Starfish Therapies
Starfish Notes
Happy St. Patrick's Day
March 2009
Volume 4
In This Issue
Starfish Updates
Check It Out
Featured Product
Just for Fun
Coming Next Month
Bikes, Trikes and Scooters
Motor Learning
Starfish Updates
starfish
Check out our website for Other Services we offer.

Limited time offer:  10% off Baby Signs Class.  Please contact Corinne at 415-346-3853 for specific information.

Topics for upcoming Body Mechanics Classes for Parents and Caregivers are:
  • Basic Body Mechanics - Part 1
  • Basic Body Mechanics - Part 2
  • Positioning for Play - Part 1
  • Positioning for Play - Part 2
Please check our Newsletter Archive for any previous editions of Starfish Notes that you may have missed!

Coming soon:  Motor Smart Kids!  Look for more information in upcoming newsletters or contact us at 415-346-3853.
Check It Out
Recess Urban Recreation
Recess - Urban recreation is a community space for kids and their adults in San Francisco.  For kids, recess boasts a 3200 sq ft developmentally rich indoor playspace, movement classes, art exploration, story time, music classes, and dance parties.  For their adults, recess offers a chance to connect with other parents/caregivers, a cafe area, lending library, and wellness services with child watch.  In conjunction with local professionals, recess also runs parent education workshops, play groups and expectant parent resources.  The goal at recess is to offer a place for families to play, learn and be well.  For more information visit Recess Urban Recreation.
Featured Product
Freedom Concepts
Freedom Concepts
As of March 18, Starfish Therapies will have at least one tricycle available for use at the clinic.  Freedom Concepts Tricycles offer a multitude of features that can benefit your child or youth, to allow them the joy of bike riding.  Some features include:  increased trunk support, rear control steering, assisted pedaling, adjustable handlebars, and foot strapping.  Please talk to your therapist to see if your child could benefit from bike riding.  In addition to it being a fun activity, it provides cardiovascular benefits as well as stimulating reciprocal leg movement which is essential for walking and crawling.  Starfish Therapies is also an assessment center for Freedom Concepts and can assist you in finding the perfect tricycle for your child.  Please visit Freedom Concepts for more information about their products.
Just for Fun
Daily Candy
DailyCandy Kids highlights the hottest and hippest stuff for the under-8 set.  DailyCandy Kids editors search for the neatest gadgets, most stylish clothing, and the coolest services designed to improve the lives of in-the-know parents and children everywhere.  There are 12 city-specific weekly editions and one national edition.  Check it out at DailyCandy Kids and like we said, just for fun!
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Coming Next Month
Horse
Hippotherapy  
We will be providing features on other therapies available to you and your children in upcoming issues.  Please don't hesitate to contact us at [email protected] if you have a specific request for alternative/additional therapies.
Greetings!

Welcome to March's edition of Starfish Notes.  With the days being longer, we piggy backed on our article of Parks and Playgrounds from February to assist you in searching for the perfect wheeled mobility to use at the park - Happy Biking!
 
Bikes, Trikes and Scooters
rachel bike
Its almost that time of year again, winter is almost past and the weather is starting to get nice again.  Its time to get out of the house and lets face it, bikes, tricycles and scooters are much better outdoors than indoors! 

For your child's first 'bike' a ride on scooting toy will be your best bet.  There are a lot out there so when it comes to choosing what is best for your child, some things you want to consider are:  1) are their feet able to touch the floor when they sit on it, 2) is the seat narrow enough that they can use their legs to push with, 3) is the seat wide enough that they can sit on it without toppling over, and 4) is it a weight that allows your child to maneuver it around? 
 
After the scooter generally comes the tricycle.  Now I have yet to find the 'perfect' tricycle with all the components I like for teaching kids how to pedal and steer, however there are some great tricycles out there depending on the level of your child and your level of patience!  Some things to consider are:  1) do you want pedals that turn when you push the bike, 2) do you want to be able to lock out the steering wheel, 3) do you want to be able to push the tricycle from the back and do you want to be able to steer while you are pushing, 4) do you want a seat with a back and a seat belt, 5) does your child do better with a recumbent or upright seat (this affects the way they push with their legs while pedaling), and 6) can your child reach the pedals?  All of the bells and whistles are not necessary, however they can make your life easier while teaching your child how to ride their tricycle.  I have found that an upright seat is a little easier to grasp the concept of pedaling than a recumbent seat, although your child may not seem as stable in the seat.

