By: Stephanie Conley PT, DPT and Maddie Keppel PT, DPT

Painters tape is an inexpensive way to provide guided play activities for your children inside or out! See our top ten ideas below! ​

Use painters tape to create a maze on the wall or the ground and provide children with toy trains, cars or small craft balls to move throughout the maze and get to the end! Encourage children to play in a squat or tall kneel position while doing this to help strengthen their hip and leg muscles. ​

Targets are a great way to help work on ball skills both catching and throwing. Try a small soft ball on a wall target. A higher target for overhand throwing and a lower target for underhand. A shape on the ground can be used to bounce a ball in and catch. When a child is learning to catch, timing can often be challenging. When they are bouncing the ball, the timing is easier because they control when they drop and catch. You can also encourage a child to bounce the ball in the shape as many times as the shape's sides (i.e. triangle = 3x) or have them stand to the side and say "triangle" as they bounce it in the triangle or "square" and they bounce it in the square. ​

 Imagine you and your child are spies and have to navigate a laser security system. Use the painters tape across the wall like hurdles for the obstacle course. As well at different angles from the wall to the floor and from wall to wall. By creating a web of painters tape the child will have to crawl, step and slide through without touching any of the tape and continue their spy mission. ​

Who said hopscotch has to be just a summer activity?! By using painters tape a hopscotch outline can be created inside. We recommend doing it down a hallway or in an open space to leave room for jumping. Hopscotch helps develop motor planning and coordination skills by completing jumping and hopping patterns. ​

Nina Berault PT, DPT  and Jessica Yoon PT, DPT
            
               As a nation, we are more sedentary today than ever before. Less than 30% of adolescents meet national physical activity recommendations (CDC). Pre-dating the COVID-19 pandemic, there were several contributors to this change in societal behaviors. Physical education and athletic programs received less funding, and the constant temptation/educational requirements to use electronic devices grew exponentially. These are obstacles to physical activity that typical children face, and may have a more significant impact for children with Autism Spectrum Disorder. 
                 Does your child with ASD resist movement in various forms? Do you have difficulties implementing a routine for exercise? Not to fear! We call you to think about daily activities your child already performs (or helps you perform) as a form of daily exercise! Below are two lists of activities that can be performed daily/weekly with household items. 

Sneaky ways to work on strength:

• Opening/closing doors (esp when out and about since doors are more weighted)
• Bringing in groceries
• Taking a box of toys/books up and down the stairs
• Pushing/pulling chair in 
• Walking up/down stairs differently
  • Crawl up
  • Go sideways
  • Go backwards
  • Hop up/down with hand hold 
  • Take large steps (skip steps)
• Tall kneeling/Half kneeling during table top activities
• Low squat and play
• Summersaults
• Building a fort with large cushions/chairs/etc

Sneaky ways to work on balance:

• Placing toys up overhead, high enough to get them up on tiptoes
• Having them stand and put on shoes/socks/pants
• Walking over different uneven surfaces: over grass, sand, sidewalk, cushions, etc
• Sitting on a stack of pillows/cushions 
• Curb balance beam
• Seated on yoga ball
• Playground: slides, swings
• Pillow fights/pool noodle fight
• Scooter/Rollerblading/Skating/Biking
• Hackey sack
• Hopscotch
• Chinese jump rope
• Laser maze using streamers attached from walls to furniture, etc 

Further reading: 
https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1635-9

By: Nina Berault PT, DPT 

            Our children spend much of their time performing sedentary activities (i.e, writing, typing, attending to a teacher's lesson, and reading). Typically in the classroom, our children assume a "short sit" position in their chairs- their bottoms supported by a surface and lower legs folded over the side. Too much time spent in this position may result in restricted hip mobility, tight hamstrings, and weakness in the neck and back to name a few things. Home is the perfect environment to switch things up. Below is a list of several positions children can assume when reading, writing, playing video games, and more!


Prone on elbows: Recruits scapular (shoulder blade), cervical (neck), and thoracic (upper back) musculature to hold the head and shoulders off the ground. Sensory input is given to the core as the belly pushes down into the floor. 




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​Side-sitting: 
​The child must recruit core and hip musculature to achieve and maintain midline position (counteracts the rotation in the trunk as a result of the hip position). 

Half kneel: Narrow base of support in this position allows for recruitment of the core and glutes. Quadriceps are also used to maintain balance! Child learns to align ribcage and pelvis. 

By: Nina Berault PT, DPT 

        We have all played the comparison game. Little Susie walked at 10 months- why is my son still crawling at 14 months? My niece is unable to roll over, but my nephew was sitting independently at her age. To add fuel to the fire, it is enticing to google search or scroll through social media to discover what's "typical" in childhood development. Consider the following prior to sounding the alarm. 

1. Has your child had a recent check-up with the pediatrician? If yes, did he/she/they examine motor skills, reflexes and/or muscle tone? If you are unsure, sending a quick email through the patient portal might be to your benefit, making sure the provider speaks to these areas. See the list of skills below for specific areas of concern. 
2. Prior to scheduling a pediatrician appointment, do some research on your physical therapy insurance benefits. Many plans will allow direct access care (without a prescription from your child’s physician) for a finite period of time. If this is the case, call your local physical therapy providers to discuss your concerns and inquire about an evaluation. 
3. Minor discrepancies exist between pediatricians and physical therapists in regards to what warrants immediate intervention. However, if you use the list below as a guide to discuss your concerns, most pediatricians will not hesitate to give a physical therapy referral. 
4. Expect to be moderately-heavily involved in physical therapy once it begins! Your pediatrician and physical therapist will encourage you to facilitate completion of your child’s therapeutic exercise program.
5. Don’t panic. Seeking knowledge to guide your child through their development means you are already on the right path!

SKILLS THAT SHOULD BE OBSERVED...

Birth to 3 months

1. Forearm weight-bearing while laying on belly 
2. Cervical extension (lifting head) ~45 degrees
3. Turning head to clear airway 
4.  Phasic arm batting and kicking in supine 
5. Hands to mouth
6. Reflexive walking (when held up)

4-6 months 

1. ATNR disappears
2. Head righting skills when turned horizontally 
3. Rolling skills back <---> belly 
4. Independent sitting, toys usually held at midline 
5. Prone on extended elbows
6. Hands to midline, then knees, then feet 
7. Feet to mouth 

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7-9 months 

1. Creeping on hands and knees
2. Pull to kneel at support surface
3. Reaching outside of base of support in sitting when playing with toys 
4. Protective reactions- upper extremity extension

10-12 months 

1. Pulls to stand through half kneel 
2. Unsupported standing 
3. Cruising
4. Independent walking EMERGING 

13-24 months 

1. Walking 
2. Ball skills- throwing, kicking, catching 
   1. Increase in height and distance with above skills as we age
3. Begins creeping up the stairs, then walking with assistance 

25-36 months

1. Jumping- up, forward, and down 
2. Single leg balance for several seconds

36-48 months 

1. Running with mature pattern
2. Skipping

 WALKING ABNORMALITIES

1. Toe-walking
2. Pigeon-toe (feet facing inward)
3. Wide base of support 

 GENERAL WARNING SIGNS 

1. Child avoids transitioning between postures- plays in position for long durations 
2. Changes in muscle tone, and/or sudden increase or decrease in joint flexibility
3. “W” sitting
4. Using upper extremities for floor to stand transitions 
5. Low tolerance to physical activities 
6. Asymmetries in gross motor skills
   1. Ex: only leads with R leg up/down the stairs, only swings one arm in walking/running