Emerson’s iCan Shine Bike Camp 2017

Once again we had an amazing bike camp over April spring break, hosted by Emerson’s Center for Rehabilitative and Sports Therapies.   We taught 37 youth and Adults (aged 8-28) with special needs how to ride a bike.  Each year I am so impressed and humbled by the persistence and intrepid nature  of our campers.  They have all tried  unsuccessfully to ride a 2 wheeled bike in the past;  most have fallen off, more than a few times, some have hurt themselves, some had given up years ago.  But they were willing to come to camp and work hard and try it again.

The iCan Shine Camp boasts an 80% success rate, this year we may have surpassed that and gotten 90% of our riders up on a 2 wheeled bike.

Learning to weave through cones on the adapted bike is a skill that is worked on early in the week.

 

Our Bike Tech Kent Husa donned a bow tie,  glasses, and suspenders and became Old Man Tandem.  The youth loved it.

Many highschoolers volunteered, including this teen from Lawrence Academy

You never know what might be happening in the “Pit”

U. Lowell Exercise Physiology Major,  Jordan Rawson was not above a little fun to motivate her camper.

                   

Terrie Enis Director of Rehabilitation gets her work out for the day spotting campers as they learn to ride on a two wheeled bike.

Our floor supervisor Andrea Patrick was everywhere (right), coaching volunteers and campers; here a camper is learning how to start.

The weather cleared in time for some outdoor fun.

On the last day parents may be taught how to spot their camper for the days and weeks following camp as they gain confidence and skill on their own bike.

Another Great Bike Camp!

 

 

 

Functional Vision and Motor Skills

This blog is to help address an area that may be holding some children/youth  back from being  independent on a bike.

These suggestions are also appropriate for many children who are slow to master stairs, catching and throwing a ball and those who toe walk.

This is alot of information. Pick one or two areas and one or two activities and work on them for a month or so.  Then pick another couple activities.  You will be pleased with their progress.

If you suspect your child has a vision issue you should have him/her seen by an ophthalmologist; an eye doctor. It is the best way to rule out any concerns for  eye health or refractive visual disturbances that may be going on.   Many times the anatomy and functioning of the eyes are fine.   Most ophthalmologist do not agree that addressing  functional vision,  will help it improve.  There for many parents go to an ophthalmologist and learn that their child’s eyes are fine, and  do not explore the issues any further. The ophthalmologist will tell the parents their child’s vision will improve with time.  To a degree this is true, but for many children their  functional vision impairment  is persistently affecting their ability to explore their environment and keep up with their peers.  Here is a link that explains what types of Visual Disturbances  can occur that affect children.

depth perception. Difficulty with this is manifested in having difficulty or being overly cautious on stairs,  not being able to catch a ball, and being cautious in outdoor situations like playgrounds.  The main reason for impaired depth perception is convergence insufficiency.

Activity to help gain control:

  1. Using a glow wand ( K Mart automotive section)  move the wand toward your child’s nose and away. Ask them to look at it. You can put a finger puppet or rattle on it to make it more interesting.  It is a somewhat annoying activity.  So let your child know you want them to watch it 8X, then you will be done.  But do it daily to strengthen their eyes.
  2. play catch while sitting on the floor, legs apart (even with your older child, teen, adult),  you are about 8 feet away, using a 8-12 inch ball. or push n go car.   If the ball makes noise- has a bell inside – all the better- we always use vision and hearing together.  You can find these in infant or pet departments.  Your child may blink, look away, grimace, squint, etc. .  Roll the ball slowly, once they are able to watch the ball  and catch it, change the parameters one at a time: roll  the ball faster,  use a smaller ball, add a bounce, sit on a chair, stand up,  stand and face each other while walking sideways…

Visual Tracking:   Being able to follow something as it moves across in front of their visual field.  Many children don’t stay with this task, they follow it part way, or loose it and find it again at the end.  Use the same glow stick move it on the X, Y axis ( algebra- its finally useful!)  and have your child follow it.

Stomp rocket, flying fairy, ball, bubbles ( only blow 1-3 so they can really track a bubble).

Have your child start in sitting, work up to kneeling, half kneeling, standing, and finally walking, and running think playing with balls.

Use a flash light in a darkened room, scan the room for their bed, ball, PJs, book; make sure they are following the beam of the light as it slowly moves around the room hunting for the object.  Let them try it.  Use a ball or push N go toy and keep the light on it as it moves across the room.

Visual Scanning:  Many children look down, and do not scan their environment.  They may be overwhelmed by everything they see- especially as it starts moving by so rapidly- when on a bike.

