Why Isn’t My Baby Walking?

The walking stage is a huge milestone for every child. It’s an exciting new time when your baby officially becomes a toddler. Most babies learn to walk between 12 and 15 months. A baby isBlog-Walking-Main-Landscape considered delayed in walking once they turn 18 months old. When a child is delayed in a certain gross motor skill, parents are always curious why this delay is happening.

Here are some reasons that your baby may be delayed in walking:

  • Muscle weakness and/or low muscle tone. This is the most common reason. A child who has weakness or low tone in their core and hip muscles may have difficulty with walking. Sometimes this weakness affects the earlier milestones such as crawling, pulling up to stand, and cruising. If your baby had difficulty learning early milestones, they are more likely to have difficulty with walking. A physical therapist can do exercises with your child to strengthen their muscles and help them learn to walk.
  • Orthopedic concerns. This involves the bones and joints in a child’s legs and how they are aligned. An example is hip dysplasia. These concerns are diagnosed by an orthopedic surgeon and are treated in a variety of ways.
  • Neurological concerns. This involves the nerves, muscle fibers, and nervous system of the body. An example is diplegic cerebral palsy. These types of concerns are diagnosed by a neurologist.

Orthopedic and neurologic concerns can be very scary to parents. It is important to understand that a delay in walking does not automatically mean that your child has an orthopedic or neurological disability. If you think your child is delayed in walking, speak to your pediatrician. A pediatric physical therapist can evaluate red flags for causes of delayed walking, as well as help your child to learn this skill.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Why Crossing Midline is Important for Development

As babies grow and develop certain milestones are often celebrated, such as rolling, sitting, crawling, and walking. As a pediatric occupational therapist, one of the milestones I always celebrate might not be visible to the untrained eye. Crossing midline, defined as the ability to reach across the body’s invisible midline with your arms or legs to perform tasks on the opposite side of the body, is a required skill for many higher level coordination activities. Blog Crossing Midline Main-Landscape

This skill typically develops around 18 months of age. Oftentimes when children are referred for occupational therapy due to poor fine motor skills, handwriting, or coordination, they are not crossing midline efficiently.

Some ways to observe whether or not your child is crossing midline efficiently include:

  • Watching to see if your child switches hands during drawing tasks. Do they switch from left hand to right hand to avoid their arm crossing over when drawing lines across paper?
  • Evaluating hand dominance: by age 6, children should have developed a hand dominance. Children with poor midline integration may not yet have developed a hand dominance.
  • Tracking an object across midline: this can be observed during reading, as decreased midline integration can lead to poor ocular motor skill development required for scanning.
  • Observing ball skills: children who are not yet crossing midline may have a difficult time crossing their dominant leg over their non-dominant leg to kick a ball forward.
  • Assessing self-care skills: putting on socks, shoes, and belts may be extremely difficult as these are activities that require one hand to cross over to assist the other in the process.

Children who have difficulty crossing midline may not be able to keep up with their peers, which may cause increased frustration during participation at school and in social situations. In addition, crossing midline is a required skill needed in order to complete more challenging bilateral coordination activities, such as cutting with scissors, using a fork and knife to cut food, tying shoe laces, writing out the alphabet, and engaging in sports.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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How to Help a Child Who is Struggling with Self-Esteem

As children get older and start spending more time with peers, it is natural that they begin comparing themselves to others. It’s healthy for children to want to excel and do their best, but itBlog-Self-Esteem-Main-Landscape becomes problematic when it comes at the expense of their self-esteem. Self-esteem can take time to develop and strengthen, but there are some things you can do to help enhance it during the earlier years.

What to Look for in a Child with Low Self-Esteem

If you notice your child making a lot of negative self-statements, this is indicative that he or she may be struggling with self-esteem. Negative self-statements are self-deprecating and tend to represent black and white thinking patterns. An example of a negative self-statement would be “I am dumb” or “I will never be good at this.”

It is very healthy for children to develop interests or hobbies and to spend time around others who enjoy similar things. Explore a variety of activities with your child and try to provide him/her with options. Whether it’s a cooking class or swimming lessons, your child is bound to show interest in something. Listen to your child and give him/her the autonomy to choose something that really interests him/her. Check out your local park district or community center to see what programs they offer. The Chicago Park District has dozens of wonderful programs and activities that may interest your child.

Each child has their own strengths, talents, and qualities that make them unique. That being said, it is great to point them out when you notice them! It is human nature to enjoy hearing that others are noticing the things we are doing well. At the same time, it is important to help your child understand that they are not defined by their achievements. Think about some adjectives that describe your child (i.e. compassionate, kind, caring). These intrinsic qualities are really what makes someone special – not the amount of trophies or ribbons on their shelf. Plant Love Grow is a wonderful website that has lots of self-esteem boosting activities that you and your child can do together.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Why is Toe Walking Bad?

