Tag Archive for: gross motor skills

Moving Away from Positioning Devices in 2017

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Obviously, no baby is going to spend 100% of their time playing on the floor or a mat/blanket. At some point you need to cook or shower and you need a place for the baby where they’re safe Blog-Positioning Devices-Main-Landscapefrom the toddler, the dog, or somewhere you know they won’t roll away. This is the time to use the exersaucer, sling seat, or bumbo seat; but try to limit the time spent in these devices to 20-30 minutes per day, collectively.

Here’s why you should consider moving away from positioning devices…

The biggest problem with these devices is children are placed in them well before they have the proper trunk and/or head control to really utilize them properly. With an exersaucer, most babies are also unable to place their feet flat on the bottom but are still pushing up into standing. This can increase extension tone, decrease ankle range of motion/muscle shortening, and can possibly be linked to future toe walking.

With a bumbo or sling seat, the baby is not placed in optimal sitting alignment causing poor sitting posture. While these appear to provide great support and make 4 month old babies look like they can sit independently, the truth is the device isn’t allowing your baby to utilize their core muscles to actively sit.

The bottom line is, if the positioning device is doing all the work, what is your child learning to do?

The best place for your child to play and spend the majority of their time is on the floor or on a blanket/mat. This allows them the opportunity to properly explore their environments and practice typical movement patterns like reaching for their feet, rolling to their side, rolling over, spending time in prone, pivoting, and creeping/crawling.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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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Physical Therapy Month: What do Physical Therapists Treat?

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When I tell people that I am a pediatric physical therapist I am often met with a blank, questioning stare. Why could children possibly need physical therapy? When most people think of physical blog-physical therapy-month-main-landscapetherapy, they think of recovering from a back injury or shoulder surgery, or maybe they think of someone in a nursing home going through rehab after a stroke. However, children can often benefit from the services of a physical therapist as well, from newborns all the way through adolescents. Pediatric physical therapists focus on the gross motor development of children, and work to address any limitations that may impact that development.

Pediatric physical therapists therefore work with a wide range of diagnoses and conditions including:

  • Gross motor delay: Development of gross motor skills is an important piece of child development. Since these skills build on one another, a delay with one skill can lead to further delays or difficulty with later skills. Pediatric physical therapists can help your child develop the major gross motor milestones listed below, as well as many more!
    • Rolling
    • Sitting
    • Crawling
    • Standing
    • Walking
    • Running
    • Jumping
  • Torticollis and plagiocephaly: Torticollis is a condition that occurs when there is asymmetrical muscle length and strength in a baby’s neck muscles, and therefore limits symmetrical neck motion. Plagiocephaly, or asymmetrical head shape, often occurs when a child has torticollis, as a result of frequent pressure being put on only one part of the head. A pediatric physical therapist can help to stretch and strengthen the child’s neck in order to promote symmetrical motion and head shape.
  • Balance and coordination disorders: Limitations in balance and coordination can have a significant impact on a child’s ability to develop motor skills, as well as to safely negotiate his or her natural environments. A pediatric physical therapist can treat these limitations to allow for improved functioning and safety.
  • Neurological disorders: A neurological disorder occurs when there is abnormal functioning of the body’s nerves, spinal cord, or brain. These are just a few of the disorders that a pediatric physical therapist can treat.
    • Cerebral palsy
    • Spina bifida
    • Traumatic brain injury
    • Spinal cord injury
  • Orthopedic conditions: Children get hurt too! Even though children tend to be more resilient to injury then adults, children who suffer an injury or require surgery can also benefit from physical therapy services to help restore function to the musculoskeletal system.
    • Post-injury
    • Post-surgery
    • Scoliosis
  • Genetic disorders: Genetic mutations may result in impaired development and functioning in children, and can therefore be addressed through intervention with a pediatric physical therapist. While there is a wide range of genetic disorders and their resulting impact on child development, below are a few examples of genetic disorders where a pediatric physical therapist is typically a part of the child’s team of providers.
    • Down syndrome
    • Duchenne muscular dystrophy
    • Prader-Willi syndrome
  • Gait abnormalities: The way a child’s lower extremity bones and muscles develop have a large impact on the child’s gait mechanics. Abnormalities with gait, such as toe-walking, can be addressed by a pediatric physical therapist.
  • Many more! If you are unsure of whether your child may benefit from the services of a pediatric physical therapist, speak with your pediatrician or reach out to a pediatric physical therapist near you.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood,Glenview, Lake Bluff, Des Plaines, and Hinsdale! 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!

