. Ex: Use couch cushions and pillows to create new surfaces for climbing and crashing. 
4. Make it fun: Be creative and try new things! You may be surprised by new interests and breaking from the same routines. See how much your child can do! 
   
5. Make it matter: Use this as an opportunity for your therapist to see your child in your home to incorporate therapy strategies and techniques in your daily routine. Let your therapist see what is important to your child and how to motivate them to achieve their treatment goals. 
   • Ex: A child is experiencing difficulty with mealtime; let the therapist observe seating and position at the table, mealtime structure, and how you communicate to your child during a typical mealtime. Pick a food that is important to your family and ask about strategies to incorporate it into your child’s diet. 
6. Give your therapist feedback: It may be more difficult to pick up on social cues, be direct about what went well and what could be improved. Share ideas and problem-solve together to plan for the next session.   

COVID Response

As we try to be one step ahead of the COVID-19 crisis and care of your child, we are committed to keeping our programs running. Our tele-therapy services are available to maintain your child’s therapy schedule, help your family navigate this new routine and manage the difficult emotions that may come with it.  We can also help parents that have a concern about their infant or toddler’s development now. There is no need to wait, as the early stages of a child’s life are the most important in their development.

We are pleased that tele-therapy has already helped many children eat a new food, stay active, and improve their regulation and play skills while building a stronger relationship with their caregiver. 

We understand the immense stress of balancing your child’s needs with the demands of work and school while also keeping your family healthy. We are here to ensure that each child and their caregivers have the support they need to adopt this technology and continue therapy progress. 

While much has changed, our commitment to you remains. If you have any needs, we are actively monitoring our main phone number, 630.620.4433 and info@eastersealsdfvr.org. Contact us at any time (please include your full name, child’s name, phone number and email) and a member of our team will return the response within one business day. 

Easy Indoor Activities for Energetic Kids

By: Laura Donatello, PT, DPT

Update: With a stay-at-home order for all of Illinois in effect, I know parents and caregivers could use some ideas for energetic children more than ever. I updated my previous blog with some new ideas.

I know it is hard to balance the need for work and for child care at the same time, so just know you are doing your best!

Push-Pull Activities

This total body strengthening activity targets shoulder stability as a child pushes an object at or below shoulder height with straight arms, core to change direction, and lower extremities to power forward.

Push/Pull Activity Ideas:

Image from 3.bp.blogspot.com

1. Hide some of your child’s favorite toys in a large open room. Have your child push a laundry basket around the room, and fill up the cart with toys. You can place toys at various heights, encouraging your child to stand on their toes, climb a couch cushion, or squat down to retrieve a toy. Pay attention to the type of flooring in the room. When using a plastic laundry basket, carpet will generally be more challenging to push against, and hardwood/tile will be easier.
2. Have a race to see how fast he/she can push the basket to the end of the hall to retrieve a toy, and back. Races can be against siblings or parents, or be in the form of a relay race.
3. Tie a string to the basket to make this a pulling activity.

Obstacle Course

The possibilities are endless with obstacle courses. You can encourage your child to help create, set up, and clean up the course. Maybe incorporate your child’s favorite play scheme; he/she has to navigate the course to place a puzzle piece in the puzzle, feed their favorite doll, or animal. You can add multiple activities together, or just focus on a few. There are many gross motor skills that can be incorporated such as walking, jumping, balancing on one foot, and hopping.

Obstacle Course Ideas

1. Lay out couch cushions on the floor for your child to step on, jump over, or climb through. Maybe even jump from cushion to cushion.
2. Navigate a hopscotch course made out of tape on the floor. This can be modified into many different patterns such as a few boxes in a row, column, diagonal, or in a traditional hopscotch pattern. Your child can walk, jump, or hop from square to square.
3. Crawl or squat under a string tied across two chairs.
4. Walk on a bubble wrap road, walk across a taped line, or both!
5. Crumple up old newspapers and grab a laundry basket to play newspaper basketball. For a balance challenge, have your child stand on a cushion or one leg to make a basket.
6. Cut a pool noodle into 26 pieces, put a letter of the alphabet on each piece and grab some string. Kids can practice putting words together, squat to pick up a piece, and go up on their toes to thread the noodle through the string.

