Thursday, December 30, 2010

Magnet Pom Poms - Fine Motor Video Activity

Here is a simple project to create some unique, fine motor manipulatives with pom poms and magnets. This project is not suitable for children under three years of age or children who frequently mouth objects. Get the download for DOT Letters and Shapes as shown in the video here. Or download the caterpillar activity to do with your magnetic pom poms.

Wednesday, December 29, 2010

Upper Extremity Work Out and Motor Planning on the Wii

Some people have the opinion that using the Wii is a work out. In many cases, very little movement is required for certain Wii games. For example, if you play Super Mario Brothers all you have to do is press the Wiimote buttons or tilt the Wiimote. Consider this, sitting down ice fishing burns more calories than Wii bowling. Therefore, if you are recommending the Wii for physical activity time for children at home or during physical education class, make sure you are also recommending truly active Wii games.

If you are looking for a great upper extremity workout along with motor planning check out Wii Just Dance for Kids. Basically, you have to copy the dance moves of the middle dancer on the screen. Because it tracks the Wiimote in your hands, there is an extensive amount of upper extremity motions to follow. It keeps tracks of your points for how well you accurately match the dance moves. There are different levels of songs based on difficulty to follow the dance moves and effort. The list of songs varies from traditional children's songs (i.e. BINGO, A,B,C,'s, etc) and Top 40 dance music.

If you are looking for a truly active Wii game, check out Wii Just Dance for Kids.

Tuesday, December 28, 2010

Right Side Hurts More?

Here is a very interesting journal article from Early Human Development on pain perception in infants. Did you know that some studies have shown that handedness and gender can effect pain perception in adults? This latest study was to determine if the same held true in infants. Prefrontal activation was measured with near infrared spectroscopy while a blood sample was taken from 21 right hands and 19 left hands of infants at 4-6 days old. Statistical analysis was done on the magnitude of the oxy-Hb value in response to pain, right or left hand, male or female and recording side. The results showed a significant effect of stimulus side with the right hand stimulation showing more prefrontal activity. No other significant differences were found between male versus female or recording side.

Wonder if this holds true for other senses? Is the sense of touch more "sensitive" on the right side? Is joint proprioception more accurate on the right side? How about male versus female?

Read previous post on right and left handed motivational levels.

Reference: Mio Ozawaa, Katsuya Kandaa, Michio Hiratab, Isao Kusakawab, and Chieko Suzuki Effect of gender and hand laterality on pain processing in human neonates Early Human Development Volume 87, Issue 1, January 2011, Pages 45-48

Monday, December 27, 2010

Botox in Upper Limbs

The Journal of Child Neurology published research on the use of injections of Botox A in the upper extremities of children with cerebral palsy. A retrospective study was done on 30 children (average age 9.9 years old +/-5 years) who received 1-5 treatments in various muscles of the upper limbs (pronator teres, flexor carpi radialis, biceps, flexor carpi ulnaris, opponens, and/or adductor pollicis). Following treatment, functional improvements were noted in 42 of the 56 treatments and muscle tone decreased significantly. These effects were noted for an average of 7 months (+/-3 months) post treatment.

Reference: Aviva Fattal-Valevski, Liora Sagi, and Dafna Domenievitz
Botulinum Toxin A Injections to the Upper Limbs in Children With Cerebral Palsy: Duration of Effect J Child Neurol 0883073810376446, first published on October 6, 2010 doi:10.1177/0883073810376446

Thursday, December 23, 2010

Calling All Students Under 25 Years Old

Do you know someone who wants to "do something"? The Do Something organization is offering awards and grants to people under 25 years of age who want to accomplish something in their community. If you know a motivated, self starter you will want to pass this website along to them. You can get more information about the awards and grants at the website. The grants are open anytime and they are awarded to start ups and well as exisitng groups. They are currently featuring a 17 year old girl with Spinal Muscular Atrophy who is organizing a walk to raise money for SMA. Visit for more information.

Monday, December 20, 2010

Fun with Virtual Sand

You have to check out this cool website - You can drop sand where you move the mouse. Simply click on the square in the upper left hand corner to change colors or erase the image. It even works on a Smart Board. Why not try figure 8's, crossing midline or air writing with thisissand.

Permit to Drive

Much like a student driver needs driving lessons, practice and a permit before they can get on the road, a child needs similar skills to drive a motorized wheelchair. Some skills can be learned, acquired or achieved with medical intervention (i.e. glasses). To start with a child must have sufficient vision in order to drive a motorized wheelchair. They must be positioned appropriately and have a point of access to drive the chair. A child must understand certain commands and actions, stop and go being the most important. In addition, a child should understand directionality - left, right, straight and reverse.

For more information and tips on getting a child ready for a motorized wheelchair read this article entitled, Pre-Mobility Training Guidelines, written by Michelle Lange OTR.

