When Should I Be Concerned About my Child’s Development?

When Should I Be Concerned About my Child’s Development?

By Josh MacDonald, OTR/L

Kids Place Clinic Director and Pediatric Occupational Therapist

As pediatric therapists, we get asked this question a lot.  Parents will ask us about their child’s eating habits, if their child should be walking by 12 months, why their child cannot tie their shoes in first grade, and countless other areas of childhood development.  Through our many years of experience we are able to offer our best and most reasonable answer based on typical development; however, many times the best answer begins with “it depends.”

If you are blessed to have a child without any major medical concerns, you will inevitably spend time worrying over every other aspect of their development and growth.  When an area of development seems to be lagging behind, most people turn to the Internet for answers.  Unfortunately, the Internet is full of conflicting data and just enough information to thoroughly confuse and frustrate parents.   So if not the Internet, then where should you turn for answers?

Our first suggestion is to spend time around other children the same age.  Get your child involved in play groups or play dates with other children the same age.  This will give your child a chance to work on socialization skills and peer play as well as give you a chance to see what other kids are doing.  There is no “one right answer” to when a child should acquire any given skill.  Because each child develops differently you are likely to find out that your child excels in some areas and not in others.  Whether it happens in a church nursery, park play group, or one-on-one play date, give your child lots of chances to play with others.  They will learn from the skills of others as well as improve their social skills.

If you still have concerns about your child’s development, you can browse the Internet, but we urge caution.  Stick to websites attached to institutions with substantial reputations.  Stay away from any website whose parent organization you don’t know or can’t identify from their home page.  Also stay away from individuals’ blog posts or websites.  There might be accurate information, but you can’t distinguish the difference between good and bad blog sources.  Below are a couple suggestions of the type of sites you can research:

University of Michigan: http://www.med.umich.edu/yourchild/topics/devmile.htm

State of Florida Family Health Agency: http://www.floridahealth.gov/alternatesites/cms-kids/families/child_family_info/your_childs_development/development_milestones.html. 

If spending time around other children of similar age and research on reputable websites leaves you concerned or uncertain, you can ask your doctor for a referral for an evaluation with a Physical, Occupational or Speech Therapist.  These specialists will be able to complete an initial evaluation between 45-60 minutes and give you solid information (based on experience and standardized tests) about your child’s development.  If additional services are necessary, they will help you determine which specialist is best suited for your child.  This may mean a visit to a different clinician (developmental optometrist, neurologist or developmental pediatrician), but the value of being certain is worth the extra appointment. 

It isn’t easy being a parent, and life is full of questions.  We all want the best for our kids.  Knowing how to achieve that is not easy.  There are options and resources available to help you answer these questions.  If you are still unsure, feel free to contact us at Kids Place, and we will work with you to schedule an appointment for an evaluation.

Keeping Your Child Safe in their Car Seat

Keeping Your Child Safe in their Car Seat

By Josh MacDonald, OTR/L

Kids Place Clinic Director

Pediatric Occupational Therapist

At Kids Place, our therapists see a lot of children coming into the clinic in their infant carriers.  Unfortunately, too many of them are fastened into the car seat incorrectly.  While every car seat is different, there are a few standard rules about how to fasten them into infant carriers and forward facing seats.

First, the plastic retainer clip (the plastic clip across the chest) should be slid up to the level of the armpits.  This may seem high and appear to put pressure between the straps and the child's neck.  But, if the clip is not high enough, it will not hold the belt in place, and the child will slide between the straps and out of the seat in an accident.

Second, the seat belt should be tight enough that you cannot pinch any excess at their shoulder.  This is relatively snug.  When applied taught against the body, the seat belt assists in riding out the deceleration slowly.  If the strap is too loose, then the child will 'collide' with the seat belt in an accident, resulting in further injury.

Lastly, no additional pieces of aftermarket items should be added to the car seat.  These pieces are often not fire retardant, and could catch fire quickly.  Any padding on the seat belt strap to protect the neck will only create space between the child and the strap.  Remember, this needs to be a tight fit.  Space is bad.  Items hanging from the handle or on the seat of the vehicle will come loose in the accident and potentially strike the child.  These items are marketed well to convince us of their necessity or cuteness, but they are not crash tested and will be dangerous in an accident.

These are only a few of the rules and guidelines about car seats.  Your local fire department is able to assist you installing your car seat, and will teach you how to properly use the car seat.  This may seem like a hassle, but 90% of car seats are installed incorrectly and will not protect a child during an accident.  Make your child's safety a priority.

Celebrating Family Health and Fitness Day

Celebrating Family Health and Fitness Day

with advice from Josh McDonald, OTR/L, MS
and Mark Salandra, CSCS

Americans young and old have been gaining weight and slowing down. A report on physical activity and health from the U.S. Surgeon General’s office in the late 1990s found that “nearly half of young people aged 12-21 are not vigorously active on a regular basis” and that more than 60% of adults aren’t as active as they should be.

(A more recent study in 2010 didn’t show any improvement, finding that only 15% of high school students achieve the recommendations set by the CDC for physical activity.)

These findings led to the creation of Family Health and Fitness Day on September 28, a celebration marking its 17th year in 2013 that celebrates activity for the whole family.

Why is this something Americans should commemorate? “Staying healthy as a family provides motivation to all members, and it increases support for the members of the family that are not as motivated for physical activity,” says Mark Salandra, CSCS, the founder of StrengthCondition.com (one of Physiquality’s partner programs). He adds that daily physical activity should be as routine as brushing your teeth or any other healthy activity you do for your body every day.

Activity expert Josh McDonald reminds parents that every action is a lesson for children. “If we want our children to value healthy and active lifestyles, then we need to model those choices for them,” says Josh, an occupational therapist at Kid’s Place, a clinic for children run by Arizona Orthopedic Physical Therapy (a Physiquality network member with two locations in Arizona).

