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Friday, May 27, 2016

Pediatric Physical Therapy--What Should I Expect? by Trisha Roberts

So your child needs Physical Therapy—what now?  How can you make the most of your therapy sessions?  What should you expect from therapy?  How can you apply the things you’ve learned?  This will give you a general idea of what Physical Therapy might look like for you and your child.

Most, but not all, Pediatric Physical Therapists are women, so I will refer to the therapist in this article as “she”.  (Please forgive me, all you wonderful male therapists out there!)  Your therapist will probably become your best friend and ally in regards to your child and their problems.  She will listen to your issues, trials, and complaints.  She will understand, like many others don’t, because she is going through this with you and has experienced similar problems with other children and families! She will provide advice and suggestions—from the type of shoes to wear, ways to position your baby in his crib, toys to stimulate growth and development, ways to play that will exercise the muscles that are weak, etc.

PT and child playing in Therapy Gym
Physical Therapy for Children

Your Physical Therapist will ask you lots of questions at your first session, so try to go prepared. Don’t be offended.  This is information that can be helpful to understanding your child and their problem. She might ask questions like:  What was your pregnancy and delivery like?  How long did your baby stay in the hospital?  Does your child have any specific diagnoses?  What specialist does your little one see?  When did she roll over?  When did he sit alone for the first time?  When did she take her first steps? What are his favorite toys?  What makes your child happy?  What makes your child sad, frustrated, angry? What do YOU feel are your child’s strengths?  What are your biggest concerns? Discuss your concerns, questions, and expectations. 

Using a Large Therapy Ball
Physical Therapists Love Using Large Therapy Balls

Your therapist will perform an Initial Assessment to determine your child’s strengths and limitations. She might use standardized testing (tests that are administered and scored in a consistent manner, which makes it possible to compare the relative performance of individual against the “standard” performance of another individual of the same chronological age). Depending on the primary problem with which your child presents, she may do a muscle test, a balance test, or measure the range of motion (ROM) in your child’s joints.
Walking up an incline in Physical Therapy Session
Practice Walking on Uneven Surfaces

The therapist will inform you of the results of the testing and let you know whether therapy is indicated for your child.  She will specify the frequency (times per week or month), duration (how long each session will run), and possibly the length of time that therapy might continue (weeks or months).  Some therapy is Clinic-based, meaning that you will need to take your children to the clinic or hospital for their therapy sessions. Other Programs, especially for young children, provide Home-based therapy, where the therapist visits the home of the child or the child’s daycare provider and the sessions occur in those familiar surroundings. She will set goals for your child based on the results of the testing and will have activities and exercises planned that will help your child accomplish those goals.

Strengthening Exercises for Children
Fun Activities to Improve Srength
Therapy with babies and children is usually in the form of play.  It is very specific play that will help your child move in new ways, gain strength, develop new skills, and advance toward their goals.                  
Fun in Physical Therapy
Physical Therapy Should be Fun!

Who visits, babysits, interacts, or plays with your child?  You might want to invite them (after getting permission from your attending therapist) to accompany you to a session or, if you are having Physical Therapy in your home, invite them to a Physical Therapy session at your house.  They can see firsthand what your child is working on and what activities they can do with your child to help improve the carry-over of those skills. 

Child learning to jump hurdles in Physical Therapy Session
Your PT Will Help Your Child Learn New Skills
Your therapist will make a written record every time you have a visit together; she will note things that you worked on together and the progress that your child has made toward their goals.  She will also perform periodic re-assessments as your therapy progresses.  You should be provided with a Home Exercise Program (HEP) that will outline things that you can do at home that will help your child make progress toward their goals.

Learning to Balance using the Rocker Board in Physical Therapy
Improving Balance

Should you be present in the session?  Usually the first session is conducted with the parent (s) present because you will be providing information to the therapist and your child will probably be somewhat shy on initially meeting a new person. Some children perform better when their parents are not present.  Other children enjoy having their parents accompany them to their sessions.  Work with your therapist to determine the best course of action.  If you are not present during the actual work session, make sure that you allow time at the end of the session to discuss with your therapist how the session went and what you should be working on before your next scheduled visit.

