ball skills

Help Your Child Develop Ball Skills

 

 

 

Pediatric physical therapists and occupational therapists often work with young children on play skills to prepare them for school and sports. Between when a baby first learns to sit on his own and when he starts preschool, many gross motor skills are developing. The ability to catch, throw, and kick a ball often reflect how well a child can balance his body in space, interact with his environment, and coordinate opposing sides of his body. As a prelude to specialized sports, ball skills are especially important for children to master. The questions parents frequently ask me are often related to the development of those ball skills.

 

When should my child be able to catch a ball?

Catching a ball takes on different qualities when it comes to development. A one-year- old child should be able to catch a ball while sitting down by enclosing the ball with arms and hands, without falling or losing his balance.

  • By age 2, a child is able to stand and hold his arms in front of his body, with palms up in a receiving position in anticipation. He should attempt to secure a ball thrown from 5ft away by bringing hands to chest.
  • By age 3, he should be able to catch a ball thrown from 5ft away with hands only, with arms outstretched, without the need to bring his hands to his chest. At four and a half, a child is able to catch a tennis ball from 5ft away using his hands only, with arms bent at 45 degrees, at least 2 out of 3 times.
  • By age 6, a child can bounce a tennis ball on the floor and catch it with 1 hand.

How should my child throw a ball at different ages?

  • At 12 months, a baby can roll a ball forward on the floor at least 3ft using his hands. He can also stand and throw a ball in any direction by extending his arm at shoulder or elbow.
  • By 18 months, a child should be able to stand and throw a ball without falling.
  • By 2 years, a child will be able to throw a tennis ball forward at least 3ft using an overhand and underhand technique. By two and a half, that distance doubles.
  • By three and a half, a child will be able to throw a tennis ball forward 10ft in the air and use appropriate technique, such as moving arms up and back using upper trunk rotation, with arms and legs moving in opposition. He can also hit a 2ft target from 5ft away with a tennis ball using underhand toss.
  • By four and a half, a child can throw a tennis ball underhandedly at least 10ft using trunk rotation and opposing arm/leg movements. He can also hit a target from 12ft away 2 out of 3 trials using an overhand toss.

When should my child be able to kick a ball?

  • At a year and a half, a child will have the balance and coordination to stand, lift his foot, and contact a ball. By 20 months, he can kick a stationary ball forward 3ft. By 2 years, he would be able to do this without the ball deviating more than 20 degrees to either side of midline, suggesting good control of his body and limbs.
  • A 3-year-old can kick a ball forward 6ft using opposing arm and leg movements. He should be able to initiate the kick by bringing his foot backwards with knee bent.
  • By 6 years, a child has the balance, coordination, and strength to kick the ball forward and up in the air at least 12ft, using proper technique.

Okay. So that’s what my child should be doing. How do I help him achieve these developmental milestones?

It is so important to start at a level that your child can achieve and then gradually increase the difficulty. Children respond well to success and praise, and they are more willing to try challenging tasks as they build up their confidence. Break down each task step by step. For example, if kicking a ball is hard or if his technique is off, have your child practice standing on one foot first or kick a balloon instead. If throwing underhandedly is tough, break down the different position of his arms and legs during each point of the motion. Achieving developmental milestones is a matter of practice, timing, cognitive maturation, and understanding the parts of each task.

Look for an upcoming blog about specialized sports for children. If you continue to have questions or concerns about your child’s coordination, development, and ball skills, come in and talk to one of our specialists!

