The Right Step: Choosing Shoes for Early Walkers and Kids in Summer and Winter
Walking is one of the most significant milestones in a child’s life. The shoes they don early on can have lasting impacts on their posture, gait, and musculoskeletal health. As seasons evolve, so should the considerations parents make for their child’s footwear. From a physical therapy perspective, here’s a guide on choosing the right shoes for young children across seasons. For the Early Walkers: 1. Flexibility: Shoes should bend and twist in your hands. This malleability promotes the natural movement of a child’s foot. 2. Flat Soles: Heels or wedges can interfere with a child’s balance. A flat sole aids in stable weight distribution. 3. Breathability: In summer, shoes made of breathable material help prevent overheating and moisture buildup. 4. Snug but Not Tight: A shoe should fit well without constricting the foot. Room to wiggle toes is vital! 5. Wide Toe Box: This feature is crucial. A wider toe box allows toes to spread naturally, aiding balance and reducing the risk of developmental issues or deformities. 6. Ankle Support: Especially crucial for early walkers, shoes with proper ankle support provide stability, helping to prevent wobbles and potential injuries. Summer Selections: 1. Open vs. Closed: Sandals with a back strap are a secure choice. Closed shoes, if preferred, should be made of light, breathable material. 2. Grip is Essential: Non-slip soles are crucial, particularly near pools or damp areas. 3. Avoid Flip Flops: They offer minimal support or protection for young, active feet. Winter Wonders: 1. Insulation: Shoes should be breathable but also offer insulation against the cold. 2. High-Ankled Boots: These boots offer enhanced stability on slippery surfaces and protect against cold. The high ankle also provides added support. 3. Non-Skid Soles: With ice and snow in winter, a shoe with good grip is a must. 4. Room for Socks: Winter shoes should have some extra space for thicker socks without compressing the foot. In conclusion, the aesthetics of a shoe, while appealing, should always come secondary to its functional attributes. The right shoe not only shields the feet but also supports the holistic physical development of your child. When unsure, your pediatric physical therapist is a valuable resource to tap into.
Gross Motor Milestones: A Guide for Parents from a Pediatric Physical Therapist
As a pediatric physical therapist, one of the most common queries I encounter is, “Is my child on track with their physical development?” Understanding gross motor milestones and knowing when it might be time to seek professional guidance is vital for every parent. Here’s a concise guide to help you navigate this essential aspect of your child’s growth. What are Gross Motor Milestones? Gross motor milestones are the significant stages of physical development in a child’s life, starting from infancy to their early school years. They encompass skills involving large muscle movements of the body—think crawling, walking, jumping, and running. Key Gross Motor Milestones: 1. Birth to 3 months: – Baby begins to lift the head during tummy time. – Gradual improvement in head control. 2. 4 to 6 months: – Rolling over (from tummy to back and vice versa). – Sitting with support and starting to sit independently. 3. 7 to 9 months: – Starts to crawl. – Pulls to stand with support. 4. 10 to 12 months: – Begins to stand without support. – May take first independent steps. 5. 1 to 2 years: – Walks independently and starts to run. – Begins to climb stairs with support. 6. 2 to 3 years: – Runs confidently and starts to jump. – Climbs stairs one at a time without holding on. 7. 3 to 5 years: – Begins hopping, swinging, and maybe even skipping. – Rides a tricycle and stands on one foot for a short time. When to Seek a Referral: While every child develops at their own unique pace, there are general timeframes in which most children acquire these skills. It’s essential to remember that occasional delays are typical. However, if you observe the following, it may be time to seek a referral: 1. Consistent Delays: If your child is regularly missing milestones or is significantly behind their peers. 2. Loss of Skills: Any regression, like a child who once walked but now doesn’t, warrants a check. 3. Lack of Coordination: If your child appears unusually clumsy for their age or struggles more than their peers with similar activities. 4. Uneven Muscle Use: For instance, if your child uses one side of their body more than the other. 5. Difficulty in Keeping Up: If they struggle to engage in age-appropriate activities or play due to physical constraints. Your child’s health and well-being are paramount. Being proactive and seeking guidance when unsure can make all the difference. Trust your instincts as a parent, but also remember to seek expert advice when needed. Pediatric physical therapists are here to assist, guide, and provide the necessary interventions to ensure your child’s optimal physical development.