Idiopathic toe walking is a type of walking pattern that occurs when children walk on their tip-toes instead of using the more “typical” heel first pattern. Idiopathic is a term that refers to the fact that this toe walking occurs spontaneously, usually out of habit, and is not due to another medical cause. blog-toe walking-main-landscape

A non-idiopathic cause may be cerebral palsy, autism, sensory processing disorder, muscular dystrophy or brain injury. As children learn to walk, some toe walking is to be expected. When this becomes a strong habit that they do not grow out of, or the predominant pattern as they are new walkers, then several issues can arise.

The following are negative consequences of toe walking:

  • Tight ankles or contractures can develop
  • Poor balance reactions, frequent falling
  • Muscle imbalances “up the chain” meaning decreased hip or core strength due to the different postural alignment
  • Difficulty with body mechanics including squatting or performing stairs, secondary to tight calve muscles
  • Inability to stand with heels flat on the ground
  • Pain in ankles, knees or hips due to faulty mechanics
  • Surgery, casting, night splinting or daily bracing may be necessary

While some toe walking should not be alarming, the earlier you intervene, the better. Discuss this with your pediatrician or see a physical therapist who can provide early strategies to stop the cascade of effects that can be seen later.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Why Are Occupational Therapy Screens Necessary for Schools?

Occupational therapists are skilled in assessing how a child’s sensory processing abilities, fine motor skills, visual motor skills and gross motor skills impact performance and function in daily life including self-care, play and academics. Proficient skills in these areas are imperative for children to be successful in the classroom environment.blog-occupational-therapy-screenings-main-landscape

  • Sensory processing skills support a child’s ability to learn. A child who is unable to process environmental stimuli effectively and efficiently will be unavailable to learn. Children with sensory processing dysfunction may have difficulty sitting still for an extended period of time in their desks or during circle time, they may be unable to pay attention when others around them are talking or they may have difficulty standing in line without touching, or hanging on a friend in front of them. These behaviors are a result of poor processing of the vestibular, auditory and proprioceptive systems, respectively.
  • Efficient fine motor skills are necessary to complete academic work. From writing to cutting with scissors and keyboarding to making crafts, fluid fine motor skills help children complete classroom activities and homework.
  • Efficient visual motor skills provide a foundation for writing and copying from the board as well as completing math work.
  • Efficient gross motor skills are important within the school environment for moving safely throughout the school and classroom, engaging with peers on the playground or during gym, and sustaining appropriate posture while sitting at a desk to complete work.

When a child struggles in any of these areas, it may not always be obvious. Oftentimes, sensory processing difficulties go unnoticed for many years and the child is left with academic or behavioral challenges. Therefore, occupational therapy screens are essential for schools.  An occupational therapist’s knowledge of child development, and its impact on daily functioning, can help identify children who would benefit from therapy services.

The screens can also be used as a preventative measure to ensure that a child’s development is on track and the child will have the foundational skills necessary to be available to learn. Occupational therapy screens also allow the opportunity for OTs to educate and collaborate with teachers and educators to provide suggestions that they can share with families and use in the classroom.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Improving Your Child’s Social-Emotional Growth Through Board Games

In the fast-paced, high tech world of childhood, girls and boys are much more likely to reach for the iPad and Xbox than a set of dice. Although, technology can provide immense growth in your blog-social-emotional-main-landscapechild’s life, it can also delay important social-emotional learning that the old-fashioned board game has to offer.

Below are some important reasons to bring back the board game to work on social-emotional growth:

Practice Social Skills

Board games are a fantastic outlet to practice turn-taking, rule following and positive sportsmanship. Depending on your child’s age, choose an appropriate game to begin the process of reading the rules, modeling the steps of a turn, and providing examples of positive praise and compliments. Commend your child as they begin to integrate this set of skills into their regular play!

Enhance Flexible Thinking

Board games also allow for children to work on improving their frustration tolerance. Many parents can often relate to observing their children shutting down, becoming angry, or walking away from the game after a missed turn, wrong move, or misunderstanding. Flexible thinking skills to practice include compromising, negotiating, and problem-solving. Taking a break and calm breathing can also be helpful strategies. Practicing how to handle frustration in the context of a board game will help children to better handle frustration in other areas of their lives.

