W-Sitting And Your Child’s Growth

W-sitting is a position that is too commonly used by children when seated on the ground. In this position, a child sits on their bottom, with knees bent, feet tucked under, and legs splayed out to each side in a “W” configuration. Because this position is so common, most adults do not realize that use of this position can have negative ramifications on a child’s growth and development. 

Negative Effects of W-Sitting:

The reality is that this position can cause orthopedic problems, delay development of postural control and stability, and delay development of refined motor skills. For these reasons, its use is strongly discouraged.

Excessive use of a w-sit during the growing years puts undue stress on the hip abductors, hamstrings, internal rotators and heel cords, leading to the possibility of orthopedic problems in the future. “W-sitting” can lead to hip dislocation, and for children with pre-existing orthopedic conditions, these conditions can worsen when major muscle groups are placed in shortened positions. The muscles begin to tighten, and this can lead to a permanent shortening of the muscle, which can affect coordination, balance, and development of motor skills.

The w-sit widens a child’s base of support, resulting in less need for weight shifting, postural control and stability as they are playing, moving and reaching than in other seated positions. In addition to resulting in decreased trunk control, the w-sit does not require as much trunk rotation, which helps develop midline crossing and separation of the two sides of the body needed for bilateral coordination. Good trunk control and stability, midline crossing and bilateral coordination are needed to develop refined motor skills and hand dominance.

How to Prevent W-sitting:

It is best to prevent children from developing this habit. However, we all know children who have already established this as a preferred seated position. When possible, anticipate and catch it before you see your child move into a w-sit. If and when you do see your child in a “W”, consistently encourage her to adjust to a different position by saying, “Fix your legs.”

Consistency is key. Make sure children know what some of their other options are so they can choose an alternative. Functional seated positions that will allow the child to develop trunk control and mature movement patterns include “tailor sit” (also called “criss-cross”), “long sit” and “side sit”. It is important for parents to teach and encourage alternate seated positions at home, and teachers to teach and encourage their students to use alternate seated positions at school. This encouragement will have positive effects on a child’s growth and development of foundational skills.

When playing with a child on the floor, hold his knees and feet together when kneeling or crawling – it is impossible to get into a w-sit from there. The child will either sit to one side, or sit back on his feet, and from there he can be helped to sit over to one side. Try to encourage sitting over both the right and left sides to promote bilateral development. Using various patterns of movements and positions demand trunk rotation and lateral weight shifting.

If a child is unable to sit alone in any position other than a “W”, talk with an occupational therapist about supportive seating or alternative positions such as prone and side-lying. Sitting against the couch while playing may be one alternative, as well as using a small table and chair. A therapist will have many other ideas based on each individual child.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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The “Container Baby” Lifestyle

“Container Baby” is a relatively new term used in pediatrics to describe a baby that spends a majority of her time in some sort of enclosed space. These ‘containers’ can include car seats, bouncy swings, vibrating chairs, bumbo seats or other devices that ‘contain’ a baby’s movement. They can be used for any number of reasons, whether it be for safety or to give mom a few free minutes to cook dinner or fold laundry.

How “Containing” Your Baby Can Delay Motor Development:

Some babies spend many of their waking hours in a containing device and don’t get enough floor time to play. Floor time, where a baby is either placed on his tummy or back to play, is extremely important to help with strengthening his neck, back, tummy, arm and leg muscles. Floor time allows a child to explore her environment and provides essential sensory input, including tactile and visual information, that helps with development.

Plagiocephaly or Flatness of the Head:

Another direct cause of the “container baby” lifestyle is the increasing occurrence of plagiocephaly, or flatness of the head. Babies who are contained in the same position are at risk for developing flatness to one part of their head, which can lead to cosmetic deformities, facial asymmetry and torticollis, or the tightening of one side of the neck. Plagiocephaly often begins in-utero, Read more

Surviving Meltdowns: Supporting Children with Language Disorders During Breakdowns

Parents often tell me about the challenges they face when helping their child through a meltdown. It’s difficult to know how to help when you can’t figure out why your child is upset to begin with. Moreover, it can be discouraging when all your efforts to diffuse a situation seem to fail.