Make the Summer Olympics Come to Life in Your Own Home

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With the Summer Olympics just days away, what could be a better time to engage your kids in fun Summer Olympicsactivities to promote physical activity, social interaction, a healthy lifestyle, and improve their overall development? Many kids dream of becoming a gold-medalist in the Olympics and with these activities, you can make your child feel as if they are standing on top of that podium while assisting in their skill development without them even realizing it! There are endless opportunities to promote your child’s well-being. Be creative! Below are a list of easy-to-do Olympic related activities to get you started:

Focus on Fine, Visual, and Gross Motor Skills:

Table time activities

  • Print off Summer Olympic word searches, mazes, and coloring pages.
  • Create the Olympic rings (Cut strips of paper, form them in to circles, and connect them).
  • Olympic torch craft (create an Olympic torch using a paper towel roll, covering it with tin foil, and cutting/taping flames to the roll using red, orange, and yellow tissue paper).
  • Origami Olympic Rings (http://www.activityvillage.co.uk/origami-olympic-rings)
  • Create gold, silver, and bronze medals using paper, clay, tin foil, or paper plates. Then connect them to a string or ribbon to wear during your Olympic games.
  • Write about a favorite sport, Olympian, or your child’s Olympic dream.

Play Sports and Competitive Activities:

  • Basketball, swimming, running, simple gymnastics tricks, volleyball, soccer, hockey, mini-golf, etc.
  • Water balloon toss or ring toss
  • Races (three legged races, sack races, spoon, or relay races)
  • Obstacle course
  • Throwing a ball through a hoop or at a target,
  • Create a long/high jump

Focus on Social-emotional Skills:

  • Model good sportsmanship- Play the Olympic games with family and friends. This gives you the opportunity to model good sportsmanship when losing, working as a team, and how to support/encourage others for your child.
  • Promote social interaction with others, sharing, and taking turns – these are all important for building friendships and play skills.
  • Use positive self-talk– “I can do it,” “I will try my best,” “The more I practice, the better I will get.” Promoting positive self-talk will help improve self-confidence, increase positive thoughts, and will help improve performance during tasks.
  • Create rules for the games to teach direction following and playing fair with others.
  • Celebrate differences– the Olympics are a time of celebration, unity, and peace. Take this time to teach your child about different cultures and countries from around the world and that we accept our differences and treat everyone equally.
  • Promote friendly competition– While playing games, time your child and see how fast they can complete the game. Then see if your child can beat their score every trial. This will promote focus, improve overall attention, and assist in friendly competition with themselves or others.
  • Identify feelings of others– Find pictures of athletes in the Olympics on the internet or in magazines which portray emotions on the athletes faces and ask your kids how they think the athletes are feeling.

Focus on Sensory Processing:

  • Tactile input
    • Create the Olympic rings with finger paint- have the child create a circle with their thumb and index finger and with a paint brush, paint their hand. Then print on to the paper and repeat with the next color (this is a great tactile play activity for the tactile defensive child)
    • Bake cookies and decorate them to look like the Olympic rings, medals, basketballs, etc. Have your child mix the dough with their hands and decorate with frosting, sprinkles, or candies. This way your child is engaging with all different textures.
  • Proprioceptive input with heavy work– Have races, whether it be while pushing a laundry basket, running around a track outside, or animal walk races (these are great activities to help regulate the sensory seeking child or increase arousal levels)
  • Oral and tactile input-Engage with and try different foods from different countries and cultures from around the world- maybe your picky eater will try something you never though they would!

Focus on Speech and Language:

  • Incorporate your child’s target sounds in the context of the Olympics. For example, if your child is working on his or her “L” sound, have them practice saying: Summer Olympics, medal, or basketball.
  • Improve expressive language by describing/explaining as well as answering open ended questions, you can ask you child some of these questions:
    1. How hard do you think the athletes work to be able to compete in the Summer Olympics?
    2. How do you think the athletes feel on the day when they will be competing in the Olympics?
    3. What types of things would you do on that big day to prepare?
    4. How do you think an athlete would feel if they took last place in the Olympic Games?
    5. If you were going to compete in the Summer Olympics, which sport would you chose and why?