Wednesday, December 15, 2010

Gross Motor Skills and Psychiatric Disorders

Developmental Medicine and Child Neurology published research on the gross motor performance and physical fitness of children with psychiatric disorders. One hundred children (81 boys and 19 girls with a mean age of 9 yrs 11 months) were divided into three subgroups: emotional disorders (17 children), behavioral disorders (44 children) and pervasive developmental disorders (39 children). The children completed the Test of Gross Motor Development and Motor Performance Test. The results indicated that "the mean gross motor performance scores of the BD and PDD group were significantly (p<0.05) lower than the score of the emotional disorders group". In all three subgroups, physical fitness was poor. The subgroup with PDD showed a high correlation between locomotion and object control and between locomotion and physical fitness.

Reference: EMCK, C., BOSSCHER, R. J., VAN WIERINGEN, P. C., DORELEIJERS, T. and BEEK, P. J. , Gross motor performance and physical fitness in children with psychiatric disorders. Developmental Medicine & Child Neurology, no. doi: 10.1111/j.1469-8749.2010.03806.x

Participation of Youth with Spina Bifada

Clinical Orthopaedics and Related Research published a study on the participation of community activities for youth with spina bifada. Sixty three children with spina bifada, ages 2-5, 6-12 and 13-18, completed a participation survey (along with caregivers if necessary). The results indicated that the "older youth participated less in recreational, physical and skill based activities". The children without a shunt or recent medical problems participated more in physical and social activities. In the 6-12 year old age group. more caregivers reported bowel and bladder needs as barriers to participation when compared to the other age groups.

Read Tips on Including All Kids

Reference: Kelly, E. et al How Does Participation of Youth with Spina Bifada Vary with Age? Clinical Orthopaedics and Related Research DOI: 10.1007/s11999-010-1693-x

Saturday, December 11, 2010

Lego Grant Available

The LEGO Children's Fund provides quarterly grants typically from $500 to $5000. Preferential consideration is given to disadvantaged youth, special projects that help children explore creativity and organizations serving Connecticut and Western Massachusetts. They are specifically looking for programs in these two areas:

"1. Early childhood education and development that is directly related to creativity
2. Technology and communication projects that advance learning opportunities "

The grant submission is due before January 15, 2011. For more information go to LEGO Children's Fund.

Friday, December 10, 2010

Free Play and Feeling Included

Adapted Physical Activity Quarterly published interesting research on children's feelings about being included. The researcher, Dr. Nancy Spencer-Cavaliere, interviewed 11 children with a range of disabilities including cerebral palsy, motor delays, DCD and more. Three themes were seen throughout the interviews regarding the children's perspective on sports, games and play:

1. Gaining entry to play - initiating play can be difficult
2. Feeling like a legitimate participant - children wanted meaningful roles in play
3. Having friends - wanted a friend they could depend on and trust so they could feel accepted

Dr. Nancy Spencer-Cavaliere also mentioned that the children never mentioned "physical education classes when discussing feeling included". She recommends when in doubt about inclusion be sure to ask the children.

Read previous blog post on including all kids.

Reference: Feeling included -- kids with disabilities have their say in landmark study. Retrieved from the web on 12/10/2010 at

Thursday, December 9, 2010

Walking to School and Cognition

A recent study done in Spain found that adolescent girls who walked or biked to school had better cognitive performance. Although, it was not found to be true for boys. Even when socioeconomics, age, body weight and activities outside of school were factored in, the difference in cognitive performance in girls was still observed. In addition, girls who walked or biked more than 15 minutes had better cognitive scores than girls who walked/ biked less than 15 minutes.

Curious to see if the same results would be found if children simply exercised before school or is it the actual walking outdoors that makes the difference?

Reference: David Martinez-Gomez; Jonatan R. Ruiz; Sonia Gomez-Martinez; Palma Chillon; J. Pablo Rey-Lopez; Ligia E. Diaz; Ruth Castillo; Oscar L. Veiga; Ascension Marcos; for the AVENA Study Group Active Commuting to School and Cognitive Performance in Adolescents: The AVENA Study Arch Pediatr Adolesc Med. 2010;0(2010):archpediatrics.2010.244.

Wednesday, December 8, 2010

Knee Surgery and Arthrogryposis

The Journal of Pediatric Orthopedics published research on ambulation gains following surgical correction for knee flexion contractures in children with arthrogyposis. Prior to surgery at 2 through 16 years of age, 11 children were non ambulatory, 2 were household ambulators and 1 was a community ambulator with orthosis. The children underwent an average of 1.8 surgeries of mostly distal femoral extension osteotomy and/or Ilizarov external fixator. Follow ups were performed anywhere from 12 months to 112 months which indicated that: 8 children were now ambulatory with adapted equipemtn (i.e. orthoses, walkers or braces), 2 children were household ambulators, one child used a wheelchair and was independent for transfers and 2 children were non ambulatory. Knee flexion contractures varied from an average of 63.7 (+/-26.8 degrees) preoperatively, 13.2±16.7 degrees postoperatively and 34.0±24.1 degrees at latest follow up. The return of the knee flexion contractures postoperatively did not limit the ambulation gains that were achieved.