Girl with headache

The Role of the Physical Therapist in Post-Concussion Management

 

 

In our blog on Signs of Concussion in Youth Athletes, it became evident that a concussion can result in a wide variety of negative signs and symptoms. Following such an injury, many young athletes are eager to return to their sport. However, complete physical and mental rest are the best things to help the brain recover, and are absolutely necessary during the first 24 hours following a concussion. A physical therapist can be an integral member of the child’s concussion management team in preparing the child to return to sport, or in helping to address impairments resulting from the concussion that may be limiting the child’s school or daily functioning. Below is a list of interventions a physical therapist may be able to provide to a child who suffered a concussion injury:

  • Girl with headacheManagement of neck pain or cervicogenic headache: A cervicogenic headache is one that is caused by injury or tightness in the neck muscles or due to limitations in mobility of the neck joints. Since these structures attach to your skull, impairments there can result in headaches. Your physical therapist can help with manual therapy and exercises to increase mobility of these structures in order to alleviate headaches.
  • Balance and coordination training: It is very common to have balance or coordination difficulties following a concussion. A physical therapist can help to re-train and strengthen these systems in order to restore function.
  • Graded return to physical activity: When your child has been cleared by the pediatrician to return to physical activity, the physical therapist can help with a gradual return to activity while closely monitoring concussion symptoms. It is important to ease back into exercise starting with light aerobic activities before participating in moderate or intense physical activities or sport-specific training.
  • Gradual return to specific sport: Once the athlete has returned to aerobic exercise with no worsening of symptoms, the physical therapist can then begin to introduce sport-specific training drills and gradual return to practice and competition.

It is important to note that your child should be closely monitored by your pediatrician or primary care physician initially following the injury, as well as frequently throughout your child’s course of treatment. Your physical therapist should also update your pediatrician with your child’s symptoms and response with return to physical activity. Please contact North Shore Pediatric Therapy to schedule an appointment with one of our physical therapists if your child has recently suffered a concussion or continues to suffer from post-concussion impairments.

Girl at the park

Top Park Picks for Children

The weather has finally decided to warm up, which means children and adults alike are yearning to be outside! Chicago has so many wonderful parks and playgrounds, below are some of the top picks to check out:

1)     Oz Park

2021 N. Burling St, Chicago 60614

— Themed for Wizard of Oz
— Best for ages 5 and under
— Wheelchair accessible
— Baseball fields, basketball and tennis courts, walking paths, gym

2)     Morton Arboretum

4100 Illinois Rt. 53, Lisle 60532

— Open air facility with live plant exhibits
— 6 treehouse structures
— Children’s Garden

3)     Adams Water Playground

1919 N. Seminary Ave, Chicago 60614

— Interactive water play area
— Small field house with indoor activities for toddlers
— Shaded playground
— There is a schedule for open times

4)     Berger Park Cultural Center

6205 N. Sheridan Rd, Chicago 60660

— Converted mansion buildings
— On the lake
— ADA accessible
— Waterfront Cafe

5)     Mothers on a Mission Playground—part of Berwyn Gardens

 Kenilworth Ave, North of Cermak Ave, Berwyn; 708-749-4900

— Opened 2011 and was assembled by volunteers
— Wheelchair accessible
— Special sensory features
— Unique AeroGlide

While enjoying the parks, children will also be practicing fine motor and gross motor skills as well as getting exercise through play.  Here at NSPT, we have wonderful Occupational and Physical Therapists who too can help with fine and gross motor concerns you may have!

push-ups child

Signs of a Concussion In Youth Athletes

What is a concussion?[1]

A concussion is a type of brain injury that can occur from a blow to the head, a blow to the body that causes a jerking motion of the head and brain, or fall resulting head impact. A concussion is a serious event requiring medical attention. Signs and symptoms of a concussion may present immediately following a head injury, or days or even weeks after initial injury.

Signs of a Concussion

  • Loss of consciousness:  A loss of consciousness is not required for a concussion diagnosis. However, if a child loses consciousness, they should be removed from sport until cleared to return by a physician.
  • Confusion:  A child may appear dazed, be confused about his/her position, or be unsure of the score.
  • Changes in memory: A child may forget events that happened directly preceding the incident, or may forget events that happened directly after.
  • Reported changes in vision:  A child may report double vision, sensitivity to light, or blurry vision.
  • Balance problems:  A child may report balance issues or dizziness; a parent or coach may observe an increase in clumsiness or falls
  • Changes in activity level:  A child may report feeling sluggish or groggy; he/she may also report “not feeling right.”

