Transitions

Transitions

Transitions are a vital, but often overlooked, part of development for most parents. I know that when I talk to my other parent friends, the only time the term transition comes up is when we are talking about transitioning to one or no nap, or to daycare and school. But, those aren’t the transitions that I’m talking about.

What are transitions?

When physiotherapists talk about transitions, we are describing the movements between two positions. For example, going from sitting to crawling, or from sitting to standing.

Why am I talking about them?

The first reason is that they are often sadly overlooked!

We are so excited to see that next big milestone that our kiddos can achieve, that we don’t think about the middle bit!

The next reason is that in the last few years I have seen more and more children that have most of their milestones ‘checked off’, but can’t get there themselves. So, they can sit and stand, and perhaps walk (these kiddos typically don’t crawl), but their parents have to put them in those positions. In addition, the child often cries until the parent comes to move them into a different position.

The last reason is that the increase in Container Baby Syndrome (check out my last post, Container Babies) means that it can often be even harder for children to get to practice these transitions.

Why are they important?

Transitions are vitally important because they help build those building blocks for future skills.

Typically, a child has to achieve one skill, and work on the transition skills to then get to the next skill. The only real exception is sitting, as children learn to sit before they learn to get into sitting by themselves – us parents put them there!

These in-between movements also help to develop a childs protective reactions and balance reactions, which in turn makes the next skill easier!

Hopefully parents will have a greater appreciation for how important all those attempts and fails (and potential face plants) are.  While a child is learning to get into and out of positions, opportunities for practice are promoted, which is so, so important – no matter how excited we are to see the next ‘milestone’!

If your child is unable to transition between positions, or they are doing the milestone ahead but can’t get there by themselves, please reach out to me if you are in the KW area, or contact your local paediatric physiotherapist for an assessment!

Container Babies

Container Babies

Some of you may have heard the term Container Baby in the media, or amongst new mom groups, and wondered what exactly that means. I mentioned the term in our previous blog post about plagiocephaly (check it out here). In fact, it is happening so much more frequently that it now even has a label – Container Baby Syndrome.

What Is A Container Baby?

A container baby is a child who spends a substantial amount of time in a device/container throughout the day. Containers include strollers, car seats, Bumbos, swings, vibrating chairs, jumpers and exersaucers.

Now, you might be thinking – my kiddo doesn’t spend a lot of time in a container! However, you might be surprised by how little time it can take. A recent study showed that the cumulative effects of 30 minutes per day was enough to change motor patterns and, therefore, reinforce inappropriate motor patterns.

Of course, you can’t avoid all containers – car seats and strollers being the big ones. But you need to add the time children spend in those to the time they spend being contained in other devices. 

Is This Really A Syndrome?!? 

Why have Container Babies become such a big deal that some are calling it a syndrome? It’s because we are seeing so many more children who are reflecting the outcomes of being contained. Fundamentally, our children are different from children who grew up a generation ago.

Why Does It Happen?

The biggest reason, in my opinion, is that baby companies are great at marketing ‘stuff’. It’s unusual to see a baby registry that doesn’t have at least a few of these items on it, and they appear on most ‘must-have’ lists. Moms I have spoken to say it’s the only way that they get things done, that they know their baby is ‘safe’, or that their child seems happy and that they like being in it, or that their child hates being on the floor.

But, at the end of the day, when there are all of these options of where to put a baby, this means that babies are spending less time on the floor – which is vitally important. 

What Are The Results?

One of the biggest things that we are seeing is children who have reflexes (primitive infant reflexes) that aren’t integrating when they should be, and it is affecting how they develop.

By placing children in positions that they developmentally aren’t ready for, they are not only being limited from being exposed to the positions that they are developmentally ready for, but they also aren’t able to learn the building blocks and fundamentals for the next steps.

The end result is those ‘milestones’ aren’t being met when they should be.

How Do We Correct It?

The biggest and most important step is, as with most things, prevention!

This one in particular is quite easy to prevent – just throw out all the non-essential equipment!

However, if this diagnosis has already happened, or if you suspect it, the first line of treatment is home repositioning. A physiotherapist can suggest things to change at home as well as showing you ways to foster more specific skills if your child is falling behind developmentally.