Helpful Tips

  • Incorporate your child’s favorite stuffed animal or Lego character as an additional player in the board game when other family members are unavailable.
  • Cooperative games are a helpful way to practice teamwork and can prevent competition from getting in the way of practicing rule-following and turn-taking skills.
  • Involve your child in picking out the board game in order to increase their interest in this new activity.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Importance of Tummy Time

In a national survey of 400 pediatric physical and occupational therapists, two-thirds of those surveyed say they’ve seen an increase in early motor delays in infants who spend too much time onblog-importance-of-tummy-time-main-landscape their back while awake. Tummy time is an important and essential activity for infants to develop the strength and musculature they need to achieve their milestones in gross motor development.

What is tummy time?

  • Supervised time during the day that your baby spends on their tummy while they are awake

Why does my baby need tummy time?

  • Being on his or her tummy will help develop the muscles of the shoulder, neck, trunk, and back. This, in turn, will allow your child to achieve developmental milestones such as independent sitting, crawling, and standing
  • Tummy time will help prevent conditions such as torticollis and plagiocephaly (head flattening on portions of their head)

What if my baby doesn’t like tummy time?

  • The sooner you start tummy time, the sooner your child will get used to it!
  • If your child cannot keep their head up, use a towel roll, Boppy pillow, or small pillows to help prop them up until they can lift their head on their own
  • Place a mirror or their favorite toys in front of them to keep them entertained
  • Put them on your lap on their tummy

How much time do they need on their tummy?

  • You can start putting them on their tummy from day one for up to 5 minutes, 3-5 times a day. As they get stronger, they will be able to tolerate increased tummy time during the day.
  • But, always remember – back to sleep and tummy to play!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, and Des Plaines! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Age Appropriate Toys for Motor Development

It’s the holiday season! As we approach the end of December, plenty of parents have been inquiring about appropriate and educational toys and games that encourage speech and language growth, blog-motor development-main-landscapefine and gross motor development, and problem solving skills. Below are some of our favorite toys that we believe would make great additions to the family toy closet:

Baby toys (birth-24 months):

  • Fisher-Price Brilliant Basics Rock-a-Stack
    • Why we love it for infants: brightly lit colors encourage basic skills such as eye tracking which helps facilitate gross motor skills like rolling and reaching across the body’s midline. These multi-sized rings are also the perfect size to encourage the baby to start using a gross grasp and release pattern, which is integral for fine motor development. The baby can learn basic discrimination skills related to sizing and colors which is necessary to develop basic problem solving skills. These rings allow the baby opportunity for oral exploration without hazard of choking, and the product boasts that the material is safe for teething.
  • Melissa & Doug Stack and Sort Board – Wooden Educational Toy With 15 Solid Wood Pieces
    • Why we love it: Facilitates tactile discrimination, encourages basic language skills by introducing names of basic shapes as well as different colors, facilitates fine motor development (particularly pincer , tripod, and lateral tripod grasp usage), and requires basic eye hand coordination to stack and unstack items on and off the centerpiece.
  • More suggestions: Caterpillar Play Gym, Fisher-Price Little People Lil’ Movers Airplane, Busy Poppin’ Pals, Fisher-Price Laugh & Learn Count and Color Gumball

Toddler Toys (3-5 years):

  • Pop Up Pirate
    • Why we love it: This is a fan favorite for kids and therapists. We use it in OT, PT, and Speech, and the kids love it because of the uncertainty of who is going to make the pirate pop out of the barrel. Therapists enjoy using this toy to encourage direction following, visual motor integration skills, and fine motor coordination. When played in a small group, it provides a great opportunity to learn some basic impulse control and encourages turn taking. This is a great game for kids who may still have difficulty playing games with 2 or 3 step directions, as there are no rules other than waiting your turn to place the sword when directed.
  • Sneaky Snacky Squirrel 
    • Why we love it: Great game to address basic social skills and direction following. This game can be played with 2-4 individuals, and can help to encourage turn taking and fine motor control to manipulate a set of squirrel-shaped tweezers. This game also helps to build frustration tolerance, as children must learn how to react when losing their turn, or having a peer take away one of their acorns. It’s also easy to understand, and there is no reading required.
  • More suggestions: Wooden Shape Sorting Clock, Pop the Pig, Spot It, Zingo, Elefun, Hungry Hungry Hippos

Grade school toys and games (6-9 years):

  • Games for balance, coordination, and core strength: Zoomball, Twister, Labyrinth Balance Board
  • Games for fine motor development: Operation, Barrel of Monkeys, KerPlunk, Angry Birds, Jenga, Operation
  • Games for visual perceptual and problem solving skills: Rush Hour, Rush Hour Junior, S’Match, Marble Runs, Cartoon It
  • Games for Social skill and cooperative play: Race to the Treasure, Stone Soup, Don’t Let the Pigeon Drive the Bus

