The Low Down on W-Sitting By Trisha Roberts

      W

W-sitting refers to a sitting posture where the buttocks are between the feet and the lower legs are bent at the knees and positioned behind the body to either side, thus forming a W shape.

When a person W-sits the medial (inside) sides of the knees are stressed.  This can lead to overstretching of the ligaments and potentially to an unstable knee and orthopedic problems.

Why do children W-sit?  Why is this bad?

Almost all children will W-sit occasionally, but persistent, prolonged W-sitting is to be discouraged because of the potential harm to the knee and hip joints.

 Children with low muscle tone frequently develop this type of sitting as their preferred method of rest.  It gives them a very large base of support, making them more stable and requiring less energy to maintain; it helps them compensate for their weak musculature. They can play and manipulate toys with their arms, using less energy to keep their trunk and pelvis controlled.   But again, reliance on this position can stress the ligaments and muscles in the hips and knees, and these children already tend to have very lax, flexible joints because of their low muscle tone.

Children with high muscle tone (hypertonia) and sometimes children with spastic Cerebral Palsy (Spastic CP) sit this way.  It should be discouraged because it feeds into their abnormal patterns of movement. W-sitting can aggravate muscle tightness, as it places hip internal rotator muscles, hip adductor muscles and heel cords in a shortened position. W-sitting can lead to more muscle tightness and possibly contractures.

When a child depends on W-sitting it can inhibit or delay them from developing the movement patterns, balance and coordination needed for higher level skills like walking, kicking, running, and skipping. They may also develop poor standing posture and gait abnormalities.

W-sitting can cause hip dislocation, especially if a child has hip dysplasia (a condition of instability, or looseness between the head of the femur and the acetabulum of the pelvis).

Children frequently move backward into a W-sitting position when they are crawling, as it is easier for them to move in and out of sitting and quadruped (all fours), requiring less energy and effort than rotating to one side or turning to sit with legs out front (long sitting).

Very little trunk rotation occurs when a child W-sits.  They are less likely to cross midline and tend instead to manipulate objects on their left side with their left hand and toys on their right side with their right hand.  This can cause delays in developing a hand preference and could lead to future coordination problems.  Additionally, because of the limited amount of trunk rotation allowed in W-sitting, children don’t practice and learn to weight shift diagonally and develop the ability to transition smoothly in and out of positions like sitting and quadruped (all fours) with good rotation.

Other sitting positions to encourage:

Long sitting:   sitting with legs straight out front

Side sitting:  both legs are to one side of the buttocks

Heel sitting:   buttocks rest on the heels (can also be referred to as low kneeling)

Crossed Legs:  legs are crossed over each other in front (also referred to as Taylor sitting, Indian style, or “criss-cross applesauce”)

Cue Your Child:

Children who W-sit find this position very comfortable and stable.  You will need to work with your child to change this pattern.  When you see them W-sitting, give them a positive command like, “Pretty Legs” or “Fix Your Legs”.  (You might want to try something even more meaningful to your individual child, like, “Princess Legs” or “Rocket Ship Legs”) If your child goes to a day care or school, you will want to communicate with the teachers or care providers so that everyone working with your child will be discouraging W-sitting and using the same cues.

Be Consistent!  W-sitting is a habit that needs to be eliminated for the good health of your child. 

Blog Administrator:  Trisha Roberts

proeducationaltoys@gmail.com

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Sensory Toys

By Trisha Roberts

Sensory Toys, as their name implies, stimulate the senses. Young infants love toys with lights, music and sounds.  Toys that move, like mobiles and suspended toys, encourage ocular movement and improve vision. Toys with textured surfaces and varied shapes teach children about the world around them.

Squishy Nemo is an Example of a Great Tactile Manipulative for Children Craving Sensory Stimulation

All toys are stimulating in one way or another, but Sensory Toys as a category have come to refer to a set of toys that are more therapeutic in nature. Children with Sensory Processing Disorders (SPD) frequently need specific stimulation in order to calm themselves.  Tactile Toys like our Squishy Nemo or Squishy Stretchable Hulk can help a child de-stress when learning a new skill.  (Remember using a Stress Ball?)

   

                                                                   

Occupational Therapists will often prescribe a “Sensory Diet” for children with Autism or Pervasive Developmental Disorder (PDD) that may include textured toys along with a variety of exercises and activities.  ***See our 4-Part Blog Series on SensoryProcessing Disorder*** The use of tactile toys can be a positive, helpful support in the classroom, allowing children to attend and focus on instructions and learning.