Warning Signs of Emergent Injury

  • One pupil is larger than the other
  • Cannot recognize familiar faces
  • Child cannon be awakened
  • Unusual behavior
  • Worsening headache
  • Loses consciousness
  • Repeated vomiting or nausea
  • Weakness or numbness
  • Slurred speech
  • Becomes increasingly confused or agitated
  • Convulsions

If you see one or more of these signs, dial 9-1-1 or take the child to the emergency room immediately!

If you feel your child has had a concussion, it is recommended that they are cleared by a physician prior to return to sport. A physical therapist can help treat post-concussion symptoms, such as neck pain, balance deficits, and vision/vestibular issues. Please contact North Shore Pediatric Therapy for a return-to-sport physical therapy evaluation. 

 


[1] “Heads Up, Concussion in Youth Sports.” CDC. Center for Disease Control, n.d. Web.






6 Health Benefits of Basketball for Children

Ever wonder which team sport keeps boys and girls busy no matter their age, skill level, or the season? I recently had the opportunity to watch one of my clients play basketball with his middle school team, and it was so rewarding to see him transfer skills we worked on during physical therapy to the court.  Basketball is a high-intensity, high-agility activity that teaches children coordination, concentration, and cooperation.

6 Health Benefits of Basketball:

  1. Endurance: As with any high intensity sport, there are many cardiovascular benefits of basketball.  Between bouts of running, jumping, dribbling, and bouts of rests, kids are participating in total body interval training without even realizing it. Interval training boosts aerobic capacity, energy levels, and metabolism, which in turn helps kids concentrate more in school.
  2. Motor Control: The ability to control our limbs in space may come naturally, but being able to pass and shoot with precision during a basketball game takes special training and repetitive practice.  Performing drills on and off the court with a basketball enables children to grade their muscle forces, control the position of their bodies in response to an opponent or a pass, and plan out successful movement sequences.
  3. Ankle Stability: All the agility training, cutting back and forth, multidirectional running, pivoting, and turning within a basketball game are great ways to challenge our lower body muscles and joints, especially the structures surrounding our ankles.  Organized basketball teaches kids safe and successful ways to block, pass, steal, jump, and run without hurting themselves or others.  Ball sports such as basketball are great for reinforcing kids’ balance reactions and balance strategies and prevent future injury.
  4. Balance/Coordination: As with most team sports, basketball requires upper body coordination, total body coordination, and hand-eye coordination. Dribbling, catching, passing, and making baskets require planning, precision, and quick reactions. Walking backwards, turning, or running while dribbling a ball and at the same time paying attention to other players is a challenging but interesting exercise for coordination and body awareness.
  5. Agility: Basketball is a fast paced sport where athletes have to think fast on their feet and respond quickly to plays that could change momentum and direction at any minute.  Young athletes are working on mental drills in addition to physical techniques. Basketball enhances children’s agility due to the swiftness needed to dodge other players and make aggressive plays.
  6. Social Skills: The great thing about team sports is the level of discipline and communication needed for success at the games. Young athletes learn from an early age how to work in a team atmosphere, pay attention to others, and respond accordingly. An athlete needs discipline to attend practices and pay attention to the rules of any game.  Team sports prepare children for necessary social interactions later in life.  Through these sports, children understand shared responsibility, team work, how to deal with triumph and defeat, all of which are applicable throughout life.

Click here to read about the health benefits of another fun winter sport: hockey!

The Rewards of Adaptive Bicycles for Children

Bicycle or tricycle riding is an important component of childhood. For certain children with medical complexities, there are special equipment that enable them to explore the world just like any other child.

When I was working as a physical therapist on the pediatric floor of a rehabilitation hospital, I encountered many children and families impacted by debilitating conditions and circumstances. From cerebral palsy and brain injury, to spinal injury, or cancer, many of the children I met proved that being physically and cognitively limited did not keep them from participating in stimulating play activities.