As always, should you have any questions, or if you feel that your child has Container Baby Syndrome, please reach out to me or your local paediatric physiotherapist!

 

Unique Gift Ideas For The Holidays!

Unique Gift Ideas For The Holidays!

It’s getting to be that time of year – Christmas shopping time. Parents are often asking for toy ideas to help promote development. There are a ton of lists out there but I’m going to focus on my favourites to help gross motor development!

Action Toys

Action toys are not toys that do things, but instead, encourage kids to be active. I also like to think of them as things that would make an awesome obstacle course (look for a future blog post about why obstacle courses are simply the BEST!).

Some ideas for little ones are:

  • play tunnels (Ikea)
  • balance beams (there are a ton of youtube videos on how to make some)
  • pikler triangle.

Another wonderful toy is the Bilibo! It can be used in so many ways and is great for those kiddos with sensory needs.

For those of us in winter, a toboggan/sled is also a great action toy.

For the older, or more adventurous, you can make your own Ninja Warrior course at home, there are a variety of kits including this Ninjaline Intro Kit.

Ride on Toys

Ride on toys are also an action toy but often are their very own separate category. I know sometimes ride ons are overlooked at this time of year given the winter weather, however, they are still such wonderful gifts to get children to be active and smaller ride on toys can be used inside or down in the basement!

Younger children may enjoy small ride on toys, and if you stick to those where they sit with their legs on either side (as opposed to a bench seat with legs in front) they can start to learn balance, steering and using legs reciprocally!

As they get older, rides ons could progress to balance bikes and plasma cars.

For even older kiddos, these are always great!

  • scooters
  • Y gliders
  • ripsticks
  • bikes

Balls

Balls are a great staple for fun and encouraging active play and coordination. Some ideas for a new twist are:

  • koosh balls (good for sensory kiddos)
  •  Waboba street or moon ball (these balls have unpredictable bounces for extra fun and in my experience lots of running)

For those little ones, kickballs, balls with a light in them and even beach balls are great additions!

Games

There are a few games out there that encourage movement.

My favourite for little ones is a game called ThinkFun Roll and Play. It’s a hit at our house and combines a variety of developmental categories including language, colours and active movement.

For the older kiddos, The Floor is Lava or ChronoBomb are great games to work on motor planning, balance – and they are FUN!

Experiences

As a parent, another favourite gift for my child to receive is the gift of experiences. Sometimes that means someplace fun to take the family, like the zoo or movies. However, the physio in me would recommend something active such as swimming, gymnastics or karate lessons.

If lessons are a bit much, passes to your local community centre for public skating or swimming is a great alternative. It’s often a great way for our children to learn new skills and continue to work on their development.

 

Hopefully this will give you some new ideas for useful Christmas gift ideas! Happy Holidays!

Sitting

Sitting

Let’s talk about sitting!

Sitting is often one of the big milestones that many parents look forward to – that and walking of course, but we will save that for another day!

Children often are excited to sit as well, as it opens up a new world for them to watch and interact with.

What does it take to sit?

Just like with rolling, in order to sit there are some fundamental skills a child needs to be able to do to sit independently.

Sitting requires control of flexion (bending) and extension (straightening) movement patterns, which start to develop during rolling.  Sitting also requires automatic postural reactions, which are made up of righting reactions (keeping head on body), protective reactions (putting our hands out if we are falling) and equilibrium reactions (balance).  These reactions also start to be developed during rolling and continue to progress with sitting.

So you can see why it’s important for children to achieve milestones in the right order, as they help develop skills that they need to complete the next one!

How sitting develops

Sitting is one of the only milestones that a child typically learns before they are able to get in and out of that position.  Parents typically put a child into sitting position and the child starts in what is called Tripod sitting – this is when a childs legs are out, often in a “V” position or a ring position, with their hands planted on the ground between their legs.  Once the child gains better control, they will start to come into a more upright position with the back in a c-shape and the child will start taking their hands off the ground to play briefly.

The child will then work on shifting directions and their body weight in the c-sit to gain more balance and control.  C-sitting should then continue to improve to nice upright sitting, with the child able to reach in front of themselves for toys, rotate to look the sides and reach up for higher toys.

