Friday, January 29, 2010

Recess then Lunch

Want to change a child's eating habits and behaviors in school? Perhaps try scheduling recess before lunch. There have been several studies done that indicate recess before lunch results in improved behaviors, calmer students, less trips to the school nurse and healthier eating habits. Read the full article at the NY Times.

Wednesday, January 27, 2010

Yet Again...Move to Improve

The Journal of Pediatrics published research on 1989, 5th, 7th and 9th graders in California. Students with lower aerobic fitness and higher body mass index scored lower on standardized tests in math, reading and language. This held true even after controlling for parent education and other co variates.

More and more research has shown that increased fitness levels improve standardized test scores! Why not try to start an early morning walking club, increase recess time, increase active physical education time or start an extracurricular fitness group after school.

Reference: Christian K. Roberts, PhDabc, Benjamin Freed, BAd, William J. McCarthy, PhD Low Aerobic Fitness and Obesity Are Associated with Lower Standardized Test Scores in Children The Journal of Pediatrics Published online 1/25/10 doi:10.1016/j.jpeds.2009.11.039

Tuesday, January 26, 2010

Pharmacologic Treatment of Spasticity in CP

Neurology published a special article to evaluate the use of pharmacologic treatments for spasticity in children with cerebral palsy. The multidisciplinary panel reviewed articles from from 1966 through 2008. The panel concluded that Botulinum toxin type A was found to be generally safe although the FDA is currently investigated the use of the drug in children. Botox was found to be effective in reducing spasticity in the upper and lower extremities but there is inconsistent evidence regarding improvement in function. The panel concluded that that diazepam is effective in treating generalized spasticity along with tizanidine. There was inconclusive evidence on diazepam and tizanidine's effects on function. Regarding the use of phenol, alchohol, botox type B, dantrolene, oral baclofen, or continuous intrathecal baclofen, there was insufficient evidence to support or discredit their use.

Reference: Delgado, M. R., Hirtz, D., Aisen, M., Ashwal, S., Fehlings, D. L., McLaughlin, J., Morrison, L. A., Shrader, M. W., Tilton, A., Vargus-Adams, J.Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology SocietyNeurology 2010 74: 336-343

Monday, January 25, 2010

Do you check for comfort?

A review in Developmental Medicine and Child Neurology reported on the use of assistive devices and technology in people with cerebral palsy. Twenty four studies were found and each study had less than 10 participants. Computer task performance was tested although only three groups studied ease and comfort of use. The researchers recommend that more research be done on ease and comfort of use, performance and design features.

As teacher, parent or therapist, do you check for ease and comfort of use with the client for any assistive technology that you suggest? This is a question that needs to be asked over and over again. Children grow and change so rapidly. Comfort and ease of use for any device (be it a computer, stander, wheelchair, adapted toilet, etc) needs to be constantly assessed. Remember not to just ask the parent, teacher or caregiver but check with the clients themselves.

Reference: Claire DAVIES, SUZIE MUDGE, SHANTHI AMERATUNGA and N Susan STOTT Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of assistive devices and technologies. Development Medicine and Child Neurology Published online 1/5/10. DOI 10.1111/j.1469-8749.2009.03564.x

Sunday, January 24, 2010

Superbowl = Movement

It is almost Superbowl time. Get kids involved by getting them to move not just watch the games. The NFL has a campaign entitled Play 60. The American Heart Association has free resources available for teachers to get kids moving for 60 minutes each day during the NFL Play60 six week challenge. Don't want to sign up for the challenge? Here are some simple physical activity ideas with a Superbowl theme.

1. Football Training: Set up an obstacle course at home or in the classroom. Set up hoops to walk through, throw the football through a hoop or into a basket, crawl low on the floor, any type of training exercise you can create.

2. Cheerleaders: Create and practice different cheers for your favorite team.

3. Football Target: Hang up a hoop from a doorway or tree. Throw a soft football or any ball through the target. Who can get the most through the hoop?

4. Flag Twirling: Create a team flag to wave during the game. Cut out a flag and tape to a small stick. Create a dance routine with the flag to perform during half time.

5. Flag Football Group Game for Outdoors: Gently tuck a streamer from the back of every child's pants except one. One person is it and has to collect as many streamers as possible by grabbing the streamers.

6. Football Scavenger Hunt: Write the letters F, O, O, T, B, A, L, L down the page. The children have to walk around the house, school or outdoors and find objects that start with each letter. The children write down the name of the object next to the letter. For example, if you see a flag write it down next to the F. If you find an oval picture write it down next to the O. Continue until the children have found objects for each letter.