Adaptive tricycles are designed to provide less able-bodied children a way to exercise their limbs, practice their skills and encourage their participation. 

They often come with various features and accessories such as extra wide frames, trunk reinforcement, head support, leg straps, hand straps, steering assist, etc. They make it possible for children who have low muscle tone, motor control, coordination, or cognitive function to engage in locomotion.

How Can an Adaptive Bicycle Help?

For children with diagnoses that reduce their trunk control, adaptive bikes provide a safe environment where they can work on coordinating their limbs while having their back fully supported or strapped in.  For children who fatigue easily due to their medical conditions, adaptive bikes offer the option of having an adult help steer from behind.  For children who lack the motor control to alternately pedal their legs, foot straps and connected pedals make the reciprocal motion easier by putting muscles and joints through those much needed ranges. Depending on the type of bike, adaptive handles can also accommodate all kinds of grip. So when a child with upper body weakness has a hard time grasping or holding the handlebars to steer a regular bike, an adaptive bike allows them more control of their locomotion.

Durable wheels and a parking brake make adaptive bikes safe for children with a wide range of physical abilities and conditions.  Children with medical complexities who are restricted to a wheelchair can still benefit from rides in an adaptive bike.  Aerobic training and upright posture, as well as limb movements (facilitated or self-initiated), are an essential part of the growth and rehabilitation process for children of all different capabilities. All of this is made easy by special equipment such as the adaptive bike. Being outside and being able to participate in activities with other children promote emotional health and create positive environments for mental and physical growth.

The Rewards of Using Adaptive Bicycles

I have watched many children blossom behind the wheel of an adaptive bicycle. Taking part in that transition is such a rewarding process.  Children who were unable to move certain parts of their bodies after an injury were eventually able to transfer what they learned during cycling to standing and walking tasks. Toddlers who were never able to stand on their own were able to experience, for the first time, limb movements and self-propulsion locomotion. Seeing the smiles on their faces, and hearing the laughter of their parents and siblings… Those moments definitely made my job worthwhile.

Tips for Buying Tricycles for Toddlers

An important part of childhood is riding around in your first set of wheels. Between 2 and 3 years of age is a good time to look into tricycles. Tricycles are important for both cognitive and physical development, helping children explore their environment in new ways and develop their confidence and independence. Tricycles are also a great way to build a child’s coordination, endurance, balance, and core strength.

Tricycles are a great transition between scooters and bicycles. Scooters, strider bikes, and seated ride-on toys (learn more about these toys here) don’t have pedals so kids just have to put their feet down on the floor to propel or stop.  Tricycles and bicycles, on the other hand, require some total body coordination to pedal and steer at the same time. Bicycles require more advanced coordination and balance than a starter tricycle.

What to look for in a tricycle:

  1. Safety: A tricycle that is compact, light, and easy to push might not be sturdy enough to support a growing child. Look for a wide base of support and a stable steering wheel (one that does not make hard turns) so the trike isn’t easily flipped over. A decent tricycle does not break easily. Look for a trike that’s made out of sturdy materials (metal as opposed to plastic).
  2. Fit: A tricycle will most likely encourage independence and confidence if the child can actually reach the pedals. There are lots of tricycles out there with adjustable seats, handles, and pedals. Make sure you pick a tricycle that your 1.5 year old can grow into for at least a couple of years. If your child has a hard time keeping his feet on the pedals, there are also Toe Clips available at most toy retailers to help strap their feet in.
  3. Function and Fun: When purchasing a tricycle for your 2 year old, consider if having a push bar would be important. Push bars let parents steer their children around, which could be a good option when trying to navigate busy city sidewalks or if your child has a hard time coordinating the pedals at first. Most push bars are removable for the more advanced tricyclist.  Some tricycles have storage or dump buckets. These are usually big hits with children; they love to cart things around.

Tricycles provide a new level of independence for young children, and promotes emotional and physical growth. As always, children should be supervised and wear protective gear when on any mobile toy.