Sensory toys can provide the particular sensory input that many children with autism crave.

Some sensory toys are also excellent fidget toys that can improve focus, concentration, and attention to task in children with ADHD and others who need to keep their hands busy in order to listen and attend.

This week we feature our Sensory-Tactile Toy Packageconsisting of 7 different toys that your child with autism or ADHD may find engaging and calming. These can be helpful for sensory cravers and those with sensory challenges.

Blog Administrator:  Trisha Roberts

proeducationaltoys@gmail.com

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Apraxia—What is It? How Can I Get Help for my Child? Part II By Trisha Roberts

Two weeks ago we presented basic information about apraxia.  This week we continue with more specific information regarding symptoms, seeking an evaluation, and getting treatment. These problems are usually seen in early childhood.  Consider some of the common problems with Motor Apraxia and Speech Apraxia.

Symptoms of Motor Apraxia May Include:

• Your baby may be slow to reach their milestones like rolling, sitting, or crawling
• Walking with a wide base of support (after age 2)
• Failure to develop a heel-toe gait pattern—a child who continues to take short steps with a flat foot
• Doesn’t like to play with puzzles, Legos, or other construction-type toys

• A messy eater (remember that all young children take time to learn the art of controlling a fork and spoon!)
• Inability to run in a smooth, coordinated fashion
• Inability to jump, gallop, or skip
• Clumsiness
• May have trouble with dressing and fasteners like zippers and buttons

• Has difficulty gripping a crayon or using scissors
• Difficulty riding a tricycle
• A child that appears clumsy, even though their muscles are not weak
• Difficulty learning new motor tasks
• May not be potty-trained by age 3
• Difficulty throwing a ball
• May take a long time to develop a hand preference—right or left

Symptoms of Speech Apraxia according to WebMD:

• Difficulty stringing syllables together in the appropriate order to make words, or inability to do so
• Minimal babbling during infancy
• Your baby may have difficulty eating
• Difficulty saying long or complex words
• May not be able to talk by age 3
• Repeated attempts at pronunciation of words

• Speech inconsistencies, such as being able to say a sound or word properly at certain times but not others
• Incorrect inflections or stresses on certain sounds or words
• Excessive use of nonverbal forms of communication
• Distorting of vowel sounds
• Omitting consonants at the beginnings and ends of words
• Seeming to grope or struggle to make words

Childhood apraxia of speech rarely occurs alone. It is often accompanied by other language or cognitive deficits, which may cause:

• Limited vocabulary
• Grammatical problems
• Problems with coordination and fine motor skills
• Difficulties chewing and swallowing

In a recent study, “How Valid Is the Checklist for Autism Spectrum Disorder When a Child Has Apraxia of Speech?” in the Journal of Developmental & Behavioral Pediatrics, the investigating team concluded that there was a high correlation between children with Autism and children with Apraxia of Speech.  Their recommendation was to monitor all children on the Autism Spectrum for problems with apraxia and to monitor or screen all children with Speech Apraxia for signs of Autism. Seeking professional help for diagnosing and treating your child is a wise move. The earlier children are diagnosed, the soon treatment can begin.  Accessing resources early can lead to better outcomes.  Physical Therapy, Occupational Therapy, and Speech Therapy are recommended services for children diagnosed with apraxia.  In fact, these therapists are the ones who usually make the diagnoses.

 

Apraxia can affect some children mildly or be more severe. If your child is exhibiting several of these symptoms, you should seek a professional evaluation.

A Speech and Language Pathologist (SLP or Speech Therapist) will be able to evaluate your child to see if they are exhibiting a Speech Apraxia.

 A Physical Therapist should be engaged to determine if your child has a Motor Apraxia; if there are more concerns regarding Fine Motor skills like hand writing, cutting, and dressing, an Occupational Therapist should be your first choice.  Children don’t outgrow apraxia, but they can be taught strategies for dealing with the symptoms.  Children with dyspraxia may improve their muscle tone and coordination over time with support and treatment.

Blog Administrator:  Trisha Roberts

proeducationaltoys@gmail.com

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Apraxia—What is It? How Can I Get Help for my Child? Part I By Trisha Roberts

Apraxia is a neurological motor disorder that affects a person’s ability to plan and execute a motor movement, even though their muscles are normal.  The posterior parietal cortex of the brain is responsible for assisting a person in motor planning and the completion of a motor task with good control.  If this area of the brain does not develop normally or is damage, it can cause a disruption of the messages from the brain to the muscles, resulting in an inability to perform the task requested. It doesn’t mean that your child has low intelligence or muscle weakness, but a “disconnect”,  if you will, between the synchronization of the brain and muscles.

