Tuesday, August 25, 2009

Predictive Value of Motor Evaluations

In a study published by Early Human Development, researchers studied the predictive values in very preterm children and small for gestational age of the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development and the Peabody Developmental Motor Scales (PDMS). The researchers concluded that for very low birth weight children, the PDI and PDMS were good tests to identify early motor problems. The PDMS was the best predictor for small for gestational age and term children with normal birth weight. For the children who were very preterm, small for gestational age or full term, all three tests showed that normal motor skills at ages 1 and 5 were predictive for normal motor skills at age 14.

Reference: Kari Anne I. Evensena, Jon Skranesa, Ann-Mari Brubakka and Torstein Vik (2009) Predictive value of early motor evaluation in preterm very low birth weight and term small for gestational age children Early Human Development
Volume 85, Issue 8, August 2009, Pages 511-518

Saturday, August 22, 2009

Hot, hot, hot! Water obstacle course

Here is an example of a water obstacle course that you can create with your client or child. Therapy does not get any more fun than this. This activity encourages gross motor skills, muscle strengthening, eye hand coordination, trunk rotation, crossing midline, balance and motor planning. Whew! That is a lot of developmental play with some simple water play.

Friday, August 21, 2009

5 Ice Breakers for Pediatric Therapy

Some of you have already started the school year and some of you will begin over the next few weeks. Get to know your new students with these 5 ice breaker ideas:
1. Write a letter to your students telling them about yourself. Perhaps let them know your favorite food, color, movie and more. Tell them about a summer vacation you took. Tell them your favorite things to do outdoors and your favorite type of exercise. Explain to them some of the things that you use or will do during therapy sessions. Request that the student write you back answering some questions that you have asked. Some examples would be: What did you do over the summer? What are your goals for therapy? What is your favorite way to exercise? If the school year has already started just start off the therapy session with a quick interview of each other.

2. Happy and Healthy Hands. Have each student trace around one hand on a piece of the same color paper. On the hand, write different things that make the student happy and healthy. Hang the hands on the wall. Have the children go around the room. Do wall push ups on different sets of hands. Can you guess whose hands matches whose print?

3. Getting to Know You Charades. Have the student's act out their favorite things in different categories. For example, some categories could be favorite sport, favorite book and favorite outdoor activity.

4. Motor Match Up. Create a matching set of cards with various movements such as crawling, dancing, jumping, walking and marching. Pass out one card to each student. The students must move around the room and find the other student moving the same way that they are. Once the pair is matched up they introduce themselves.

5. Silly Name Game. Stand in a circle. Pick one student to go first. This student says his/her name and adds a movement (i.e. shakes head yes). The next student says the first students name and shakes head yes, then introduces himself adding a movement (i.e. claps hands). The third student says student #1's name and shakes head yes, then says student #2's name and claps hands. Student three then says his own name and adds a movement. Keep going around the circle.

Need more back to school activities? Check out Sensory Motor Activities for Fall and Back to School Handwriting Activities.

Thursday, August 20, 2009

Sensory Responses, Anxiety and ADHD

The American Journal of Occupational Therapy published research on the relationship between ADHD, sensory overresponsivity and anxiety. Forty eight children in total were studied with and without ADHD. The children were assessed using the Sensory Over-Responsivity Inventory and the Revised Children’s Manifest Anxiety Scale (RCMAS). Results indicated that the children who had ADHD and sensory overresponsivity were significantly more anxious than the ADHD and non-ADHD children. In addition, the children with ADHD and sensory over-responsivity were more likely to have clinically significant anxiety as per the RCMAS.

Reference: Stacey Reynolds-PhD, OTR/L, Shelly J. Lane-PhD, OTR/L, FAOTA (2009) Sensory Overresponsivity and Anxiety in Children With ADHD AJOT Volume 63 (4).

Monday, August 17, 2009

Sensory Motor Activity Idea - Rock Bowling

Here is a fun game to play with young children to encourage tactile input, proprioceptive input, fine motor skills and eye hand coordination. Visit www.YourTherapySource.com for more sensory motor ideas.

Therapuetic Horseback Riding and Children with Autism

The Journal of Autism and Developmental Disorders published research on the effects of therapeutic horseback riding on children with autism. A 12 week intervention of therapeutic horseback riding for 19 children with autism resulted in less inattention, distractibility and sedentary behavior. In addition, the children displayed increased social motivation, sensory seeking behaviors and greater sensory sensitivities.

Reference: Margaret M. Bass, Catherine A. Duchown and Maria M. Llabre (2009) The Effect of Therapeutic Horseback Riding on Social Functioning in Children with Autism Journal of Autism and Developmental Disorders Volume 39 (9):1261-1267.

