Thursday, May 27, 2010

Parents Turn Off TV and Get Kids Moving

A recent study published in BMC Public Health reported on parental television viewing habits and children's TV habits along with physical activity. The research indicated that children of parents who watch many hours of television daily are more likely to watch more hours of television per day as well. For boys the risk of watching more than 4 hours of television per day was 10.47 time higher if the boys parents watched more than 4 hours per day. Whereas, for girls the risk was 3.67 times higher to watch more than 4 hours of television per day if the girls parents watched 2-4 hours per day. No association was discovered linking parental physical activity levels to children's physical activity levels.

With the weather so nice and warm, set a good example and turn off your television sets. Even if you are unable to be physically active with your child you can still encourage active play.

Reference: Parents' physical inactivity influences children. Retrieved on 5/26/10 from at

Wednesday, May 26, 2010

Effects of Standing Programs on Walking in Children with CP

Physical and Occupational Therapy in Pediatrics published research on the effects of prolonged standing on the walking patterns of children with cerebral palsy. Six children with spastic cerebral palsy (Gross Motor Function Classification Levels II and III) participated in this study over a period of 9 weeks. The first three weeks the children received physical therapy. The second three weeks the children received physical therapy and prolonged periods of standing, 3x per week. The last three weeks the children received only physical therapy again. Before and after each 3 week phase, gait analysis and spasticity assessment was performed. The results indicated that after the middle three week period with prolonged standing, testing showed a significant difference in improvements noted in the following areas: stride length, gait speed, stride time, stance phase time, double support time, muscle tone, and peak dorsiflexion angle during midstance. These results were not sustained when tested again 3 weeks later. The researchers recommend additional research with larger sample size and to establish specific duration and frequency of the standing program.

Reference: Yasser Salem‌ Venita Lovelace-Chandler‌ Reta J. Zabel‌ Amy Gross McMillan‌ Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy Physical & Occupational Therapy in Pediatrics February 2010, Vol. 30, No. 1, Pages 54-65

Tuesday, May 25, 2010

Injuries in Children Who Use Pediatric Mobility Aids

Pediatrics will be publishing research in the incidence of injuries related to pediatric mobility aids such as wheelchairs and crutches. US hospital records were analyzed from 1991-2008. Over 63,000 children, 19 years and younger, were evaluated in the emergency room for injuries related to mobility devices. The highest rate of injury occurred in wheelchair users accounting for 70% of the injuries. Younger children, aged 2-10 years old, were more likely to sustain injuries from walker and wheelchair use. This age group suffered more head injuries and traumatic brain injuries. The older age group, 11-19 years of age, sustained more injuries with crutches, strains and sprains. Older children were also at greater risk for injuries that occurred during transfers.

The wheelchair injuries in general were more likely to results in head trauma and hospitalization. The injuries due to crutch use were more likely to be due to lack of proper use, stairs and curbs. The researchers recommend additional research to establish injury prevention techniques.

Barnard, Alison M., Nelson, Nicolas G., Xiang, Huiyun, McKenzie, Lara B.
Pediatric Mobility Aid-Related Injuries Treated in US Emergency Departments From 1991 to 2008
Pediatrics 2010 0: peds.2009-3286

Monday, May 24, 2010

Recommended Evaluation Tools for Developmental Coordination Disorder

Pediatric Physical Therapy has published research analyzing seven performance based measures of gross motor skill development for use with children with developmental coordination disorder. The Movement Assessment Battery for Children (MABC - Version 1)and the Test of Gross Motor Development Version 2 scored highest on the comparison. The researchers recommend starting with these two previously mentioned tests when evaluating gross motor performance in children with developmental coordination disorder.

Reference: Slater, Leanne M.; Hillier, Susan L.; Civetta, Lauren R.
The Clinimetric Properties of Performance-Based Gross Motor Tests Used for Children With Developmental Coordination Disorder: A Systematic Review Pediatric Physical Therapy. 22(2):170-179, Summer 2010. doi: 10.1097/PEP.0b013e3181dbeff0

Friday, May 21, 2010

Benefits of Sensory Integration Interventions

The American Occupational Therapy Association released information on the sensory integration interventions resulting in positive outcomes. This press release discusses a review of 27 studies on the effectiveness of sensory integration therapy. The researchers found that:

"Results of the systematic review suggest the sensory integration approach may result in positive outcomes in sensorimotor skills and motor planning; socialization, attention, and behavioral regulation; reading-related skills; participation in active play; and achievement of individualized goals. Additionally, gross motor skills, self-esteem, and reading gains may be sustained from three months to two years".

