Starfish Therapies
Starfish Therapies Newsletter
Happy  Thanksgiving!
November 2013
Volume 59
In This Issue
Updates
Just for Fun
Crafty Corner
Holiday Activities
What is Low Muscle Tone
Starfish Updates
Thanksgiving Week (AKA Crazy Sock Week):
The week of Thanksgiving 11/25/13 - 11/29/13 we are declaring 'Crazy Sock Week'.  We can't wait to see what your favorite socks are, or in what combination you decide to wear them!


Other Stuff... 
November has been a busy month for us.  We are actively looking for a Physical Therapist so please pass this link on to anyone you think would make a great addition to our team.

Stacy presented at the private practice conference in New Orleans on how to use technology and social media to create communities in pediatrics.  The biggest thing they loved hearing about was using Pinterest for treatment ideas and education!

At the same time the rest of the PT's
went to southern California for the Section on Pediatrics Annual Conference and not only learned a ton but created our very own motorized car (see below for more information)! 
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Just For Fun
 
Motorized Mobility

While at the Section on Pediatrics Annual Conference one of our therapists had the opportunity to create a motorized car that would simulate a fun way for kids to practice power mobility.  It can help to assess if they are ready for learning power mobility as well as provide independence for exploration.  There is a power switch that allows it to turn on and off easily and gives kids that immediate feedback of cause and effect.  We can't wait to try it out with some of the kiddos.
Crafty Corner


   

 

DIY Weighted Lap Bag

 

Many kids do better when they get the sensory input provided by a weighted object.  Often this can look like a weighted vest or a weighted blanket.  An easy way to make your own is to buy a stuffingless toy for a dog and take the squeaker out (or a stuffed one and take the stuffing and squeaker out).  Then fill it with aquarium rocks, beans, rice, etc to provide the weight.  Sew up the end and voila you have your own sensory tool.

 

Weighted lap bags can provide isolated proprioceptive input for kiddos who have trouble sitting still.  You can use it on their laps when they are sitting at their desk, at the table for eating or even when they are sitting on the floor for circle time.  It can also provide input in other areas such as draped over the shoulders.  However if you have a kiddo that has challenges with posture, this is not a good recommendation for them as it can enhance their postural difficulties.  Another use is it can be used  as a transitional item for kids. It gives them some weight to hold onto when going from place to place and can help to ground them during transitions which can be challenging for some kiddos.

Since it was newly completed it was exciting to use it with some of the kiddos during therapy that benefit from the input this tool can provide.  One of the cool side benefits was that it provides great tactile input as well.  One of the kiddos sat petting the stuffed animal while it sat on his lap and he did his work.  He was able to access both the weighted/proprioceptive input as well as the tactile input he needed in order to organize himself so that he could effectively work.

It make take a little playing with to get the correct weight and flexibility for your kiddo.  The more beans, rice or rocks you add to the body, the heavier and less flexible it becomes.

 

I hope you have as much fun as we did creating your weighted, furry friends!



Welcome back! October is National Physical Therapy month and we are happy to celebrate it with you. Look forward to seeing you at the clinic in your Halloween costumes!

 Holiday Activities    

 

 

Thanks to my mom for digging through her files and sending me these great ideas!  I grew up helping my mom run activities for people of all ages and every year we had a Christmas in July where the whole week was holiday themed activities.  Here are a few of them for you and your families to explore this year!  Could be some fun ideas to try out over Thanksgiving this year! 

 

Big Mouth Reindeer Toss- Paint reindeer faces on a large cardboard box.  Cut out the open mouths.  Paint the numbers next to each mouth.  Each player, in turn, throws a soft "Nerf" type ball, into the open mouths.  Keep score: the player to get 500 pts first wins.

