Recommended Toys For Childhood Development

Recommended Toys For Childhood Development

By Ian Larson, AZOPT Physical Therapy Student

Birth to 3 months

During the first couple of months your baby needs plenty of tummy time and opportunities to reach for toys.  By the end of the third month your baby can hold their head up while on their tummy, and what better way to encourage your child than to use the tummy time prop up mat.(1.)

The tummy time cruiser is a great way to encourage your little one to push themselves on their elbows and arms.  This amazing toy will help your little one develop their arm and neck strength:

Twist and Fold Gym

Bright Starts Tummy Cruiser Prop & Play Mat(2.)                               

$24.99

The activity gym will help your child develop arm and trunk strength while they are on their back.

Infantino Vintage Twist and Fold Activity Gym (2.)

$39.99

4-7 months

Elephant Shape Sorter

Your baby has grown so fast and can now sit and reach for toys that are close by and bring them to their body.  Your baby may now be rocking on their hands and knees and creeping on his tummy.  Your child will also start to place their hands around toys. (1.) 

Here is a great toy to encourage your baby to reach for objects, identify shapes and begin to solve problems:

Growing baby elephant shape sorter (2.)

 $9.00

8-12 months old

Your baby amuses themselves by putting things in containers and taking them out again.  Your baby is getting closer to walking each day.  At this stage in their development the child should work on strengthening their legs and increasing their balance. (1.) 

This toy is great to build your baby’s balance and abdominal strength.  This toy will also help strengthen their leg by getting on and off the toy:

Rockin’ Tunes Giraffe (2.)

 $40.00

1 to 2 years old

During this time your child is moving around more and learning how to play through walking and some jumping.  This is a great time to encourage your child to walk as much as they can in order to improve their balance and leg strength. (1.) 

This toy is fantastic for your child’s development because it can be used for many activities that will help your child walk, balance, and improve their overall coordination:

Fisher-Price 3-in-1 Push N' Scoot (2.)

 $54.99

3-4 years old

Your child continues to be on the move.  At 3-4 your child should walk up and down stairs, kick , throw, and catch a ball.  Your child should also demonstrate run and ride a tricycle, hop, ride a tricycle, and walk forwards and backwards. (1.)

The little basketball set is a great way to enhance your child’s ball catching, and throwing skills:

Little Tikes Easy Score Basketball Set (3.)

 $39.99

This hopscotch fun rug is a timeless classic to strengthen your child’s legs, coordination, and balance while alternating between single or double limb jumping:

19 x 29 inch Primary Hopscotch Fun Rug (3.)

$19.99

5-7 years old                     

At these ages your child will enjoy complex tasks such as swimming, climbing, jumping rope, and other complex tasks. (1.)

This sports set is a fantastic way for your child to develop and strengthen a variety of hand eye skill, coordination, and balance:

Stats Multi Sport Set - Soccer, Hockey and Lacrosse(3.)

$29.99

This jump rope set is a great way to strengthen your child’s balance, coordination, and legs:

Stats Double Dutch Jump Rope (3.)

$7.99

References

1. Center for disease control and prevention. Developmental milestones( all ages).  http://www.cdc.gov/ncbddd/actearly/milestones/index.html.  Accessed October 19, 2013.

2. Fisher Price. Infantino Vintage Twist and Fold Activity Gym, Bright Starts Tummy Cruiser Prop & Play Mat, Growing baby elephant shape sorter, Rockin’ Tunes Giraffe  , and Fisher-Price 3-in-1 Push N' Scoot. Fisher Price online store. http://www.fisher-price.com/fp.aspx?st=900000&e=storethumb&pcat=fps_babygear. Accessed October 19, 2013.

3. Toys R Us. Little Tikes Easy Score Basketball, ,19 x 29 inch Primary Hopscotch Fun Rug, Stats Multi Sport Set - Soccer, Hockey and Lacrosse, and Stats Double Dutch Jump Rope. Toys R Us online store. http://www.toysrus.com/family/index.jspcategoryId=10811247&view=all. Accessed October 19, 2013.

