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.

Gross Motor Play- Why Some Kids Won’t Participate

By Laura Znajda, PT, C/NDT
Manager of Community Based Therapy and Continuing Education

Summer is the ideal time for outdoor play, and children who love to run and climb are in their element. But children with very mild developmental challenges– or even no diagnosed problem at all— can have a great deal of difficulty learning new motor skills and keeping up with their peers on the playground.  Some children are mistakenly thought to be “clumsy” or “lazy” when they don’t try the advanced motor skills other children their age are mastering.

Physical and occupational therapists sometimes receive referrals to work with these children to strengthen their bodies so that they can gain skills more easily and keep up with their peers.  However, there is more to motor skills than just strength.  Pediatric therapists must analyze a child’s performance and consider all factors that might be impacting their success:

Flexibility:  We all need normal range of motion in our joints to perform daily tasks, but outdoor play can require extreme ranges of movement as kids stretch their limbs to make that great play of the game or to access new parts of a play gym.  A restriction in range of motion at the hip or shoulder might make climbing the slide ladder difficult.  A neck range limitation could make it challenging for a child to scan the playing field for a teammate that is open for a pass.

Motor Planning:  Paraphrased from Jean Ayres, PhD, motor planning is defined as the act of planning movements inside the brain to complete a series of actions in the proper sequence.  Before a child even starts to move, the sequence of action is planned out in the brain.  When the child lacks experience with a particular skill, like pumping herself on a swing or hitting a ball with a bat, she might hesitate in order to give her brain time to make a plan for this novel task.  Typically, the time it takes to get started will decrease as the task becomes more familiar, but for some children this motor planning component does not come naturally and needs assistance.

Balance:  Children need to be able to balance on one leg long enough to lift the other leg to a raised surface or to kick a ball.  Even more importantly, they need dynamic balance—that is, control of their bodies while they are moving and balanced on one limb in order to reach out to the side to catch a baseball or make a soccer save.  A child with balance difficulties will seek out stable objects to hold when he has to lift a foot for any length of time or will avoid these activities altogether.

Coordination:    According to CanChild, a research center at McMaster University that organizes clinical  research concerning children with developmental conditions, coordination is a sequence of muscular actions or body movements occurring in a purposeful, orderly fashion (smooth and efficient).  We often think of coordination as the ability to use both sides of the body at the same time.  We need coordination to make the same movements with both arms and legs when we do exercises like jumping jacks.  And we need coordination to do different things with each body part, but all at the same time, such as dribbling a basketball while walking or running.  A child with coordination difficulties might need these advanced motor skills to be taught in a more graded manner before she can master them.

Motivation:  It might seem obvious that a child must be interested and motivated in an activity in order to be successful with it, however this important component of motor skill performance is sometimes overlooked.  Although research is inconclusive as to exactly how many repetitions are needed, we do know that a new skill requires at least hundreds of repetitions in order to become proficient.   If a child is not motivated to play a particular sport, he will not have the determination to practice a skill over and over and will not see the success that comes from that critical repetition.

Finally, strength is important. Just as necessary as all of these motor skill components; but not the only factor to consider when a child is hesitant or unsuccessful with outdoor play.

Easter Seals DuPage & Fox Valley therapists are expanding their ability to get to the bottom of why children don’t participate in outdoor play and develop new strategies to help them through a continuing education course taught by Lezlie Adler, OTR/L, C/NDT and Jane Styer-Acevedo, PT, DPT, C/NDT on September 22-23, 2016 at our Villa Park center.  Registration is open to all therapists at:  http://www.eastersealsdfvr.org/ce

References

Can Child, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada L8S 1C7  www.canchild.ca

Ayres, A. Jean, Sensory Integration and the Child, Western Psychological Services, 2005.

A New Perspective about the Playground

By: Bridget Hobbs, PT

Summer is finally here and your little ones are asking to go to the park.  So, pack a few snacks, slather on the sunscreen and take advantage of this free way to build confidence, make friends and gain gross motor skills at the same time.

Children learn best through play-based experiences and exploring the playground is great way for children to refine their gross and fine motor skills.  Here are a couple ideas for parents and caregivers to engage their children at the park in order to build not only bonding and fun, but to also build muscle strength, endurance and gross motor skills.

Here are some new or different ideas to incorporate to your little one’s playground fun:

Climbing up the slide

As a child, you were likely told to just go down the slide.  Of course if there are children waiting to go down the slide, climbing up it is not a good idea.  However, if the park isn’t crowded, help your child bear walk (on hands and feet with bottom in the air) up the slide.  Doing this builds great core strength as well as cross-body coordination skills.

