physical deficits

Lumiere Children’s Therapy: Autism and Physical Therapy

Happy Autism Spectrum Disorder (ASD) awareness month! Many recognize speech therapy as an important component of the overall treatment plan for ASD due to difficulty with spoken language, eye contact, facial expressions, and emotional recognition. Although language deficits are a core symptom of autism, children may also demonstrate difficulty with coordination, motor planning, and hand-eye coordination. Therefore, physical therapy can help facilitate gross motor development to increase participation in everyday activities and social activities such as gym class, sports, playing, etc.

Lecates - Flickr

Lecates - Flickr

What are the signs and symptoms of Autism Spectrum Disorder?


  • Social communication challenges

    • Difficulty with social interaction including initiating and maintaining topics during conversation

  • Pragmatic difficulties

    • Children with ASD may present with poor eye contact, difficulty gauging personal space, and decreased facial expressions

  • Difficulty identifying emotions

    • Difficulties may include recognizing one’s own emotions as well as the feelings of others. They experience trouble expressing their emotions during a variety of situations. Also, children may lack knowledge of when to seek emotional support or provide emotional comfort to others.

  • Repetitive behaviors

    • Repetitive behaviors present differently for each individual but some examples may include repetitive body movements (arm flapping, spinning), motions with objects (spinning wheels), staring at lights, and/or ritualistic behaviors (lining up toys in order)

What physical difficulties may a child with autism experience?

Children with ASD may present with the following physical challenges:


  • Developmental Delay:

    A developmental delay is when a child is lacking the age-appropriate skills in one or more of the developmental areas: cognitive, social-emotional, speech and language, fine and gross motor. If a child demonstrates a physical developmental delay, they may have difficulty rolling over, holding up their head, sitting up, crawling, and eventually walking and jumping.


  • Low muscle tone:

    Muscle tone is the amount of tension in muscles used to hold up our bodies while sitting or standing. Low muscle tone is when the muscles require more effort to move properly while doing an activity. They may have difficulty maintaining good posture when standing and sitting, and often affects their overall gross motor development.


  • Difficulty with motor planning.

    Motor planning is the ability to conceive, plan, and then execute the physical skill in the correct sequence. Motor planning assists children in attempting new tasks without the need to consciously learn the steps to each new task. Motor planning arises from organizing sensory input from the body, and having adequate body awareness and environmental perception. Children who have trouble with motor planning may experience difficulty carrying out new tasks, following physical commands when given verbal instructions, and appearing clumsy while executing new tasks.


  • Decreased body awareness.

    Children with ASD may lack awareness of where their bodies are in relation to their environment, causing children to become accident-prone or present clumsy.

Who is a Physical Therapist?

Physical therapists, often referred to as PTs, are professionals that help people gain strength, mobility and gross motor skills. They are experts in motor development, body function, strength, and movement. Pediatric physical therapists can help children with a variety of disorders gain functional physical skills so they can participate in everyday activities.

What does physical therapy target?

  • Basic skills. Physical therapists can help children develop the primary gross motor skills of sitting, rolling, standing and running if they are experiencing a developmental delay.

  • Coordination. Physical therapists focus on the necessary muscles and skills to improve balance and coordination in everyday activities.

  • Improve reciprocal-play skills. Help children use motor planning to coordination throwing and catching a ball, and other activities that involves interacting and reacting to another person.

  • Development of motor imitation skills. In order to learn new skills, a child must be efficient in imitation and following physical directions. PTs can offer strategies and practice of imitating movements.

  • Increasing stamina and fitness. For older children, physical therapy may focus on skills required to participate in play and sports such as kicking, throwing, catching, and running.

  • Parent education. PTs create home exercise programs so that family members can help facilitate building on strength, coordination, and development of specific goals into their natural environments and routines.


Why is physical activity important for children with ASD?

Physical therapy increases a child’s ability to participate in physical activities by improving strength and coordination. Once a child is able to functionally participate in physical activities, they are able to reap the many benefits of daily exercise.


  • Social skills. Gym class, playgrounds, and organized sports teams offer opportunities for children to develop friendships and social skills. For children with ASD, physical activity programs provide a fun, safe environment to develop and practice social interaction skills.

