Starfish Therapies
Starfish Therapies Newsletter

Happy New Year!

January 2015
Volume 73
In This Issue
Updates
Developmental Milestones
Winter Crafts and Activities
Let's Play
What Does Low Tone Mean?
Starfish Updates

Blogs:  One of our favorite parts about the end of the year and the start of a new one is seeing the 'top posts of 2014' from the various bloggers we follow.  Below are some great 'top lists' to check out!

New Staff:  We would love to welcome Leslie Lam to our staff as the newest addition to our PT department.  We are so excited to have Leslie back as she completed one of her internships with us way back when, when she was still a PT student.   

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Developmental Milestones Resource

MamaOT is a great blog and resource that we regularly follow. We are so excited about her most recent edition to her page. It is a list of developmental milestones by age, and then blog posts from various authors to support you and your child in achieving those milestones, or answering questions about those milestones.  We hope that you find this resource as helpful as we have!
Winter Crafts and Activities
With the winter months upon us, you may be looking for some ideas for your kids.  Here are a few we stumbled upon that we thought you might enjoy!


Welcome back! Enjoy reading for some great ideas for indoor play and winter crafts.
Let's Play!        

Some play ideas to keep you and the kids busy during these cold winter months!

 

Simon Says

What you need: Imagination

What you do: You can play this with one child or several children.  Depending on their age will depend on the complexity.  This is a great way to encourage imagination and creativity as well as work on coordination and motor skills.  You can start out by leading and say 'Simon Says' (jump up and down, turn in circles, stand on one foot, do jumping jacks, jump in a circle, jump like a frog, hop on one foot, stand on your tip toes, walk on your toes, etc).  For little kids I just do Simon Says for everything because I am trying to get them to do/try the skills.  For older kids you can switch it up and not say Simon Says for some of them so they have to work on deciphering and remembering directions.  You can take turns being Simon or you can go back and forth.  Its great for the child to have to come up with something.  Initially they may start with just repeating whatever you said but they may start coming up with some really fun skills/ideas.  In addition it works on following directions with audio and visual cues.

 

Animal Parade

What you need: Imagination or pictures of animals

What you do: If you are going to use pictures or replicas of animals you want to have your child close their eyes and pick an animal.  Then you try to figure out how that animal would get across the room.  For example, if it's a dog, you would crawls across the room and you can make noises like a dog.  If it's a frog you can hop and ribbit across the room.  Or you can take turns picking an animal to be.  This encourages gross motor skills and creativity.

 

Lily Pad Walk

What you need: Step stools or objects that can be stood on

What you do: Set the step stools up in a path and have your child walk on them.  You can use toys that they have to get from one side to the other to encourage repetition.  This works on balance, and hand-foot coordination.

 

Newspaper Shoot-out

What you need: Newspaper and bucket

What you do: Have your child tear a newspaper into strips and then crumple up into balls. Then they can throw the balls into the bucket like they're playing basketball. Tearing the pieces of newspaper works on bilateral use of their hands. They can practice pulling their hands in opposite directions in order to be successful with making strips. Crumbling the newspaper works on bringing their hands to midline and bilateral use of hands once again. This is also assisting in fine motor strength to crumple the paper.

 

Stacking Blocks

What you need: Stacking blocks and possibly a toy car or person

What you do: Your child can stack the blocks into a tower as high as they can and then knock it down. They can also try and make bridges, houses or whatever their imagination leads them to make.  Sometimes adding a toy car or person can help with the imaginative part so that they have something to go under the bridge or walk up the stairs they just made. Building with blocks works on eye-hand coordination and incorporates grasping with their fingers in order to be more successful. Some kids will still grasp with their palm and they may still be able to build like this, but can sometimes use too much force and have less control when attempting to build this way. Blocks can also work on motor planning and imaginative play. If your child is just stacking and knocking down, assist them in building a bridge or house and then incorporating pretend play.

 

  

 
What Does Low Tone Mean?
 

 

 

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. Happy New Year from the Starfish family to yours!! 
Sincerely,
 

Your Friends at
Starfish Therapies