Using the dividers as balance beams

There are often railroad-tie type of dividers that divide the grass from the wood chips/foam surface under the playground equipment.  Challenge your child to go across these as they would a balance beam.  They can experiment with going forward, backward, side-stepping and even doing toe taps to the ground each step.  This activity helps with control of leg and core muscles as well as coordination skills that your child will use in gym class and on sports teams in the future.

Use hills to your advantage

If you participated in track or cross-country in high school, you know that training on hills was a vital component to the big picture of a race.  Make hills fun for your little one by rolling down them like a log to help with development of the vestibular system.  You can also really challenge them by bear walking or crab walking up or down the hill.

Don’t avoid the climbing wall

Children as young as toddlers can enjoy the climbing wall with help of their parents.  Even if you have to support their body, children learn motor planning and sequencing by deciding where to best place their hands and feet to navigate the wall.   A bonus is that the small muscles in the hand are strengthened by grasping the holds, which can lead to improved ability to write and play ball sports in the future.

There is a lot of research that clearly links play with brain development, motor and social skills.  Playgrounds provide different textures, sensory experiences and motor planning opportunities for children to help build their development.  So, think outside the box the next time you are at the park with your child and try to incorporate these different ways to assist with their development.

For more information on physical therapy and play based therapy services at Easter Seals DuPage & Fox Valley visit our website.

*Above images by Molly Gardner Media

 

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

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

2.  Make an “X”

3.  What lace is on top? (blue)

4.  Top Lace (blue) goes through the tunnel

5.  Pull Tight

6.  Make a loop

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

    7.  Blue lace goes aroouuund town

     8.  Drop it!

    9.  Thumb pushes bunny through the hole

   10.  Grab both bunny ears

           11.  Pull tight

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.

 

 

 

 

 

How Monkey Bars (and Other Fun Summer Activities) Will Improve Your Child’s Handwriting Skills

By: Maureen Karwowski, OT

Summer is here and that means plenty of opportunities for outdoor fun.  I can only guess that the last thing that your child is thinking about is handwriting.  That is okay because many outdoor activities actually help with fine motor skills such as handwriting.  If handwriting skills are challenging for your child then summer is a perfect time to address them.

Fine motor skills are important for so many things.  Buttons, zippers, cutting with scissors, cutting food with a knife, opening glue bottles, unlocking a door, opening a bag of chips, and writing are just a few examples of how we use refined fine motor skills every day.  Many of the children that I see in occupational therapy are working to improve their fine motor skills, and especially handwriting.

Activities to help promote fine motor skills typically focus on two areas:

1. Strengthening of the core and upper body
2. Strengthening of the fine motor muscles of the hands.

We know that in order for our hands to develop precision, for grasping, and for handwriting, the core must be as stable as possible.  Imagine sitting on a wobbly chair and trying to write your name.  That is an example of how the stability of the core impacts the way we are able to use our hands effectively.  We also know that in order to use both hands together the core needs to be strong.  Again, sitting on a wobbly chair and stringing beads would be very challenging.

The good news is that you can incorporate activities to help your child develop core and upper body strength into outside play naturally.  These will then impact fine motor skills.

• Wheelbarrow walking.  Hold your child at the hips or knees, wherever you see your child have the best posture.  A “sagging” stomach is not an ideal posture.
• Animal walks such as bear walks and crab walks.  Donkey kicks are also great.
• Help your child climb the rock wall at the park.

  

  Photo by Petra Ford

• The glider at the park is a great way to promote core strength.  Have your child look at his/her knees while gliding to encourage even more trunk strength.
• Help your child cross the monkey bars at the park.
• When you are swimming help your child push themselves up to the side of the pool with both arms.
• Play tug of war with your child.  Encourage them to pull you towards them pulling one hand over the other.
• My favorite game to use in occupational therapy sessions is the “zoom ball” which is a great way to work on using both hands together.

Some ideas for grip strengthening activities:

• Squirt guns and spray bottles.  The squirt guns that require both hands are especially good.
• Squeezing out nerf balls while in the swimming pool.
• Digging in the dirt and sand with a small shovel.
• Drawing with sidewalk chalk.  Drawing on vertical surfaces such as on the garage wall is even better.  Use large chalk for whole arm movements, and small chalk pieces to strengthen a pencil grip.  Have your child “erase” the drawings with a squirt bottle.
• Have your child wash the picnic table, or a wagon using soap suds and a large car wash sponge.  Encourage them to squeeze out the sponge in the process.
• Draw” shapes or letters in the dirt using a popsicle stick.
• Tools are a great way to build up hand strength.  Make a project with kid sized screw drivers, paint brushes, nuts and bolts.