Color Under the Table

Color Under the Table

Tape a piece of paper or coloring book to the underside of a kid’s table. Your child can color up from laying on the floor to work on strengthening their shoulder and trunk muscles!

Exercise Dice

Create a six-sided dice out of cardboard and tape. On each side draw or print out a picture of a different activity such as clapping, jumping jacks, running in place, jumping, heel raises, and dancing. You can also create another dice with numbers on each side to determine how many times or seconds to complete an activity for.

Photo by Patti Mendoza

Online Resources

1. Cosmic Kids Yoga is a website, app, and free YouTube channel where a narrator demonstrates popular yoga poses in the form of stories. Kids can follow along with the instructor on the screen as they narrate their favorite stories or movies in the form of yoga poses. You can access a free 2 week trial if you download the app, or type in “Cosmic Kids Yoga” into the YouTube search bar to access free videos!

• Go Noodle is another great free online resource to get kids moving! The website is full of videos including dance parties, yoga sessions, and games. The resources span a variety of ages, abilities, interests, and can be interactive to include siblings.  Access Go Noodle for Families website through the link.

10 Popular Toys on Amazon Under $20

Here are some of my favorite entertaining, therapeutic toys used with a variety of ages.

1. Beads are a great multi use toy you can take practically anywhere with your imagination.
2. Bubbles are another perfect activity to incorporate into obstacle courses, pop in a variety of positions such as sitting or standing, or work on blowing them to control your breath. “Fubbles” are a personal favorite because they don’t spill.
3. Paint in a Bag is a great sensory activity. Grab your favorite paint colors and squeeze them into a zip lock bag. Tape the bag to a table or the floor and watch your child be entertained with pushing the colors around.
4. Spinning Toy is a fun way to work on gross motor and fine motor to spin the gears around the pipe.
5. Pop Tubes are a fun, noise making, resistance toy your child can practice pulling in a variety of positions.
6. Zoom Ball is a partner game to propel the ball along the string by moving your arms. It’s a great shoulder exercise even adults can feel the burn from!
7. Squigz are little suckers that stick to a variety of surfaces. They’re great for sticking on mirrors and pulling off against resistance. The company Fat Brain Toys also makes Whirly Squigz that spin.
8. Get ready to make cookies with the Melissa and Doug Slice and Bake Cookie Set. This pretend play set is the perfect toy for obstacle courses. The cookies come on a Velcro tray making this toy the perfect resistance activity. The frosting also Velcros to the cookie. Hide the cookies in an obstacle course or navigate over couch cushions to put the cookie on the tray.
9. Top Bright Bird Feeding Game is a great fine motor activity. Play this game laying down on your side to use different muscles to feed the bird!
10. Spike the Fine Motor Hedgehog is another great fine motor toy to pull his spikes out and push them back in.

• 

• 

• 

• 

• 

• 

• 

• 

Whatever activity you choose, be sure to have fun with it!

For more information on Easterseals DuPage & Fox Valley services, visit eastersealsdfvr.org.

Best Children’s Books on Disability

By: Sarah Peabody, Physical Therapist

According to the Center of Disease Control, developmental disabilities affect 1 in 7 kids in the U.S. and 1 out of 9 children under the age of 18 receive special education services. Explaining a disability to children can be difficult for many reasons. The children’s books below each have a unique way of illustrating what really matters. These books are a great addition to any home, school, library, or waiting room.

With inspiring messages and an emphasis on strengths, they help all children understand kids with different needs. These powerful messages share stories and celebrate victories of all kids in spite of a range of different disabilities. If you are struggling to find a way to start a conversation with a child or a child’s sibling, friend, classmates, or family, these are a great way to start conversations about disability and inclusion!