Make it even more fun by making a whole day out of it and creating your own Olympic Games! Create an athlete registration table, make teams, dress up, and don’t forget the award ceremonies. Enjoy and may the odds be ever in your favor!

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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fitness goals for kids

Fitness Goals For Elementary Aged Children

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Parents often wonder if their children are happy and healthy. While most children will let you know if they are happy or not, determining a child’s health may require some more investigative work. A child’s innate athleticism, or lack thereof, may make a child appear more or less fit than they actually are. Here are some fitness standards pulled from standardized gross motor tests, the Presidential FitnessGram, and endurance norms for 6-12 year old children.

Fitness Standards for Children:Fitness Standards for Elementary Aged Children

6 Year Old

  • Completes 5 sit-ups Independently
  • Completes 8 push-ups with good form, given 1 demonstration
  • Skips forward 10 feet
  • Completes half mile run in 6 minutes

8 Year Old

  • Completes 6 sit-ups Independently
  • Completes 8 push-ups with good form
  • Completes 4 pull-ups
  • Rides a bike 20 feet independently
  • Completes half mile run in 6 minutes

10 Year Old

  • Completes 12 sit-ups Independently
  • Completes 10 push-ups with good form
  • Completes 4 pull-ups
  • Completes mile run in 12 minutes

12 Year Old

  • Completes 18 sit-ups Independently
  • Completes 10 push-ups with good form
  • Completes 4 pull-ups
  • Completes mile run in 9 minutes for boys and 11 minutes for girls

If you feel your child isn’t meeting the above fitness goals, please see the pediatric experts at North Shore Pediatric Therapy for a free physical therapy screening.

north shore pediatric therapy physical therapy

NSPT offers services in Bucktown, Evanston, Highland Park, 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 today!

w sitting

What’s Wrong With W-Sitting?

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Parents bring their kids in for a physical therapy evaluation for many different reasons, from toe-walking to neuromuscular conditions to decreased ability to keep up with peers. Regardless of the diagnosis, about 25% of my clients under 5 also present with w-sitting. When brought to the attention of the parents, typical responses range from, “I’ve never noticed that before; is that bad?” to“I w-sat as a child, and I turned out fine.” Physical therapists will most always work to correct this sitting posture and some of the underlying impairments. Here are some of the reasons w-sitting is not healthy for children.

What’s wrong with w-sitting?

  • Decreased Core Activation – Due to the wide base of support afforded with w-sitting, less coreWhat's Wrong With W-Sitting? muscle (trunk extensors and abdominals) activation is required to maintain position. This wide base of support also limits the child’s need to weight shift from side to side during play, resulting in decreased use of lateral and posterior balance reactions.
  • Poor Posture – “W”-sitting encourages excessive posterior pelvic tilt, which can result in slouching. Excessive hunching over results in minimal trunk extensor activation. This creates a cycle of poor sitting posture due to muscle weakness, resulting in poor sitting posture.
  • Pigeon-Toed (In-Toeing) Walking Pattern – Increased hip internal range of motion, decreased hip external range of motion, and hip abductor weakness can contribute to an in-toeing gait pattern. It should be noted, however, that some in-toeing gait can be attributed to femoral anteversion.
  • Decreased Trunk Rotation – Poor trunk extension due to posterior pelvic tilt can limit ability to turn trunk from side to side. This is important because decreased trunk rotation during play can impair the body’s ability to integrate left and right sides of the body, leading to decreased coordination
  • Delayed or Impaired Fine Motor Development – This delay is usually due to a combination of the impairments already mentioned above, such as decreased trunk rotation and poor core strength. These impairments can lead to decreased play involving midline crossing and poor development of bilateral coordination. High level fine motor tasks, such as fastening a button, requires a coordinated effort between left and right hands.

Click here to read more about w-sitting and the young child.

To help your child who ”w”-sits, please contact one of our physical therapists at North Shore Pediatric Therapy for a free screen.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!