When should my child be sitting?

Children can typically begin to tripod sit (within a parents legs) around 4 months of age.  C-sitting for brief periods (with lots of tipping over!) should start to develop just after 5 months.

I recommend parents stay close by, but allow their child to tip in order to help children develop those important reactions mentioned above.

You may also try propping pillows just beside and behind them (or use a breastfeeding pillow) so that you can be in front of your child to play and engage.

By 6 months, children should be starting to sit independently (working towards that tall sitting) with only the occasional loss of balance.  This typically coincides with introducing solids, as a child should be able to maintain good sitting posture in a high chair to ensure safe eating.

If your child is not showing the building blocks of sitting by 6 months, call your local pediatric physiotherapist for a consult.  As always, if you are in Kitchener-Waterloo or Perth County, give me a shout!

Back To School = Backpack Shopping

Back  To School = Backpack Shopping

It’s that time of year again – the littles (or not so littles in some cases!) are about to go back to school!  It’s the time of year when parents run around trying to get all those back to school supplies and prepare their kids for their return.

One of the biggest and most important purchases is a backpack.  Ill fitting backpacks can lead to back and shoulder pain, changes in walking and potential balance issues which could lead to injuries.

Here is a handy guide on what to look for in a backpack!

Things To Consider

As with any purchase, there are lots of things to consider and, unfortunately, sometimes the biggest consideration for many children/families is what the backpack looks like.  I know that it can be hard when your child has their heart set on a certain colour, character or style but, for the sake of their bodies, here are a few more things that you should you can consider:

1.  Bigger isn’t always better

Especially not for little kiddos!

Little ones should have a smaller backpack that fits well and, if needed, they can carry their lunch bag separately.

2.  Weight of the backpack

When I was a kid we had a ton of textbooks and I know that has changed with the growing amount of technology in classrooms – however, there is still lots of stuff that needs to go into a backpack!

The golden rule is that the backpack should weigh no more than 10-12% of the child’s weight.

3.  Ease of use for your child

Can your child put on and take off their backpack independently?  Can they easily carry it?

Practice if you need to!

This is a great opportunity to promote independence in younger children.  Have your child carry/wear their own backpack, whether getting on the bus or walking to school, right from the first day of school.

How To Choose The Right Backpack

Fit, fit and fit!

Only after finding a backpack that fits consider the internal features.

A good fitting backpack:

  • Should fit snuggly against the back
  • Have wide padded straps that can be adjusted for length
  • The bottom of the bag should be no more than 3-4 inches below the waist line (true waist NOT hips)
  • Has two straps!
  • If your child is older and carrying heavier loads, the backpack should have a clavicle strap and hip straps to help distribute the weight

Internal features should include different compartments, which help distribute the load – and stay organized!

Arrange the heaviest items closest to the back to help minimize the stress of their weight.

A water bottle pocket on the outside is always a good idea as well.

Hopefully this post helps guide you towards a great backpack for your child – happy shopping!!!

Rough and Tumble Play

Rough and Tumble Play

My last post was discussing risky play, the types of play that make up risky play and why they are important.  I promised a second post on rough and tumble play specifically, so here it is!

Rough and tumble play is a subtype of risky play that includes:

chasing

tickling

being swung

being bounced

being lifted

being thrown

It is spontaneous and fun!  This type of play, unlike some of the other risky play, is often done with both peers and parents/adults.

I believe this type of play is happening less and less, with parents/educators worried this type of play can get out of hand.

Often rough and tumble play is misinterpreted by adults as aggression and is discouraged.  It is interesting, however, to note that most children, even ones with learning disabilities, can distinguish the difference between rough and tumble play and aggression.  Research also shows that rough and tumble play rarely turns into real fighting (less than 1% of the time).

Why is it important?

From a physical standpoint, rough and tumble play helps build strength, improves gross motor skills, improves hand eye coordination, increases flexibility and is good cardiovascular work.

It also provides a ton of other developmental benefits!

Socially, children learn to adjust to changing social situations.

Emotionally, it helps develop self-regulation and compassion.

Cognitively, it assists with problem solving skills and behaviour correction in order to remain in the group of play.