  

 

Blizzard Blast:

  1. Snowball Bombardment- Before going to the activity you need to make rolled up newspaper balls.  The group is then divided into two teams.  Separate them across a field or a room.  You can then play like bombardment.  If you get hit with a snowball you are out.  However if you catch the snowball the person who threw it is out.  Continue until there is nobody left on one side.   
  2. Snowball Fight- teams wad up stacks of newspaper into "snowballs" and throw them into the other team's territory.  The team with the least amount of snow in their territory at the end of the game is the winner.
  3. Ice Melting Contest- Each team gets a tub of ice or a block and must try to melt it using only their hands (rubbing it).  Game goes for 10-15 minutes.
  4. Mining for Marbles- Try to find as many marbles as you can in a large pan of ice using only their toes.
  5. Snowflake Contest- Kids try to make the best snowflake.
  6. Ski Relay- Make something to resemble skis or find an old pair of snowshoes.  Have the kids put them on and race.
  7. Snowman Feed- Hold a pie eating contest (use vanilla pudding).  No hands permitted.
  8. Santa Feed- pie eating contest with whip cream (no hands permitted)
  9. Santa Look Alike- use whip cream and see who can make themselves or their partner into the best looking Santa

  

Candy Canes

Supplies: Deck of Cards, candy canes, pencil, paper and quick hands
If you have played the card game Spoons, then substitute Candy Canes for spoons and you are ready to play. If you have never played Spoons, here are the directions so you can play Candy Canes.
This game is best played with 6 people or less, as you need to be able to reach the Candy Canes.

Getting Started
To get started you will need a deck of cards, candy canes (you'll want 1 less candy cane then people playing, so if 6 people you start with 5 candy canes), pencil and paper.
Have everyone sit around the table and place the Candy Canes in the middle of the table.
Select a dealer, have them shuffle the cards and deal out 4 cards to each player. The remaining cards are then placed face down in front of the dealer.
Game Goal The goal of Candy Canes is to be the first to get 4 of a Kind in your hand. Once you have 4 of a Kind you can take a Candy Cane as unnoticeable as possible.
After the first Candy Cane is taken, any player can then grab a Candy Cane (you don't need 4 of a Kind to grab a Candy Cane at this point) and the player who does not grab a Candy Cane is given a point or letter in the word C-A-N-D-Y.
If a player get 5 points or has all the letters in the word C-A-N-D-Y, then they are out of the game and 1 Candy Cane is removed from the middle of the table.
Last player remaining wins.
How to Play Candy Canes
Once all the players have been dealt their cards and the remaining cards are in front of the dealer, the game begins.
The dealer selects the top card from the remaining deck of cards and decides whether to:
a. Add the card to their hand and discard an unwanted card by passing it to the next player on their left.
b. Immediately pass the card on to the next player on their left.
Once a card is passed to the next player, the dealer may then pick up the next card in the deck.
The person receiving the dealers card must then decide whether they want to keep or pass the card. This continues as each player around the table begins reviewing cards. Be aware cards will be moving at a very fast pace, so you need to decide quickly if you want a card.
Note: Players can only have 4 cards in their hand so every time a card is added one must be discarded.
The last player to receive the cards, the player on the dealer's right, will create a pile of unwanted cards then are no longer in play.
If all the cards are passed and no player gets 4 of a Kind, then the unwanted cards are shuffled by the dealer and the process begins again. Note: This rarely occurs, but it can happen.
Once someone has 4 of a Kind, they pull a Candy Cane from the middle and then others will follow. The person who doesn't get a Candy Cane earns a point or a letter in the word C-A-N-D-Y. Once a player has 5 points or the word C-A-N-D-Y is spelled out that person is out of the game and a candy cane is removed.
Once a Round of Candy Canes is complete the candy canes are placed back in the center and the cards move to the next dealer. Play until there is a winner.

What is Low Muscle Tone? 
crawling baby

Muscle tone is the resting state of your muscles.  When a child has low muscle tone it means that they need to put a lot more energy into getting their muscles to turn on to do what they want them to do.  I often try to explain this to parents by describing that feeling when you finally get to sink into the couch or your favorite arm chair and relax and then someone calls you from the other room and you have to rev up the energy to get up.  Think about having to do that every time you move because that's what it can be like for kiddos who have low tone.

