Your 5-month-old just learned to lift his feet from the ground and grab them with his hands. What’s next? Putting the toes into the mouth, of course!
This is such a sweet phase of development. Here is a quick review of the amazing things that are happening as your baby pulls her toes to her mouth.
- Activated abdominal muscles! You can see activity in the lower abdominals from the wrinkles on this baby’s tummy. Additionally, the baby’s pelvis is up off the ground.
- Developing and strengthening downward visual gaze/capitol flexion.
- Developing and strengthening balance of postural flexors and extensors, now in advancing to a diagonal motion.
- Grasping and pulling feet with either one or both hands.
- Activating quadriceps muscles as the leg straightens.
- Stretching out hamstrings from the physiological flexion present at birth.
- Stretching the toes into extension.
- Foot desensitization (with the heel pounding that happens when the feet hit the floor again).
- Tactile input from mouthing, grabbing, stretching; preparing the feet for walking.
- Developing general body awareness.
When a baby discovers this position, they are becoming experts at rolling to their side.
There are hundreds of medical reports in Kiyoshi’s file. In addition to oligoarticular juvenile idiopathic arthritis (JIA) he has uveitis and a seizure disorder. Kiyoshi has severe pain, joint contractures and difficulty moving around. Medications are not controlling the inflammation, there have been more seizures lately and his foot orthotics are too small. How do you begin physical therapy decision-making with a child this complex?
The International Classification of Functioning (ICF) conceptual framework allows you to apply your knowledge and skills to challenging situations. It will take a while to sort information into proper categories and edit. However, once this is complete, connections become clear and sound clinical decision-making will follow. The question I get asked most often about the ICF is , “where do you start?”. This post will guide you as you fill in the ICF/NDTA Enablement Model categories for the first time. Continue reading “10 Strategies For Filling In the ICF-CY/ NDTA Enablement Model”
Do you want to burn extra calories, work on motor coordination and challenge your balance? Is your knee hurting as you walk up the hill? Turn around and take a part of your walk backwards. It’s called retro-walking.
Walking in reverse with balance and control comes in handy many times a day. Where does this happen?
- As you take a step back to open the front door.
- Forgot your keys in the house? You will probably place one foot back while changing direction.
- During a two person furniture lift, you’re the lucky one who gets to walk backwards!
- Moving in a crowded kitchen, you back up to let your daughter squeeze by.
- At the gallery you see a beautiful painting and take a few steps back to take it in.
- On the playground you balance with a backward stepping response as your friend races by. This time, you don’t fall.
- On the soccer field you run in reverse to prevent the other team from scoring.
Continue reading “Backward Walking: What Are the Benefits?”
“I was lost at the meeting. Everyone was bringing up ideas so quickly; I was unsure about everything by half way through. I didn’t agree and I didn’t want to sign. It was just overwhelming”. Melina has been to her first IEP and needs advice from a person who has been in her place. She is also interested in respite care, a parenting class, and options for more affordable and accessible housing. What are the resources for parents of special needs children in the North Bay Area?
Continue reading “10 Resources: Support and Information for Parents of Disabled Children.”
Freya is a 6-year-old girl with ataxic cerebral palsy. She moved to California from Iowa last month and has been prescribed six months of physical therapy. Freya’s parents are concerned; she has been having difficulty going down the front stairs of their new home. As her physical therapist, do you have a standardized test that will measure her initial gross motor function? In six months, how will you determine whether Freya has made progress?
GMFM-66 Quick Facts:
- 5mo-16 years
- Cerebral palsy
- Test re-test reliability GMAE-scoring method: 0.9932
- Most sensitive to change in children 5 years and younger
- Motor growth curves link
My Gross Motor Function Measure User’s Manual is tattered. I could not work without the GMFM! Like all things that are well designed, the creators have taken a complex concept and made it logical and simple. The GMFM is an evaluative measure that assesses change in motor function over time in children with cerebral palsy. Freya is evaluated in January, receives PT 1x/week and then is retested in July to determine if she has made significant progress. In addition, Freya’s inability to reach across midline will not be overlooked while therapy is heavily focused on stair skills; the test covers all domains from lying and rolling up to running and jumping, with each skill being incrementally harder than the last (in the GMFM-66). Continue reading “How to Use the Gross Motor Function Measure (GMFM-66)”
“My son’s core is so floppy, he really can’t push open the doors when we go to the library. There is no force through his arms. Now that he is older, this is stopping him from doing quite a few things”.
Pushing is an essential skill. To go shopping, a cart must be pushed from aisle to aisle. A dresser drawer can’t stay open; it must be pushed back into position. We push all day long without much thought about our action, whether it is tidying up the kitchen drawers, pushing a vacuum, going through a revolving door, or moving furniture back into its place. Continue reading “Core Stability: Pushing”
Kaylee is a five-year-old girl with quadriplegic cerebral palsy. She is not able to walk or move herself around, but she can use her legs to propel an adapted trike. She loves this and can enjoy a half-mile ride with her mom pushing to help out as needed. No insurance source will pay for the trike and it costs too much to buy out-of-pocket. What are the options?
There are many organizations that make needs and wishes like this one come true. If you are based in Northern California, these are some of the best known ones serving kids with disabilities. If you know of other resources, please make suggestions.
Continue reading “Eight Funding Resources”
“My daughter has low tone. What can I do to get her core muscles working? When she is trying to pull open a heavy door, she can’t get any stability and she just gives up and asks us to do it for her”
Are you wanting to work on core stability with a young child? Strengthening is possible, but the way you go about it is quite different from adults. Instead of counting repetitions, use the context of play.
Imagine that we are stranded on a tropical island! We have just caught the biggest fish in the sea and we are pulling it to shore! There is a long rope with just the right amount of weight tied to the other end. That doesn’t have you? OK, I am in the water and you are pulling me back to shore! The story is yours to create: castles, sleeping dragons, stubborn donkeys. Have fun with the stories! Once children come up with a story and get hooked into the imaginative play, they don’t realize they are working themselves into a sweat! Continue reading “Core Stability: Pulling”
Have you ever wanted to try out a whole selection of adapted trikes? Try a new swimming experience? Enroll in a summer camp?
Participation is defined as anything that involves friends, family, future, fitness, fun, or function. There are many local activities that promote play, new friends, and new interests for children and young adults with disabilities. However, these opportunities are not always easy to find. Most suggestions on this list are based in Sonoma County, California. Some are further away, but could be a fun destination or a special side trip if you are in the mood for adventure! Additional suggestions are welcome.
Continue reading “Recreation for Children With Disabilities in Sonoma County (updated 2022)”
“Is my baby standing OK? It seems like he is up on his toes, and toe walking runs in my family”.
The answer to this question, of course, depends on how old the baby is and how long he or she has been on their feet. I teach in an infant mobility class every week and have the amazing opportunity to watch children pull to stand at the big drum in the middle of the room. How they love to pound on that drum! I love their joy and their success. However, as the class physical therapist, I’m also looking closely at how they are standing. Are they up on their tip toes and leaning into the drum, or are they standing with their hips a little behind their firmly planted feet? Continue reading “Nice Weight Through Your Heels, Little One”