  • Improvement in behaviors. Physical activity may help decrease maladaptive behaviors and aggression. Children with ASD have difficulty expressing and understanding their feelings. Physical activity can aid in reducing stress and frustration in children, often helping them adjust in different activities without aggression.

  • Overall health improvements. Staying active and participating in daily physical activities can decrease the risk of general health problems in individuals with ASD, including obesity.

  • Increase quality of life. Daily activities such as climbing stairs, walking on the sidewalk, and going grocery shopping require the use of gross motor skills. Improving one’s strength and stamina can positively affect their participation in everyday chores and activities.


If your child has Autism Spectrum Disorder, and is experiencing difficulty with coordination, strength, and motor planning, physical therapy might be right for you. Our physical therapists at Lumiere Children’s Therapy can offer evaluations, customized treatment plans, and home exercise programs for carryover into the home.





References:

“Does Physical Activity Have Special Benefits for People with Autism?” Autism Speaks, www.autismspeaks.org/expert-opinion/does-physical-activity-have-special-benefits-people-autism.

Morin, Amanda. “What You Need to Know About Developmental Delays.” Understood.org, www.understood.org/en/learning-attention-issues/treatments-approaches/early-intervention/what-you-need-to-know-about-developmental-delays.

“Motor Planning.” North Shore Pediatric Therapy, nspt4kids.com/healthtopics-and-conditions-database/motor-planning/.

“Physical Deficits.” Mental Help Physical Deficits Comments, www.mentalhelp.net/articles/physical-deficits/.

Rudy, Lisa Jo. “What Can a Physical Therapist Do for a Your Autistic Child?” Verywell Health, 24 July 2018, www.verywellhealth.com/physical-therapy-as-a-treatment-for-autism-260052.

Ries, Eric. “Physical Therapy for People With Autism.” Physical Therapy for People With Autism, www.apta.org/PTinMotion/2018/7/Feature/Autism/.

“What Are the Symptoms of Autism?” Autism Speaks, www.autismspeaks.org/what-are-symptoms-autism.






Torticollis: What is Torticollis?

Devinf

Devinf

Torticollis means “wry neck” and refers to the position of your baby’s head and neck.  A common presentation is if your baby prefers to tilt his head to one side and/or look to the opposite side. Parents usually first notice that their baby only prefers to look one way and has difficulty or resists looking the other way. (Note: every baby with torticollis will present differently.)


How can I tell if my baby has torticollis?

Does your baby tilt his head to one side or prefer to look to one side more than the other? Does your baby only reach with one hand? Can your baby look all the way to each shoulder while on his back, belly, and sitting? If you notice some of these signs, you can ask your pediatrician for a physical therapy referral for an evaluation and assessment of your baby’s alignment, range of motion, and strength. An early referral is always best!

What causes Torticollis?

Torticollis can occur for a few reasons. It is commonly caused due to your baby’s position in utero. Some additional factors include a larger size baby, a larger size head, a smaller uterus, or a twin pregnancy. Additionally, if your infant gets accustomed to looking to one way, this can become a habit and cause some muscle tightness that will further compound the head position.

Due to his position in utero or post-birth, your baby can develop muscle restrictions in his neck, trunk or pelvis that cause him to develop a lateral head tilt and rotation preference to look one way. Subsequently, often his trunk and pelvis will also be asymmetrical.

Another factor that can exacerbate the torticollis is your baby’s head shape. If a baby spends too much time on his/her back, especially looking to one side, your baby can develop a flat spot on one side of the head which then will reinforce the head tilt/rotation. This is called plagiocephaly. Sometimes, a shaping helmet is required to address your baby’s plagiocephaly in addition to the torticollis. Your pediatrician can give insight on whether a shaping helmet is required for your baby and will work with an orthotist or plastic surgeon to decide. (Note: Helmets are only needed if a baby’s head shape is moderate or severely misshapen, and also depends on baby’s age. It’s important to note that not all babies with torticollis have plagiocephaly.)


How can physical therapy help Torticollis ?

Every baby with torticollis may present a little differently, and a physical therapist should evaluate your baby in each developmental position (on his back, tummy, sitting, on all fours, crawling, standing, walking) to determine specific positions, exercises and activities that are optimal for your baby to obtain symmetrical alignment and strength.