4 year old doctor visit checklist

4-Year Doctor Visit Checklist

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We continue our series on checklists for yearly Pediatrician check-ups (click here to see the checklists for the 1-year visit, the 2-year visit and the 3-year visit). Pediatricians have a set of developmental red flags, but these only hit the “big-bad-uglies” as we like to call them, including the following: Can you understand everything your child says? Does your child fall excessively? Is he feeding himself? These red flags are very specific, meaning a child who exhibits these red flags would be identified for services, but not very sensitive, meaning many children who would benefit from therapy services are missed. To help bridge the gap between Pediatricians’ red flags and children who need therapy services, I have put together a checklist of things to discuss with your Pediatrician at your child’s 4 year check-up.

At 4 Years Your Child Should Be Able to Do the Following:

Gross Motor Skills4-Year Old Doctor Visit Checklist

  • Places one foot on each stair, while going up and down stairs without handrail use
  • Hops forward on one foot
  • Throws ball at a target 5 feet away
  • Runs and stops without falling to ground

Fine Motor Skills

  • Unbuttons and buttons clothing
  • Cuts paper in near straight line
  • Independent eating with good fork use

Speech Skills

  • 100% intelligible to familiar audience
  • Uses plurals and past tense
  • Correctly uses “he”, “she”, “they”
  • Follows 3-step commands
  • Points to parts of pictures

Take this checklist with you to your 4-year visit. If you have further concerns, schedule a pediatric physical therapy evaluation.

north shore pediatric therapy physical therapy

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!

3 year doctor visit checklist

3-Year Doctor Visit Checklist

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We continue our series on checklists for yearly Pediatrician check-ups (click here to see the checklist for the 1-year visit and the 2-year visit).  Pediatricians have a set of developmental red flags, but these only hit the “big-bad-uglys” as we like to call them, including: stutter, go up and down stairs by themselves, or answer and ask “yes or no” questions.  These red flags are very specific, meaning a child who exhibits these red flags would be identified for services, but not very sensitive, meaning many children who would benefit from therapy services are missed. To help bridge the gap between Pediatricians’ red flags and children who need therapy services, I have put together a checklist of things to discuss with your Pediatrician at your child’s 3 year check-up.

At 3 Years, Your Child Should Be Able to Do the Following:

Gross Motor Skills3-Year Doctor Visit Checklist

  • Pedals a tricycle
  • Catches a ball thrown from 5 feet away
  • Jumps forward at least 24 inches, with both feet leaving the ground at the same time
  • Stands on 1 foot for 3 seconds
  • Walks up stairs with 1 foot on each step

Fine Motor Skills

  • Draws circle, horizontal lines, and cross, with demonstration
  • Strings small beads
  • Opens screwed top container
  • Pulls up pants and puts on coat independently

Speech Skills

  • Increases word production to >300 words
  • Combines 3 word phrases
  • Starts to understand differences between opposites
  • Begins to follow 2 –step commands
  • Names colors
  • Demonstrates parallel play

Take this checklist with you to your 3-year visit. If you have further concerns, schedule a pediatric physical therapy evaluation.

north shore pediatric therapy physical therapy

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!

2-Year-Old Checklist

2-Year Doctor Visit Checklist

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Building off of last month’s 1 year check-list for Pediatrician check-ups, we bring you a check-list to look at prior to your child’s 2 year old check-up.  Again Pediatricians have a set of developmental red flags, but these only hit the “big-bad-uglys” as we like to call them, including the following questions: does your child get frustrated when trying to talk, can he or she jump or attempt to jump, did your child walk by 18 months. These red flags are very specific, meaning a child who exhibits these red flags would be identified for services, but not very sensitive, meaning many children who would benefit from therapy services are missed. To help bridge the gap between Pediatricians’ red flags and children who need therapy services, I have put together a checklist of things to discuss with your Pediatrician at your child’s 2 year check-up.