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.

Enjoy Halloween Candy with a Challenge

Enjoy Halloween Candy with a Challenge

By the Kids Place Pediatric Speech Therapists

What’s a parent to do when your child has a three-pound bag of candy after trick-or-treating?  While some families allow candy consumption in moderation, here are some other ideas for limiting your child’s candy intake:

1. Agree in advance on a set number of candies your child will be able to choose from their bag/bucket
2. For older children, agree on a percentage of their total number of candies
3. Agree on special activities/items for which your child may “trade-in” their candy (books, videos, games, etc.)
4. Use candy for arts and crafts

For the candies your children do eat, consider the following ideas to help develop speech and language skills:

1. Use words to describe the qualities of your candy (sweet, sour, crunchy, soft, sticky)
2. Have your child imitate oral-motor movements while enjoying their candy (For example, holding a lollipop, have your child protrude tongue forward then to the right/left to touch it. You can also practice holding the lollipop with lips only)
3. Encourage longer sentences by offering your child choices of candy that differ only by one quality (“Do you want the big square chocolate or the small square chocolate?”)
4. For nonverbal children, model signs for “eat,” “more” or “candy” and encourage imitation before reinforcing.
5. Have your child follow directions incorporating the candy (“First, get the red one, then, get the blue one”).

It is especially important to be aware of choking risks.  According to the Center for Disease Control and Prevention, 15% of choking episodes in children under 14 are caused by hard candy.  An additional 12.8% is caused by other candies.  This amounts to nearly 30% of choking incidents from candy.

Halloween foods that have the highest choking risk include:

• Gum
• Peanuts
• Hard candies
• Jelly beans
• Gum drops
• Gummy bears
• Licorice
• Fruit snacks
• Raisins
• Pumpkin seeds
• Popcorn 
• Caramel
• Candy corn
• Taffy
• Marshmallows

Lastly, be cautious of non-food items that have a high potential risk for choking.  Especially small toys or balls/marbles which a diameter of less than 1 and 1/3 inches.

This Halloween, allow your children to enjoy some of the candies from trick-or-treating, but challenge them to do more than just simply eating the candies! 

Happy Halloween!

The Halloween Conundrum – What to do with Extra Candy

The Halloween Conundrum – What to do with Extra Candy

By the Kids Place Pediatric Occupational Therapists

Many parents struggle with what to do with all the leftover candy their kids have from trick-or-treating.  Candy can be used in many fun activities that do not involve actually eating it, but rather promote the development of fine motor skills, visual processing skills, cognitive processing skills, and sensory development. 

First, try sorting the candy by color, size, shape, first letter of the name, the type of candy, or any other way you prefer.  To improve your child’s fine motor skills, encourage the kids to use only their index finger and thumb or only the index and middle finger with the thu

mb.  Sorting this way will help children develop isolated finger movements necessary while using writing utensils.  Also, by using the index and middle finger with the thumb, you are promoting the correct positioning your child should use writing with their pencil. 

Furthermore, you can have your children sort their candies using clothespins.  With the index finger and thumb, or index and middle fingers with their thumb, children can pinch the clothespin to grip and move the candies.  The resistance of the clothespin will help strengthen your kids’ fingers and improve their endurance during writing tasks.  Tweezers and chopsticks are other tools that encourage isolated finger movements.

Secondly, making crafts with candy can also be a fun way to use the extra.  You can draw pictures and have your kids glue candies on the lines.  You can also have your children draw their own picture and explain what each candy represents at the conclusion.  Candies, such as lifesavers, can be strung to make bracelets or necklaces.  This activity promotes bilateral integration, or using two hands together.  If a candy does not have a hole, your child can use a toothpick to push through the candy, also helping to strengthen the fingers. 

Additionally, candy can be used to create a gingerbread house.  You can either freeze the extra candy until it is closer to Christmas time, or make a Halloween/Fall themed house.  Using frosting as the glue, place the candies on graham cracker walls for decorations.