Children with speech and language difficulties often display frustration when they cannot effectively express themselves. Frustration can result in even less effective communication, which ultimately exacerbates the problem; it’s far more difficult to communicate when our emotions are heightened, whether through anxiety, fear, frustration or anger. This presents a problem for children with communication disorders, who are often less able to convey their needs in moments when they need to the most.

If you’re a parent and this issue sounds familiar, you’re not alone. Here are strategies I often encourage families to try when helping their child through a meltdown.

Strategies To Help Your Child Communicate During A Meltdown:

Use a calm voice: You may feel as frustrated as your child looks, but do your best to keep your response calm, consistent and neutral. Your tone will convey a message of safety to your child.

Use simple language: Your child may have more difficulty processing incoming language during a meltdown, so it’s important to keep you language simple. Simple language will be easier for your child to process. Instead of saying “John, you need to stop crying and put your shoes on because now it’s time to go home,” try using concise phrases such as “shoes on” or “first shoes, then go home.” Read more

How To Help Fidgety Students Pay Attention In Class

For many teachers, it can be hard to teach class when students are wiggling around in their seats or on the rug during instruction. Though it may be difficult to determine exactly why children fidget and have difficulty paying attention there are things that teachers can do to help!

Some children might fidget in an effort to pay attention to the teacher. These children are often classified as “low arousal” children who need more movement to keep their bodies upright and to participate in the classroom. Other children might be fidgety because they are constantly seeking out sensory experiences from their environment to get a better understanding of where their body is in space.

Some children might fidget because they do not have the trunk control to maintain a static muscle contraction in order to sit upright. Other children might be overly sensitive to light touch and might be bothered by the way the chair or rug feels on their body, how their clothing feels, or how close their classmate is sitting next to them.

Below are some strategies for teachers to help their students with fidgety behaviors in the classroom:

• Provide students with seating surfaces, such as a Move’N’Sit cushion or therapy ball to give their body sensory input. Read more

Low Muscle Tone | What Does Hypotonia Mean?

In the pediatric therapy world, a diagnosis of “low tone” or “hypotonia” is often given. But what exactly does this diagnosis mean? Muscle tone is the term for the resting length of muscles in the body ( i.e. before a contraction). With low muscle tone, the resting length of the muscles is greater than average and causes hyperextension at the joints, or what some refer to as “double jointedness.” (However, the term double jointed is misleading, as a person doesn’t actually have two joints, just increased muscle length and therefore increased flexibility at the joint).

Signs of Hypotonia in Children:

How can you tell if you or your child has low muscle tone? As stated above, individuals with low tone muscles often have increased flexibility at many joints. The muscles may feel soft and squishy, and because they have increased resting length it literally takes longer for the muscles to contract. Therefore, the individual may seem slow to get going or even lazy, but there truly may be a physiological reason behind it.

Also, because it requires more energy to get the muscles moving, these individuals may be reluctant to move, or conversely, they may move more because sitting still is exhausting and uncomfortable. Read more

Strategies to Decrease Nail Biting and Other Anxious Habits

Many things can cause stress for children, including academics, social problems at school, or even sports. Some children may be less resilient than others, and these stressful events can lead to anxiety problems. Unfortunately, many children may be unable to express their worries and emotions verbally, or they may not be aware of what it is that causes them stress. Therefore, often times children will express their anxiety through behaviors or anxious habits. Stress and anxiety can lead to poor and inconsistent sleeping patterns, depression, fears, difficulties with social interaction and isolation, among other problems. Follow the tips below to help ease the stress in your child’s life.

Tips To Identify Decrease Stress In Your Child’s Life:

• Children don’t often express anxiety with words, as they tend to not understand these feelings, not be fully conscious of them, or do not know how to express them.

• Habits/symptoms that may be signs of anxiety or stress include: nail biting, chewing on fingers, picking on clothing, inconsistent sleep routine, stomach aches, head aches, fear, worry, distress or isolation.