Active Family Fun: Boosting Gross Motor Skills the Enjoyable Way!
Engaging in family activities isn’t just about spending quality time together; it’s also a fantastic way to boost your child’s gross motor skills. These skills, involving large muscle movements, play a pivotal role in a child’s physical development. Here are some entertaining and simple ideas to get your family moving while having a blast! 1. Chalk Obstacle Course: Transform your driveway or sidewalk into an adventure-filled obstacle course using just chalk! – Draw zigzag lines, spirals, and circles for children to walk, run, or hop through. – Sketch out numbered lily pads or islands that they can leap between. – Outline large shapes for kids to fill with different movements, like spinning or star jumps. 2. “The Floor is Lava”: A classic game that never gets old and perfect for a rainy day indoors. – Scatter couch cushions, pillows, and blankets across the floor. These are your “safe” zones. – The objective is to move from one side of the room to the other without touching the floor. – It’s a great way for kids to utilize different muscles as they balance, jump, and plan their path. 3. Nature Walks with a Twist: A family walk is always refreshing, but adding a few fun challenges can make it even more exciting. – Organize a scavenger hunt where children need to find specific items, like pinecones or colorful leaves. – Challenge kids to mirror animals they see or talk about, like hopping like a frog or waddling like a duck. 4. Dance Party: Crank up the music and let loose! Dancing is not only fun but also an excellent way for kids (and adults) to develop coordination and rhythm. – Choose different music genres and move to the beat. – Freeze dance: When the music stops, everyone freezes until it starts again. 5. DIY Bowling: Use empty water bottles and a soft ball to create a bowling alley in your hallway. – Set up the bottles in a traditional triangle or in any fun pattern. – Take turns rolling the ball and trying to knock them down. 6. Build-a-Fort: While building a fort may seem like a quiet activity, the physical process involves lifting, pulling, and arranging, all of which are great for gross motor development. – Use chairs, tables, and blankets. – Once it’s built, kids can crawl in and out or incorporate it into their imaginative play. Active play is essential for a child’s physical and cognitive development. Plus, it’s a great way for families to bond. The key is to keep activities engaging and enjoyable, ensuring that children are eager to participate. Remember, it’s not about structured exercise but about moving, laughing, and learning together. So, gather your family, pick an activity, and let the fun begin!
What is Torticollis?
You may have heard of the term “torticollis,” also known as wryneck. Torticollis is the twisting of the neck that causes the head to rotate and tilt at an angle. The twisting of the neck occurs when the large muscle running on both sides of the neck, from the back of the ear to the collarbone, is too tight and/or shortened. In newborns, torticollis can happen due to the baby’s position in the womb or from consistent positioning following birth. The following are the most common symptoms of torticollis; however, each person may experience symptoms differently. Symptoms may include: Inability to turn the head (rotation) Spasm of the neck muscles The top of their head may be tilted to one side and their chin may be tilted to the other side. Difficulties visually tracking Difficulties holding the head in an upright position Preference among breast-fed and bottle-fed babies to eat on one side over the other or problems latching onto the breast or bottle. Physical therapy helps prevent permanent shortening, head and neck pain, and helps prevent developmental delays that could occur secondarily. Early physical therapy for torticollis is very helpful and effective. The physical therapists’ focus includes passive range of motion, active range of motion, stretching, muscle strengthening, and parent education for positioning, stretching and activities that they can incorporate into their daily lives in order to increase the child’s ability to turn and move their head and continue to make gains towards their developmental milestones. If you have any questions or concerns in regards to torticollis, please reach out to your doctor or your child’s physical therapist.