You can place a visor on your child’s head- under their helmet- and see if cutting down on their visual  field helps.

play games:

play I spy; again think moving from easy to hard- siting in the living room to walking down the street.

Move their snack around each day and make a game of finding it.  You can do this with any daily activity- find their shirt, PJs, toothbrush.  Don’t hide it, just move it from its usual place to another place – in the same room.

Gaze Stability/Fixating:     This is when the eyes just aren’t as stable in the head as we would like.  Even a small amount of  eye movement side to side, or up and down while walking, running, biking can be very disconcerting.  This tends to be present if the vestibular system is still maturing.  It leads to balance issues, clumsiness and lack of desire to run around and play.   Gaze stabilization exercises

Hold a glow stick or shake a ball and ask them to move their head side to side but keep looking at the glow stick.

Ask them to look at something as they are swinging,  the object may be right in front of them, or to either side.  Or talk to them while they are swinging, and make sure they are looking at you, be at their side.

Ask them to look at you as they go down the slide, you can be ahead, or at the side of the slide.

Shifting Gaze:  Many children on a bike look – shift their gaze to something- and their body follows- the bike follows and they run into the post or tree they were hoping to avoid.  They need to shift their gaze to the tree, and back to the path.

When in a store ask your child to push the carriage down the isle, while looking for a certain product.

Go for a walk and point things out to your child, look at the purple flower, red tree, yellow dog, but keep  them walking.  This could be I Spy.

Set up stickers/ pictures on the walls in the hallway of your home, have your child crawl, walk, scooter on their stomach or sitting-

and name what they see as they move down the hall, rearrange and change the stickers.

Use a standing scooterImage result for child's scooteroutside and have them practice moving down  the driveway  and looking for things that you call out.   I Spy ….

General Ideas:

Sledding:  This can be done any time of year on a flying saucer- tie a string to it, and  pull it around on the grass, or your carpet, and ask them to find things, or point to objects you name, as they are moving.

Obstacle courses:  These can be a great way for your child to practice all their visual skills together.  Use stools,  steps,  rail road ties at the playground, inclines- hills,  soft surfaces like pillows,  tunnels.

Modified T ball: hang a ball on a string from a tree, swing set, basketball hoop,  any cross bar you might have.   Give your child a soft foam bat, or short pool noodle and ask them to hit the ball, and avoid being hit by the ball as it flies back at them.  Stop the ball every few swings.   You can also play catch back and forth with this hanging ball.   A tether ball game will  also work well.

Image result for images of tetherball

Many children will do a visual activity 3-5 times and then experience eye fatigue- evident by their loosing interest in the task, eye rubbing and maybe increased clumsiness, for a period of time.  That is fine, their endurance to these activities will increase with practice.

Many optometrists work with functional vision impairments.  You can find them online and if you feel your child has school related visual issues, it might be worth your time to have your child evaluated.  They will have different ideas – more closely related to fine motor activities and reading.

Parentium

Image result for new elements + images

Just for fun.

Recently I asked my husband if he thought I had changed much in the past ten years.  He agreed that I had, and asked me how I thought I had.  “Flexible, more open minded, larger world view,” came to mind.  ” I think it is due to our children, and we would not have changed as much with out them.” I said.  “Yes,” he replied, “They have expanded, beaten and molded us.”  After a chuckle; “Yes,” I said “We are strong like a metal; maybe it would be called Parentium.”

So here is the unveiling of a new element.

Parentium:   NO2

Carbon based.  Strongest element on the periodic table.  Malleable, conductor of energy,  with stands high pressure, ages well, burnishes to a coppery finish, has a glazed look.

Pat your self on the back and try to enjoy the ride; parenting makes you grow whether you are ready or not.

And if  you have one or more children with special needs, give your self a super hug, because you are in the super heavy metal category.

Emerson Hospital iCan Shine Bike Camp April 17-21 2017

Its that time of year once again!  Emerson Hospital in Conjunction with Lawrence Academy will host a bike camp for children and adults with special needs.  The location is  Groton Massachusetts at the Lawrence Academy Hockey Rink.    This is our third year hosting this program, and we are all just as excited as we were the first year.   We are once again teaming up with the University of Massachusetts Lowell- Exercise Physiology Department: who will be providing many of our college student volunteers.  Our volunteers feel it is a joy and a privilege to work with the campers and see them gain this life changing skill.

Calling all Campers and Volunteers:  Registration is open!

To learn more visit our site :

iCanshine Groton MA.


The goal of the 5-day camp is to teach individuals with special needs  to ride a conventional two-wheel bicycle and become lifelong independent riders.
This achievement, in turn, creates a gateway of opportunity, helping them gain assurance and self-reliance in many other aspects of their lives.