Extra candy can also be used for finger painting.  Place one color of hard-shelled candy (Skittles, M&M’s, etc.) in a class of water and watch the coating dissolve and become colored water.  Children can then dip their fingers in the water and “paint” paper towels.  For more concentrated colors, use just enough water to cover the candies.  

These crafts are fun for all ages, but they are especially beneficial if your child has difficulties with messy play (does not like to get food on their fingers, does not like to play in sand boxes, or does not like to play with finger paints, etc.).  Your child will most likely get frosting on themselves in small amounts while placing the candy, and will need to dip their fingers in water to get color on them.  These experiences will provide them with tactile input (or feeling it on their skin).  Working with small amounts of tactile input and increasing it over time can help your child become less hesitant towards messy play. 

We hope some of these suggestions will help your family enjoy Halloween candy in new ways that promote positive development in your child.

Happy Halloween!

Halloween Themed Outdoor Activities for Children

Halloween Themed Outdoor Activities for Children

By the Kids Place Pediatric Physical Therapists

As snow and cold weather sweeps through many parts of the country, this time of year is a perfect reminder to why we live in Arizona.  The beautiful weather outdoors plays host to many possibilities of games and activities.  In the spirit of Halloween, we want to introduce you to some themed games that are sure to be fun for your children, but also beneficial to their development.

Spider Web Maze

With a piece of chalk, draw a large spider web on the ground.  Using paper, plastic, or extra candy, place the “spiders” along the lines of the web.  Have your child walk the lines of the spider web, keeping both feet on the line, and count how many “spiders” they can grab in one minute without stepping off the lines.  This game is beneficial in that it improves coordination and balance.

Candy Grab

Dump a bucket of candy on the floor.  Using only their toes, see how quickly your child can pick up the candy and place it in a bucket.  This will work your child’s ankle strength and balance.

Candy Hopscotch

Draw hopscotch on the ground.  Throw the candy on the ground to skip that step.  All you will need is chalk and your Halloween candy.  This game will benefit your child’s jumping, coordination, and balance.

Spider Web Catch

This game can be enjoyed both indoors and outdoors.  Using painter’s tape, build a spider web in an open hallway or tree.  Crumble up some newspaper into various sized balls, and count how many your child can throw and stick in the spider web.  Throwing is a gross motor task that can be improved with items typically found in your house!

This Halloween, we are challenging families to use their candies in ways other than eating.  There are many additional games and activities that can be played for Halloween or any time of the year.  These ideas do not have to involve a lot of equipment or work.  The most important thing is to get up and play outdoors with your children.  Performing these activities with your children provides the proper foundation to encourage consistent exercise and activity!

We would like to hear from you.  What types of outdoor activities do you play with your children during Halloween?

Strategies for a Successfully Potty-Trained Toddler

Strategies for a Successfully Potty-Trained Toddler

By Liezel Fernandez, OTR/L

Kids Place Pediatric Occupational Therapist

Potty training is around the corner.  Your child is finally ready to say goodbye to diapers!  But… will you be prepared?

Independent toileting is an important milestone and a complex task in a child’s life.  A child must be ready both physically and psychologically to begin the learning process of toileting.  Parents need to be prepared to devote significant time and effort in toilet training their child.  When starting to potty train, it is important to keep in mind your child’s developmental level, not their chronological age.  Children are likely ready for toileting if they have a regular pattern of urine and feces elimination.

The first sign of readiness is when a child indicates discomfort when wet or soiled.  Consider whether your child is able to follow simple directions and able to tell you through verbal or non-verbal communication (sign language/gestures) they need to go potty. 

Here are some helpful strategies to successfully potty train your child:

• Schedule toileting and use habit training.  For example, go at the same times of the day every day.
• If possible, dedicate a bathroom to toilet training.
• If you child is unable to communicate verbally, provide ways to indicate a need to go by using picture cues.
• Hang visual cues on walls, like step by step picture instructions.  We have all seen the hand washing examples in various bathrooms.  This is a perfect example of these visual cues.
• Demonstrate and explain the process.
• Use a story telling when trying to teach your child the socially acceptable behaviors in public restrooms.  These pretend stories can provide a model to teach your child what is appropriate.
• Teach physical, gestural cues, or sign language so your child can communicate the need easily.
• If your child does not stay long enough on the potty, use a timer and instruct your child to stay seated until timer rings.
• Use positive reinforcement, like a sticker chart to improve motivation.