Incorporating these activities naturally throughout the summer will greatly improve fine motor skills before the school year.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

An Incredible Mile

By: Hannah Thompson

Hannah started this blog in 2012 as an Easter Seals DuPage & Fox Valley intern. You can read the first blog post here. The below post has been adapted from her personal blog.

Photo by Rich Howe

I woke up super excited as it was the day of the 12th Annual Run for the Kids: Superhero Hustle. Morgan comes in at 7:00am and is tired but excited! I picked out yoga pants, an Easter Seals T-shirt, and my Victoria Secret athletic jacket.

I see Mom and Dad in the parking lot and I am pumped! I find my therapists and we go stretch in one of the therapy rooms. We quickly stretched and Mom helped us bring the walker to the start line. Mom had to go to my little sister’s water polo tournament but she took so many pictures before.

10, 9, 8, 7, 6, 5, 4, 3, 2, 1, START! I started walking with Dad, Joanne and Tami who are my devoted physical therapists, and Morgan. About a block in, Jenn, my main caregiver shows up with her dog so I have quite the entourage! I’m surrounded by little kids who have unimaginable challenges in their lives. They have a lifetime of surgeries and therapies to go through. However, on that day, they were being applauded for their heroism. To have them acknowledge me by cheering me on was humbling. In my case, being an adult has been easier than being a child with a disability. I had the storybook childhood but I had a lot more doctor appointments because I was always growing and that meant a lot of adjustments with my equipment or people wanting to make sure everything was working as it should. Now that we have that all figured out, Mom, Dad, and I know what is important which is my movement disorders so I see a neurologist once a year and physical therapy twice a week. That is nothing compared to other individuals with disabilities have to go through. We dodged so many bullets and that was why I was able to complete this goal.

When I was roughly three blocks away, I could feel the energy of the crowd. I start going faster and faster! My dad had to speed it up along with my entourage! I was fifty feet from the finish line and the crowd is CHANTING my name! Morgan and Jenn start taking pictures. It’s my moment! I cross the finish line and its bliss! I did it in 46 minutes which is less than we anticipated which had been an hour.

I got so many hugs and good wishes. I have to say thank you, thank you, thank you for the outpouring of love on Facebook and Twitter. It was unbelievable! Of course, thank you to my dad and other entourage members. It was an incredible mile!

The real reward was a therapist coming up to me and informing me that her client now wanted to walk a mile next year. That feeling is priceless!

Of course, thank you to Easter Seals DuPage & Fox Valley for 7 years of outstanding love and support!

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

Taking off the Training Wheels: Transitioning to a Two-Wheeler

Blog by: Bridget Hobbs, PT, DPT

Photo by Ann Mehrman

Spring is here and bike riding season is upon us!  Since May is national bike month (#bikemonth) I want to shed some light on biking, which is a fun activity the whole family can enjoy.   Taking off the training wheels can be a big step, so here are a few tips that will ease the transition to a two-wheeler.

First, always make sure the child’s bike is in good condition.  Inflated tires, working brakes and an oiled chain help to ensure safety.   In order to properly assess if the bike is a proper height for your child, have them stand on the ground and adjust the seat so it is just under their bottom.  Practicing getting on and off the bike before riding will also help them feel more independent and comfortable with the transition to a two-wheeler. A proper fitting bike helmet is a must as well!  Some children may need comfortable fitting elbow and knee pads for safety.

The ‘run-behind’ method, where Mom or Dad runs behind while holding underneath the bike seat to give the child peace of mind, is a proven technique for beginning the two-wheeler process.  Giving positive feedback such as “keep up the good work” can keep your child from getting discouraged while learning the skill of balancing on two wheels.  Offering  a reward,  such a family bike trip to the ice cream shop will keep your child motivated to succeed.

Photo by Amy Onesti

Learning the balance of a two-wheeled bike is often the hardest part when transitioning from training wheels or a tricycle.  If your child is having difficulty with the balance of a two-wheeler, it might be good to try a Strider Bike.   A Strider Bike is a bike without pedals which can be used by children as young as 18 months to learn the balance, coordination and steering of a two-wheeler.  This bike gives children the confidence they need to ride independently before transitioning to a bike with pedals.

The best way to teach your child to bike ride and enjoy overall fitness is to lead by example.  So, plan some fun family outings to a forest preserve or park trails today!