Books about kids with physical disabilities:

• Hip, Hop, Hooray for Brooklynn Bunny: This book is great for encouraging children to persist in achieving long-term goals and to cooperate with wearing an orthopedic brace. This book focuses on the whole child working toward a positive outcome over time. Whether it’s jumping rope, or wearing a brace, the message of this book is to keep trying.
• Danny and the Merry-Go-Round: One day while watching kids play and ride a carousel, Danny becomes frustrated by his inability to participate. It’s not easy to join in because he is living with cerebral palsy. Luckily, a little girl befriends him and they embark on an adventure. It’s a touching story, made more powerful for its way of showing children with disabilities that they are valuable people.
• Meet ClaraBelle Blue (The ClaraBelle Series): Written by a mother of a child with cerebral palsy, this book celebrates differences by illustrating how much we all share in common. ClaraBelle’s favorite line is “I’m ClaraBelle Blue and I’m just like YOU!”
• My Belly Has Two Buttons: This book was written for children who use feeding tubes, and the main character is excited to show and teach everyone he knows about it.
• Ben’s Adventures: This series was written by a parent with a son with cerebral palsy. Ben shows that despite his disability, he can dream, he can play, and he can interact and have meaningful experiences.

Books about kids with autism:

• Looking After Louis: The story of Louis, a boy with autism in a general education class, is told from the perspective of one particular classmate. This is a great book to explain to young children how autism can affect behavior and promotes understanding of others.
• Andy and His Yellow Frisbee: When a girl notices that Andy spends most of his recess spinning a frisbee by himself, she befriends him despite his trouble connecting with others. It’s a great story, told through the shoes of Andy’s older sister, providing a great perspective on Autism that even the youngest kids can understand.
• Ian’s Walk: Ian is nonverbal.  His older sister Tara takes him on a walk and is embarrassed that he does things out of the ordinary including staring at the ceiling fan in the drugstore and putting his nose against the bricks by the post office. But when he wanders off on his own, she must try to see the world through his eyes in order to find him.

Books with a focus on inclusion and coping with a disability:

• We’re All Wonders: This story shows how one child copes with his own differences, and other’s reactions to them. The reader will find comfort in Auggie’s imaginative tactics and his positivity about being able to change the way others see him.
• Susan Laughs: This book celebrates the similarities and differences between children with and without disabilities, and encourages acceptance and tolerance of differences. It’s not until the end of the book that Willis reveals Susan uses a wheelchair. It’s a simple, yet powerful, way to show how people aren’t defined by the barriers they face.
• My Sister, Alecia May: This book is written from the perspective of a younger sister of a child with Down Syndrome. Although Alecia May can be hard to be around, she is a lot like other 6-year-olds. Rachel appreciates the unique qualities of her sister and learns to stand up for her when others tease her. A great book about inclusion!

Books about kids with a learning disability, anxieties/worries, and more:

• Hudson Hates School: This book is a useful introduction to dyslexia for children. It reassures children that dyslexia should not be a barrier to success if it is properly recognized and managed.
• Eagle Eyes: This book focuses on a child who has ADD/ADHD and learning difficulties.  It acknowledges the difficulties that Ben experiences at home and school because he has trouble controlling how he moves and thinks. The hallmarks of ADHD are discussed as well as ways to cope with them.
• When My Worries Get Too Big: This is a great book that makes it easy for kids who struggle with anxieties to not feel so alone. The included stories are fun, engaging, and filled with encouragement to help kids come up with their own calming methods when anxiety issues arise.
• I’m Not Weird, I Have Sensory Processing Disorder: If you have a child that struggles with sensory processing disorder (SPD), this book will help your child relate to the main character as she describes what it is like for her each and every day. This is a great resource to explain to others what it feels like living with sensory issues that affect them constantly throughout the day.
• Whole Body Listening Larry at School: This is an excellent book to teach the concept of whole body listening and following directions. The story begins with two new students attending school who have trouble listening and following along with the class schedule, social cues, etc. Larry helps them by teaching them how to listen with “their whole body”.