Remember to teach all aspects of the task.  Independence in toileting or being fully potty trained includes:

1. Getting on and off the toilet. 
2. Managing fasteners and clothing.
3. Cleansing after toileting.
4. Washing and drying efficiently without supervision.

Potty training requires a lot of time and patience.  If you continue to have problems, you may want to consider getting professional assistance from an Occupational Therapist.  Good luck, and happy potty training!

Your Child is Going to be a Baseball Player!

Your Child is Going to be a Baseball Player!

By Teri Roberts, DPT

Owner and Pediatric Physical Therapist, AZOPT Kids Place

As a parent of a newborn, inevitably you have heard someone tell you “wow, your baby’s grip is so strong; I bet he will be a baseball player.”  While true, in all likelihood your baby’s grip is strong, it does not necessarily mean your child will grow up to be a baseball player.  The reason your baby has a strong grip when you place your finger in their hands is due to the Palmar Grasp Reflex. 

The Palmar Grasp Reflex occurs at birth until approximately 6 months of age.  You can elicit this response by placing your finger into a newborn’s hand from the pinky finger side.  Your child should immediately grasp their hand around your finger.  Even with a slight tug, your baby will most likely not release.  This reflex is important to teach children how to grab objects and use their hands in a functional purpose. 

At approximately 6 months of age, the grasping is no longer reflexive, but an automatic process of grasping objects and subsequently choosing to release these objects.  When this happens, the Palmar Grasp has been integrated.  Many babies develop the ability to grasp and release prior to six months.  These babies still require the use of the Palmar Grasp Reflex with activities like pulling to sit, standing, and bouncing on a parent’s legs with the support of a finger. 

Parents should watch for their baby’s ability to demonstrate open hand postures during awake or sleep times during the first few months.  Additionally, parents should look for their baby to release objects when grabbed after six months.  The inability to complete the above tasks can point to signs of neurological issues.  Please contact your physician or contact me at Kids Place if you are concerned with the overall development of your child.

So yes, your baby may grow up to be a Major League Baseball star, but it has nothing to do with newborn grip. 

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.

Premature Introduction of Solids to a Baby

Premature Introduction of Solids to a Baby
By Colleen Riordan, CCC-SLP
Speech and Feeding Therapist, Kids Place

First milestones for babies can be very exciting for a new parent.  First smiles, first words, and first steps are moments to be cherished.  But is there such a thing as pushing for these milestones to happen too early?  In the case of introducing solids to an infant, the answer is yes.  Although common advice is to begin introducing solids at 6 months of age, some health professionals are now giving the green light for solids at 4 months of age.  Recent polls have also revealed that some infants are receiving their first tastes of infant cereals and purees as young as 2 months.  Although it may be tempting to give your baby solids before 6 months of age, it is important to take into account your baby’s nutritional needs, gastrointestinal maturity, oral-motor development and a number of readiness cues.

Nutrition

Through the age of 6 months, breast milk or formula provides all of your baby’s nutritional needs.  In fact, many infants can thrive on breast milk or formula alone through 9 months of age.  Infant cereals and purees cannot provide the necessary calories, fat and nutrients for an infant’s developing body and mind.  Between the ages of 6 and 9 months, introduction of solids is for practice only; breast milk or formula is essential.  Some erroneously believe that infant cereal is necessary for iron supplementation. This is untrue.  Typically developing infants are born with iron stores to last them at least through the seventh month of life.  Another myth is that adding cereal to a bottle before 6 months of age will help a baby sleep through the night.  There are no studies to support this idea.  Adding cereal will change the nutrient content of the formula, and is linked to higher risk of obesity later in life.

