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:
- 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.
- 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 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 scooteroutside and have them practice moving down the driveway and looking for things that you call out. I Spy ….
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.
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.
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.
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.
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 :
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.
To learn more and register, visit www.icanshine.org/ican-bike-groton-ma
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.
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
The Emerson Wellness Center
For Mind and Body
Infant Massage Class
Happy New Year to All!
Many of us set resolutions for things we want to change in the new year. Giving the gift of infant massage to you and your baby means you are committed to building a healthy relationship for life. Did I mention how much fun it is?
Parents can easily learn this age old practice, which has more relevance today than at any other time in history. It is estimated that a significant percentage of children in the US are insecurely attached . The reasons are many: as parents we are distracted by technology, we are told to place our babies in chairs that will rock them better than we can, and many of us are heading back to work at 8 weeks, instead of 4-12 months. These factors can contribute to insecure bonding. Insecure bonding affects behavior, learning and relationships. To read more about attachment see this site: Better Brains For Babies .
This two part class will teach you all you need to know about giving your infant the gift of massage. This age old practice is common in many cultures around the world and is now becoming more popular in the U.S.. Massage is key to bonding with your child, and becoming the intuitive parent you want to be. Massage has been shown to improve engagement, bonding, attachment, weight gain, decrease colic pain, and fussiness, as well as improve sleep. When you massage your infant on a regular basis, both you and your child experience a feeling of calmness. During this class we will cover techniques you can do easily with your infant in your own home. This class is appropriate for babies 4 weeks and older; the full term infant, as well as children born prematurely, or babies with a history of medical complications. Bring a pillow and blanket for your baby. Oil will be provided.
Sign up for one or both classes, these can be repeated as a refresher. Up to two caregivers per child may attend.
Mary Evans PT, DPT, MS, CEIS
Mary has a doctorate in physical therapy, and is a certified early intervention specialist, with over 20 years working with babies and their parents in both home and outpatient settings. She is a certified educator of infant massage. Her goal is for parents to feel comfortable and enjoy giving their baby a massage.
Time: 12:00-1:00 pm
Massage Class Level I
Concord MA location: Emerson Wellness Center for Mind and Body, 310 Baker Ave.
Thursday January 12,
Thursday March 9
Thursday May 4
Westford MA. Emerson Hospital Health Center 133 Littleton Rd., Suite 314
Thursday February 2
Thursday April 6
Massage Class Level II
Concord MA: Emerson Wellness Center for Mind and Body, 310 Baker Ave.
Thursday March 23
Westford MA. Emerson Hospital Health Center 133 Littleton Rd. Suite 314
Thursday February 16
Thursday April 27
Cost $20.00 per class.
Sign up online at EmersonWellness.org