7. Superbowl Quiz: Put 10 lines of tape on the floor each about 1 foot apart. If playing with a group create long lines for 2 children to be able to stand side by side. The child starts at one end. Ask the child a question. It could be a review question from school, something about football, etc. If the child gets it right, he/she jumps forward to the next line. Continue on until the child gets to the end of the lines to score a touchdown. To increase the difficulty, see if the child can score a touchdown in under 2 minutes.

Best Time to Toilet Train

A recent study in the Journal of Pediatric Urology indicated that the best time to toilet train a child is between 24 and 32 months of age. Children who did not receive toilet training until after 32 months had more issues with bed wetting, day wetting and urge incontinence. The researchers concluded that the timing of toilet training was more important than the method of the training.

Reference: Robert Wood Johnson Medical School (2010, January 11). Best time to toilet train children pinpointed through research. ScienceDaily. Retrieved January 24, 2010, from­ /releases/2010/01/100109230611.htm

Tuesday, January 19, 2010

Treadmill Training, SMO's and Down Syndrome

Physical Therapy published research on the use of supramalleolar orthosis (SMO) and treadmill training in infants with Down Syndrome. Seventeen infants were assigned to treadmill training with SMO's or treadmill training without SMO's. The infants received 3 minutes of treadmill training until the infant was able to take 3 steps independently. One month following the motor skill acquisition of independently taking 3 steps the Gross Motor Function Measure was administered. The infants who did the treadmill training without the SMO's had higher scores on the Gross Motor Function Measure in standing, walking, running and jumping. The researchers concluded that the use of orthosis may have a "detrimental effect of overall gross motor development".

Reference: Looper, Julia, Ulrich, Dale A. Effect of Treadmill Training and Supramalleolar Orthosis Use on Motor Skill Development in Infants With Down Syndrome
PHYS THER 2010 0: ptj.20090021

Friday, January 15, 2010

Alternatives to Written Assignments

Voice Thread is a tool to talk about pictures, documents or videos. For those children who have difficulty with written assignments, why not try using voice thread. The child can record his/her voice to go along with pictures or videos. There are so many ideas of how to use Voice Thread on their website. Check it out. A basic account is free for educators.

Want to do more with recorded voice? Check out Blabberize. Take any picture and make it talk. It is also very simple and free to use. Kids get a kick out of this one. Here is a sample video of Blabberize in action.

Thursday, January 14, 2010

Exercise and Juvenile Idiopathic Arthritis

Current Opinion in Rheumatology recently published a review on the use of exercise therapy in the management of juvenile idiopathic arthritis (JIA). Previous studies indicate that children with JIA have significantly impaired aerobic and anaerobic exercise capacity. This can result in deconditioning and disability. Girls with polyarticular rhematoid factor positive subtype are at the great risk for disability. The authors state that
"Recent trials suggest that structured aerobic training or low-intensity programs do not exacerbate arthritis and can lead to improved physical fitness, quality of life and functional abilities in children and adolescents with JIA".

Reference: Long, Amy R; Rouster-Stevens, Kelly A The role of exercise therapy in the management of juvenile idiopathic arthritis
Current Opinion in Rheumatology
2010 doi: 10.1097/BOR.0b013e328335d1a2

Tele-Rehabilitation for Hemiparesis in Teens

A recent case study report of three teens with cerebral palsy (hemiplegia) and the use of remotely monitored in home video games was published in Archives of Physical Medicine and Rehabilitation January 2010. The three teens used a specially fitted sensor glove linked to a video game at home for 30 minutes a day, 5 times a week for 3 months. The video games played were specifically designed to improve hand function. After the three month training, all three teens showed improved hand function, brain activity changes on functional MRI's and 2/3 teens showed increased radial bone mineral content. Specifically, occupational therapy testing improved, finger range of motion improved and an increased ability to lift objects. All of this was tested remotely.

Reference: Golomb MR, McDonald BC, Warden SJ, Yonkman J, Saykin AJ, Shirley B, Huber M, Rabin B, AbdelBaky M, Nwosu ME, Barkat-Masih M, Burdea GC. In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy. Archives of Physical Medicine and Rehabilitation Volume 91, Issue 1, Pages 1-8.e1 (January 2010)

Wednesday, January 13, 2010

National Handwriting Day is January 23rd

National Handwriting Day is January 23rd each year. This date honors John Hancock who is well known for his signature on the Declaration of Independence. Here are some suggested ideas to celebrate the day with your children or students.

1. Bake a cake to celebrate John Hancock's birthday. Following a recipe, measuring, mixing and stirring incorporates motor planning, sequencing, fine motor skills, muscle strengthening and bilateral coordination. Ice the cake and purchase the store bought gel icings. The children can write their signatures on the icing to decorate the cake.