A mild form of apraxia can also be called dyspraxia. Other names for apraxia include developmental coordination disorder, motor planning difficulty, or motor learning difficulty. Some professionals may use terms like:

• Ideomotor dyspraxia: Makes it hard to complete single-step motor tasks such as combing hair and waving goodbye.
• Ideational dyspraxia: Makes it more difficult to perform a sequence of movements, like brushing teeth or making a bed.
• Oromotor dyspraxia, also called verbal apraxia or apraxia of speech: Makes it difficult to coordinate muscle movements needed to pronounce words. Kids with dyspraxia may have speech that is slurred and difficult to understand because they’re unable to enunciate.
• Constructional dyspraxia: Makes it harder to understand spatial relationships. Kids with this type of dyspraxia may have difficulty copying geometric drawings or using building blocks. (Understanding Apraxia by Erica Patino)

  Apraxia may be seen at birth or acquired later in life.  In a young child the symptoms of ataxia become apparent as the child develops and grows.  Acquired apraxia is the term given to an apraxia that develops in a person who was previously able to perform the motor task. Some of the more common causes of acquired apraxia are traumatic brain injury, brain tumor, stroke, or a degenerative disease of the nervous system.

A child with a speech apraxia has difficulty saying words or making sounds correctly because they cannot move their tongue or lips to the correct position; their speech may be slurred or difficult to understand.  In another form of motor apraxia affecting the extremities (arms and leg), a child may have difficulty figuring out how to move through an obstacle course, how to hold and manipulate a pencil, how to put on and button a shirt, etc.

Next week we will feature Part II of “Apraxia—What is It? How Can I Get Help for my Child?”

Blog Administrator:  Trisha Roberts

proeducationaltoys@gmail.com

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Digital Addiction (Part 2) By Trisha Roberts

Last week we discussed what Digital Addiction is and how pervasive screen usage has become. Research and anecdotal information is showing that early exposure to this form of stimulation can be more detrimental than helpful.

Let’s be honest.  After a long day at work, it is much easier to hand a child an IPad than engage them in a family activity.  A video game is often cheaper than a babysitter.  Planning creative play takes time.  It is easy to rationalize with, “It’s educational”, so it must be good.  Many parents struggle with staying off their devices themselves and feel guilty denying their children when they are frequently distracted by technology. 

There seems to be an urgent desire or need to "check in" with our social media. Fear of Missing Out (FOMO) is a new term that has surfaced to describe this.  Wikipedia defines it as,  "a pervasive apprehension that others might be having rewarding experiences from which one is absent".  This social angst is characterized by "a desire to stay continually connected with what others are doing"."  The problem with this type of behavior is that a person is no longer actively participating in life!  Instead of focusing on their present situation with all of its potential pleasure and enjoyment, they are worried about what others might be experiencing without them! We become "glued" to our screens!

From a Physical Therapist’s point of view, frequent use of electronic devices is very unhealthy.  First of all, children are being encouraged to participate in sedentary activities rather than the activities that lead to better strength, balance, and motor control needed for a lifetime of good health. Kids are at risk for “repetitive use” injuries to their fingers, wrists, and hands.

Healthy development involves imaginative play, creativity, social interaction, engagement with nature. Children need to develop healthy relationships with parents, peers, and siblings. Conversation doesn't develop when looking at a screen--it develops with time spent one-on-one, face-to-face!

Recommendations: 

• Keep your children from getting addicted in the first place! 
• Don’t buy a tablet for your child until they are at least 10 years old. Remember, you are the parent and you hold the purse strings!!  (You would not buy a 6 year old a Corvette just because they pleaded for one--they are not old enough to reach the pedals nor responsible enough to drive!)
• Limit screen time to 15 minutes per day for younger children and adjust for older children
• Sit and play and educational game WITH your children then turn the screen off and put it away.
• Tie Internet use to completion of homework or chores.
• When you have a quiet moment, write out a list of fun, active things to do.  Put them on slips of paper and put them in a jar.  Let kids pick a slip every day and do the corresponding activity.  (This could be very helpful when you are arriving home from work and trying to get supper on the table!)
• Try a "Token" System:  Issue a set number of tokens that correspond to minutes of Internet use per week. Add additional minutes for stellar behavior or let children earn more minutes by completing additional chores.  Take away minutes for poor behavior or uncompleted homework/chores.
• Discuss with your children why you are limiting their access to electronic devices.
• Play a card game, board game or puzzle inside, take a walk outside, or kick a ball around.
• Don’t buy a smart phone until your child is a teenager.  (If they need a phone to stay in touch with parents, arrange after-school activities, etc., consider a “non-smart” phone with the ability to make a phone call and nothing else!)
• Place computers in public areas of the house rather than in children’s bedrooms.
• Require that all devices be placed outside of bedroom doors at a set hour of the night.
• Set a timer on the modem to limit Internet access to given hours of the day/night.
• Eat meals without any devices, including television.  Concentrate on conversation! Read our article on, "Making Meal Time Great!".