Remember, you are a vital part of the team and of the entire therapy process.  You have the responsibility for your child 24/7.  Make the most of your parenting time!  Your therapist is a valuable resource, so get as much information from her as you can so that you can apply what you’ve learned and help your child advance between sessions.

by Trisha Roberts, Early Intervention Physical Therapist

Copyright © 2016 TNT Inspired Enterprise, LLC, All rights reserved.
Unauthorized duplication is a violation of applicable laws.

Tuesday, May 24, 2016

Interview of Trisha Roberts by Baby Dot Dot


by Baby Dot Dot

About Pro Educational Toys

Pro Educational Toys was developed to help parents, care providers, therapists, Day Cares, Nurseries, and schools find quality products for children of all ages.  Trisha Roberts, the founder, is a Physical Therapist and Early Intervention Specialist with decades of experience working with children.  Toys should be fun and educational at the same time.  We want to make available toys that will stimulate growth and development. Play with a Purpose is our motto!


BabyDotDot: Tell us about yourself.

Some of the Hats that I wear and Titles I hold are: Crazy Cat Lady, Lover of all Things Furry, Wife, Nana, Physical Therapist, Daughter of The King, Ham-Bunny (a cross between the Energizer Bunny and Hammy the Squirrel from the movie Other Side of the Hedge), Writer of Crazy Kid Songs, Hoarder of Chocolate, Rehabilitator of Wildlife, Dollar Tree Shopper Extraordinaire, Cinderella, Chief List Maker, The Travel Queen, Master Hummer, Award-winning Suitcase Packer, Spontaneous Performer, and Remarkable Collector of Collections (Hot Sauces, Walking Sticks/Canes, Books made out of Paper from unusual plants, Hummingbirds, Musical Instruments from around the world, woven baskets, Stamps).
My specialty and great love is Pediatric Physical Therapy. I am an Early Intervention Specialist, focusing on the treatment of children birth to three years old.  I have many years of experience working with children of all ages with special needs nationally and internationally. I am skilled in neuro-developmental techniques (NDT), myofascial release, sensory integration, taping for neuro-developmental problems, and craniosacral therapy. I am fluent in Spanish, having lived and worked in Latin American for 15 years.
My goal is to maximize the potential of each child in my care. I am extremely creative in using toys and activities to motivate children to move and develop. I created a video featuring activities and games using everyday items in the home or purchased inexpensively at the Dollar Tree Store.
I work to empower parents and care providers with the skills they need to see their children advance. I understand the struggles of parenting a child with special needs; my adopted son has ADD, learning difficulties and an auditory processing disorder.


BabyDotDot: What was your inspiration behind Pro Educational Toys?

I have discovered the world of “Blogging”  and recently started an online retail store called Pro Educational Toys with the goal of providing parents, therapists, daycare providers and others quality toys and products to stimulate the growth and development of children through play. Pro Educational Toys was birthed out of a desire to see families choose great toys, games and activities for their children and to promote active and interactive play.
I have seen the rise and reign of technology in my lifetime.  And while it is wonderful, it is also overwhelming. Electronic devices allow us access to information instantaneously that previously took hours of research—I love that!  But addiction to gaming and other electronic entertainment has numbed our society and retarded our development.
We no longer communicate well face-to-face. We lack imagination—we’re never bored for more than 5 seconds—we just whip out the smartphone or tablet and get instant entertainment and gratification.
I want therapists, parents, grandparents, day cares and preschools to see play as a critical part of each child’s development and to select toys that will stimulate the imagination and cultivate a love for learning. My website and blog were created and designed to educate the community about toys and how to use them to stimulate growth and development in children.
I discuss children, parenting, children with special needs, developmental stages, and play activities. Toys should be fun and educational at the same time. I want to make available toys that will stimulate growth and development. Play with a Purpose is our motto!


BabyDotDot: What products do you love to promote?

I have put together sets of items and props for Pretend Play for boys and girls. Pretend Play is important on so many levels; give children a few props or costumes and they will imagine, create and play for hours!
I love to travel, and I know that traveling with children can be challenging. I have also prepared packages of toys for girls and boys that are pre-wrapped and ready for the hectic parent to throw into the car. Each Travel Toys Surprise Package contains 8 items that can be unwrapped at intervals and played within a vehicle, making the trip more exciting and stimulating learning at the same time.


BabyDotDot: What inspires you on a daily basis?