Read the full AOTA Press Release

Or view it below:

Thursday, May 20, 2010

Idiopathic Toe Walking and Botox

The Journal of Children's Orthopaedics has published research on the use of Botox A in children with idiopathic toe walking. Fifteen children (ages 5-13)with a diagnosis of idiopathic toe walking underwent a gait analysis followed by Botox in the calf muscles and an exercise program. Gait analysis was repeated at 3 weeks, 3 months, 6 months and 12 months after treatment. Results from the gait analysis indicated significant improvements in decreased plantar flexion angle at initial contact and during swing phase and increased dorsiflexion during midstance. At 12 months post treatment, parents reported that 3 of the 11 children stopped toe walking completely, 4/11 decreased toe walking, and 4/11 continued to toe walk. The researchers concluded that Botox and exercise treatment for idiopathic toe walking displays gait pattern changes but does not always stop toe walking.

Reference: Pähr Engström1, Elena M. Gutierrez-Farewik1,Åsa Bartonek1, Kristina Tedroff1, Christina Orefelt1 and Yvonne Haglund-Åkerlind1 (2010) Does botulinum toxin A improve the walking pattern in children with idiopathic toe-walking? Journal of Children's Orthopaedics DOI 10.1007/s11832-010-0263-9 Published online 5/12/2010.

Wednesday, May 19, 2010

Get Kids Gardening

Here is a simple idea to start planning for next year for some of the children that you teach - Gardening! Getting into the garden encourages motor skills, sensory stimulation, self esteem, sense of accomplishment, discovery and outdoor time. If you have at least 15 children willing to participate and work with children ages 3-18 years old you could apply for the Subaru Healthy Sprouts Award. This is a grant for $500 in supplies and a kit and literature package from the National Garden Association filled with ideas. They would like the youth gardening program to focus on the environment, nutrition and hunger issues in the United States. What a great, functional activity to teach to children! The grant application is due by October 1, 2010. There are 30 awards available and if you win it will be distributed in January 2011.

Tuesday, May 18, 2010

How to Find OT and PT Blogs

Blogs can offer great inside information on a variety of topics, although it can be hard to sift through all the daily information that is posted. In addition, it can be difficult to even find niche blogs to begin with. Here are several suggestions on how to find blogs specific to pediatric occupational and physical therapy.

1. Blog Rolls: Some blogs offer blog rolls on the side of the blog. This is a list of blogs that the writer recommends. There are usually some that have similar topics.

2. AllTop: This website offers popular stories that hit the web on certain topics. They have an occupational therapy page and a physical therapy page.

3. OT Blogs: This is my favorite. This is a collection of OT blogs with the title of the posts listed. It is an easy way to scroll through lots of information very quickly. Check it out at

4. Google Alerts: You can set Google alerts to send you emails when specific topics are discussed. If you follow keyword phrases i.e. occupational therapy, physical therapy for children, etc Google will send you email alerts when those topics are posted to the web. This is a nice feature but you do get a significant amount of junk along with it.

5. Comments Sections:
If you find a blog that you like, check out the comment sections. Usually, the people who comment may have blogs of their own on similar topics and you can track them down.

Anyone else have any other suggestions to track down relevant blogs?

Friday, May 14, 2010

Effects of Goal Directed, Activity Focused Group Physical Therapy for Kids with CP

BMC Pediatrics published a research study on the changes of basic motor abilities, quality of movement and everyday activities after intensive, goal directed, activity focused physical therapy is a group setting for children with cerebral palsy. Twenty two children (mean age 5 years, 6 months), hemiplegia (7), diplegia (11), quadriplegia (2) and ataxia (2), participated in goal directed, activity focused group physical therapy for five days a week for three weeks. Each session was three hours.

The sessions consisted of:

1. functional goal directed training practicing specific activities

2. family centered practice

3. carry over training to parents and other persons associated with the child's everyday life

4. motor learning techniques regarding motivation, environments and variation.

Immediately following treatment, the Gross Motor Function Measure scores significantly improved. Children in GMFCS Levels I and II improved more that Levels III-V. Positive changes were seen on the Quality of Upper Extremity Skills Test but no significant difference was found. The Pediatric Evaluation of Disability Inventory scores displayed significant improvement in the self care int he functional skills dimension, self care and mobility dimension and the Caregiver Assistance dimension. Goal Attainment Scales were developed for the children. Following the intervention, on average the children reached the pre-determined goals. Seventy one percent of the activity goals, 50% of the movement goals and 80% of the combined goals were reached.

