Here's a list of gross motor milestones for children 3-5 years old:
Mobility Skills
* Imitates standing on one foot for 8-10 seconds
* Stands on tiptoes without moving for 6-8 seconds
* Jumps over low obstacles and jumps 24-36" forward
* Walks on a line on the floor like a balance beam
* Runs with arms swinging back and forth, pushing off the balls of their feet
* Walks up and down stairs without a railing with one foot on each step
* Hops forward 5 times on one foot
* Begins to skip, gallop, and complete a forward roll
Ball Skills
* Catches a tennis ball by trapping it to their body, progressing to catching it with hands only
* Throws and hits a target with a tennis ball 5 feet away, taking a step forward with the opposite foot
If you have questions about your child's development or are concerned, a pediatric physical therapist can assist you and provide more information. Please feel free to contact Child and Family Development at (704) 541-9080.
Here's a list of gross motor milestones for toddlers, aged 24-36 months:
Walking/Moving
* Imitates standing on one foot for 3 seconds
* Walks backwards
* Jumps down from 16" high step and jumps 18-24" forward
* Runs with greater speed, avoids or stops at obstacles
* Rides Tricycle
* Walks on tiptoes a few steps
* Begins to hop on one foot
* Begins to pedal a tricycle
Stairs
* Walks up stairs with one foot on each step without a railing
* Walks down stairs with one or both feet on each step without a railing
Ball Skills
* Catches large 12 inch ball progressing to smaller 8 inch ball
* Throws tennis ball overhand or underhand 8-10 feet forward
If have questions about your child's development or are concerned, a pediatric physical therapist can assist you and provide more information. Please feel free to contact Child and Family Development at (704) 541-9080.
Walking/Moving
* Begins to run
* Walks backwards
* Begins to jump up or forward a few inches
* Jumps down off low objects
* Moves on ride on toy without pedals
* Climbs on adult sized furniture
* Stands on tiptoes
Stairs
* Walks up and down stairs with one hand held consistently
Ball Skills
* Kicks a ball in a forward direction, swinging his or her leg behind in preparation
* Throws a small ball over and under hand several feet forward
* Begins to hold his or her arms in front of their body to attempt to catch a ball
If have questions about your child's development or are concerned, a pediatric physical therapist can assist you and provide more information. Please feel free to contact Child and Family Development at (704) 541-9080.
Learning to ride a bike can be a huge accomplishment in a child's life...it can also be one of the most frustrating for a child and whoever is trying to teach them. Most parents run behind the bike holding on, find a moment to let go, and pray! There are several other things you can do to help your child learn the skills necessary to ride a bike independently.
• Take off the training wheels, and the pedals if possible. Have your child practice putting the kickstand up and down and climbing on and off the bike, with an adult steadying the bike as needed, trying to decrease the support as the child's confidence and success improve. These activities increase your child's balance while standing on one foot, and their coordination for managing the bike with their hands while also moving their legs.
• Have your child "jump" side to side from one foot to the other while sitting on the seat. This will help your child learn how far to either side they can keep their balance and also learn that they can put their foot down to catch themselves if they lose their balance
• Have your child sit on the seat, use their feet to push the bike forward and try to glide for a few seconds before putting their feet down. Make sure there is open space and no obstacles.
• Set up cones in different shapes such as a line, square or circle, and have your child practice walking their bike through or around the cones while sitting on the seat so they learn to lean with their bike as it turns, instead of pulling their body in the other direction which may cause them to lose their balance.
In addition to these tips, it takes practice, practice, practice!
As children have started back to school, the books, binders, papers, and folders are adding up to equal one heavy backpack. Carrying a very heavy bag every day for an entire school year can cause pain in your child's neck, shoulders, and back and may cause them to walk with poor posture as they try to compensate for the extra weight. In general a child's backpack should weight about 10% of what they do, up to 20% can still be acceptable. A few schools have the option to have one set of books at school and another for home to limit the amount children have to carry, but if that is not an option, here are some suggestions to help your child be more comfortable carrying their things back and forth to school:
~Use a traditional 2 straps over the shoulder backpack instead of a cross body messenger bag, which can put strain more on one side of the body and cause the child to walk unevenly
~Look for over the shoulder backpacks with wide straps and chest or waist straps to distribute the weight more evenly through the body
~Make sure the straps are snug enough for the backpack to sit up higher on the back, rather than low on the waist and hips, which will cause your child to curve their spine in an unnatural way
~Load the bag correctly with the heaviest books in the back of the bag that will be closest to your child's body, moving the lighter things towards the front of the bag, further away from the body. The closer the weight is to the body, the less strain it will cause on your child's back
If your child is still having back pain after these modifications, they may benefit from physical therapy services to learn some stretches and a strengthening program to help them adjust to the new demands of the school year.