2. Practice writing your signature on one piece of paper using various mediums such as crayons, pencil, colored pencil, pens, markers and watercolors.

3. Hand write a thank you note or letter to a loved one.

4. Find a pen pal and exchange letters.

5. Pick a topic from the Scholastic Story Starter (or any story starter) and write a story.

Need more ideas to practice handwriting? Check out our Valentine's Handwriting Activities or Winter Handwriting Activities.

Monday, January 11, 2010

Handwriting Practice on the Interactive Whiteboard

If the classrooms that you work in have an interactive whiteboard check out this cool free program entitled Sky Writer. You just click on the letter and the plane makes each letter in the air. The children can trace along with their fingers. It is also a fun visual for the child to see how the letter is made. Although, the plane drives a little fast for some letters and it is only lowercase letters. Another idea would be to have the child try to trace the letter before it disappears, too. Let me know what you think if you try it.

Added 1/19/2010: Students can watch letter formation at as well. This is much more exact in the letter formation.

Or how about trying actual letter formation from MeddyBemps. Here you can watch letter formation and write letters as well.

Added 6/2/2011: Just found this website,, for some more ideas for handwriting practice and the interactive whiteboard. This website has many lesson plan suggestions for students with special needs.

Friday, January 8, 2010

Fine Motor and Coordination Activity Video - Stacking Foam Beads

Here is a new activity video idea that encourages fine motor skills, muscle strengthening and coordination.

Need more fine motor activities? Check out...

Creative Clay Activities
Clay Play Mats
Fine Motor Activity Pack #1
Fine Motor Breaks

Designing Optional Patterns of Movement

The November 2009 issue of Neuron reports on a study on how limb motion is encoded in the nervous system. The researchers determined that certain movement patterns were easier to learn than others. A quote from one of the researchers states:

"We observed that the initial stages of motor learning are often quick but non-specific, whereas later stages of learning are slower and more precise," says Sing. "Further, we saw that some physical patterns of movement are learned more quickly than others."

The goal of the researchers is to develop a set of rehabilitation activities that will achieve the best outcome in stroke patients.

I look forward to seeing what the determine are the best activities to encourage the effected limb. Although these studies are being conducted on adults, the information behind them are informative for pediatric clients and motor learning. Curious to see if some of the movements patterns are similar to proprioceptive neuromuscular facilitation (PNF). Any comments?

Reference: Harvard University (2010, January 8). Observation about how nervous system learns and encodes motion could improve stroke recovery. ScienceDaily. Retrieved January 8, 2010, from­ /releases/2010/01/100107132600.htm

Assistive Technology Comes Out On Top

The current issue of the American Journal of Occupational Therapy reports on a small study done in a Virginia school district on the benefits of assistive technology. Thirteen students were followed regarding the benefits of assistive technology in reaching IEP goals compared to 9 other interventions including related services, tutoring, curriculum changes and more. According to the Student Performance Profile Measure, assistive technology was a better intervention strategy for IEP goal improvement than the other interventions.

Reference: Anne H. Watson-PhD, OT/L, Max Ito-OTR/L, Roger O. Smith-PhD, OT, FAOTA, Lori T. Anderson-EdD, OTR/L, FAOTA Research Scholars Initiative-- Effect of Assistive Technology in a Public School Setting January/February 2010 Volume 64 / Number 1

Wednesday, January 6, 2010

Evaluating Student's Needs for Writing

I came across a comprehensive website for evaluating a student's needs for writing. The Montgomery County Public Schools of Rockville, MD has developed a Written Productivity Profile (WPP). All of the forms and directions are on the website to evaluate a student's handwriting versus typing abilities. There are also tools to evaluate spelling.

What a great FREE resource to compare handwriting versus typing!

Monday, January 4, 2010

The Mozart Effect on Weight Gain in Preterm Infants

The most recent issue of Pediatrics reports on 20 healthy preterm infants that were exposed to a 30 minute period of Mozart music for 2 consecutive days. The resting energy expenditure of the infants was significantly lower during the 10 to 30 minute period of listening to the music. There was no difference in resting energy expenditure during the first 10 minutes of listening. The researchers conclude that listening to Mozart music lowers the resting energy expenditure which may explain why listening to music improves weight gain in infants.

So simple and so interesting! Very small sample size but it can not hurt to try.

Reference: Lubetzky, Ronit, Mimouni, Francis B., Dollberg, Shaul, Reifen, Ram, Ashbel, Gina, Mandel, Dror Effect of Music by Mozart on Energy Expenditure in Growing Preterm Infants Pediatrics 2010 125: e24-e28
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