Physical therapy treatment sessions will incorporate positions, stretches, and exercises that are specific to your baby’s head and neck alignment. Treatment sessions will consist of passive or active stretches, strengthening exercises, and positioning to achieve postural symmetry with symmetrical muscle length and strength. A large part of physical therapy treatment will include parent education and a home exercise program so that the baby’s parents can be empowered to help the baby at home throughout the week to ensure good carryover from physical therapy sessions for optimal results.



Torticollis Treatment: The Traditional Way


My baby has torticollis. What can I do to help?

Torticollis exercises will be specific to your baby’s presentation, alignment, muscular restrictions, and head tilt. At a physical therapy evaluation, your therapist will determine a treatment plan, goals, and home exercises.

Note: all described exercises need to be prescribed and demonstrated by a physical therapist.


Torticollis exercises

Positioning

If you tend to lay your baby down on the crib and changing table the same way each time, try switching it up. Sometimes a child will look more to the right because there is a wall on the left of his crib, and it is more interesting to look to the right. Additionally, if a baby consistently is bottle or breastfed in the same orientation, try switching up the way you hold your baby for feeding to allow your baby a different orientation and place to look around. Your physical therapist can provide further details on this.


Active stretches

Depending on your baby’s muscle length/strength, active stretches can be indicated to gain muscle length and strength. For example, if your baby prefers to look to his left, you can place toys to his right to get him to look further to his right and hold his gaze. During such exercises, always follow your baby’s lead and allow the baby to perform the motion on his own. A physical therapist can help educate you on the best way to help your child to look the other way safely and comfortably. Sometimes passive stretches are indicated however, most babies do not tolerate passive stretching and should only be performed under supervision of a physical therapist and with the baby’s tolerance.



Strengthening

Depending on your baby’s muscle length/strength, strengthening exercises can be indicated to gain muscle strength to obtain symmetrical posture and development. Strengthening is important to make sure both sides of his body are equally strong in order to hold his head, neck, and trunk in the middle and use both arms and legs equally to play and move within his environment. Your physical therapist will educate you on gross motor milestones and will guide you to ensure your baby develops symmetrically, with assisted reaching, assisted rolling, tummy time, assisted sitting, etc., until your baby performs on his own.



Massage

Typically, your baby’s muscles will be tight on one side, so your physical therapist can help educate you on techniques to gently massage your child’s neck.



Home Exercise Program

Your physical therapist will demonstrate and teach prescribed exercises to the baby’s caregiver to ensure good carryover from physical therapy sessions for optimal results.



Torticollis Treatment: Total Motion Release Tots and Teens


What is Total Motion Release?

Total Motion Release (TMR) is a postural release technique founded by physical therapist Tom Dalonzo-Baker over 15 years ago1 to help his adult orthopedic patients with back pain, gain range of motion. These techniques release restrictions in muscle/fascia to encourage improved range of motion and symmetrical alignment in the pelvis/trunk, that leads to functional improvements in patients with pain, decreased range of motion, or atypical presentations. These techniques have been used on generations of orthopedic adult patients. 

Tom connected with a pediatric physical therapist Susan Blum in 2006 to modify these techniques to be utilized for the pediatric population, which is now called TMR Tots and Teens (TMR TNT).2 Susan now teaches TMR TNT courses for physical and occupational therapists in pediatrics all over the United States. You can reference the TMR website at www.tmrTots.com3 for more information!

Who is TMT TNT for?

TMR TNT is indicated for the many pediatric diagnoses including torticollis, Down Syndrome, cerebral palsy, hyptonia, motor control, scoliosis and more, however here, we will focus on using TMR to treat torticollis. It can be performed on babies and children of any age and it will be specific to your child!


Why is TMT TNT different?

While the traditional way to treat torticollis works, TMR TNT is a different way to treat torticollis. Using TMR TNT, therapists look for interconnected areas of limited range of motion elsewhere in the body which are associated with the torticollis. For example, TMR TNT therapists will focus on the entire body, not only the neck, when treating torticollis. Results can often be limited when only the neck is treated. From TMR TNT’s website2, it lists five features that make TMT TNT different than traditional therapy:


1. Focus: “Treatment is precise to get to the root problem and quickly fix it.”

2. Build on What They Know: This builds on your child’s strengths. “We reinforce the patient's successes with positive motor experiences, which aid in motor recruitment.”