Adolescent games (10-15):

  • Games for Executive Functioning : Logic Links, Qwirkle, Mastermind, Labyrinth
  • Games for Visual perceptual and problem solving skills: Knot so Fast, Blokus, Rush Hour
  • Games for Social development: Life, Scattergories, Scrabble, Apples to Apples

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to  help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Age Appropriate Toys for Children with Autism

It’s the holiday season and everyone is out shopping for family! If you’re looking for age appropriate toys for children with Autism, then check out this age-by-age list:blog-autism-toys-main-landscape

0-18 months

Goals of Play:

  • Manipulate and explore a variety of toys
  • Show variation in play
  • Demonstrate generalization by playing with toys in a variety of environments
  • Engage in movement play (gross motor play)
  • Cause-and-effect play

Toy Ideas:

  • Blocks (Duplo blocks or Large Lego)
  • Cause and Effect Toys
    • Car Ramps
    • Pop-up Toys
    • Push-and-Pull Toys
  • Simple puzzles (individual/non-adjoining pieces)

18-30 months

Goals of Play:

  • Toys with multiple parts (learning to look for pieces and assemble)
  • Using toys for their actual functions (i.e building blocks rather than just dumping them out of a container)
  • Play with everyday items in creative ways (i.e. pretends a marker is a magic wand)
  • Gross motor play on play structures/playground equipment

Toy Ideas:

  • Doll houses/dolls (i.e. Little People sets)
  • Tea party set
  • Pretend Food
  • Smaller blocks/Lego/K’nex blocks
  • Potato Head
  • Train set
  • More complicated puzzles (such as those with adjoining pieces)

30-48 months

Goals of Play:

  • Spontaneous engagement in pretend or imaginary play
  • Arts and Crafts activities
  • Drawing and writing in pre-academic activity books
  • Social play becomes a focus

Toy Ideas:

  • Dress up clothes
  • Play Kitchen
  • Board games or other games that encourage turn-taking
  • Arts and Crafts materials- paint, markers, glitter, glue, dot markers
  • Pre-academic workbooks (can be found online or in a variety of bookstores)

Resources:

Sundberg, M. L. (2008) Verbal behavior milestones assessment and placement program: The VB-MAPP. Concord, CA: AVB Press.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Executive Functioning Skills: How Can I Help My Child?

Executive Functions are a set of higher order mental processes that allow an individual, or in this case, children; the ability to control their thoughts, actions, and attention in their ever-changingblog-executive-functioning-main-landscape environment. Often, children can present with executive functioning issues as a result of many different factors such as Autism and ADHD.

Below are some executive functioning skills and how they present in both individuals with normal and poor executive functioning, and some tools/strategies for parents:

Skill Example Tools
Organization Your child has trouble being organized or often loses, or misplaces items. Create a “home space” for your child’s items. This can include simply labeling areas of the home where items should be stored, so your child knows where to place items and lowers the risk of loss. Make checklists or use planners to help your child create a schedule.
Working Memory Your child easily forgets what they just heard, or what they were asked to do. Make connections in every lesson. Have you ever heard of ROY G. BIV? – this is how most people remember the colors of the rainbow. When teaching new content such as tying a shoe use cute, age appropriate analogies such as the bunny rabbit in the hole. Also, helping your child visualize information by writing it down, drawing pictures, and even becoming the teacher are great tools as well.
Self-monitoring Your child may not seem aware of themselves such as when they are doing well. Behavior charts are a great tool to help your child self-manage their own behavior. Choose an important behavior for your child to manage and how often you would like for your child to “check in” on this behavior.
Task Initiation/Planning and Prioritizing Your child takes forever to get started on a particular task or has trouble planning activities. Break whole tasks down into smaller achievable steps. If the desired result is for your child to complete an entire homework sheet, maybe setting a goal to do the first 2 problems together can be a happy medium. Also allowing your child to take breaks or receive rewards between tasks are a good strategy as well.
Flexibility Your child often has trouble with new ideas, transitions and spontaneity. Visual schedules and first/then language are your biggest friend. For a child who has trouble being flexible, try to alert your child to changes in routine as far in advance as you can. To help combat rigidity such as not wanting to try a new food, try to approach slow and steady first. This can include tasting a small amount of a new food instead of a large portion.
Impulse/Emotional Control Your child often has trouble controlling their emotions and impulses when they are sad, happy, or angry. Speak and repeat. When providing directions to a child, if applicable, state the directions remembering to adhere to your child’s learner and listener styles, and then have your child repeat back to you. Use social stories and modeling: For example, if your child often gets upset when they lose a game, a social story can help teach tools on how to act in this situation.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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