The researchers concluded that intensive training in a group setting may be a cost effective method to optimize function in young children with cerebral palsy.

Reference: Anne Brit Sorsdahl1, Rolf Moe-Nilssen1, Helga K Kaale, Jannike Rieber, Liv Inger Strand Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy BMC Pediatrics 2010, 10:26 doi:10.1186/1471-2431-10-26

Thursday, May 13, 2010

Recheck ADHD Symptoms Yearly

An interesting study was published in the Journal of Developmental and Behavioral Pediatrics on teacher's assessment of inattentive symptoms. Three groups of children were followed: 27 first graders, 24 fourth graders and 28 first through fourth graders with a diagnosis of ADHD. The children were rated twice (12-14 months apart) on their inattentive symptoms by teachers. The results indicated that for all three samples, the ratings persisted for less than 50% of the children and 25-50% of the children's ratings decreased to within the normal range. The researchers concluded that children should be evaluated yearly to avoid continuing to treat children if it is not necessary.

This is important research. Many school districts only perform complete evaluations every three years. Many children are simply tagged as ADHD and the label never disappears. The child moves on to the next grade level and some teachers immediately assume the child will be inattentive.

Reference: Rabiner, David L. PhD; Murray, Desiree W. PhD; Rosen, Lisa PhD; Hardy, Kristina PhD; Skinner, Ann MEd; Underwood, Marion PhD Instability in Teacher Ratings of Children's Inattentive Symptoms: Implications for the Assessment of ADHD Journal of Developmental & Behavioral Pediatrics: April 2010 - Volume 31 - Issue 3 - pp 175-180 doi: 10.1097/DBP.0b013e3181d5a2d8

Wednesday, May 12, 2010

Exercise and Bone Density

Over 200 six year olds, had their bone mass measured and femoral neck and thigh bones analyzed. The physical activity of the 6 year olds was measured for 7 consecutive days. The results indicated that vigorous physical activity time was related to the strength and mineral density of the femoral neck. The researchers from Southhampton and Cambridge Universities in the United Kingdom, concluded that vigorous physical activity in childhood is likely to improve bone development and prevent osteoporosis.

Reference: Vigorous exercise strengthens hip bones in young children Retrieved from the web on 5/11/10 at

Sensory Motor Activities for Summer
- $4.99 for an electronic book with over 35 sensory motor activities with a summer theme.

Tuesday, May 11, 2010

Modified Constraint Induced Movement Therapy and Gait Characteristics

In a recent issue of Disability and Rehabilitation there was research published on an intervention using modified constraint induced movement therapy (mCIMT) wtih 12 preschool children with hemiplegic cerebral palsy. The intervention consisted of mCIMT for 5 consecutive days at 6 hours per day. Following the experiment, the data was analyzed revealing a significant decrease in base of support and improvements were noted in most other temporal spatial aspects of gait. The researchers recommend additional studies on the long term effects of mCIMT for the lower extremity deficits.

Reference: Patricia Coker‌, Tasos Karakostas‌, Cindy Dodds‌, Simon Hsiang‌ Gait characteristics of children with hemiplegic cerebral palsy before and after modified constraint-induced movement therapy Disability & Rehabilitation 2010, Vol. 32, No. 5, Pages 402-408

Monday, May 10, 2010

Including All Children on the Playground

The American Journal of Occupational Therapy published research in 2008 on children's interaction on the school playground. Twenty children were videotaped for 11 weeks on a school playground. The children participated in extended recess with loose parts or materials such as bicycle tires, hay bales, fabric, trash can lids, strips of foam and more. Following the 11 week intervention, teachers were interviewed and the Test of Playfulness indicated significantly higher scores. In addition, teachers reported increased socialization, creativity, cooperation and resiliency in the children. Teachers observed that children of varying abilities were more likely to play together. Some teachers mentioned that children who did not usually participate in sports activities were leaders for the creative activities.

Reference: Bundy AC, Luckett T, Naughton GA, Tranter PJ, Wyver SR, Ragen J, Singleton E, Spies G.Playful interaction: occupational therapy for all children on the school playground. Am J Occup Ther. 2008 Sep-Oct;62(5):522-7.