3. Empowerment of Caregiver and Child: “Therapeutic activities are incorporated into daily routines at home, school and daycare.  Instead of 1 or 2 hours of therapy a week, treatment becomes 24/7 for even more accelerated results.”

4. No Tears - Parent Satisfaction: “The language of TMR is comfort!”

5. Results: “Many patients with incomplete correction of torticollis achieved full correction once TMR was used to identify and treat the associated restrictions"



What does TMR TNT treatment look like?

It involves placing the child in positions to their preferred/easy side to "unlock" the restriction to gain improved active range of motion, so it does not involve any stretching. It then allows your child to explore in his new range of motion and achieve symmetrical alignment, improved gross motor skills, gain motor control, and more! It is tears-free, feel-good therapy! 

The home exercises are simple and can be worked into the parent's day for two minutes at a time, so allows for easier carryover. For example, positions can occur while being bottle or breastfed, being held, while reading a book, and while playing! This empowers the caregiver!



Who can perform TMR TNT?

A physical or occupational therapist who has taken a TMR TNT continuing education training course seminar can utilize the TMR evaluation tool and protocol to treat your baby or child. There are three levels of TMR TNT. Three physical therapists at Lumiere Children’s Therapy have taken TMR TNT Level 1!



Torticollis Tips, Tricks, and Toys


  • Utilize your pediatrician and physical therapist to help get you started! Don't let the internet or anyone else scare you. We will work with your family for an optimal treatment plan to help your baby.


  • Perform exercises when your baby is the most energized and ready to play, such as after your baby has slept, eaten, and has a clean diaper, to ensure your baby is the best mood to “exercise”!


  • Some babies will need to wait an hour after eating before tummy time to minimize spitting up, especially babies with reflux. Ask your doctor about specifics if your baby has reflux.


  • Utilize toys listed below to help your baby have the most fun during exercises!



Toys

  • Tummy time mat: a comfortable tummy time mat will motivate your baby to stay on his tummy, engage in the toy, and be comfortable!

  • Small rings: small rings are initially easier to grab, so it promotes your baby to reach. Your therapist can show you positions for your baby to reach on his back, belly, and in sitting!

    Bright Starts Lots of Links: https://www.amazon.com/Bright-Starts-Lots-of-Links

  • Music toys: toys that play music will distract your baby to look to one side and keep him focused on the toy, so he maintains his gaze. This toy is a parent favorite because of the soft music, and a baby favorite because of the size, colors, and sounds!: Baby Einstein Take Along Tunes Musical Toy

  • Cause and effect toys: Toys that encourage your child to reach in order to produce a song/sound/movement on a toy will encourage reaching and further gross motor development. Kids and therapists love this spin toy!: Leap Frog Spin and Sing Alphabet Zoo


Next Steps


If you have any questions or require an evaluation or therapy plan for your baby’s torticollis, please contact Lumiere Children’s Therapy.

Written by: Morgan, PT, DPT, a licensed physical therapist at Lumiere Children’s Therapy.

Physical Therapy: In-Toeing and Out-Toeing

The first year of life is full of new beginnings, between crawling, pulling up to stand, and finally walking! Watching your child take their first steps can be both exciting and nerve-racking. The first steps may look different for each child.  While watching your children explore the world on their feet, you may observe that their toes point inward or outward. Learn more about the causes and treatment of in-toeing or out-toeing below.

Andrew Seaman

Andrew Seaman

In-Toeing or “Pigeon Toe”

            In-toeing, commonly known as “pigeon toe”, is when the toes face into each other while walking or running. This is commonly seen in infants and young children. In-toeing may be caused through hereditary genes or the baby’s positioning in the womb. If a parent demonstrated in-toeing as an infant or child, it is likely they will pass down the gene to their children. An infant may also develop in-toeing due to small feet movement and positioning in the womb. In-toeing is typically not painful for children and does not lead to arthritis.

There are three types of in-toeing: Tibial Torsion, Metatarsus Addactus, and Femoral Anteversion. 

Tibial Torsion

When the shinbone (tibia bone) is tilting inward causing the feet to point in. It is the most common cause of in-toeing in infants and young children typically under the age of two years old. It is typically due to positioning in the womb, and is noticeable at an early age. Tibial torsion frequently straightens out once the child begins to walk, but may take up to 6-12 months to fully correct. Although tibial torsion does not typically require intervention, surgery may be recommended after the age of eight for more severe shin rotations.  