The 411 on Infant Rolling

Around the 4th or 5th month of a baby’s development, he will roll over from being on his tummy to his back. This is often purely accidental; he does not have the ability to control his weight-shifting on his tummy and often tips over as a result.  Around the 5th or 6th month, a baby will have the abdominal strength to lift up his feet and roll over from his back to his tummy. Many of the kids I see are infants and toddlers who somehow missed this important step, or who didn’t start rolling until after the 9th month.  Many of the parents I talk to didn’t give this a second thought until they noticed delays in other skills later on in their children’s growth.

Why is rolling so important?

A healthy, typically developing infant is constantly moving. Like the rest of his body, his musculoskeletal and nervous systems are constantly maturing. As he gains strength in all his big muscle groups, he is also learning how to control his limbs. Motor control is an important aspect of a baby’s neuromuscular growth. Rolling encourages postural muscle recruitment (including the back extensors, hip flexor/extensors, the obliques, and the abdominals). The muscles need to be strong before a baby can learn to crawl, stand, or walk.

The segmental volitional rolling that babies learn to do also encourages trunk dissociation. Through rolling, they learn to separate the movement of their limbs from the movement of their head and trunk. Through these transitional positions, they learn to balance the muscles on the front of their body with the muscles on the back and sides. When they roll to one side of their body, they are elongating that side and contracting the other. It is through this unilateral segmented use that children develop their sequential motor skills – crawling, walking, and most other locomotion skills require the ability to separate one side from the other and separate limb movements from trunk movements.

How can parents help encourage rolling?

  1. Start early. This is similar advice I give to parents about increasing infant tummy time: get down on the floor and play with him. Encourage him and motivate him with toys, sounds, lights, and faces. Start as early as you can. Babies have certain built-in reflexes that help them roll to their side if they just turn their head (the neck-righting reflex).
  2. Ease in.  The more a baby rolls, the more input he receives from his environment to his big muscle groups. Our job is to introduce him to his environment and help him tolerate each new position. His own maturation process will take it from there. Play with him when he is on his tummy or back, then help him to his side and play with him there.
  3. Engage your child, step-by step. With your baby on his back, place a toy just out of reach. Help lift one of his legs and bend his hip to 90 degrees or higher. Slowly cross his leg over the other hip. Wait for him to turn his upper body and kick in his trunk muscles. Your pressure across his hips should be firm, but gentle.
  4. Practice. Practice. Practice. And repeat.

When should I seek a pediatric physical therapy evaluation?

What I often look for is initiation.  The lack of initiation by 6 months is a good indicator that your baby may need a little push from a pediatric physical therapist.  If your baby is not picking up his feet and rolling easily from side to side while on his back by 6 months, bring him in for an evaluation.

What Should My Baby Be Doing on Her Tummy by 6 Months?

Many first-time parents are not told about the importance of tummy time for newborns until their children become toddlers with atypical movement patterns, clumsy gait, or motor delay.  With our hectic schedules and fast-paced lifestyle, sometimes it is just easier to pick our children up and get going. But, pediatricians and physical therapists will agree, tummy time is an important aspect of infancy to develop the motor skills children need to actively engage in their environment.

How do you know if your baby is spending enough time on her tummy?

By 6 months, these are the things your growing explorer should be able to do:

Reach for nearby toy while on tummy:

Her gradually improved trunk stability, shoulder girdle mobility, and emergent interest in her surroundings allow your baby to briefly prop on one hand and reach with the other for toys.

Raise entire chest:

Now that your child can props on her hands with arms straight, elbow in front of shoulders, she not only can lift her head up, but her trunk as well.

Extend arms and legs (alternately or together) off a surface, and lift head up against gravity with neck elongated:

At 6 months, a baby’s back muscles are strong, but that strength is also balanced by her chest muscles. Because of this, a baby at 6 months can lift up her head against gravity but also tuck her chin. She may be able to perform swimming motions that eventually lead to belly crawling.