Books geared towards siblings:

• Sara’s Secret: This book explains the story of a grade school-aged child that has a brother with a severe disability. The main character struggles with not wanting her classmates at her new school to find out about her brother in fear of being teased. It is a beautiful message of acceptance and inclusion as the main character delves into her emotions and realizes the bond between she and her brother despite his difficulties, which is not any secret to hide.
• We’ll Paint the Octopus Red: A great resource for those who are awaiting the arrival of a new baby brother/sister who has a disability (this book specifically geared towards Down Syndrome). It also has a great message that with help and patience, their sibling will be able to overcome any obstacle.
• Leah’s Voice: Parents and educators can use this book as a great resource for teaching siblings, friends, and classmates about autism, inclusion, and acceptance. Although the focus is on a sibling with autism, its important message on the acceptance of differences and treating everyone with kindness is for all children.
• Views from Our Shoes: This book includes numerous stories of siblings that share their experiences as the brother or sister of someone with a disability with a wide range of various difficulties. Their personal stories introduce young siblings to others like them and allow them to compare experiences.

For more information on the services Easterseals provides for children with disabilities, visit:http://www.easterseals.com/dfv/our-programs/

March is Cerebral Palsy Awareness Month

By: Jack McGraw, Easterseals DuPage & Fox Valley client

While many wear green on St. Patrick’s Day, you can wear green all month long to honor Cerebral Palsy Awareness Month. Why green? The color was chosen to reflect youthfulness and new growth, as well as hope for advancements in treatment and acceptance.

Cerebral Palsy is a disability that is caused by damage to the brain before or at birth. It mostly affects movement and fine motor skills but can have a large range of severity for children. Some children with cerebral palsy can walk or talk, while some may use a wheelchair or assistive technology device to speak like me.

Honestly, living life with a disability can be very challenging but I don’t let it stop me from having an awesome life! I have a lot of friends, a great family and have been a successful student. I graduated from St. Charles North High School in 2017 and am now a proud honors student at Elgin Community College. My communication device uses eye gaze technology and helps me type up essays and lecture notes.

I also love sports. I really, really love sports. While my disability has kept me from participating on teams with my friends, it hasn’t stopped me from being a huge fan. I had the privilege  of being a team manager for football, basketball and volleyball while in school and those were very special experiences. I really felt like a part of the team and got close to some of my teammates.

I have been going to Easterseals since I was a little boy. I have done Physical, Occupational and Speech therapies. Easter Seals has helped me to be as independent as I can be and my therapists have always listened to me and asked me what I want to be working towards in therapy. They have been a great support to me and an asset in my life.

People with disabilities aren’t really very different from people that don’t have disabilities. We enjoy a lot of the same things and want to be treated fairly like everyone else! Having a disability is hard, but I haven’t let it stop me yet! Life is good!

Editor’s Note: Easterseals DuPage & Fox Valley offers many resources for children with spastic and non-spastic cerebral palsy and their families including physical therapy, occupation therapy, speech-language therapy, assistive technology, inclusive day care and parent-to-parent support.

Treatments and therapies can benefit a child with cerebral palsy by helping him or her gain the strength and mobility needed to take first steps, speak first words and maximize their independence.

For more information on cerebral palsy and therapy service at Easterseals DuPage & Fox Valley, visit http://www.easterseals.com/dfv/our-programs/cerebralpalsy.html.

Top Developmental Toy Ideas

By: Laura Van Zandt, MS, OTR/L and Sarah Peabody, Physical Therapist

Play is an essential piece to optimal child development as it contributes to the cognitive, physical, social, and emotional well-being of children. Walking through the toy aisle can be overwhelming, but it is important to choose a toy that is age-appropriate, promotes healthy development, and encourages positive behavior. View our favorite holiday toy selections below!