Parents can be overwhelmed with the number of baby toys available these days. Baby walkers are advertised as a safe way for a baby to develop motor skills, specifically standing and walking. Many babies enjoy being upright and mobile, and when used appropriately, a walker can help your baby with these skills. However, when a walker is not used appropriately, it can hinder rather than help your baby's development.
Spending time pulling to stand at a couch or coffee table, cruising and learning to let go to step between these objects are extremely important for achieving developmental milestones. An alternative to a baby walker is to help your child learn to use a push toy. By using a push toy, your child will learn these skills while also allowing them to be upright and mobile before they are ready to be independent walkers.
Below are some other factors to consider of baby walkers and push toys:
Baby walkers:
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Can encourage leaning forward when walking, toe walking, or turning feet in
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Can discourage independence and safety awareness due to being surrounded by support
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Allows motor behavior before other areas of development are ready (safety, cause and effect)
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Can cause damage to ligaments in hips, knees, and ankles if child is dangling and not fully supporting weight through legs
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Can delay independent walking
Push toy:
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Builds strength in trunk, arms, and legs
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Encourages safety awareness by holding onto toy
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Prevents damage to ligaments; child must be completely weight bearing through both legs
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Teaches problem solving, such as backing up and turning around
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Improves balance
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Encourages appropriate foot/arch development
If you have questions about how your child is learning to walk, or what the best toys to learn might be, feel free to contact a physical therapist at Child and Family Development.
Seeing a child in pain is one of the most difficult things a parent can experience. What happens when a seemingly minor injury turns into long lasting, extreme pain for a child?
When a child has a relatively minor injury, such as a sprained ankle or wrist, a regimen of rest, ice, splinting or casting, gentle range of motion, and time are usually recommended as the area heals. However, sometimes the pain seems to get worse instead of better. Further x-rays or testing can reveal that the original injury has healed and there is no obvious cause for the continued, intense pain. A possible explanation for families and medical professionals to investigate is Complex Regional Pain Syndrome (CRPS).
Advance for Physical Therapy and Rehab Medicine published an article entitled "Within Reach". This article discusses CRPS as difficult to diagnose, however provides evidence of improvements in patient's pain level with combinations of education, physical therapy, and other strategies. Treatment strategies for CRPS involve changing pain pathways and messages that the brain sends long after the original injury has healed.
If your child experiences pain that seems to be significantly more severe in relation to the injury, longer lasting than expected, and severely limiting in most aspects of their daily life, please contact a physical therapist at Child and Family Development to discuss your child's case more specifically and the resources available to help your child get back to their healthy, happy self.
Families that feel that their child does not have great coordination as he or she is growing and learning new skills often wonder if its just clumsiness or something more. I recently came across an article about dyspraxia that may provide parents with more information about this condition, and help them decide whether or not to seek out an evaluation of their child's skills. Dyspraxia is a diagnosis that can be difficult to fully understand without the proper resources.
"Deficits of Dyspraxia" in
Advance for Physical Therapy and Rehab Medicine defines dyspraxia as "dys" meaning dysfunction and "praxis" meaning based on will. In layman's terms, this can be described as being able to accurately complete a task spontaneously, however having difficulty completing the task when instructed by someone else, when attempting a new task, or with specific, conscious intention of their own thought.
The article also describes how children with dyspraxia are able to complete higher level skills, however may not have mastered lower level, basic fundamentals. Children with dyspraxia can also have difficulty with ordering the sequence of the activity, achieving the right timing, and using the necessary force required for the activity. Various body systems as well as treatment approaches are also described in the article.
The full article is available on
Advance's website. If you have questions about whether your child may have dyspraxia, please contact a physical therapist at Child and Family Development to discuss your concerns or seek out an evaluation.
Midway through summer, parents start hearing the dreaded phrase from their kids--"I'm bored". An alternative to kids relying on technology for entertainment are some games that most adults remember from their childhood. Games that allow children to build their gross and fine motor skills, cognitive and play skills, as well as their ability to learn turn taking and working well with others--hopscotch, jump rope, four square, tag, and climbing trees. These games are simple to learn, require little, if any, equipment, and can be played almost anywhere.
Real Simple has complied 10 fun summer activities on their website at
www.realsimple.comTry these games with your children to bring back old memories, and create new ones!
School's out, the weather's hot, and it's time to head to the beach! Many families take advantage of this opportunity to head to a lake or the ocean to cool off and have some fun. It's also a great time to take advantage of the sand and water and how they can provide new and fun activities for your child to work their muscles, improve their balance and coordination, and learn new skills.