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

April is Occupational Therapy Month!

By: Maureen Karwowski, OT

Photo by Carl Jaloweic

I am so lucky to work in a profession that I feel so passionate about and enjoy so much.  Occupational therapists help people of all ages participate in the things they want and need to do.  Occupational therapists use everyday activities, a holistic and customized approach to treatment to assist children gain skills to become as independent as possible.  I see children of a variety of ages, and with a variety of challenges.

Here is what my clients and their parents told me occupational therapy is helping them to do:

• I am learning to use my right hand better.  I learned how to put on my coat, pants, shoes and socks.  I am learning to make a peanut butter and jelly sandwich, and carry a tray of food like in the school cafeteria.    Max, 14 years old.
• I am learning to keep my body in the “green zone” so I don’t fall so much when I run around. Jack, 5 years old.
• I am trying to get stronger in my arms so I can play games like 4 square, and climb the monkey bars during recess. I used to be afraid to do things where my feet were off the ground, like climb on the risers in music class.  I am not scared anymore.  Faith, 8 years old.
• OT is helping us figure out what will calm my daughter…she is very sensitive to noises, touch and is cautious with anything new. It is fun to see her personality come out now that she is getting more confident.  Mother of Abby, (4 years old).
• My favorite game is “super hero training” where I practice climbing and jumping without falling and not too fast. I am working on my handwriting for school too.  Max, 6 years old.
• In OT I work on jumping, swinging, and climbing. After that we sit at the table and work on buttons, and tying my shoes.  I want to tie my cleats for baseball.  Justin, 8 years old.
• Andrew has been in OT since he was 2 years old. He is learning to engage with people better.  It has also helped him be less sensitive to sounds and textures.  The OT’s have worked with us on strategies for at home for so many things that were a struggle.   Haircuts, hair washing, bedtime, family parties, and church just to name a few.  Mother of Andrew, 12 years old. 
• My daughter used to be on the go all the time before she was in OT. She was always moving around, climbing on chairs and jumping.  Going out in public was so stressful.  Now she is getting better at regulating herself.  I have learned what sensory input she needs every single day in order to be calm.  Mother of Rachel, (4 years old). 

Thank you for these great quotes!

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

Headed to the Gym

Physical activity for people with disabilities is crucial. If we don’t participate in the proper amount of physical activity, our physical impairments could get worse. For me, the proper amount of physical activity is physical therapy twice a week and getting out of my chair as much as I can. I know this is incredibly important, however, I get distracted. I’ll make plans with friends ex: go shopping and it creates a distraction. Obviously, I can’t always be exercising or stretching; I would not have a social life or go to work, but I have to balance physical exercise with the demands of life.

National Center on Health, Physical Activity, and Disability state:

“More recently, the 2008 Physical Activity Guidelines for Americans provides science-based guidance to help individuals with disabilities aged 6 and older improve their health through appropriate physical activity. These benefits are even more important if you have a disability, since people with disabilities have a tendency to live less active lifestyles”.

This is a challenge that everybody deals with. How much do I work out? What exercise classes are best? We all struggle with balance. How many hours of therapy give my child a life and also maximizes independence? It’s a hard question that I don’t have the answer to.

 However, some people commit their life’s work to physical fitness. The community of Easter Seals DuPage and the Fox Valley Region would think of our wonderful physical therapists as people who dedicate their lives to physical fitness and we do appreciate them. However, some people with disabilities decide to shatter stereotypes in the world of physical fitness. Craig Koonce, a power lifter who has Cerebral Palsy does that every day. He defies the odds in a gym. Koonce goes to the gym everyday to prepare for weight lifting competitions. He won state in Pennsylvania  in 2010 for power lifting and he went on to nationals.  He dreams of starting a center that takes holistic approaches for both disabled and able-bodied individuals. Check out his story here.

We can’t all be like Craig. I could never spend that many hours in a gym. That amount of physical activity does not appeal to me. Personally, I set aside certain parts of the day to have my personal care attendants get me out of my chair. It can be as simple as laying on the couch and watching my favorite TV show or after work, I usually stand with an attendant for a good ten minutes. USA Today states, “If you are in a negative-thinking cycle for more than 10 minutes, stop thinking and start moving. Move your body every hour; sitting saps motivation”. The magazine also says, building incentives and giving yourself a rest day is a good way to keep working out.

You can set your own regime and choose your own activities but it’s important to remember that physical activity is crucial when you have a disability. Plus, the holidays are practically here…if you exercise, you won’t feel as bad when you eat all those holiday goodies!