Sitting Up Straight: The Importance and Impact of Postural Stability

Whether sitting at a desk at school, eating at the dinner table, or simply playing with toys on the floor, seated activities are an integral part of your child’s life. While we may not think of sitting as a complex task, it provides your child with a stable base to develop essential fine motor, visual-motor, and self-care skills. If you notice your child slouching frequently, propping his or her body against a desk or table, or fatiguing easily during seated activities, your child may be struggling with postural stability.

What is Postural Stability?

Postural stability refers to your child’s ability to achieve and maintain an upright and unsupported sitting posture against gravity. While seemingly simple, unsupported and stable sitting is dependent on a variety of factors, including muscle strength and tone, joint range of motion, the alignment of the body against gravity, and the support your child’s body receives from contact with surface they are sitting on. Core and trunk strength are essential for postural stability. If your child has a weaker core, you may notice slouching, propping of his or her head in the hands, heavy leaning against the back of a chair or the top of the desk, or sliding/falling out of chairs.

Why Does Postural Stability Matter?

While children are often on the move, a majority of their learning time takes place in a seated position. When children have to devote an excessive amount of energy to merely sitting up, the resulting fatigue can affect their ability to focus on classroom learning. Moreover, a strong and stable core allows your child to reach the arms away from his or her body in order to use the hands. Therefore, handwriting, scissor use, table-top crafts, self-feeding, and toileting tasks can all be negatively impacted by poor postural stability.

What Does Poor Postural Stability Look Like?

Some common signs of postural instability include:

  • Extreme or exaggerated slouching when sitting in a chair.
  • Leaning heavily or laying torso on the table or desk.
  • Frequently falling or sliding out of chairs.
  • Sitting in a “W” position.
  • Walking with a wide-legged stance.
  • Leaning against walls or holding onto rails for increased support.
  • Excessive fatigue following prolonged sitting (e.g. after school).

What Can I Do?

You can try to help improve your child’s postural stability through the following activities:

  • Knee walking: Try walking, playing catch, or playing “keep it up” with a balloon with your child standing on his or her needs. This helps to build the trunk muscles necessary for sitting balance.
  • Wheelbarrow walking: Encouraging your child to wheelbarrow walk helps him or her to engage their core and trunk, as well as build upper body strength. If provide support further from the core (e.g. holding the knees instead of the hips), your child will get a more intense core workout!
  • Animal walks or yoga poses: Encouraging your child to bear walk, crab walk, or perform other animal walks promotes core and trunk strengthening. Additionally, a variety of yoga poses (e.g. plank, boat, candlestick, etc.) promote overall strengthening which is great for postural stability!
  • Set your child up for success: Observe your child’s sitting environment. If your child’s feet are dangling in the air when sitting in chair, try providing a step stool or even a pile of books to rest his or her feet on. This will provide your child with a more stable base of support from the sitting surface.
  • Wedges or inflatable discs: There are a variety of tools available to help develop your child’s sitting posture. Sitting on a wedge or inflatable disc encourages your child to engage his or her core and prevents some slouching from occurring.

If you have questions or concerns about your child’s postural stability, please contact us at info@playworkschicago.com or 773-332-9439.

Natalie Machado, MS, OTR/L
Occupational Therapist

Reference:

Case-Smith, J., & Clifford O’Brien, J. (2015). Occupational therapy for children and adolescents (7th ed.). Canada: Mosby, Inc.

Photo Credit:

Anissa Thompson via freeimages.com

Developmental Therapy: Destigmatized

What is developmental therapy?

Developmental therapy focuses on your child as a whole. Therapists look at a child globally (i.e. cognition, social-emotional development, speech and language development, fine motor, gross motor, and self-help skills). Developmental therapy typically begins during your child’s most significant time of development, between ages birth to three. During this time, your child is creating the foundation for their developmental track. A developmental therapist will focus their sessions on your family’s needs and your child’s needs.

What does a developmental therapist do?

Developmental therapists (DT) assess a child globally to determine their areas of strength and need. A DT also looks at your child’s home and/or school environments and their daily routine to see how their surroundings attribute to their development. DTs then service your child as needed using a combination of play and parent education. Children use their cognitive processing, memory, and attention span to regulate themselves and to help them understand their environment. DTs provide your child and your family with the tools to help them develop in their natural environment. A DT’s ultimate goal is to empower your family in understanding and navigating their child’s learning process.

What are the benefits to developmental therapy?

