Freya is a 6-year-old girl with ataxic cerebral palsy. She moved to California from Iowa last month and has been prescribed six months of physical therapy. Freya’s parents are concerned; she has been having difficulty going down the front stairs of their new home. As her physical therapist, do I have a standardized test that will measure her initial gross motor function? In six months, how will I determine whether Freya has made statistically significant progress?
My Gross Motor Function Measure User’s Manual is tattered. I could not work without the GMFM! Like all things that are well designed, the creators have taken a complex concept and made it logical and simple. The GMFM is an evaluative measure that assesses change in motor function over time. I can test Freya in January, provide PT 1x/week and then retest in July to determine if she has made significant progress. In addition, I won’t overlook Freya’s inability to reach across midline while I am heavily focused on her stair skills; the test covers all domains from lying and rolling up to running and jumping, with each skill being incrementally harder than the last. Continue reading “Why I love Using the Gross Motor Function Measure”
“My son’s core is so floppy, he really can’t push open the doors when we go to the library. There is no force through his arms. Now that he is older, this is stopping him from doing quite a few things”.
Pushing is an essential skill. To go shopping, a cart must be pushed from aisle to aisle. A dresser drawer can’t stay open; it must be pushed back into position. We push all day long without much thought about our action, whether it is tidying up the kitchen drawers, pushing a vacuum, going through a revolving door, or moving furniture back into its place. Continue reading “Core Stability: Pushing”
Kaylee is a five-year-old girl with quadriplegic cerebral palsy. She is not able to walk or move herself around, but she can use her legs to propel an adapted trike. She loves this and can enjoy a half-mile ride with her mom pushing to help out as needed. No insurance source will pay for the trike and it costs too much to buy out-of-pocket. What are the options?
There are many organizations that make needs and wishes like this one come true. If you are based in Northern California, these are some of the best known ones serving kids with disabilities. If you know of other resources, please make suggestions.
Continue reading “Seven Funding Resources”
“My daughter has low tone. What can I do to get her core muscles working? When she is trying to pull open a heavy door, she can’t get any stability and she just gives up and asks us to do it for her”
Are you wanting to work on core stability with a young child? Strengthening is possible, but the way you go about it is quite different from adults. Instead of counting repetitions, I find it is best to strengthen within the context of play.
I am imagining that we are stranded on a tropical island! We have just caught the biggest fish in the sea and we are pulling it to shore! I have a long rope with just the right amount of weight tied to the other end. That doesn’t have you? OK, I am in the water and you are pulling me back to shore! The story is yours to create: castles, sleeping dragons, stubborn donkeys. Allow yourself to have fun with the stories. Once children come up with a story and get hooked into the imaginative play, they don’t realize they are working themselves into a sweat! Continue reading “Core Stability: Pulling”
Have you ever wanted to try out a whole selection of adapted trikes? Try a new swimming experience? Enroll in a summer camp?
A few years ago I started compiling a list. Every time a parent or child came in beaming from a new community experience, I wrote it down. In the ICF, Participation is defined as anything that involves friends, family, future, fitness, fun, or function. The activities below promote structured play, meeting new friends and exploring new interests. So here is the list with links included… let me know if you have any other additions. I hope you find something here that provides an enriching experience!
Continue reading “Recreation Opportunities for Children With Special Needs in Sonoma County”
“Is my baby standing OK? It seems like he is up on his toes, and toe walking runs in my family”.
The answer to this question, of course, depends on how old the baby is and how long he or she has been on their feet. I teach in an infant mobility class every week and have the amazing opportunity to watch children pull to stand at the big drum in the middle of the room. How they love to pound on that drum! I love their joy and their success. However, as the class physical therapist, I’m also looking closely at how they are standing. Are they up on their tip toes and leaning into the drum, or are they standing with their hips a little behind their firmly planted feet? Continue reading “Nice Weight Through Your Heels, Little One”
You are playing a game on a flat surface during a PT session and everything is going well, but have you thought about the benefits of playing it on the wall instead?
When we actively reach above shoulder level with hands on the wall, the scapular stabilizing muscles (lower trapezius and serratus anterior muscles) hold the scapula in place while other muscles work off that stable foundation to elevate the arm (humerus). Holding in this position dissociates the movement of the scapula from that of the humerus. Dissociation of this kind naturally evolves in babies at about 5-6 months as they are on their stomachs and beginning to bear weight on extended arms. Most children older than a year don’t enjoy a prone position any longer and will protest. Don’t worry, you can get some of the same movement by playing a game on the wall or other vertical surface instead. Check that you have optimal alignment in all other segments of the body: rib cage, low back, hips, knees and ankles.
Continue reading “Wall Activities for Scapulo-Humeral Dissociation”