Nice Weight Through Your Heels, Little One

“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”

Wall Activities for Scapulo-Humeral Dissociation

 

You are playing a game on a flat surface during a PT session and everything is going well, but have you thought about the benefits of playing it on the wall instead?  

When we actively reach above shoulder level with hands on the wall, the scapular stabilizing muscles  (lower trapezius and serratus anterior muscles) hold the scapula in place while other muscles work off that stable foundation to elevate the arm (humerus).  Holding in this position dissociates the movement of the scapula from that of the humerus.  Dissociation of this kind naturally evolves in babies at about 5-6 months as they are on their stomachs and beginning to bear weight on extended arms.  Most children older than a year don’t enjoy a prone position any longer and will protest.  Don’t worry, you can get some of the same movement by playing a game on the wall or other vertical surface instead.  Check that you have optimal alignment in all other segments of the body:  rib cage, low back, hips, knees and ankles.
Continue reading “Wall Activities for Scapulo-Humeral Dissociation”

HOW does she move? Pulling the ICF-CY Together by Describing Motor Function.


Ivan is always on the move, always running from here to there. He never walks slowly, never slows down.  Moving quickly and never standing still can represent difficulty with static balance.

How does a person move?  What is the quality? Do they have habitual postures, asymmetrical positions,  particular movement patterns?  In this discussion relating to the International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY), we explore an added domain of Posture and Movement (otherwise known as Motor Functions).  As discussed in a previous post, this is an addition to the traditional ICF-CY made by the Neuro-Developmental Treatment Association.  This domain highlights common postures and movement patterns that run through many activities.  Continue reading “HOW does she move? Pulling the ICF-CY Together by Describing Motor Function.”

What Makes a Good Quality Squat?

The couch creaks and slides every time she sits down.  “I have no control once I start to bend my legs!”, she says.  

Controlled squatting allows babies to get down to the mattress after pulling to stand in their crib.  It allows children to sit down in a chair with control.  It is the ready position,  allowing a low basketball dribble or ease while moving wet clothes from the washing machine into the dryer.    If we don’t have the required alignment, strength and endurance,  falls and crashes start to happen.  Squat with good alignment and build the strength and endurance to squat and recover over and over again in daily life. Continue reading “What Makes a Good Quality Squat?”

One Child’s Response to “What is Your Favorite Thing to Do?”

 

Exciting changes are happening in the field of pediatric physical therapy.  While participation was once off the list of important things, it is now at the very top of the list.  Also, while therapists were once the consultants, we are now the collaborators with parents and the children themselves.  I find this is so refreshing! Continue reading “One Child’s Response to “What is Your Favorite Thing to Do?””

Exploring the ICF-CY: What are Personal Factors?

The International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.  The ICF is a useful to in the field of pediatric physical therapy, where we are moving toward treating the whole child.

This post will discuss what constitutes personal factors.  Personal factors are independent of the health condition but can often influence how a person functions.  These factors are specific to social and cultural customs of each country.  While all the other categories have codes, this one does not yet have specific codes.  Continue reading “Exploring the ICF-CY: What are Personal Factors?”

Exploring the ICF-CY: What are Environmental Factors?

The International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.

This post is the tenth in the ICF series and explores what constitutes an environmental factor.  Environmental factors have an impact on all components of functioning in the ICF.    They affect the experience of participation and can be either facilitators or barriers to an individual’s participation. Continue reading “Exploring the ICF-CY: What are Environmental Factors?”