He encourages parents to make good choices for the entire family. By turning off the television and taking them out to play catch, by enrolling them in sports and camps, or by gathering everyone for a bike ride, parents are showing their children the value of health and wellness. As a parent, he notes, “When I initiate healthy decisions for myself, and I include my kids in those decisions, I establish lifelong patterns that they will carry with them into adulthood.”

The easiest way to be active with the family is to take a walk. The CDC recommends walking at least 10,000 steps a day, Mark notes. Why not strive for that goal with a daily walk after dinner? It’s a way to burn off some of the calories in your meal while continuing discussions started around the dinner table.

There are lots of ways to make healthy choices with your family, but Josh reminds parents that the responsibility for such healthy choices starts with them. “These decisions aren’t always easy,” he notes, “but the benefits are immense for both the parents and the children.”

Play-Doh®: Fun and Functional

Play-Doh®:  Fun and Functional

By Josh MacDonald, OTR/L

Occupational Therapist and Kids Place Clinic Director

Play-Doh® is a great tool for helping your child develop hand skills.  The texture and resistance are great for building up the muscles in the hands.  However, when it is time to pull out the tub of Play-Doh®, hold off on using all of the cool tools and gadgets. 

Hasbro has made some awesome and exciting accessories to go with the rainbow of colors for Play-Doh®.  Most of these tools do not promote the development of hand skills.  These tools and Play-Doh® factories rely on pushing or pulling levers and holding basic tool handles.  While playing with these items is not terrible for development, to make the most of this awesome Doh put the tools away and let the child’s hands work.

 

Learning how to keep a hand flat and active while rolling out a snake works different muscle groups than giving it a big squeeze to leave grip marks.  Rolling a ball between your palms requires more control than rolling it on the table, but both encourage exposure to different textures.  Pinching the Doh to squish small balls between the thumb and first finger builds up grip strength and thumb skill.  Small items can be hid forcing small finger movements to hunt for objects, and making flat pancakes takes more hand strength than banging with a hammer. 

The tools made for Play-Doh® are fun, but the creative, tactile and fine motor coordination benefits are so much greater when the child simply uses their own hands.  If your child insists on using the toys, try playing without them for 10 minutes, then allow the toys.  Even 10 minutes of direct hand play with Play-Doh® will improve overall hand strength and coordination.

Concerned about Your Child’s Handwriting? Try These Helpful Tips

Concerned about Your Child’s Handwriting?  Try These Helpful Tips

By: Josh MacDonald, OTR/L

www.SharonsCreativeCorner.com

Increasing expectations in pre-school and kindergarten can mean children are learning to write much earlier than before.  This has the potential to create multiple issues with your child’s handwriting.  Gripping the pencil tightly, wrapping the thumb completely around the pencil, the hand becoming tired out easily, or letters appearing choppy without any smooth lines can all indicate your child has fine-motor coordination delay or weakness.

'Fine motor' refers to the development of small muscle movements of the hands which develop as your child's whole body gains mobility, stability, cognitive, and emotional/social development.   Unfortunately, the hands of 3 to 5 year old kids are often not developed enough to manage the accurate fine motor requirements of handwriting without specific warm-up and training.  The in-hand manipulation skills required to make the small, smooth circles and straight lines are often more challenging than many kids are ready for at this stage.  Nevertheless, schools have increased writing in the curriculum resulting in many kids who are struggling to keep pace.

There are solutions that can be effective for many of these kids.  If the challenges are minimal and the child is motivated, some of the following suggestions may bridge the gap and improve their performance:

Play with Play-Doh!

Improving overall hand strength, including the smaller muscles in the hand, will help prevent fatigue and increase muscular endurance.  Have your child play with Play-Doh or 3 to 4 containers of silly putty at the same time.  Making large and small balls, rolling out snakes, and using tools to ‘work’ the Play-Doh will all help strengthen the hands.

Count Your Pennies

Coordination of the fingers plays a big part in handwriting.  The ability to manipulate objects with coordination and accuracy will greatly improve the accuracy of letter formation.  Try playing with pennies and nickels, picking them up from the table and transferring them from the palm to the finger within the hand.  Using a small coin bank with a slim slot will encourage the use of finger tips for accuracy of placement.

Arts and Crafts

Cutting small items, beading or working to glue small items will all help to develop awareness and coordination of the hands and fingers.  Whether it is cutting out shapes from paper plates, or coloring in small spaces, craft time is a great way to help kids with hand skills.

Tools Make a Difference

Minor equipment changes can also help with handwriting.  Using crayons broken into 3 smaller pieces or very small pencils prevents ‘over gripping,’ and will encourage use of fingertips and result in more accuracy.  You can also try one of the many different pencil grips available on the market.  There is no one magical grip that works for everyone.  Try several of them and stick with one of it makes a noticeable difference.  You don’t want your child becoming dependent on this grip, so limit it to either only homework time, or only school time.

Each of these is offered as suggestions and may not, independently solve the problem.  Your child may need more involved help.  If this is the case, occupational therapy may be necessary.

If you are concerned with the overall development of your child, contact Kid’s Place for a Complimentary Developmental Assessment.  Our complimentary developmental assessment is a 15 - 30 minute exam performed by a licensed physical, occupational, or speech therapist to assess developmental concerns with respect to gross motor, fine motor, or speech.  Based on these results, our therapists will make recommendations for your next steps, which may include following up with a medical doctor.  Additionally, you may be shown simple exercises for the home to improve physical development.  

To schedule a Complimentary Injury and Performance Screen or for more information, simply call (623) 229-7808.  Appointments are required.