 

Generally kiddos with low tone seem to be squishable because they melt right into you when you hug or hold them.  This is great for cuddling but if you are carrying a baby or kiddo around that is melting into you, it means they aren't able to help support themselves in your arms so it can seem as if you are carrying a heavy weight around.  As their muscles get stronger they get better at activating them so that if you are carrying them, they can hold their own trunk up without having to lean on you.  Its amazing how much lighter this can make them feel!  (Another way to get the idea is if you are holding a kiddo by their hands to help them stand and they just decide to have spaghetti legs and you weren't expecting it).

 

When I talk about strength being a challenge for kids with low tone I am talking about not just their ability to generate enough force to move their arm or their leg, but also their endurance and their ability to switch their muscles on and off.  These components all work together to produce movement.

 

I know that I talk about core strength a lot but for these kiddos its really important.  Just think if your trunk (core) was as stable as a slinky.  Do you think it would be easy to move your arms and legs, to do fine motor activities, to run and jump or even walk, to keep an upright posture in school to help with learning?  It would be challenging to do all of these things and so many more. That's why when I work with kids with low tone I am often doing activities that will challenge the whole body but also focus on the core.  I also work to increase either how long they can do an activity (such as sitting on a ball for trunk control) or how many times they can do something (such as bridging) because this will help to increase the endurance of their muscles so they can stay working as long as they want them to.

 

Since it is harder to move and to activate their muscles, a lot of times they may need more practice, help and support, not to mention motivation to get moving! When they are little I do lots of tummy time to develop their butt muscles, anti-gravity trunk extensors, their head and neck muscles and their shoulder muscles.  The more interesting you can make the activity the longer you can get them to want to play in this position.  I do other activities as well, such as pull to sit to work on abs and head control (I make them work both going up and going down).  Going down is often easier (until you get close to the ground) because their muscles are already turned on so they just have to keep them on so they don't 'crash' unlike going up where they have to turn their muscles on and its really hard when you are flat on the ground because you are fully working against gravity. I could go on all day and I might have to do another post just on activities!

 

Since these kiddos have to put out so much more energy to do things than a person with regular muscle tone, and the fact that we are constantly asking them to do more, don't be surprised if they get tired easily.  For instance, it may not seem like it is that hard to sit in a chair to do work but if you think about all the energy they have to expend to keep their body up nice and straight its not surprising that they are tired.  When they are little they may need to nap more often, especially if they are doing therapy.  If you are in a mommy and me or a gymboree class you may notice that your kiddo needs to take breaks a little more frequently than the other kiddos.  This is normal for them.  However, you also want to remember the goal of working on their endurance so it doesn't hurt to challenge them.  Just like when I am training for a race, 3 miles may be in my comfort zone but to get to the marathon I will have to challenge myself to run a little bit further than my comfort zone allows each day.

TheraTogs or the Spio suit or even hip helpers are tools that can be helpful for kids with low tone to give them a little extra support in the core so that they can practice the skills they need to practice.  I also use a lot of tickling to remind a muscle to turn on and stay on.  Sometimes using a slightly unstable surface like a sitting disc or a therapy ball can also be a reminder to keep muscles on.  Since it is unstable its a lot harder to sink into the support like they would be able to in a nice firm chair.  Also using wedges (although I wish I could find these filled with sand in addition to the air filled ones) in a chair (tilted forward) can help to activate a child's core for improved sitting as well.  What are other tools that have helped either kids you have worked with or your own child - I'm sure I'm leaving out a ton of ones I've thought of or used but I always love to hear new ideas!

Thank you for reading this month. We are so thankful for all of you who support the children and families that we work with!   Have a safe and happy Thanksgiving! 
 
Sincerely,
 

Your Friends at
Starfish Therapies