Differences between Parents

Moms and dads typically engage in play differently with their children, regardless of the child’s gender.

Mom’s play tends to be more cautious, as mothers use more language and often use objects to engage in pretend play.

Dad’s play tends to be more physical, unpredictable and dads use less language (aka more rough and tumble).

As parents/adults what is our role?

Our role is, ultimately, to support our childrens development.  With respect to rough and tumble play, we need to ensure our children are getting enough.

That may mean taking a step back when children are engaged with their peers in this kind of play and, instead of stopping it, simply ensure that it remains safe (i.e. the play space in clear of hazards and everyone is enjoying playing).

A good general rule is “If the smiles stop, the play stops”.  It also means that we likely need to challenge ourselves to explore different types of play with our children, even if it’s outside our own comfort zone.

Lastly, the most important thing is to remember to have fun!

Risky Play

Risky Play

 

If you read the blog post about sitting still in school. you may remember me mentioning risky play – including rough and tumble – and that it is important.  As the weather gets warmer and the kids flock to the parks, I thought that now would be a great time to tackle the subject!

This will be a two part post – the first being about risky play and the second looking more at rough and tumble play specifically, so stay tuned!

What is Risky Play?

Risky play is a form of play that is thrilling, unpredictable, uncertain and has the potential for physical hazards and injury.

Researchers have identified six different types of risky play:

Great heights

Great heights type of play includes:

– climbing

– hanging

– jumping off of things

At the park, it’s all about monkey bars, tall climbing structures, including rope ladders, spider webs, parallel bars and rock climbers.

Climbing and hanging from our arms helps develop shoulder girdle strength, which is vital to fine motor control.  Opportunities to continue to strengthen our shoulder girdle typically decrease as we stop playing and get older (unless we specifically focus on it at the gym).

To be able to swing from the monkey bars or climb up to the top of the equipment, it also takes motor planning to figure out how to move our bodies to get where we want to go.  Hanging and jumping off of a height helps develop body awareness and spatial awareness.  All of these are building blocks in our physical development.

High speeds

High speeds type of play includes:

– sliding

– swinging

– biking and running at the edge of control

These types of activities serve a number of purposes, such as helping us continue to develop our vestibular system, which is responsible for giving us sensory information about motion, spatial orientation and equilibrium.  Additionally, high speeds typically means children are working on their overall fitness or cardiovascular work, leading to better endurance.

Rough and tumble

Check out our next blog post of this part of risky play.  There is just too much important stuff to fit in!

Getting lost

Getting lost sounds a bit scary, however this type of risky play includes playing alone and exploring unfamiliar environments independently.

The benefit of this type of play is much more psychological in nature rather than physical.  It allows our kiddos to develop resiliency and independence as well as a sense of self-security – that “I can do this!” mindset.

Of course, this type of play looks different at different ages.  A toddler may “hide” during hide and seek, however, the parents will know exactly where they are, whereas an older child might explore a forest while parents are nearby.

Dangerous tools

Dangerous tools play includes play with items that may cause harm, such as knives, hammers, screws and saws.

A child may help in the kitchen chopping veggies or build a birdhouse or fort.  Not only does this help reinforce creativity and planning, but it also helps develop hand eye coordination.

Dangerous elements

This type of play is in environments with an element of risk.

This might be near water, a steep drop off or fire.

The benefits of this kind of play are similar to getting lost.  From a physical perspective however, these environments can add an extra challenge.

Sand and rocky ground are unstable surfaces which can challenge balance, increase foot strength and in general take more energy to navigate – all great things from a physio point of view!

Growing and learning through Risky Play

All of these types of risky play allow children to grow and learn.  From a physiotherapy prospective, being physically active is of great importance, but it is also important to have the ability to continue our physical development with new challenges that we often don’t get an opportunity to experience otherwise.

From a global development perspective, children who engage in risky play foster greater self-esteem, build resiliency and learn to manage risks.

It can be hard to step back and let our little people try these things, as worry seems to be a natural part of parenting!

There is a fantastic website https://outsideplay.ca/ which can help parents/caregivers with the worry in order to encourage their child to experience more outdoor risky play.

Stay tuned for the second part on rough and tumble play!