Friday, May 7, 2010

Mother's Touch Effects on Brain Development

Recent research published in the Journal of Neuroscience, indicates that a mother's touch not only provides security, comfort and love but also cognitive function and stress reduction. This study was performed using rats. The results indicated that "sensory stimuli from maternal care can modify the gene that controls a key messenger of stress called corticotropin-releasing hormone (CRH)" (1). Basically, when a baby senses soothing touch, DNA in the brain cells activate a "silencer" of CRH in the hypothalamus. As a result of decreased CRH, nerual dendrites can fully develop in the hippocampus (2).

This is important information for early intervention therapists to reassure mother's that their touch alone is a positive intervention in their babies brain development.

Would love to see this study done in older rats to find evidence based research that human touch can change the hippocampus' wiring. That would be a great stride for sensory integration therapy techniques.

An additional study of valuable information regarding human touch was published in Nature Neuroscience. This study indicated that people preferred to be touched (soft brush stroking) at a certain speed: 4-5 cm per second. When the touch was pleasurable it activated "C-tactile" nerve fibers which are only present on skin with hair on it (3).

1. University of California Irvine. Mother's Touch. Retrieved from the web on 5/6/10 at

2. Aniko Korosi, Marya Shanabrough, Shawn McClelland, Zhong-Wu Liu, Erzsebet Borok, Xiao-Bing Gao, Tamas L. Horvath, and Tallie Z. Baram Early-Life Experience Reduces Excitation to Stress-Responsive Hypothalamic Neurons and Reprograms the Expression of Corticotropin-Releasing Hormone J. Neurosci. 30: 703-713; doi:10.1523/JNEUROSCI.4214-09.2010

3. Loken, L et al. Coding of Pleasant Touch by Unmyelinated Afferents in Humans. Nature Neuroscience 2009 12, 547-548.

Wednesday, May 5, 2010

Fine Motor Skills & Visual Peceptual Skills Activity Video

Complete the Picture:

Materials: picture, scissors, glue stick, markers or crayons
Purpose: Encourage fine motor and visual perceptual skills

Check out What's Missing? for more fine motor and visual perceptual activities. Only $3.99!

Early Childhood TV Watching and Effects Later in Life

The Archives of Pediatrics and Adolescent Medicine published research on television watching at 2 and 4 years of age and its effects when the children are 10 years of age. Parents reported how much television was watched during the early years. Parents and teachers also reported on academic, psychosocial, and health behaviors and body mass index measurements when the children were 10 years of age. The results indicated that television watching delayed development in children. The study indicated that every additional hour of television exposure at 29 months corresponded to:
1. 7% decrease in classroom engagement
2. 6% decrease in math achievement
3. 10% increase in victimization by classmates
4. 13% decrease in time spent doing weekend physical activity
5. 9% decrease in activities involving physical effort
6. 9% higher consumption of drinking soft drinks
7. 10% higher consumption of eating snacks
8. 5% increase in body mass index

According to the American Academy of Pediatrics the average child watches three hours of television. Can you imagine the effects on the children on the higher end of viewing times? Now add in computer use and video game use. Scary numbers for an upcoming generation...

This is an easy, preventable solution. Turn off the television and let children play. Need ideas to encourage children's sensory motor development? Check out these titles:

Motor Magic
Sensory Motor Activities for Summer
50 Sensory Motor Activities for Kids!
Scavenger Hunts

Reference: Linda S. Pagani, PhD; Caroline Fitzpatrick, MA; Tracie A. Barnett, PhD; Eric Dubow, PhD Prospective Associations Between Early Childhood Television Exposure and Academic, Psychosocial, and Physical Well-being by Middle Childhood Arch Pediatr Adolesc Med. 2010;164(5):425-431

Tuesday, May 4, 2010

Grip in Children with Congential Hemiplegia

Neurorehabilitation and Neural Repair published research comparing predictive and reactive control of grip force in children with congenital hemiplegia. The precision grip of 12 children (ages 10-16 years) with hemiplegia were compared to a control group in two different conditions - predictive and reactive. For the predictive control, the child triggered the drop of an object to grip before it fell completely. For the reactive control, the examiner triggered the drop of the object for the child to grip before it fell completely. Results indicated the following:
1. Predictive grip in the hemiplegic hand was intact but was changed after impact "suggesting an inability to anticipate the consequences of a dynamic perturbation".
2. Under the reactive conditions, a delay was seen in the hemiplegic hand
3. Both predictive and reactive conditions were intact in the non hemiplegic hand.

Reference: Bleyenheuft, Yannick, Thonnard, Jean-Louis Predictive and Reactive Control of Precision Grip in Children With Congenital Hemiplegia Neurorehabil Neural Repair 2010 24: 318-327
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