If you suspect that your child is already "addicted", contact your pediatrician and plan a course of action!  

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Digital Addiction (Part 1) By Trisha Roberts

What is Digital Addiction?  Why are we seeing more and more problems of this type? Should we be concerned?  What can we do to reduce the risks?

Digital addiction is the preoccupation with and compulsive participation in online activities that can include issues with video games, smart phones, and social media, such as Facebook, Twitter, Snap Chat, Instagram, Imgur, Reddit, etc.

There are many parallels between excessive digital-age technology use and the “classic” addiction to drugs, gambling, and alcohol.   Studies indicate that people with these types of addictions experience increased levels of “feel good” chemicals in the brain. (The four main chemicals being serotonin, endorphin, oxytocin, and dopamine).  As these chemicals are released, there is a “high” or feeling of euphoria and a desire to repeat the experience.  In a true addiction, the brain becomes dependent on these artificially boosted levels to maintain normal function.  Similar brain changes have been observed in Internet addicts, leading to increased dopamine in the brain and boosted blood flow to reward and pleasure centers in the brain. The hyper-arousing technology raises the level of dopamine leading some experts to call screens “digital heroin” or “electronic cocaine”.

Behaviors that are typical with Digital Addiction include:

• Preoccupation with being online or playing a video game. 
• Compulsion to engage in the activity.
• Inability to curb or control the action. 
• Poor attention span when children aren’t receiving the high-level stimulation provided by devices.
• Frequent hiding or lying about the amount of time spent in the digital activity.
• Agitation or anxiety when not engaging in the behavior.
• Psychotic-like stupor exhibited during activity.

• Loss of touch with reality when gaming—living in a digital “fantasy world”
• Boredom, apathy, depression, or lack of interest when not “connected” to the screen.
• Interference with day-to-day life.
• Losing interest in sports, reading, hobbies, etc.
• Aggressive behaviors when devices are removed from use.

Screens are ubiquitous! They are an integral part of our 21^st Century and digital use is on the increase, as is Digital Addiction.

Quoting from the article, “Digital Addiction:  This is Your Brain Online” posted by Promises.com on September 26, 2015:

“An American study focusing on gaming addiction found that among kids between the ages of 8 and 18, around 8 percent could be classified as addicted. Other research from the U.S. and Europe has suggested that rates of Internet addiction range from 1.5 to 8.2 percent (although estimates vary due to unclear definitions). In some parts of Asia, the rate may be as high as 26 percent, and China has identified Internet addiction as one of its main public health risks.”

Many parents think that they are doing their children a great service by getting a “jump start” on technology for their children by starting them early on electronic devices. Schools are starting children in younger grades on technology--from computer screens to tablets. There seems to be an epidemic of this type of addiction be it to video games, the Internet, smart phones, or social media. Many children are playing with tablets before they are talking!  

Watch a group of teenagers or even younger children--very rarely are they talking together or playing a game.  More often they can be found clumped together, each one attached to an electronic device! Children are getting less and less exercise and are developing 'over-use' injuries to fingers, hands, and wrists.

 Dr. Nicholas Kardaras in the New York Post sited on August 27, 2016 states,

 “According to a 2013 Policy Statement by the American Academy of Pediatrics, 8- to 10 year olds spend 8 hours a day with various digital media while teenagers spend 11 hours in front of screens. One in three kids are using tablets or smartphones before they can talk. Meanwhile, the handbook of “Internet Addiction” by Dr. Kimberly Young states that 18 percent of college-age internet users in the U.S. suffer from tech addiction.”

This is HUGE!  And it is a problem that is not going away soon!

We will continue next week with Digital Addiction Part 2 and discuss how parents, teachers, and care providers can intervene to decrease the use of addicting technology.

www.proeducationaltoys.com

Copyright © 2017 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.