The camp uses adapted bicycles, a specialized instructional program and trained staff to enable individuals with special needs to learn to ride a two-wheel bicycle.
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To learn more and register, visit www.icanshine.org/ican-bike-groton-ma

Baby Equipment and Container Syndrome

Container syndrome is on the rise.  It affects  both the child and their parents/caregivers.  Parents/caregivers are believing that you need the equipment -that is being marketed by very smart people- who want your money.  The marketing states that the equipment will:

a. Advance your child’s development

b. Keep your child safe.

Other than car seats none of this equipment will keep your child safer than not using it.  All the equipment if used more than once a day for very short periods of time; will slow or hinder normal development.  And some like a standing jumper should never be used.   I see many infants,  and I am seeing a growing number of children and parents with this  Container Syndrome. Each year their are more and more products.   A container is anything that holds your infant and does not allow them to explore their environment in a typical developmentally appropriate way.  Giving them a “crutch” such as an upright container is short changing your child.   The syndrome is a child who does not like to move on their own.  By five months of age : they would rather stand than sit on your lap, sometimes it is hard to get them to sit; they stiffen their legs, so you can’t bend them.   They have not learned to roll yet.  They dislike moving on their own, preferring to sit and have toys brought to them.  They don’t tolerate tummy time well, and have not mastered it yet. They are not kicking their legs up in the air, when on their backs.  They have a flat head, or torticollis.  They do not learn the crucial skill of crawling.  Their fine motor skills are delayed so their play skills are limited; they can’t explore toys well, so appear to become bored and discontent easily.They are sensitive and can be  a bit fussier, and more demanding than the average bear.

The long term implications are the possibilities of: diminished core strength, delays in milestones, toe walking, sensory integration dysfunction, ADD/ADHD, diminished engagement, poor coordination.

I will use this blog to run through containers and explain the pros and cons.

Car Seats: Yes necessary, can’t live with out one. Restrict time when not in car to diminish flat head syndrome.  Carry baby instead.   Should be rear facing until the age of two.  The police department in your town can instruct you on the correct way to install the seat in your car. Should not be used to sleep in at home.  Like the upright cradles it causes your infants head to fall to one side. This can lead to, or exacerbate torticollis and flat head syndrome.  It also does not allow your child’s normal arm, leg and head movements that occur when they sleep.   They definitely should not be in a car seat while awake.  Carrying your baby in your arms whenever possible is better for them.  They will develop improved head and neck control as you hold them in your arms, and be able to visually explore.  It is also  better for your back and shoulders, then carrying the car seat. And remember a loving caregivers touch stimulates their  brain development.

 Sleep Sacks:  Can limit motor development and diminish ability to self sooth.  Very young babies have always been swaddled, but generally because they were on their stomachs, and lifting their heads up they started to move out of, and undue  the swaddle, and parents stopped by 8-12 weeks, which is appropriate.   Now we have sleep sacks that children can’t get out of even if they wanted to, so parents are leaving them on for 5-12 months or more,- because they aren’t getting cued by their babies  that they need to move.  Remember very young babies spend a lot of time sleeping, but there is a lot of movement that can happen while they move in and out of  stages of sleep.  Babies move arms and legs in increasingly more coordinated ways- given the opportunity.  Sleep sacks can prevent this. Arm movements stay jerky and uncoordinated longer.  “Non nutritive sucking” is a term we use to describe what happens when a baby sucks their thumb or a pacifier.  It helps with GERD, keeps baby relaxed and thus they expend less energy; it is a self calming technique that can help your baby mature behaviorally.  If your baby can not get to at least  one hand they can not learn to self sooth.  Think about letting them have access to at least one hand while sleeping, even at a very young age- 2-4 weeks.

Upright cradles/ Dockatots:  Limit normal movement, delay motor milestones, increase flat head syndrome.  Parents have always been concerned about infants sleeping through the night.  Infants by and large don’t sleep through the night.  And this may go on for many months.  But with many Moms having to return to work earlier and earlier; the need for sleep has fueled the rise in  new products.    Babies are on their backs so not working out their necks; the result is children who have very limited movement experiences.  Remember very young babies spend a lot of time sleeping, but there is a lot of movement that can happen while they move in and out of  stages of sleep.   If they are so confined they can not experience normal movements; learn and grow. There arm and leg movements are hindered, they can not easily turn their head to look around, or move their shoulders and adjust themselves.   The   Dock a Tot web site  explains that it is designed to prevent baby from rolling over.  This is a fine idea for sleeping, assuming they are getting enough time on the ground to learn to roll when they are awake.  Beyond that your baby should have had enough tummy time  (30-60 minutes of active awake tummy time over the course of a day by 12 weeks) to be able to  lift and control their head and start to roll to each side.  The site says rolling is an 8 month activity.  It is a 4-6 month activity.   Anything that limits their ability to move their arms and legs  may delay their motor milestones, and affect their ability to integrate sensory experiences.