Sunday, August 16, 2009

Pediatric Sitting Gadget

Here is an interesting sitting gadget for children with and without special needs called the Nada Chair. The Nada Chair is a sling that you wrap around the child's back (or adults) and knees. The knees are used as a helper to stabilize the back. There are also stretch straps that you can purchase to assist with long sitting and hamstring stretching. It is inexpensive for the therapy world of products - $45.oo for the KiddyUp kit which includes the posture assist and stretch straps.

Perhaps many of your have heard of it or currently use it. I would love to hear what you think of it. Please comment.

Friday, August 14, 2009

School Based PT's and Standing Programs

Survey results on standing frame prescription and implementation by school based physical therapists was published in the latest issue of Pediatric Physical Therapy. The survey results indicated that most school based PT's prescribe standing programs based on ambulatory status and specific needs. The benefits of standing programs were rated very important for social and educational reasons. Most standing programs were prescribed for 30-45 minutes daily.

Reference: Taylor, Kristin PT Factors Affecting Prescription and Implementation of Standing-Frame Programs by School-Based Physical Therapists for Children with Impaired Mobility Pediatric Physical Therapy: Fall 2009 - Volume 21 - Issue 3 - pp 282-288 doi: 10.1097/PEP.0b013e3181b175cd

Summer OT/PT/Speech Program News Story

Here is a great news story about an innovative summer program idea. They raise the money to provide therapy services over the summer for free for children with special needs. Heard about this from @AdvanceforOT on Twitter.

Thursday, August 13, 2009

Enuresis and ADHD

Recent research in the Journal of Pediatrics reports on ADHD and enuresis (bedwetting). Enuresis in children with ADHD occurs at a higher rate but the cause for this is unknown. The researchers studied 344 children with ADHD ages 6-12 years old. Out of the 344 children, 16.9% had nocturnal enuresis. The 16.9% had more inattentive symptoms. These children also had decreased arousal levels with regards to night waking and the ability for children to wake themselves. The researchers conclude that nocturnal enuresis may be an endophenotype for ADHD - inattentive type.

Question to ponder for any sensory trained therapists or parents? For children with low arousal levels, do you notice any changes in enuresis following sensory integration therapy? Does anyone know of any research on this topic? Comment below.

Reference: Josephine Elia, MDab, Toshinobu Takeda, MD, PhDa, Rachel Deberardinisb, et al. Nocturnal Enuresis: A Suggestive Endophenotype Marker for a Subgroup of Inattentive Attention-Deficit/Hyperactivity Disorder
The Journal of Pediatrics
Volume 155, Issue 2, Pages 239-244.e5 (August 2009)

Wednesday, August 12, 2009

ADHD and Balance

The Journal of Pediatrics published research on children with ADHD (Type C) and sensory organization. The sensory organization of standing balance of 43 children with ADHD-C was compared to typically developing children. The children with ADHD-C scored significantly lower equilibrium scores, somatosensory, vestibular and visual ratios on the Sensory Organization Test(SOT). The largest difference was seen in the visual system.

Reference: Selina B.M. Shum, MSc, Marco Y.C. Pang, PhD (2009) Children with Attention Deficit Hyperactivity Disorder Have Impaired Balance Function: Involvement of Somatosensory, Visual, and Vestibular Systems The Journal of Pediatrics Volume 155, Issue 2, Pages 245-249.

Tuesday, August 11, 2009

Adaptive Ice Skating

Now I know this is not the time of year to be discussing ice skating, but on this very hot day I can at least think about colder weather. Developmental Neurorehabilitation reports on an adaptive ice skating program which was evaluated. Twenty two children with developmental disabilities participated in a 1x/week group for 6 weeks. There was instructors for group lessons and individualized instruction as well. Attendance was high for the 6 sessions (83% attended). Parents reported improvements in their child's balance, lower extremity strength, endurance, self esteem and ability to participate in a group. One minor injury was reported. The authors conclude that the program was successful but would benefit from some minor changes.

Reference: Fragala-Pinkham, Maria A., Dumas, Helene M., Boyce, Megan, Peters, Christine Y., Haley, Stephen M. (2009) Evaluation of an adaptive ice skating programme for children with disabilities Developmental Neurorehabilitation 12(4):215- 223
UR - http://www.informaworld.com/10.1080/17518420902980100

Monday, August 10, 2009

Sensory Recipes Including Gluten Free

Pediatric therapists, parents and teachers use sensory recipes daily. Here is a collection of fun ones from the Internet to explore.