Gastrointestinal Maturity

Before 6 months of age, infants have what is referred to as an “open gut”.  They are unable to filer out harmful substances and allergens.  Similarly, the intestinal tract is also unable to facilitate adequate absorption of nutrients in anything other than breast milk or formula, which contains enzymes to digest fats, proteins and starch.   By feeding a baby solids before his GI tract is mature, there is a higher risk of diabetes and food allergies.

Oral-motor Skills

Babies will exhibit a tongue thrust reflex which disappears between the ages of 4 and 6 months.  This reflex exists to protect an infant’s airway.  Before 6 months, infants will exhibit a sucking motion, a movement that is effective for anterior/posterior transit of liquids.  In order to deal with solids effectively, infants need to develop some tongue lateralization and rudimentary munching skills.  These skills are typically developed by 6 months.  Add to this the fact that most infants do not get their first teeth until after 6 months; this may be an evolutionary cue to us that infants are just not fully equipped to begin eating solids until after 6 months.

Reading the Cues

Many books will tell you that once a baby has doubled her birth weight, he is ready to begin solids.  Remember, that it is the combination of maturity of intestinal tract, nutritional needs, and oral motor skills that should be taken into account, instead of age or weight.   Conversely, if your baby is underweight at 4 or 6 months, the best nutrition is provided by breast milk or formula, and not solids.  Another cue parents should look for is the infant’s interest in the food that others are eating around her.  While this may be one readiness cue, it is also important to remember that infants are becoming great imitators at this age, mimicking your movements while eating.  This may be more of a social interaction than a cue that she really wants what’s on your plate!

Introduction of solids is one milestone that does not need to be forced. You will be eating with your baby in no time.  For now, enjoy the special moments breast or bottle feeding your infant, as they will go by quickly!                                                          

Bouncers, Walkers and ExerSaucers, Oh My!

Bouncers, Walkers and ExerSaucers, Oh My!

By Bobbi Michels, PT

Kids Place Pediatric Physical Therapist

For a first time parent, standing in a Babies R Us equipment aisle is an overwhelming experience.  With all of the advertisements and Consumer Reports, it’s hard to tell which piece of equipment to use with your child.  There are bouncers, swings, Bumbo seats, ExerSaucers, and more.  So, what do you really need? 

The answer – nothing!  Truthfully, most infants are happy simply being held and listening to familiar voices.  When awake and not being held, infants are best on their stomachs on the floor, where they can explore their bodies and develop motor skills.  But this is an unrealistic proposition.  Parents still must have time for daily household activities like laundry, cooking, and dishes.  You also deserve a shower, maybe even a relaxing bath.

So what do you do with your baby when holding them or placing them on the floor is not an option?  This may be a very appropriate time to place your baby in their crib or playpen.  You may think this would also be a good time to place your baby in special equipment, like walkers or Exersaucers?  We say NO!

Studies indicate the two leading causes of head injuries in babies are from the use of walkers and falling from baby furniture.  Other studies indicate 40 percent of babies are injured during the use of a walker - falling down stairs, climbing out of the device, or tipping over in the device.  In most instances parents were present and supervising their baby prior to the injury, but were unable to react fast enough to prevent the injury. 

What about using an ExerSaucer or jumpy to work on leg strength, balance, and gait skills improvement?  Several studies have examined and concluded that motor development is decreased in infants and toddlers who spend the most time in play-assisted equipment.  On the same lines, in a study by A.L. Abbott and D.J. Bartlett, infants with lower equipment use scored higher on motor development tasks when tested using the standardized test - Alberta Infant Motor Scale. 

When placed in a walker or equipment that allows a baby to stand, the baby uses mostly the muscles in the back of the leg.  This is especially true in the beginning as they will often push forward leaning their chest on the support surface and rise up on tip-toes to move the device using both feet together.  This position does not allow the same use of the muscles at the front of the legs or the use of tummy muscles.  Walking requires equal use and strength of both the front and back leg muscles.  In these types of equipment, the baby’s balance point or center of gravity is lower and behind the normal balance point when leaning forward in equipment.  Further, normal balance reactions and arms are not used in the same manner as normal walking.