Of course we are concerned about SIDS and that is why infants are not put on their stomachs or sides to sleep. Read the  American Academy of Pediatrics  recommendations on safe sleep products before purchasing any sleep device.   Firm, flat surfaces are recommended for sleep.

Rocker/ Vibrating Glider/Swing:  Abnormal sensory experience; with out the normal purposeful movement experience to go along with it.  This generation of children are craving this type of movement because it stimulates their inner ear.  Because we put them in containers they are lacking this movement experience.  The solution is  to put them down  on a firm surface so they can play – on their back, side, stomachs, rolling around and stimulating their inner ears on their own while purposefully exploring their world.

Babies like to be held, and  rocked, some more than others.  It can be thrilling and exhausting, engaging and boring to take care of your baby.  But we can’t let machines do it for us and expect our children to develop a normal sensory system and be willing to engage in relationships. So limit the amount of time you place your baby in a  swing- 20 min/day makes sense.    For the  child with colic, or another digestive issue, I have great sympathy and understand the challenges you have day in and day out.  A swing can give you  both  a piece of mind- just limit the amount of time (once a day),  try to encourage thumb sucking, use a vertical wedge for awake tummy time (helps with reflux), and  consider learning infant massage.

Seats: Parents often start using these before child should be sitting, and the child is stuck; in a poor posture; not  able to move in and out of sitting which is what their body wants to do.  As soon as children can start to sit between your legs, (4-6 months) let them reach to the front,  and sides, so they experience a small loss of balance to one side or the other, this builds their core and the balance centers in their brains.  Remember children are not little adults; their brain learns through movement, not sitting still as we do.   For the 4 month old who is starting to take solids having them in a reclined  bouncy seat can give them the  head and trunk support they need to manage the foods, before they are ready for a high chair. Use these seats to feed your child, then out they come to explore. 

 Walker/ Jumper: Limits  the opportunity to explore their environment, gain strength, use vision.  Abnormally stimulates newborn reflexes; so they don’t go integrate; leading to inability to crawl, and toe walking. Remember standing is a 10-12 month activity, jumping is a 2-3 year old activity.

Because children are not sleeping on their stomachs, they are slow to develop core strength, and show delays in motor milestones.   In fact today’s infants are on average 2 months delayed in their motor milestones.  As parents we need to put more intention -than previous generations- into letting them explore on the floor.  The work of the first year of life is exploration, and gaining the ability to come up against gravity. By giving them short cuts and having them stand or try to sit before they should, we are directly affecting their brain development, and it can have a negative impact.  Babies are not ready to explore in a sitting position until 6-8 months,  and they are not ready to explore in standing until 9-12 months- once they can pull themselves to standing.  And remember jumping is a 2-3 year old activity not an infant activity.

Letting them  play on their back, side, stomach and  visually explore, touch and move;  develops their brain, integrates their sensory experiences and builds muscle strength.  These experiences have a positive effect on behavior, perception, and learning.

Here is when motor milestones normally occur: Web MD

Your child should more or less move through these milestones in a sequential way, mastering tummy time before  sitting.  Note that by 3 months your child lifts their head and chest off the floor- that is an upward facing dog in yoga terms- a bit of work, so give them the chance to get there. Crawling is crucial to vision, core strength, sensory processing, help your baby learn this important skill.  Don’t short change them by putting them in containers.

If your day care rotates your baby from one container to the next through out the day, have a conversation with them about limiting time in upright containers to no more than 1 out of 8 hours.  Consider a play yard/portacrib if you want your child to be safe while you cook dinner.  Consider holding your baby while your older child does their after school activity, instead of keeping them in a car seat.  Holding your child will help develop head  and trunk control,  visual development, and promote bonding with you.  Remember it is the accumulation of limited movement experiences over the course of a day that is hindering infant development today.

Check out my blogs on Tummy Time,  and learning to crawl.

Consider talking with your pediatrician about your infant if you feel they are delayed in any way.  A pediatric physical therapist can work with you on ways to stimulate their development.  Early Intervention is present in each and every state in this country and just takes a phone call from you, and a team will come out and evaluate your birth to 3 year old.  If  your child does not  qualify for services, but you feel they are delayed, contact a pediatric outpatient center.  Because of funding many EIs can only qualify children who are behind by more than 30% in  two areas.

Check out this great post by the American Physical Therapy Association: an organization I am proud to be a member of.  Container Baby Syndrome