On the sand:
* March through soft, deep sand in a follow the leader parade--soft sand is harder to walk on than moist, packed sand and will help build your child's core and leg muscles
* Dig a big hole and bury other people in the sand--your child will use all of their muscles to scoop, push, and dump sand, and also use their problem solving skills to figure out how to hide every finger and toe!
* Ride big wheels, tricycles, and ride on toys on the packed sand--your child will have to work harder to pedal than when they are on sidewalks or driveways
* Make "animal" foot prints on the sand by having your child walk like a duck, frog, crab, or move like other sea creatures to improve their balance and coordination
* Make "sand angels" by laying on the sand and moving their arms and legs in and out against the resistance of the sand
In the water:
* Scoop buckets of water and bring them up the beach to make "pools" in the sand--squatting to fill the bucket and then walking with it is a full body workout!
* Jump in the waves with hands held as needed by an adult--this will help your child work on their timing and coordination of gross motor skills to jump over each wave
* Walk through the water with a floating tube or noodle for balance--the deeper the water, the harder your child will have to push to move through it. Have them "chase" you through the water to try to move faster against the resistance of the water.
Enjoy the summer because it's back to school before you know it!
In a continuation of the TAOS blog series, here is more information on how the TAOS walker is different than other gait trainers.
The TAOS orthotic system support a child from their chest down to their feet, with specific joints aligned with the child's own hips, knees, and ankles. The orthotic system's design allows it to harness all of a child's energy and movements and direct them into the movements needed for walking, without wasting energy on unproductive movements. The child is able to move their legs through full flexion and extension patterns, while limiting undesired movements, such as scissoring.
When the child is using the orthotic system on the TAOS mobile base, all of their movement is directed to move the walker forward--which is our goal!! There are cords in the front of the base that attach to the ankle joints of the orthotic system, and cords in the back of the base that attach to the knee joints of the orthotic system. These 2 sets of cords work together as a pulley system to encourage hip and knee extension of the stance leg, while encouraging the opposite leg to swing forward and take a step. The pulley system will then encourage the same motions on the opposite legs. This pulley system also prevents inefficient gait patterns such as trying to push with both legs at the same time or toe walking.
Learning to walk in any gait trainer takes practice, practice, practice, but the TAOS walker's many original features helps set a child up for great success. Check out videos on the TAOS website to see how the walker works with a variety of children at
taos1.com/prospective.html or contact a physical therapist at Child and Family Development in Charlotte to discuss if the TAOS is right for your child.
The TAOS walker was described in a previous blog as an orthotic system on a mobile base to assist children with different abilities in learning how to walk. Which children can benefit from the TAOS walker?
- Children as young as 18 months old can benefit from the TAOS walker.
- The TAOS walker can be used by children with a variety of diagnoses, such as cerebral palsy, spina bifida, Down syndrome, genetic disorders, increased or decreased muscle tone,and children with neuro-motor impairments.
- The first area that is assessed by a physical therapist or an orthotist is a child's ability to actively move both legs--decreased strength and range of motion are not limitations in the TAOS walker. In fact, the TAOS can help children improve both of these areas.
- The second area that would determine if a child would be an appropriate candidate for the TAOS walker is the ability to learn through a cause and effect experience.
- Other factors to assess when considering the TAOS walker for your child are such areas as endurance, ability to hold his/her head upright for specific amounts of time, motivation, and the family and caregiver's ability to assist the child with using the walker.
More information on the TAOS walker can be found on their website at
www.taos1.com/index.html or contact a physical therapist at Child and Family Development. Check back for my next blog on how the TAOS works as a system.
Image courtesy of
www.taos1.com/index.html
Some children need more help than others to learn to walk. For a variety of reasons, they may seek help from a piece of equipment to help them learn the "steps" of walking, and look to a physical therapist to help them find just the right walker, or gait trainer. As a pediatric physical therapist, I have found pros and cons to many kinds of gait trainers. While each child is different, I have helped children find great success with a gait trainer that is combined with an orthotic system.
One such gait trainer/orthotic combination is the TAOS walker – Therapeutic Ambulatory Orthotic System. The basis of the TAOS is a custom orthotic to support the child's trunk, hips, knees, ankles, and feet, set on a mobile base. The orthotic system helps to harness a child's energy and any extraneous movement and direct it into productive, forward motion for walking.
The
TAOS website provides information about the history and development of the walker, as well as videos of children using the walker.
Check back for more in this series about the TAOS walker–how it works as a system, who may benefit from this system, and how it is working for the clients we see every day. If you have questions about if the TAOS walker may be right for your child, please contact
Child and Family Development to speak to a physical therapist or set up an appointment for an evaluation.
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