Developmental therapists look at how a child is developing in every area of development. Sessions may focus on joint attention, engagement, play skills (functional and symbolic), attention span, following directions, frustration tolerance, cognition, social sills, preschool readiness, etc. DTs can also provide support for your family’s daily routine goals (i.e. sleeping, meal time, going to the park). Your child’s developmental therapy may include a combination of these areas based on your family’s needs.

Common misconceptions:

Although your child may benefit from developmental therapy services as a young child, this does not mean they will always be in a special education program. Many children who benefit from developmental services are provided the tools that will help them succeed when they enter school. Developmental therapists are trained to provide the children and the families that they service with the resources to help children succeed throughout their development.

If your child is demonstrating difficulty in one or more of the areas discussed above, consider contacting one of our developmental therapists.

Questions or concerns?

If you have questions or concerns about your child’s development, please contact us at info@playworkschicago.comor at (773) 332-9439.

Rachel Weiser, MS, DT
Developmental Therapist

Reference: EB Pediatric Resources, Inc. (Chicago, IL). What is Developmental Therapy? Retrieved from: http://pediatricresources.org/developmental.html.

Photo credit: Tanaphong Toochinda via unslaps.com

Why OT?: Destigmatizing the Need for Therapy

“Why was my child recommended for occupational therapy, they don’t have a job!” You might have many questions if your child has completed an occupational therapy evaluation and was recommended to receive occupational therapy services. What does this mean, exactly?

What is occupational therapy?

The term “occupational” does not refer to one’s employment, in this instance. Occupationscan be defined as activities that support the health, well-being, and development of an individual (American Occupational Therapy Association, 2014). An occupational therapist’s job is to increase the engagement and participation in meaningful daily activities that support your child’s learning, growing, and most of all, fun! There are a wide variety of circumstances that may affect your child’s optimal engagement in day-to-day activities at home, at school, or in the community.

How is occupational therapy going to help my child?

The benefit of occupational therapy is that practitioners are equipped for focusing therapy on a widevariety of skills required in your child’s daily life, such as:

  • Fine motor skills
    • Your child uses fine motor skills to write their name on their school work and to tie their shoes before heading out to play!
  • Visual motor skills
    • Your child utilizes visual motor skills when playing catch in the park and to copy written work from the chalkboard in the classroom.
  • Self-help skills
    • Self-help skills help get your child out the door in the morning! Your child needs to eat, get dressed, and use the bathroom to start their day.
  • Gross motor skills
    • Gross motor skills are required to walk to the front door and down the stairs safely to begin your child’s commute to school.
  • Sensory processing and regulation
    • Your child’s body is constantly processing sensory information in their environment to attend to and enjoy their world.
  • Executive functioning skills
    • When recalling the steps of their favorite family board game and following their teacher’s instructions, they are using their executive functioning skills, i.e., working memory, sequencing, and problem solving.
  • Social interaction skills
    • Your child utilizes their social interaction skills to make new friends and keep familiar ones.

What does it mean if my child was recommended occupational therapy?

Receiving a recommendation for therapy can be difficult and may bring about many questions and concerns regarding your child. Common concerns after receiving a recommendation for your child to receive therapy are “Will my child be singled-out from their peers?” or “Will my child always need therapy?”  When your child receives a recommendation for therapy, it does not necessarily mean that there is something wrong. A recommendation for occupational therapy does mean that a trained therapist has noted suspected concerns that warrant further evaluation. As an occupational therapist, many times I am asked, “Do you work with children with disabilities?” and my answer is, “Yes I do, but not exclusively!” Just as pediatric occupational therapists work on a wide variety of skills, we also work with a wide variety within the pediatric population. An occupational therapist will utilize a holistic approach to empower your child and your family so they can live their life to the fullest in their daily routines, school activities, and excitement within the community.

Questions or concerns?

If you have questions or concerns about your child’s engagement in meaningful daily activities, please contact us at info@playworkschicago.com or 773-332-9439.

Reagan Lockwood, MOT, OTR/L
Occupational Therapist

Reference: American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006

Photo Credit: Photo by Thiago Cerqueira on Unsplash

Co-Treatment 101: What is it? And is it right for my child?

Co-treatment, or sometimes referred to as a co-treat, refers to when two different disciplines provide treatment for one child at the same time. For example, the speech-language pathologist and occupational therapist work together to implement both of their goals into one therapy session. Co-treating can be any combination of therapists, including developmental therapists, occupational therapists, physical therapists, speech-language pathologists, social workers, nutritionists, or any of the other members on your child’s therapy team.

When it comes to therapy, doesn’t more equal better?