Metatarsus Adductus

When the front half of the foot, or forefoot, is turned inward. Studies have shown that metatarsus adductus may spontaneously recover without intervention in the majority of cases. Manual stretches of the forefoot can improve metatarsus adductus and may be provided by the child’s pediatrician, nurse, or physical therapist. In the rare case that metatarsus adductus does not correct on its own, feet casts can stretch the soft tissues of the forefoot to straighten out the foot. 

Femoral Anteversion

When the upper end of the thighbone (femor), close to the hip, has an increased twist causing the feet to turn in. It is usually not detected before 4-6 years old. A common symptom of femoral anteversion is sitting in the “w- position”. Treatment may include physical therapy to teach the correct positioning of walking, and occasionally, braces to shift the bone. 

Femoral retroversion

The thighbone (femur) is angled backwards relative to the hip joint, resulting in outward feet positioning. Femoral retroversion is less common than femoral anteversion.

Out-Toeing or Duck Feet

Out-toeing is when the child’s feet point outward as they are walking and running. Out-toeing occurs less frequently than in-toeing and may be due to fetal positioning, abnormal growths, and/or underlying neurological problems. Unlike in-toeing, out-toeing may result in pain over time. There are three causes of out-toeing in children: Flatfeet, Hip Contracture, and Femoral Retroversion. 

Flat feet

A child is considered to have flat feet if they do not have an arch in their foot. If an arch does not form, the foot may appear to turn outward. Out-toeing due to flat feet does not require medical intervention and rarely causes pain. 

Hip contracture

An infant’s hip may be externally rotated due to their positioning in the uterus. The external hip contracture may cause hip tightness as they begin to walk resulting in out-toeing. Hip contracture will spontaneously resolve on its own, so out-toeing does not require treatment if it’s due to hip contracture. 

Treatment for In-Toeing and Out-Toeing

 In the majority of cases for in-toeing and out-toeing, braces, special shoes, and surgery are not required. Most children will spontaneously recover if their condition is not associated with an underlying neurological disorder.

Children may require intervention if the following persists:

·     Not improved by the age of three

·     Complaining of excess pain (especially for in-toeing)

·     One foot more turned than the other

·     Other developmental delays such as fine motor, gross motor, and/or language development. 

·     Gait abnormalities (deviation from normal walking)

            Physical therapy can help provide awareness of correct foot positioning when walking. Physical therapy may be recommended if the issue does not resolve on its own in a reasonable amount of time. If you feel like your child would benefit from a physical evaluation for in-toeing or out-toeing, contact Lumiere Children’s Therapy.

 

LUMIERE THERAPY TEAM🖐️

 

References: 

Children's Hospital. (2014, August 24). Metatarsus Adductus. Retrieved from https://www.chop.edu/conditions-diseases/metatarsus-adductus

Children's Hospital. (2014, August 24). Femoral Anteversion. Retrieved from https://www.chop.edu/conditions-diseases/femoral-anteversion

Gupta, R. C. (Ed.). (2015, February). In-toeing & Out-toeing in Toddlers. Retrieved from https://kidshealth.org/en/parents/gait.html

Intoeing - OrthoInfo - AAOS. (n.d.). Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/intoeing/

Media, H. M. (n.d.). Out-Toeing. Retrieved from https://www.chortho.com/common-conditions/out-toeing

Pigeon Toe (In-toeing). (2016, November 07). Retrieved from https://uichildrens.org/health-library/pigeon-toe-toeing

Child Physical Therapy: Treatment for Toe Walking

As children learn to navigate walking, they may initially learn to walk on their toes while cruising along furniture. Toe walking is developmentally appropriate until the age of three. If your child persistently walks on their toes in the absence of any underlying neuromuscular or orthopedic condition, it is considered idiopathic toe walking. 

Kristal Kraft

Kristal Kraft

Idiopathic toe walking is defined as habitual toe walking with no known cause. Idiopathic toe walking may lead to tightened calf muscles, decreased range of motion of ankles, and eventually, shortened Achilles tendon. 

 

What is the treatment for toe walking?