Equilibrium reactions in prone:

What this means is that the muscles on the front and back of her trunk can now adapt to changes in her center of gravity. The equilibrium reactions return her to her tummy when she shifts her weight and prevents her from falling over. The more controlled her movements become, the better equipped she is to start scooting after toys.

To Summarize:

For a typically developing child, tummy time should be her most preferred position because of the mobility and freedom she experiences in that position. Tummy time is where a child learns to separate her two sides and use them independently of each other. It is an important place to encourage the initiation of belly crawling and eventually crawling.

Red flags – Signs that warrant a physical therapist evaluation:

Remember, every child develops differently. The tummy time skills listed above are the skills pediatricians and physical therapists look for to make sure a child is on track.  If your baby isn’t consistently showing these skills by 6 months, keep putting her on her tummy, play with her, and give her a couple weeks’ time. Some babies just need more input to their hands and abdominals before they build up the strength to do all of the above.

However, consider an evaluation if you still notice the following by the 7th month:

  • Difficulty lifting her head
  • Stiffens her legs with little or no movement
  • Does not roll over
  • Arches body backwards stiffly in an attempt to roll over, instead of using the abdominals.
  • Does not sit independently
  • Does not play with her feet when lying on her back

If your baby gets really fussy during any time spent on her stomach, read here for great alternatives to tummy time.

Get the Family Healthy in 2014, Part 2 of 2

Last week, I discussed three New Year’s resolutions to help get your family healthier in 2014. Here are some more ideas. Like I said in last week’s post, adopt as many of these as you think are realistic for your family. Or pick one change to implement each month as the year goes on. By summer, you will see some real changes!

More Fixes for Healthy Family Eating:

1. Eliminate sugary beverages, including juice. This change is pretty simple and can have a huge impact. Sugary beverages are problematic because it’s easy to quickly consume a lot of calories without feeling full. Juice and sports drinks are not ideal drink choices either, as they are just as calorie-dense as other sugary beverages like soda. It is better to get the vitamin C and electrolytes from healthy food choices. Kids rarely need sports drinks to replace electrolytes during or after physical activity unless they are involved in multiple hours of continuous physical activity and are sweating a lot. Chocolate milk is also considered a sugary beverage, and should be replaced with plain milk. If you are wondering how much sugar is in some of your family’s favorite drinks, measure out one teaspoon of table sugar for every 4 grams of sugar in the “Total Sugar” content on the Nutrition Facts Label. Be sure to look at what the serving size is and how many servings your family member is consuming. I have done this experiment with many families, and they are always shocked since no one (not even the kids) would consider drinking that heap of table sugar.

2. Do something active for at least 60 minutes, every day. Encourage your child to be active by having plenty of outlets for physical activity all year round. For days the weather is not conducive for outdoor play, have a bin filled with things like jump ropes, hula hoops, balls, and other toys. Encourage your child to participate in sports or other hobbies that involve physical activity. Be a good example. Find ways to be physically active as a family, such as walking places within a mile or so instead of driving. This is possible even in cold winter months as long as you dress warmly. If your child is resistant to doing fun physical activities, then offer another option— house chores.

3. Limit screen time to less than 2 hours per day. When you think about how many hours your child spends sitting at school, then how many hours they spend sitting doing homework, then how many hours they spend sitting watching TV or playing on the computer—it adds up to a pretty sedentary lifestyle. This is one of the biggest implications of childhood obesity in our culture today. We have transitioned from a society that relied on physical labor to complete daily tasks, to a society that relies on convenience. Kids used to play outdoor games and sports for fun, and now they play video games. I have had some school-age kids tell me that they just don’t know how to play. Set boundaries around screen time. One idea is to have the kids earn screen time by doing 60+ minutes of physical activity and completing homework.

Any of these New Year’s resolutions will make a healthy impact on your family, especially if the whole family is on-board and participating together. The resolutions described are all simple changes, but can be challenging to implement and sustain without commitment. For more personalized planning and troubleshooting, make an appointment with a registered dietitian at North Shore Pediatric Therapy.

Click here if you missed part 1 of this series, Get Your Family Healthy in 2014.