Reference: Yang, Stephen Su et al. Ambulation Gains After Knee Surgery in Children With Arthrogryposis. Journal of Pediatric Orthopaedics: December 2010 - Volume 30 - Issue 8 - p 863–869 doi: 10.1097/BPO.0b013e3181f5a0c8

Tuesday, December 7, 2010

Wii Motion Analysis

Now this is really cool, especially if you are a nerdy, techie therapist. This physical education teacher, Mr. Robbo, explains how to use your Wii remote to do some simple motion analysis. You download a program, connect your Wii remote to your computer with blue tooth capability and 'voila' instant motion analysis. Give someone the Wii remote and start collecting data.

Unfortunately, I could not test this out because my computer is not blue tooth enabled. But... if it worked I could see many uses for therapists:

1. Place the Wii remote on a child's belt to get a simple analysis of pelvic motion during gait training.

2. Track a child's motion using different assistive devices i.e. anterior versus posterior rolling walker.

3. Track upper extremity active motion.

4. Analyze the forces on the child's motion when walking on different surfaces

5. In the comments section of the blog one reader says he/she used the Wiimote inside a ball to collect data on throwing and catching.

Would love to hear if you get it to work in the clinical setting.
Read on how to turn the Wii Remote into a data logger.

Read Wearing a Wiimote During Sport

Watch his videos below:

Monday, December 6, 2010

Motor Planning in Toddlers

Child Development published research on movement planning in toddlers. Thirty five toddlers, ages 18-21 months, were observed building a tower with blocks or placing blocks into a container and kinematic measurements were taken. The kinematic measurements indicated that there was a longer decelerating phase when the hand approached the block for pick up versus putting into the container. In addition, toddlers who were more skillful at building the towers exhibited a longer deceleration phase when placing blocks on higher towers compared to toddlers who built lower towers. After one year the same tasks were repeated in 16 of the toddlers. The difference in the deceleration was still present between the two groups (skillful builders with higher towers versus toddlers who could only build lower towers).

Reference: Yu-ping Chen, Rachel Keen, Kerstin Rosander, Claes Von Hofsten. Movement Planning Reflects Skill Level and Age Changes in Toddlers Child DevelopmentVolume 81, Issue 6, pages 1846–1858, November/December 2010

Sunday, December 5, 2010

Assessing Self Regulation

Pediatric therapists and early childhood teachers frequently assess a child's ability to self regulate. Child Trends has released an excellent document on assessing self regulation. Included in the document are several simple questionnaires to determine a child's ability to self regulate. The paper recommends that children participate in out of school programs to help improve self regulation skills. You can view the document below or here.

Read more on activities to encourage self regulation.

Saturday, December 4, 2010

Tips for Daily Routines

The Technical Assistance Center on Social Emotional Intervention has published informative handouts on various daily routines to help parents of children who have emotional or behavioral disorders.

There are three hand outs on:
1. Naptime/ Bedtime
2. Running Errands
3. Diapering

Worth a look at TACSEI

Friday, December 3, 2010

Including All Kids

In the classroom, on the playground and during recess all children should feel included. Many times pediatric therapists focus on environmental modifications. Don't forget other types of modifications as well. Each child can bring their own unique abilities to a classroom setting. Here are several ideas to ensure that all kids are included during the school day:

1. Accept each child for who they are - don't try to change a child, realize that each child has their own unique traits.

2. Encourage group participation - many parts make up a whole. We all benefit when we work together.

3. Acknowledge all efforts - make sure each child knows that their opinions and actions are valid and appreciated.

4. Promote group decision making - let all voices be heard to make a decision

5. Break up big, group projects into smaller parts - assign each child a small part that they can accomplish.

Thursday, December 2, 2010

Improving Postural Control in Sitting

Physical Therapy published research that compared two interventions to improve postural control in sitting between two groups of infants with cerebral palsy. Thirty five infants were assigned to either a home program or a perceptual motor intervention. The infants on the home program has a mean age of 15.5 months and were seen 1x/week for 8 weeks. The infants who receiving the perceptual motor program had a mean age of 14.3 months and were seen for 2x/week for 8 weeks. The results indicated that both groups made gains on the Gross Motor Function Measure. With regards to center of pressure measurements in sitting, the infants who received the perceptual motor program had an advantage.

Reference: Regina T. Harbourne, Sandra Willett, Anastasia Kyvelidou, Joan Deffeyes, and Nicholas Stergion A Comparison of Interventions for Children With Cerebral Palsy to Improve Sitting Postural Control: A Clinical Trial
PHYS THER December 2010 90:1881-1898; published ahead of print October 21, 2010, doi:10.2522/ptj.2010132
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