You are now asking, what are the possible long-term health risks of what we just described?  Without the proper development of leg muscles and balance there is an increased risk of muscle weakness and tightness which can lead to future surgeries and expensive medical bills.  We treat children who develop into “toe-walkers” which causes the foot and calf to shorten and tighten, eventually requiring surgery to release the muscles and realign the foot.  We also treat children with muscle weakness at the front of their leg, or at their hips and knees, causing many challenges with basic movements like dressing or walking up stairs.  Not all children will develop these issues with the use of these types of equipment, but the possibility exists.

If you find you have acquired a myriad of equipment, our recommendation is to limit the time your baby spends in equipment.  We understand you cannot hold your baby all day.  The floor may not always be the best option with older kids or pets around.  In Arizona, parents often are afraid their tile floors will cause injuries.  Our suggestion: use a pack and go or a playpen.  Using these will allow your baby to explore their environment and bodies to gain strength and awareness the way we did as children.  If you want to use walkers or ExerSaucers, the maximum amount of time per day in any piece of equipment should be 15 minutes.  Please note:  you should always supervise your baby closely in equipment to decrease the incidence of an injury.  As always, encourage your baby to spend most of their "play" time on the floor sitting, crawling, cruising and perfecting other motor skill milestones.

Read more: http://www.livestrong.com/article/495767-is-a-bouncer-harmful-for-a-babys-development/#ixzz2TEbM4D8x

References/Sources:

• Kauffman IB, Ridenour M (1977) Influence of an infant walker on onset and quality of walking pattern of locomotion: an electromyographic investigation. Percept Mot Skills 45:1323–1329. MedlineWeb of Science
• Kavanagh CA, Banco L (1982) The infant walker: a previously unrecognized health hazard. Am J Dis Child 136:205–206. CrossRefMedline
• Fazen LE III., Felizberto PI (1982) Baby walker injuries. Pediatrics 70:106–109. Abstract/FREE Full Text
• Stoffman JM, Bass MJ, Fox AM (1984) Head injuries related to the use of baby walkers. Can Med Assoc J 131:573–575. Abstract
• Infant walkers: developmental tool or weapon? Jacquelyn Chamberlin, OTR/L The Children’s Medical Center.
• Chelsea and Westminster Hospital; Promoting Your Baby's Physical Development; January 2011
• Consumer Reports; Bouncer-Seat Safety; April 2007
• "Child: Care, Health and Development"; Infant Motor Development; A.L. Abbott, D.J. Bartlett; May 2001
• National Institute of Child Health and Human Development; Safe Sleep; August 2009
• Healthy Children; Movement: 8 to 12 Months; May 12, 2011

The Long Term Dangers of W-sitting

The Long Term Dangers of W-sitting

By Teri Roberts, DPT

Kids Place Owner and Pediatric Physical Therapist

One of the greatest milestones achieved during a baby’s first year of life is sitting.  This is an enormous progression towards independence for the child and the parent.  Sitting is typically learned around 5 months of age through “prop sitting,” where the child is placed in a seated position with their hands down in front to assist with balance.  At 5 months, babies do not have the postural control (balance) to sit without some assistance.  Between 6 and 8 months of age, babies can sustain a seated position independently.

There are many varieties of seated positions:

• Long sitting with feet directly out in front
• Ring sitting with legs in a ring position and feet either touching or slightly apart
• Tailor sitting or Indian style sitting
• V-sitting with legs straight like a V
• Side sitting when knees are bent and both feet are pointed to the same direction
• W-sitting when both feet are behind and legs look like a W

Throughout a baby’s normal development, each of these sitting postures is normal.  You will frequently see your child transition in and out of these sitting postures frequently as they lead up to independent walking. 

A Baby W-Sitting

Although I just stated that all of these sitting postures are normal, I want to stress the importance of children not excessively W-sitting.  W-sitting does not pose a long term concern if your child transitions in and out of the position smoothly and efficiently, and does not maintain the position during periods of seated play.  W-sitting regularly can cause secondary hip and knee problems during walking, seen through excessive inward feet because of the position of their legs and hips.  