• Anxiety and stress affects concentration, decision-making, ability to make friends, and mood. Depression is closely linked with anxiety.

• How To Help:

Make sure your child has good sleeping habits and can recharge her batteries for the next day. Sleep improves concentration, boosts the immune system and aids in Read more

Help Your Child Develop the “Crossing the Midline” Skill

What is “crossing the midline”?

By the age of 3 or 4 years old, a child should have mastered the bilateral skill (using both sides of the body together) called “crossing the midline”. This is the ability to move one hand, foot, or eye into the space of the other hand, foot or eye. We cross midline when we scratch an elbow, cross our ankles, and read left to right. Crossing the midline of your body helps build pathways in the brain and is an important prerequisite skill required for the appropriate development of various motor and cognitive skills. Children who have difficultly crossing the body’s midline often have trouble with skills such as reading, writing, completing self care skills and participating in sports & physical activities. These skills require a type of coordination that comes from experience with “cross-lateral motion,” which is movement involving the left arm and right leg, or the right arm and left leg at the same time. 

Establishing a “worker hand” and a “helper hand” is a sign that the brain is maturating and lateralization is occurring, and is strongly correlated with the ability to cross the midline. Both sides of the brain need to talk to each other for the “worker hand” and the “helper hand” to work together and compliment each other. Coordinating both sides of the body can be difficult for the child who avoids crossing midline. Often, these children have not yet established a hand preference, sometimes using their left and sometimes using their right to draw, color, write, eat, and throw.

Affects on children who do not develop the bilateral skill:

Furthermore, when a child has difficulty crossing midline, it can affect his/her ability to read. While the child is moving his/her eyes from left to right across the page, the eyes will stop at midline to blink and refocus; however, when this happens, the child will very frequently lose his/her place on the line and become confused as to where they left off. It also affects handwriting, as diagonal lines cross the midline, and the child may need to stop in the middle of the page to switch hands when writing from left to right. Many self care and daily living skills require crossing midline. For example, perfecting the skill of putting socks or shoes on requires one hand to cross over to the other side of the body.

Children who have difficulty crossing midline may appear ambidextrous because they are often observed using both hands, but they actually have a hidden neuroprocessing issue. Both sides of their brains are not communicating, resulting in decreased coordination, decreased motor control of movements and difficulties achieving higher level skills. Often, these children end up with two unskilled hands.

Activities to help develop the ability to cross the midline:

To help develop efficient crossing of the midline, provide children with a variety of two-handed (bilateral) activities. Try some of the below activities to help build more pathways in the brain and to develop the ability to cross the midline, improve coordination, and improve overall functional performance on a daily basis.

Right brain/left brain teasers-

a. Pop bubbles with only one hand (they will have to reach across their body to pop the bubbles floating on the opposite side).

b. Reach for bean bags, balls, stuffed animals, or other objects across midline, then throwing at a target.

c. Draw large figure eights (the infinity sign or an 8 turned on its side) on paper, on the floor with a finger, in the air with a finger, or drive a matchbox car around a figure eight pattern.

d. Let the child play with sand, scooping sand from one side of the body and putting it into a bucket on the opposite side of the body without switching hands.

e. Let the child pretend to drive a car with a ball in his/her hands to use as a steering wheel and encourage the crossing of his/her arms as he/she turns the ‘steering wheel’ OR to make this similar in style to most of the others—pretend to drive a car with a ball in both hands to use as a steering wheel and cross both arms while turning the “steering wheel”.

f. Play flashlight tag. In a dimmed room, lie on your backs and have the child follow your flashlight beam projected on the wall with his own flashlight.

g. Touch the opposite elbow and knee.

h. Cross one foot over the other while walking sideways.

i. Do “grapevine” walks.

j. Knee slap walk- Walk around raising each knee while touching/slapping it with the opposite hand (or elbow). Change it to a skip while touching the opposite knee as it comes up.

k. Windmill-stand with feet spread apart and arms extended out to the sides. Bend over at waist and tap right hand to left foot. Stand back up and then bend and tap left hand to right foot.