2-Year Check-Up Red Flags:

Gross Motor SkillsParent Checklist for 2-Year-Old Well Visit

  • Runs forward 10 feet, without a loss of balance
  • Jumps in place, jumps forward, and jumps down from a step
  • Walks forward, backwards, and sideways independently and without a loss of balance
  • Walks up and down a set of stairs, using a handrail
  • Kicks a ball forward 3 feet

Fine Motor Skills

  • Turns pages of thick page book, 1 at a time
  • Stacks 5 cubes
  • Draws vertical lines given demonstration
  • Takes off button-less clothing and socks independently

Speech Skills

  • Begins saying 2 word phases and 2 word questions
  • Increases vocabulary to saying >50 words and understanding >300 words, with new words added every week
  • Answers “yes or no” questions
  • Points to objects named
  • Speech should be understood at least  50-75% of the time by a familiar listener

Take this checklist with you to your 2-year visit. If you have further concerns, schedule a pediatric physical therapy evaluation.

north shore pediatric therapy physical therapy

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!

12-Month Doctor Visit Checklist

12-Month Doctor Visit Checklist

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Developmental check-ups with a Pediatrician throughout your child’s first year of life (at 2, 4, 6, 9, and 12 months) are a perfect place to bring up any concerns you as a parent may have a about your child’s development. While Pediatricians have their own set of developmental red flags, these only hit the “big-12-Month Doctor Visit Checklistbad-uglys” as we like to call them, including the following:

  • Is your child rolling by 6 months?
  • Is your child sitting independently by 8 months?
  • Is your child crawling by 12 months?
  • Is your child walking by 18 months?

These red flags are very specific, meaning  a child who exhibits these red flags would be identified for services, but not very sensitive, meaning many children who would benefit from therapy services are missed. I have seen many children referred to physical therapy for delayed walking skills, who are not standing independently or didn’t roll consistently until 8 months. To help these children who are being missed by the Pediatricians red flags, I have put together a checklist of things to discuss with your Pediatrician at your child’s 12 month check-up.

Checklist for your child’s 12-month doctor visit:

Gross Motor Skills

  • Independently transitions into and out of sitting
  • Rolling independently from back to belly, and belly to back, with ease
  • Crawling on hands and knees with reciprocal form
  • Pulls to stand at stable surface
  • Cruises along furniture

Fine Motor Skills

  • Begins using pincher grasp (thumb and single finger)
  • Transfers objects from one hand to the other
  • Places toys into large container, and takes toys out
  • Begins holding spoon during feeding

Speech Skills

  • At least 1-2 words
  • Babbling with constant – vowel combination, ie. ba-ba, ma-ma, da-da
  • Labeling object with consistent sounds, ie. ball is always “ba”
  • Pays attention to speech around them
  • Follows simple commands, ie. “go get the ball”

Take this checklist with you to your 12-month visit. If you have further concerns, schedule a pediatric physical therapy evaluation.

north shore pediatric therapy physical therapy

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!

Why Isn’t My Child Walking Yet?

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As a follow up to last week’s blog, Signs that My Child Will Walk Soon, I present the next topic in my walking series, Why Isn’t My Child Walking?. As first birthdays come around, many anxious parents wonder, “why hasn’t my child taken his first steps?” First off, let me dispel the myth that babies will begin taking their first steps by their first birthday. The normal range for independent walking is 10-18 months, however most children begin walking around 14-15 months. Delayed walking skills may be due to decreased muscle strength, decreased confidence, or impaired balance. Read below for a description of signs of each and tips to help improve them.

 Reasons Your Child May Not Be Walking Yet:

  • Decreased Muscle Strength: Walking is a major milestone for children and requires a lot of lower extremitywhen will my child walk strength. This is why there are so many important precursors to walking, such as cruising and creeping on hands and knees. Children typically spend 1-4 months in each of these precursory milestones in order to build the strength necessary for walking. Encouraging your child to spend time in these gravity dependent positions will help build lower extremity strength.
  • Decreased Confidence: Often times children who have been cruising for significant periods of time without making the transition to independent stepping may have decreased confidence in their walking skills. Employing a towel or blanket that is held as a link between parent and child, can help build their confidence.
  • Impaired Balance: A child who shows difficulty with independent standing may have impaired balance and proprioception. Using heavier shoes that help give feet to the child that let them know where they are in space.
  • Other Medical Reasons: There may be an underlying medical condition preventing your achieving his gross motor milestones in an appropriate time frame If your child is not demonstrating signs that he will walk soon by 12 months of age, please contact your physician or come into North Shore Pediatric Therapy for a free physical therapy screen.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview 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 today!