Not necessarily. There is no one-size-fits-all recommendation for therapy frequency and is entirely dependent on the needs of your child. Some children benefit from multiple sessions of the same discipline to provide intense focus on specific goals, while others may benefit from a combined therapeutic approach. When an increase in therapy is recommended, it is best to consider both individual and co-treatment sessions.

What are the benefits of a co-treatment session?

There are many reasons why your team of therapists may recommend a co-treatment for your child. Below are just a few:

  • Co-treatments with OT or PT
    • When sensory regulation support is needed in order to attend to therapy activities
    • Gross motor activities may increase your child’s verbal output
    • Postural support may increase your child’s success in various therapy activities
  • Co-treatments with DT or SW
    • Behavioral strategies may be easier implemented with two trained therapists to support your child’s needs
    • Your child requires additional support to establish early developmental milestones prior to focusing on more complex therapy tasks
  • Co-treatments with SLP
    • When your child demonstrates a receptive language (comprehension) delay and benefits from modified cues for therapy directions
    • Appropriate language models can be implemented into structured tasks to increase verbalizations
  • General benefits
    • Therapists are able to brainstorm new therapeutic strategies and modify approaches in real-timeto see what works best for your child
    • Your child is already receiving multiple therapies per week and may become fatigued with additional sessions

How do I know if a co-treatment session is right for my child?

The first step is to talk to your current team of therapists to review your child’s individual goals. Depending on their needs, you and your team will be able to decide if a co-treatment session would be beneficial for your child. If you do decide upon a co-treatment, discuss the therapy plan prior to implementation to make sure that your child is not being placed under too many demands. A successful co-treatment will use basic principles of resource allocation to guide therapy – basically, your child only has so many resources to spend on one difficult task at a time, so they should not be challenged in both discipline areas during the same task (i.e. working on both speech therapy and occupational therapy goals while playing with one toy). This most likely will be asking too much of your child and will often cause them to be unsuccessful with both goals.

Questions or concerns?

If you have questions or concerns about implementing a co-treatment session for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Autumn Smith, MS, CCC-SLP
Director of Speech-Language Services

Photo Credit:rawpixel.com

Speech Therapy: Debunked

Most people have had some exposure or connection to speech and language therapy, whether it was for themselves, a friend, or a family member. It could be that your child has recently been recommended speech therapy and you are not sure what this will entail. In this blog, I hope to debunk a few common misconceptions regarding speech and language therapy, as well as provide a brief overview of the field of pediatric speech-language pathology.

Common Myths and Misconceptions: Debunked
While it may look to the outside world that we are simply playing with toys and games, there is a method to this play-based madness. Our job is to find out what motivates your child and use it to target their therapy goals. When your child is a toddler, this might mean making a cow jump over a barn. While that isfun, your speech therapist may be working on improving your child’s engagement and ability to imitate play-actions, which will hopefully lead them to imitating sounds and words. A population that is often thought of when discussing speech therapy are those with disfluencies, or those who stutter. This is true but is a small percentage of children worked with for a general speech therapist. Articulation therapy is another familiar area, as many of my friends remember being pulled-out of class to play Candyland and work on speech sounds as a child.  Although I do own Candyland and use it semi-regularly, there is so much more we, as speech-language pathologists, do to help improve your child’s communication skills.

What is speech and language therapy?

Variety is the spice of life, and as speech therapists, we get a good taste of this! Speech therapists have a broad scope of practice when it comes to the pediatric population. Below are a few of the most common areas a speech therapist might help your child with.

  • Articulation/Phonology:The actual sounds your child makes to create words.
  • Motor planning:Your child’s ability to plan and execute the fine motor movements required to speak in words, phrases and conversation.
  • Language:The words and phrases your child both usesand understands.
  • Feeding:This involves oral-motors skills like sucking, chewing and swallowing. Also, the sensory processing of different textures, tastes and consistencies.
  • Voice:Your child’s vocal quality. Is it appropriate for a child their age and size or is it breathy or hoarse?
  • Fluency:The way your child’s speech flows.
  • Pragmatics:Your child’s social communication skills, such as making eye-contact, initiating communication with peers, and taking conversational turns.
  • Advocacy: Your child could benefit from additional therapies that you may not be aware of. Your speech therapist can help advocate for your child to ensure they get the best possible care from a qualified team of providers, if necessary.

If your child is demonstrating difficulty in one or many of the areas above, consider contacting one of our speech-language therapists.

Questions or concerns?

If you have questions or concerns about your child’s communication or feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

Photo Credit: Photo by Leo Rivas on Unsplash