l. Point your left finger out and put your right thumb up. Switch them, and switch, and switch, and switch…

m. Hold your nose, then cross the other hand over and grab your opposite ear. Slap your thighs and switch your hands…switch, slap, switch, slap…

n. Write your name in the air while rotating your foot in a circle clockwise.

o. Wash the car and make sure the arms cross midline while scrubbing.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Strategies for Oral and Motor/Sensorimotor Input

Children who put toys in their mouths, chew on their clothing or bite their pencils at school may be seeking oral motor/sensorimotor input to help their bodies reach anGirl chewing pencil optimal arousal level. We want to provide them with strategies to get this input in an appropriate manner. Here is a list of alternative strategies to support your child’s oral motor/sensorimotor needs.

Strategies For Children Seeking Oral Input:

1. Engage in activities such as whistling, blowing bubbles and using blow pens

2. Play games with straws (i.e. hockey by blowing cotton balls or splatter painting by blowing on paint using a straw)

3. Have them eat sweet and sour candies

4. Chew gum

5. Blow up balloons

6. Make a chewy necklace out of cheerios and licorice

7. Drink thick liquids (e.g. applesauce, pudding) through a straw

8. Drink water through a water bottle with a straw

9. Make a bubble volcano: Fill a bucket with soap and water, and have your child use a straw to blow bubbles to make the volcano. This is an activity you can use at home to help with self-regulation.

10. Send chewy, crunchy snacks (e.g. pretzels, granola bar, fruit leather, bagels) for lunch

11. Purchase products designed for chewing:

• Chewlery: http://www.therapro.com/Chewlery-and-Chewies-P321445.aspx

• Chew tubes and similar objects: http://www.therapro.com/Designed-to-Chew-C307786.aspx

• Other fun oral motor tools: http://funandfunction.com/oral-motor-chewies-c-65_107_110.html

• ChewEase pencil toppers: http://www.amazon.com/3-Clear-ChewEase-Pencil-Toppers/dp/B001G2DAK8

What Is Executive Functioning?

Disorganized Child“Executive functioning” is a buzzword right now in the academic and parenting worlds. I often hear teachers use the term loosely at staffing and school meetings. What does it actually mean, though, and why do so few children seem to have executive functioning skills?

Executive Functioning Defined:

The definition of executive functioning is actually implied in the name – it is the CEO of an individual’s daily activities. These skills make up the child’s ability to organize, plan, problem solve, inhibit responses, fluidly transition between tasks, monitor work, and effectively change solutions based upon new information.

Examples Of Executive Functioning Skills:

These skills can be seen throughout a child’s day: does the child have a set plan for a morning routine, or is it chaos on a daily basis? Is the child’s room organized so that anyone walking in knows where items should be? What about his/her backpack or locker? Does the child forget to turn in homework assignments that he/she actually completed? Does the child forget to write down daily assignments or forget to bring home necessary materials? What about the social world – does the child struggle planning activities with friends? Read more

Baby Sign Language: Does It Delay Speech Or Increase It?

Baby Sign LanguageYour one-year-old child looks up at you, and you wonder when their first words are going to start so that you’ll know exactly what they’re thinking. Or maybe the child is starting to cry, and you can’t wait for her to tell you what she wants instead of leaving you to figure it out.

There might be a way to speed up the process – baby sign programs have been introduced to encourage early language with infants. But the important question is, do they work?

Reasearch Of Baby Sign Language:

Existing research for baby signing is inconclusive. It wavers from not having a significant difference for the child’s language to increasing a child’s vocabulary and helping spoken language emerge.

Before beginning a baby sign program, consider the following questions:

• Is the program designed to teach a child American Sign Language, or to teach Baby Sign for encouraging spoken language? Make sure the program you are using fits your need.

• Is the program researched-based?

• Does the person teaching the program have extensive knowledge of American Sign Language or another sign language?

• Does the program use developmentally appropriate signs? For example, teaching the sign for “milk” may be more appropriate for beginning baby signs than teaching the word for “flower”. Signs may be simplified in the same way that spoken language may be simplified when speaking to an infant. Read more