Gifts for Infants:

• Activity mat – Activity mats are great for promoting tummy time. Some have mirrors attached which helps the infant to lift his or her head up and engage in the mirror. Tummy time should start as early as possible for 3-5 minutes a couple times a day, building up the length and duration as the baby grows. Tummy time is essential to help your baby build the strength needed for rolling over, sitting up, crawling, and walking.
• Black and white toys – For young infants (birth – 3 months), toys with high contrast are the most appealing, as their vision has not adapted to seeing colors yet. Around 5-6 months of age, bright and colorful toys are appropriate as infants will likely be able to see the full spectrum of colors.
• Mirrors – These are a great resource for visual engagement.
• Colorful rattles, O-ball, a textured toy – Toys that children can reach for and grasp are great to promote fine motor development. Toys that appeal to multiple senses are ideal for infants and promote positive sensory development. Infants enjoy exploring the feeling of new textures.

Gifts for Toddlers – The toys listed below help kids learn to understand patterns, problem solve, and develop competence and confidence.

• Push toys – Ideal for the early toddler/young walking stage (bonus – with the one linked here, you can put objects into the push toy to weigh it down. Heavy work is great for building core strength!)
• Sorting and Nesting Toys
• Blocks, LEGOS, Magnetic Sets – Open-ended toys like these can be used in a variety of ways. Kids love to take things apart and add to structures at this age, and these toys will extend into the preschool years and beyond. This is also a great way to incorporate problem solving skills and provide opportunities for adult interaction into play.
• Hand puppets – These are a great way to encourage interaction and communication in the young child.
• Shape Sorters and Simple Puzzles– Shape sorters and early inset puzzles are great for toddlers. Interlocking puzzles of various sizes can be a great interactive toy for learning about all kinds of things. Look for puzzles that have large knobs for younger children or those that struggle with fine motor skills.  Puzzles are also great to help children develop their visual perceptual skills and become better problem solvers.

Gifts for Preschool Age Children:

• Play sets – Play sets with little people, dolls, animals, etc can expand a child’s language and communication skills and help them make sense of the world by imitating adult behavior and encourages imagination.
• Mini trampoline, scooter, tricycle – Improve a child’s gross motor skills and helps release their boundless energy.
• Easel, markers & crayons – These are another great way for a child to use their imaginations and develop their fine motor skills.
• Floor puzzles
• Simple dress-up costumes – When kids play dress up, their imaginations really get to blossom. Instead of buying a specific cartoon/movie character dress up costume, buy a generic tutu or princess dress where a child can be multiple different characters all in one outfit.
• Games- The nice thing about games is you can play them in a variety of ways. You don’t have to be stuck to the traditional rules. You can even use the games in pretend play. Here are just a few names of popular games used in therapy sessions: Pop the Pirate, Pop The Pig, Sneaky Snacky Squirrel, Scatterpillar, Jenga, Spot It, Hullabaloo, I Can Do That, Connect Four, Thumbs Up, Tricky Fingers, Boggle, Rush Hour, Gravity Maze, Quirkle, Blokus, Go Fish, Chutes and Ladders, and Dragon Dash.

Gifts for Elementary Age Children:

• Dolls
• Books – Reading will help advance a child’s language, vocabulary,  and social skills, while helping build coping feelings, and building their self-confidence levels.
• Adventure/Building Toys – These are great for problem solving, critical thinking, and imagination.
• Board Games – Don’t forget about the classic board games such as Sorry or Trouble that promote social interaction, turn-taking, and inclusion!
• Bike

Never forget, a trip to the museum, theater, or special exhibit is a great gift too! Experiences can never be replaced with toys and the trip will stay with a child for a long time. Capture them with your phone or camera and you can pull them out to talk about and connect on a later date.

For more ideas, visit our Amazon wishlist that shares suggestions for multiple age range and child need. Most of the toys listed can be adapted in some way or used by children of all abilities.

If shopping online, remember AmazonSmile is a website operated by Amazon with the same products, prices, and shopping features as Amazon, but the difference is that when you shop on AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price of eligible products to the charitable organization of your choice. Please choose Easterseals Dupage & Fox Valley to help support our cause.

We wish you a Happy Holiday and New Year!