MEAGAN POSTS:
DEAR ERI COMMUNITY: I have a high school student with cerebral palsy who is using ad UP and Free walker. He has been using it now for about 4 months. He continues to struggle with controlling it even when he holds on. HE was completely independent with a Kay posterior walker but now needs help even with steering and initating movement with this walker. Does anyone have any experience with this or any links to research? Any help is much appreciated!
]]>Ask an expert:
[caption id="attachment_1793" align="alignleft" width="151" caption="Barbara Hodge"]
[/caption]
Barbara Hodge, PT, Coordinator-Instructor Pediatric NDT
Q. Is there value of “tummy time” for children with neuromuscular issues?
I do say for many children with neuromuscular issues the floor is not their friend.
The value of tummy time for typical children is undisputed. Among other things it helps elongate and activate the abdominals, especially the obliques, it gets mobility of the rib cage/ ribs to spine. It lengthens hip flexors as they extend away from the floor and activates the gluts, develops the secondary curves of the spine, and the one we focus so much on, shoulder girdle alignment and stability, early formation of the hand arches for fine motor, with appropriate scapular depression and adduction.
The documentation of the benefit of tummy time on plagiocephaly and also torticollis is all there, not mention all the sensory systems that are vital for development.
However, when we put the children we treat in prone on the floor we need to ask ourselves which of the above is being promoted by putting them there.
Are they getting what we want, or are they in fact reinforcing the very impairments we are trying to minimize. If what we see, particularly with the hypertonic children, is increasing adduction/internal rot of the humerus/ winging of the scapulae , the head in hyperextension, thoracic spine in flexion and the thoracic-lumbar junction in hyperextension, and adduction/internal rotation of the lower extremities, then compulsory tummy time , as in prone on the floor, is not a good plan.
For those with hypotonia who melt into the floor, lifting the head from this position (prone) is hard. Having them in upright and pushing their hands into the surface is a place they can often get some activation and is therefore a better position to begin in.
We definitely need to work on all the same components that typical children do when on the floor, but we need to find alternatives, such as on the therapist’s lap, on the ball, held supported against the mother, and pushing away from that surface etc. The foundation of much of our handling techniques will be in places where we can help them get alignment and activation for developing function.
In general, I think that if a technique or position works it’s fine to use, but what we need to emphasize is the observation and analysis skills to be able to ask: why are you doing this, are you getting what you want, and if not, how can you modify it to be productive?
I get many mothers who tell me that take the message that they have from therapists is that their child must be placed in prone on the floor as tummy time is vital. The components of tummy time are vital, but we would promote the thought that they often cannot be successfully achieved in prone on the floor, and may in fact be detrimental for their particular child.
We welcome your thoughts and experiences
]]>We wanted to share this pilot study from an Occupational Therapist.
What are your thoughts?
Efficacy of Sensory-based Interventions for Children with Autism Spectrum Disorders: A Pilot Study An Occupational Therapist working in a pre-school program used the SymTrend data collection app to collect data about a student’s out-of-seat behavior during circle time activities. She wanted to record and report data about the effectiveness of interventions she was going to try to increase in-seat behavior. The child was in a substantially separate classroom for children with ASD ages 5-6 years. Her study demonstrated the effectiveness of her sensory-based intervention to increase in-seat behavior.
]]>Should you be recommending tummy time for children with neuromotor issues?
Please share your thoughts and experiences and then hear from our expert.
]]>
Each year APTA honors outstanding achievements on the part of its members in the areas of overall accomplishment, education, practice and service, publications, research, and academic excellence. We are thrilled to announce that Education Resources Faculty Member: Barbara Connolly has been awarded the Marilyn Moffat Leadership Award
Nominees must have:
Barbara Connolly[/caption]BARBARA H. CONNOLLY, PT, DPT, Ed.D.,FAPTA received her BS degree in physical therapy from the University of Florida; a DPT degree from the University of Tennessee; a M.Ed. degree in special education with a minor in speech pathology and an EdD in curriculum and instruction from the University of Memphis. She is a Professor Emeritus at the University of Tennessee Health Sciences Center where she served as Chair of the Physical Therapy Department for 24 years. She also holds an adjunct academic appointment in the Graduate School of the University of Indianapolis. She is currently the President of the International Organization of Physical Therapists in Pediatrics, a subgroup of the World Confederation of Physical Therapy. She has served on the APTA Board of Directors, on the APTA Pediatric Specialty Council and the American Board of Physical Therapy Specialists. She was President of the Section on Pediatrics of the APTA from 2002 – 2006. She has also received the Bud DeHaven Leadership Award, the Research Award and the Jeanne Fischer Distinguished Mentorship Award from the Section on Pediatrics. In 2002, she received one of the highest honors from the APTA when she was named a Catherine Worthingham Fellow. She is the first author of 29 publications in peer reviewed journals, has written 21 book chapters and has coauthored or edited seven textbooks for physical therapists. She is certified in NDT and in SI. She continues to provide services to children through her private practice.Award recipients are recognized in June with a ceremony and reception
We are thrilled to offer Barbara’s course:
Praxis: Evaluation and Treatment of the Clumsy Child
April 25-26, 2014 – Cedar Knolls, NJ
July 25-26, 2014 – Columbia, MO
November 15-16, 2014 – New Brunswick, NJ