Finally, the bike.  Once your child masters the tricycle you can find a small bicycle and put some training wheels on them.  I have found that tying a jump rope around the handle bars saves my back while helping children to master the skill of propelling the bike forward while steering.  In order to graduate to a bike you want to make sure your child can maintain good balance on the bike seat since it is a lot smaller than a tricycle seat.  You want the seat so that they can reach the pedals during a full circle while maintaining a slight bend in their knee when the pedal is at the bottom position.

Other wheeled mobility options are standing scooters and the skuuts.  Scooters work on single leg stance and push off while maintaining balance.  Many kids struggle with learning how to do the glide and will initially propel the scooter with a stepping type motion.  The skuut (this is a brand name and there are other brands with a similar idea) works on balance and coordination of the legs.  It allows your child to sit on a seat, like a bike, and propel themselves along with their feet.  This can be done with a running motion or a push and glide motion. 

I would recommend taking your child someplace where they can sit on the various bikes, tricycles and scooters so you can see the fit as well as try out the various components that are available.  Talbots Toy Land in San Mateo has a great selection and the models are available for kids and parents to test them out.  Please ask your therapist for their favorites or if they have specific recommendations for what may suit your child best.

Biking with Kids
Bicycle Safety Classes
Bicycle Shopping
Motor Learning: Stages of Motor Learning and Strategies to Improve Acquisition of Motor Skills
 balance beam
 Motor learning has been defined as a "set of internal processes associated with practice or experience leading to relatively permanent changes in the capability for skilled behavior."  In other words, motor learning is when complex processes in the brain occur in response to practice or experience of a certain skill resulting in changes in the central nervous system that allow for production of a new motor skill. 
 
There are three stages in which motor learning occurs:
1. Cognitive Stage- During this initial stage of motor learning, the goal is to develop an overall understanding of the skill.  The learner must determine what the objective of the skill is and begin to process environmental factors that will affect their ability to produce the skill.  The teacher must do their best to provide an optimal environment for learning, which may mean removing large distractors.  During this stage, the learner mostly relies on visual input and trial and error to guide learning. Example: Before your child masters walking, they will most likely look a bit awkward and will definitely stumble a few times. The reality is that the process of learning how to walk begins way before your child actually takes their first assisted or independent step as they have been visually observing others around them walking and beginning to understand the purpose. So while they make look clumsy during this stage of learning, they are only just beginning to transition from understanding the skill to executing it.
 
2. Associative Stage - During this stage, the learner begins to demonstrate a more refined movement through practice. Now that the learner has had some practice and has identified various stimuli that may occur, they can focus on "how to do" moving on from the "what to do" in the first stage.  Here, visual cues become less important and proprioceptive cues become very important.  Proprioceptive cues refer to the learner focusing more on how their body is moving in space and what input is being felt from their joints and muscles. The more practice, the more proprioceptive input the learner receives to aide learning.  Therefore, the more practice the better! Example: Let's continue with walking.  During the initial clumsy stage your child may demonstrate small, choppy steps, wide base of support, arms up high in a guarded position, and little to no trunk rotation.  In this stage, you may see your child taking longer, more controlled steps, narrowing their base of support, and allowing their arms to relax at their sides.  These behaviors indicate that your child has moved past the initial stage of learning and has progressed to a more refined movement.
 
3. Autonomous Stage - During this final stage of learning, the motor skill becomes mostly automatic. Progression to this level of learning allows the learner to perform the skill in any environment with very little cognitive involvement compared to the first stage. Example: Your child will now be able to walk in a predictable environment such as your home or an unpredictable environment such as a crowded birthday party at the park on grass without difficulty.
 
Keep in mind that the learning process can take different lengths of time for every individual and progression can be dependent on a variety of factors such as motivation of the learner, feedback received, environmental stimuli, organization of practice, and the presence of musculoskeletal or neuromuscular impairments.  Talk with your therapist for more suggestions to optimize motor learning more specifically for your child.
 
Check back in April to read about Motor Control followed by information about Postural Stability and Balance Strategies in May. 
 
References:
Physical Rehabilitation: Assessment and Treatment. O'Sullivan, S. B., Schmitz, T. J. 1994. pgs 366-367.
Physical Therapy for Children.  Campbell, S.K. et al. 2006. pgs. 76-90.
Thank you for your continued interest in Starfish Therapies.  We enjoy searching for interesting tidbits and useful information for you and your family.  Please pass along any fun or useful information you may have discovered during your journey as a parent!  Don't hesitate to contact us with questions or for more information.  Happy St. Patrick's Day!
 
Sincerely,
 

Your Friends at
Starfish Therapies