1. Recipes for Sensory Fun: This is a nice 5 page download created by a therapy company to hand out to parents.

2. Fun and Messy Dough Recipes: This has all the favorites plus some interesting new ones such as white bread and glue dough, clean mud and snow.

3. Gluten Free Dough Recipes: Anyone who works with or has children on a gluten free diet here is lots of suggested products and recipes.

Need some suggestions of how to use the clay or play dough? Check out Creative Clay Activities book or Clay Play Mats.

Play-Doh is currently running a contest where your child (or student) could win a $5000 Playroom makeover and $5000 school donation. Just have the child create a favorite food out of Play-Doh, take a picture and enter it in the contest.

Friday, August 7, 2009

More Research on Why You Should Turn Off TV

Two recent studies once again recommend that television and screen time should be limited for all children. Pediatrics recently published research on Vitamin D deficiencies in children. Over 6,000 children were studied with 9% being Vitamin D deficient and 61% being Vitamin D insufficient. Low levels of vitamin D are associated with a higher risk of bone and heart disease. Children should consume foods/drinks high in vitamin D such as milk and fish. In addition, some children should take vitamin D supplements. The researchers recommend that children turn off the TV and go outside at least 15-20 minutes a day.

Archives of Pediatric and Adolescent Medicine published research indicating that certain sedentary activities in children (ages 3-8) resulted in an increased risk of high blood pressure. Television viewing and screen time, but not computer use, was associated with elevated blood pressure regardless of body composition.

Here are some fun ideas for outside play - Rock Smash or how about Put Out the Fire.

Albert Einstein College of Medicine (2009, August 3). Millions Of U.S. Children Low In Vitamin D. ScienceDaily. Retrieved August 7, 2009, from http://www.sciencedaily.com­ /releases/2009/08/090803083633.htm

JAMA and Archives Journals (2009, August 4). TV And Computer Screen Time May Be Associated With High Blood Pressure In Young Children. ScienceDaily. Retrieved August 7, 2009, from http://www.sciencedaily.com­ /releases/2009/08/090803173127.htm

Wednesday, August 5, 2009

Evidence Based Tips on Childhood Obesity and Physical Activity

The World Confederation for Physical Therapy (WCPT) published a fact sheet on childhood obesity and physical activity. Here are several of the suggested recommendations based on research:
1. 60 minutes of moderate to vigorous physical activity per day for children ages 5-18 years old.
2. Preschoolers should participate in 60 minutes of unstructured physical activity per day.
3. To increase physical activity in adolescents involve the school, community and family.
4. To encourage physical activity in preschoolers have outside play areas and supportive staff.
5. Preschoolers will engage in more physical activity if their parents are active, they have a large yard and there are restrictions on television.
6. Encourage and assist children with disabilities to find appropriate physical activities.

For the fact sheet in its entirety visit http://www.pediatricapta.org/pdfs/WPTDay-C1-Child_obesity.pdf

Reference: World Confederation for Physical Therapy. Childhood Obesity and Physical Activity. Retrieved from the web on 8/5/09 from http://www.pediatricapta.org/pdfs/WPTDay-C1-Child_obesity.pdf.

Monday, August 3, 2009

National Inventor's Month August 2009

Did you know that August is National Inventor's Month? Why not incorporate this theme into some therapy sessions or carry over activities for at home? Here are some suggestions to help celebrate:

1. Working together with a child, determine a task that is difficult for them to achieve. See if you can create a simple invention or adaptation that will allow the child to complete the task with greater ease. Ask other children for help on solving the problem.

2. Invent a new recipe. Let the children experiment mixing and stirring different ingredients together. Then have a tasting session. Children LOVE this activity.

3. Invent a new game. Go outdoors and have the children all invent their own games. Encourage the children to invent games allowing ALL children to participate.

4. Pick a theme such as cars, robots or spaceships. Have children invent different items using materials that encourage fine motor skills such as LEGO’s, clay or interlocking blocks.

Energy Expenditure with Active Video Games

Pediatrics published research comparing the energy expenditure rates, heart rate, perceived exertion and step rate during television watching, playing Dance, Dance Revolution, Wii bowling and boxing and walking at different rates. The subjects were 14 boys and 9 girls ages 10-13 years old. The results indicated that energy expenditure increased two to three times when gaming or walking compared to television watching. The energy expenditure while playing Wii boxing and Dance Dance Revolution level 2 was equal to moderate intensity walking.

Reference: Graf, Diana L., Pratt, Lauren V., Hester, Casey N., Short, Kevin R.
Playing Active Video Games Increases Energy Expenditure in Children
Pediatrics 2009 124: 534-540
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