            Treatment options vary on the degree and duration of toe walking. It also depends on the flexibility of the Achilles tendon. As with any habit, the longer it persists, the harder it is to break. In extreme instances, surgery to lengthen the Achilles tendon may be most appropriate. For most cases, ankle foot orthosis (AFO) and/or physical therapy are recommended. AFOs are removable braces worn during day and night to help maintain the foot at 90-degree angle. 

Physical therapy creates a program designed for your child’s needs by incorporating a combination of stretches and strengthening. In order to increase the effectiveness of physical therapy, daily home exercises are crucial. Below are a list of at-home stretches and activities you can incorporate into your weekly routine. 

 

At-home Stretches: 

·     Manual calf stretch: This stretch requires help from an adult. Your child will sit on the floor with his/her knees straight. The adult will cuff the child’s heel with their hand as the foot rests on the adult’s forearm. Slowly apply pressure on the child’s foot so their foot points up and towards the child’s body. Hold for 30 seconds on each side. 

·     Wall stretch:  The child is standing for this stretch. They should place their hands on a wall and point both feet at the wall one behind the other. Lean into the wall as the front leg is bent and the back leg is straight. Hold both feet on the ground flat for 30 seconds.  

 

Activities to strengthen muscles: 

·     Sit to stand: While your child sits on a chair or bench, place your hands below their knees with moderate pressure downward to provide tactile cues to keep heels on the floor. With the steady pressure, your child will stand up with heels remaining on the ground. Complete 5 repetitions. 

·     Basketball stretch: Encourage your child to sit on a small ball such as basketball while keeping both heels on the ground. Practice squatting by standing and sitting back down on the ball while keep heels down. 

·     Bear walks: Animal walking is great for stretching and strengthening leg muscles. For a bear walk, place hands and feet on the floor while hips aim towards the air. As one foot moves towards the hands, the other leg stays back while actively pushing the heel to ground. 

·     Penguin walk: Pretend to walk like a penguin by keeping the toes in the air and walking only on the heels! 

·     Crab walk: Start in the bridge position and propel forward by using hands and feet. Keep feet flat on the floor! 

·     Bozo Buckets: Line up three buckets in a row to play bozo buckets. Instead of throwing the beanbags into the buckets, place the beanbag on top of the feet and fling the bean bag by kicking. 

·     Scooter races: Race a friend or sibling on the driveway! Sit on the scooter with feet in front and use the heels to propel forward. 

·     Slide: With parent supervision, have your child climb up the slide. Climbing up a playground slide targets range of motion, strength and weight bearing. 

 

LUMIERE THERAPY TEAM🖐️

 

 

References:
Beazley, Elizabeth, et al. “Activities for Children Who Walk on Their Toes.” University of Rochester Medical Center, www.urmc.rochester.edu/MediaLibraries/URMCMedia/childrens-hospital/developmental-disabilities/ndbp-site/documents/toe-walking-guide.pdf.
SickKids hospital staff. “Toe Walking, Idiopathic .” AboutKidsHealth, 11 Apr. 2011, www.aboutkidshealth.ca/Article?contentid=946.
“Toe Walking in Children.” DINOSAUR PHYSICAL THERAPY, 5 May 2018, blog.dinopt.com/toe-walking/.
“Toe Walking in Children.” Mid-Maryland Musculoskeletal Institute, 8 Oct. 2015, mmidocs.com/media/blog/2015/10/idiopathic-toe-walking/46.
http://blog.dinopt.com/toe-walking/

Child Physical Therapy: Jumping!

Jumping feet first into muddy puddles as water splashed onto our rain boots is a fond childhood memory many of us experienced. Even though jumping in puddles creates a dirty, wet mess for many parents, jumping is an important gross motor milestone for children. 

trec_lit

trec_lit

Toddlers first learn how to jump off low surfaces such as the last step or curb around 24 months. Between 26- 36 months, children will gain the strength and confidence to jump up from a leveled surface, the ground. Jumping requires balance, coordination, strength, and courage. The first step to learning to jump is exploration of balance. 2-year-olds may begin by shifting their weight back and forth to experience the sensation of one foot in the air.

            Each child learns to jump differently as they explore one’s body weight and balance. Some may jump with both feet on first jump, and others mays jump with one foot in front of the other. Most children learn to jump through exploration, but for children that seem reluctant or uninterested, here are some tips to encourage their first jump!   