Occupational Therapy and the Adolescent Years
Adolescent years bring about many changes including taking on responsibilities in the home, more demands at school, employment, driving, bodily changes, relationships, money management, increasing independence as they prepare for adulthood, and more. Occupational therapists come alongside adolescents to help support and increase their independence in these daily occupations, or everyday activities one engages in. More specifically, within the OT Practice Framework (AOTA, 2014), daily occupations consist of ADLs and IADLs. Activities of daily living (ADLs) are considered to be nine activities: bathing/showering, toileting and toilet hygiene, dressing, swallowing/eating, feeding, functional mobility, personal device care, personal hygiene and grooming, and sexual activity; whereas, instrumental activities of daily living (IADLs) encompass 12 activities that “require more complex interactions than those used in ADLs” including care of others, care of pets, child rearing, communication management, driving and community mobility, financial management, health management and maintenance, home establishment and management, meal preparation and cleanup, religious and spiritual expression, safety and emergency maintenance, and shopping (AOTA, 2014, p. S19). An occupational therapy session with this age group can include so many functional, important skills, while keeping the session fun! When working with adolescents, a treatment session might include activities such as hygiene tasks including brushing teeth, applying deodorant, nail trimming, and combing hair, dressing skills, simple household chores such as separating and completing laundry, bed making, loading and emptying a dishwasher, sweeping, or vacuuming, meal prep and cleanup, and kitchen and food safety. Other sessions might include walking to a nearby restaurant or store to complete a point of service transaction to purchase items, going for a walk outside to address environmental safety awareness, or completing simulated work tasks such as sorting, stocking, and typing for vocation/job-related skills. Moreover, when addressing ADL and IADL skills, the occupational therapist is also incorporating skills such as problem solving, organization, planning and ideation, initiation, flexibility and regulation. These skills are important and are used regularly throughout our daily activities. Regulation is also an essential skill during the adolescent years with the various changes these individuals experience. Self regulation can help work through emotional regulation, self consciousness and negative self-talk that is often difficult during these years. Ultimately, it is the occupational therapist’s goal for each child to be as successful and independent as possible in order to participate in their daily activities and fulfill their dreams and aspirations!
Orthotics
Karina Moore, PTA Orthotics are used for several different reasons and can be made several different ways. Pediatric orthotics can range from shoe inserts to knee high braces and more. According to Orthotics.pdf (pediatricapta.org) an orthosis is an external device with controlling forces to improve body alignment, improve function, immobilize the injured area, prevent or improve a deformity, protect a joint or limb, limit or reduce pain, and/or provide proprioceptive feedback. Orthoses are named for the part of the body they cover. Orthoses can be custom molded and custom fitted (custom fitted from prefabricated orthoses or off the shelf). There are many reasons why a child may benefit from orthotic intervention at all different ages, with and without a medical diagnosis. The use of orthotics can vary from child to child, however, the main goal is to provide stability while promoting functional ability. Orthotics or orthoses can be used to assist with pronation (rotation of the medial bones in the midtarsal region of the foot inward and downward so that in walking the foot tends to come down on its inner margin) flat feet, toe walking, weakness, poor balance, frequent tripping, leg length discrepancies, low tone, and structural issues. Orthotics are made to improve a child’s walking pattern to as normal for them as possible to facilitate age appropriate child development. Excessive pronation in the absence of high tone is usually easily corrected. A variety of “off the shelf” inserts are available, but may require customization. This type of insert is the one most commonly required. Sure Step is another commonly used orthotic. It’s not a fast fit product and must be measured. It offers wrap around support of the foot, assistance at the hind foot for position, and some assistance with ankle modulation. Open trim lines at the forefoot.”Surestep orthotics are custom-made to provide the extra support these amazing children need to run, jump and play. In fact, our core product, the patented Surestep SMO system, revolutionized orthotic management for children with pronation or low muscle tone (hypotonia) worldwide.” – Sure Step Physical therapists are trained in the function of orthoses and will frequently fit and measure orthoses. If the child is measured by the physical therapist, the orthoses are usually centrally fabricated and returned to the therapist for custom fitting and delivery. Following delivery of the orthosis, physical therapists provide education and functional training to the child and family. The physical therapists at No Limits are trained in serial casting, fitting, and measuring for orthoses. We work closely with the orthotists at Orthotics At Home to ensure a proper fit for the child’s best outcome. We also help educate the family on how to put on and take off along with a proper wearing schedule. If you are having concerns about the way your child walks, foot placement, or overall gross motor delays reach out to your pediatrician or physical therapist. We would be happy to take a look and help in any way we can. Orthotics.pdf (pediatricapta.org) Why does my child need orthotics? – ABC Pediatric Therapy Surestep–Dynamic Stabilizing System: www.surestep.net Cascade DAFO: www.cascadedafo.com