Not every child who W-sits will acquire a skeletal or muscular problem; however, it is extremely difficult to change these impairments once they begin.  W-sitting limits the amount of rotation that is typical during play, creating a pattern that does not utilize good core strength.  To prevent any negative hip or knee changes and the likelihood of core strength concerns, encourage your child to sit with “feet in front”.

By the time your child is 15 months old, you should rarely see your child in the W-sitting position.  Children are very intelligent and the W-sitting position (if hip flexibility allows for it) is the easiest way to sit without using any core strength.  It allows children to “lock out” at the pelvis and play in a seated position with the least amount of effort.  Children that have lower tone and need to work harder to maintain a seated position choose to W-sit frequently. 

If you notice your child W-sitting too frequently, encourage a feet forward seated position.  You could also bring toys up to a taller surface so your child either has to sit and play on a chair or in standing to discourage the W-sitting position. 

If you spend over a week with cueing and changing environment of play and you still notice constant W-sitting, an appropriate recommendation is to have your child evaluated by a pediatric physical therapist.  The physical therapist will check the range of motion of the hips to make sure that your child has functional external hip rotation to allow for a comfortable tailor sitting.  The physical therapist will also check to make sure that the core strength is appropriate to maintain a seated position with feet in front for functional play.

Child Development of Self-Care Skills

Child Development of Self-Care Skills
By Jessica Holyoke, OTR-L

Activities of daily living (ADLs) are a necessary part of our day and include various tasks such as getting dressed, bathing, brushing our teeth or hair, and feeding ourselves.  Most of us place very little thought or effort when carrying out these tasks, but how did we learn to perform them?  Throughout the first year of our life, we will begin to develop the skills necessary to take care of ourselves.  It is important that children have many opportunities to practice these skills.  This blog will look at the typical development of these self-care skills and give examples of how to encourage your child’s development.

Dressing

A 1 year old child has already begun to explore how to take off clothes by removing their socks and raising their arms to help get a shirt off.  Between 1 and 2 years old, your child will continue this exploration and learn to take off his or her shoes and socks.  They will also begin to help put their arms through holes and hold out their legs for pants.  Between the ages of 2 and 3 years, a child can remove simple clothing on their own.  They are learning to put on front closing tops (jackets, button-up shirts) and to unzip and unbutton large buttons.  By 4 years old, a child can dress and undress themselves with assistance for fasteners and ties.  By 5 or 6 years old, a child is nearly independent with dressing skills needing help only with difficult fasteners such as belts and selecting appropriate clothing to match the weather.

Bathing & Grooming

A 1 year old child is starting to become aware of cleaning themselves.  They can wipe their face with a napkin or towel (not completely).  They can grasp tools such as a toothbrush or spoon, and mimic movements that will develop into controlled use.  Between 1 and 2 years, a child begins to enjoy bathing and takes an interest in helping.  By 3 years, they are actively participating in washing and helping with brushing teeth.  At 3 or 4 years, a child can wash themselves with supervision and some help with hair.  A 5 to 6 years child should be able to complete bathing and grooming tasks on their own with occasional reminders to do a thorough job.

Toileting

When to potty train can often be confusing for parents.  Typically, the first indication that a child is ready to start potty training is their ability to indicate when they are wet or soiled, which typically occurs by age 2.  The next step is their ability to indicate needing to go to the bathroom.  A 3 year old child should be using the bathroom with daytime control, still needing help for wiping and managing clothing.  By 4 years old, a child develops nighttime control and needs less help with wiping and managing fasteners on clothing.  At 5 or 6 years, a child is independent with toileting tasks.

Feeding

Around 6 months, a child develops the upper body and hand strength to hold their own bottle.  By 7-8 months, they can grasp small pieces of cereal or baby cookies and bring it to their mouth. They may start using a spoon for feeding by about 12 months.  Between 1-2 years, a child is using a spoon (with spilling) and can hold and drink from a Sippy Cup.  Between 2 and 5 years, a child develops the ability to use a spoon and fork, and can drink from a cup with no lid (with some spilling).