·     Model

Make jumping look fun and adventurous by squatting really low and jumping off the ground. Model jumping over a toy, jumping to touch the ceiling, or jumping on a trampoline. Your child will begin to show more interest after watching family members model the skill. 

·     Teach squats

The first step to learning to jump is bending your knees low to the ground and standing back up. Squats not only mimic the movement of jumping, but they provide strengthening of the necessary muscles.

·     Frog jumps

The next step to learning to jump is squatting low and hopping off the ground. This version is slightly easier than jumping from standing tall, and provides more visuals. Pretend to be frogs jumping from one lily pad to the next! Make it more fun by dressing in green and shouting “ribbit ribbit”.

·     Hold hands

Holding your child’s hand as they jump off a small step or sidewalk curb can provide a steady support. Jumping off of a higher ground requires less strength and skills but allows the child to explore jumping. 

·     Motivate

Provide targets such as neon tape around and encourage your child to jump from spot to spot. Draw a line with a chalk on the sidewalk for your child to jump over or draw a full hopscotch board!

·     Feedback

As with any new skill, give your child positive accolades along the way. “Wow, look at you bend your knees” or “Look how high you jump” can go a long way!

·     Make room

Clear an open space in the house or spend time outdoors for your child to explore gross motor activities without fear of hurting oneself. 

Read more about physical milestones in our post Gross Motor Development.If you feel your child is behind in gross motor development, contact Lumiere Children’s Therapyfor an evaluation. 

 

 

LUMIERE CHILDREN'S THERAPY🖐️

 

 

References:

Drobnjak, Lauren. “CHILD DEVELOPMENT QUICK TIP: LEARNING HOW TO JUMP.” The Inspired Treehouse, 24 Sept. 2014, theinspiredtreehouse.com/child-development-quick-tip-learning-how-to-jump/.

WhattoExpect. “Running, Climbing, Jumping and Kicking.” Whattoexpect, WhattoExpect, 21 Oct. 2014, www.whattoexpect.com/toddler/run-jump/.

Child Physical Therapy: Autism and Physical Therapy

Children with autism spectrum disorder present with challenges related to social skills, repetitive behaviors, speech and language, and sensory processing. Speech, behavior, and occupational therapy is recommended to improve communication, behavior, and sensory deficits in children with autism spectrum disorder. Along with these disciplines, physical therapy is a crucial component of an autism treatment team. Physical therapists focus on improving a child’s balance, posture, and incoordination to improve engagement and participation in everyday activities.

Jake Guild - Flickr

Jake Guild - Flickr

What is physical therapy?

Pediatric physical therapists help guide children through physical milestones. Areas of intervention include gross motor skills, balance/coordination skills, strengthening, and functional mobility. 

What are common physical deficits in ASD?

Children with autism spectrum disorder may experience some of the following physical challenges:

·      Decreased eye-hand coordination

·      Difficulty controlling posture

·      Lack of Coordination

·      Poor balance and instability

·      Low muscle tone

Research has shown that children with autism may also demonstrate toe-walking ankle stiffness, and motor apraxia.

Physical Therapy treatment for ASD

Pediatric physical therapy utilizes play and therapy techniques to improve balance and posture in children with autism. Improving posture in sitting, standing, and walking can build endurance and increase attention during school-time activities. Once a child feels secured and balanced, they can focus on other areas such as socializing, interacting, and playing. Physical therapists improve the lives of Children with ASD by improving their day-to-day functioning.

 

Learn more about Autism on our blog: Autism and Sensory Integration, Autism Awareness, Art and Autism, and many more articles!

 

LUMIERE THERAPY TEAM🖐️

 

Resources:

“Autism Spectrum Disorder.” American Physical Therapy Association, 31 Oct. 2014, www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=a6482e75-65c6-4c1f-be36-5f4a847b2042.

“The Role of the Pediatric Physical Therapist for Children with Autism Spectrum Disorder.”Center for Autism Research, www.carautismroadmap.org/the-role-of-the-pediatric-physical-therapist-for-children-with-autism-spectrum-disorder/.

Wang, Judy. “Physical Therapy for Children with Autism.” North Shore Pediatric Therapy, Judy Wang, PT, DPT Http://nspt4kids.Com/Wp-Content/Uploads/2016/05/nspt_2-Color-logo_noclaims.Png, 13 Jan. 2015, nspt4kids.com/autism/physical-therapy-children-autism/.