The most important thing to remember about any skill development in childhood is that is takes time and lots of practice.  Spend time on these skills, especially in the evenings and weekends when there is a bit more time to spare.  Give as little help as possible.  As the child gets older, allow them to work through problems and give more verbal feedback than hands on help.  Children learn through play so turn it into a game.  You can play dress-up or dress a stuffed animal for dressing skills, play peek-a-boo games where the child pulls a napkin or washcloth off their face or head for grooming skills, and use spoons and other utensils while playing in pudding or applesauce for feeding and utensil use.  Give your child as many opportunities as possible to practice their skills, let them make mistakes, and have fun learning new skills.

It is important to remember that these skills develop at a different pace for each child and the ages presented are considered average.  If your child develops these skills slightly faster or slower, there is no need for alarm.  If there is a significant delay in the development of these skills, your child may benefit from an occupational therapy evaluation.  Please feel free to leave your comments in the section below if you have specific questions regarding your child.  

A Newborn Baby's First Year - The Sound Development Parents Can Anticipate

Early Speech Sound Development

By Lanni Reisinger,SLP-CFY

Kids Place Pediatric Speech Therapist

Often times, parents of a newborn will wonder which sounds will first be heard by their baby and how to help produce these sounds.  From the time a newborn baby reaches three months and starts making their first sounds to when a baby is 12 months and forms their first word, parents can expect to hear a wide variety of noises and sounds. 

In this blog, I will address these milestones as well as the activities parents can perform to help their newborn progress.  Please note, these milestones are meant to be generalized.  There is no reason to be alarmed if your baby is slower at hitting certain milestones.  At the end of this article, I will list certain “red flag” milestones that may indicate your newborn needs to be evaluated.

At three months, your baby will begin to make sounds.  The first sounds you can expect to hear are vowel sounds when your baby is cooing and making pleasure sounds (“oo,” “ah,” “uh,” “oh,” “ee”).  At this time, your baby will also begin producing distinctive cries when they are hungry, wet, etc.  They will then begin producing strings of vowels with varying intonation.

When your baby begins babbling at four to six months, the first consonants they are likely to produce are “bilabial” sounds, produced with their lips (p, b, m).  These sounds are learned first because they are easily seen by your baby and fun to make.  This is also around the time you will first see your baby laugh.

At seven months, your baby will produce “reduplicated syllables” - repeating the same sounds over and over again (“babababa”).  Your baby will first produce these sounds in play, without any communicative intent.  You should then begin to notice your baby making sounds to gain attention.  Furthermore, around this time your baby will begin imitating more sounds and “talking” when others are talking.  You can prompt your baby to make sounds playing some basic games in which you take turns making sounds.

Here are some of my favorite games and songs for babies at this age:

• Peek-a-boo (hiding behind hands, blanket, napkin, etc.)
• Patty-cake
• This Little Piggy
• Head, Shoulders, Knees and Toes
• Row, Row, Row Your Boat
• Old MacDonald

It is also important to read with your baby.  It is not necessary to read every word in a book.  Simply talking about the pictures and pointing to things in the book will help.  You can prompt the production of sounds through making silly and nonsensical sounds while you play (“wee!” or “uh-oh!”).  You can also prompt your baby to imitate environmental sounds like animal sounds (“quack-quack!” and “moo!”) and transportation sounds (“vroom!” or “urch!”).

It is important to remember not only to prompt your baby to imitate your sounds, but imitate your baby’s productions as well.  Face-to-face time with your baby is important and using a “sing-song” tone with lots of rising and falling intonation will help your baby attend better to your sounds.  

By your baby’s first birthday, you can anticipate their first word, typically a word they use often (e.g., “mama,” or “hi”).

As a precaution, if your baby is not making any sounds by six months, or no consonant sounds (p, b, m) by ten months, an evaluation by a doctor is appropriate.  By 15 months, a baby should be saying their first word.  If this is not the case, an evaluation should be sought.