I am inspired each day as I read and meditate on the Bible. I attempt to take a “kernel of truth” and apply it to my life daily. Looking at the intricate, minute details of a cell, or gazing into the immense expanses of our universe, I can’t help but be awed by God’s creation.


BabyDotDot: What are you most proud of?

I am extremely proud of my children. They have finally “launched”! They have left the nest and are now fulfilling God’s plan for their lives. They are wonderful, unique human beings that have grown from delightful children to charming, remarkable adults!


BabyDotDot: What makes you cry?

A broken, mutilated piece of chocolate—I really like a whole, uncirculated bar of chocolate in excellent condition! Coming to the end of a good book series and saying goodbye to my fictional friends whose lives and adventures I’ve shared.  Seeing children and animals abused. Apathetic or overwhelmed parents.


BabyDotDot: What do you love?

A Foot Massage can make me melt! Chocolate makes me drool! My husband and children bring me great delight. Jesus Christ fills me with Joy.

BabyDotDot: What unique talents do you think you have?

Give me 60 seconds and I can make up a song and burst into a performance. Tie my hands and I can’t talk!

BabyDotDot: What makes you laugh?

I hold onto several funny memories that are guaranteed to bring a smile to my face and a chuckle to my throat. One of my favorites is a time that I was able to “surprise” my husband. He loves to play practical jokes and harass me. One evening I was given the perfect chance to retaliate. Before retiring early, I coiled up a very life-like snake and placed it on his side of the bed. The look on his face when he pulled back the covers that night would have won an award! It makes me laugh hysterically every time I recall his shock and momentary fright.

BabyDotDot: What matters to you?

Knowing that God loves the people He created and that he wants a relationship with each of us. Valuing each of God’s creatures, especially the young. I liken Kids to Bubbles. They are beautiful, fragile, multi-faceted, fun, engaging, mesmerizing, and ephemeral. We have but a brief moment to enjoy them before they vanish. How I wish each parent would treasure every moment with their children. When our lives are finished and we draw our last breath, it will not matter what occupation we had, what degree or title follows our name, what the bottom line registers, how clean our house is, or what possessions we have in our garage. What matters most is how we lived our Life and loved our Loves. Fill your thoughts and schedule with the most important things and minimize the prominence of the urgent and unimportant—learn to discern which is which!
BabyDotDot Bio

This interview was done by BabyDotDot with Trisha Roberts. BabyDotDot – a blog that writes all about pregnancy, parenting, nursery and baby information. At BabyDotDot, you can find guides and tips as well as best baby and mother product reviews and more. Visit BabyDotDot for more awesome reading.

Copyright © 2016 TNT Inspired Enterprise, LLC, All rights reserved.
Unauthorized duplication is a violation of applicable laws.

Monday, May 23, 2016

"I Don't Want to Break Her!" A Survival Guide for New Dads by Trisha Roberts

New parents are priceless!  When a Mom or Dad looks at their newborn for the first time, there is wonder and awe.  But if you look closely at Dad, there is an underlying PANIC when that newborn bundle is placed in his arms for the first time.  “I don’t want to break her! I don’t know what to do!  How do I soothe him?  How do I play with her—she can’t hold a football yet!”
This is for all of the new fathers out there.  My Survival Guide or SOS Manual for helping Dads bond with their children and overcome their overwhelming fear of the unknown.

My SOS acronym:

S is for Slow.   Move slowly so as not to startle your little one.  Talk quietly and lovingly with your face 6-8 inches from your baby’s face, as this is the distance that infants can see most clearly.

O is for Often and Observant.  Hold and talk to your baby frequently.  She will get used to seeing and hearing you and will look forward to your times together.  Be observant—learn what his little frown means, when she is squirmy she might want to change position, when you feel rumblings in his belly he might be ready to ‘let loose’!

S is for Soft and Secure.  Hold your baby securely so that she doesn’t feel like she is falling.  Use a soft touch to stroke her skin, roll her over, or pick her up.

There are many ways to hold your newborn.  You want to make sure that his head is kept in line with his trunk whether he is vertical or horizontal, because a little baby does not yet have the control and strength to hold their head upright.  You might want to lay your baby over your forearm and hold her next to your chest.

Father holding Baby on Forearms
Position Baby so You can Talk Face-to-Face
You can sit with your legs bent on the sofa and put her in the cradle of your thighs so that you face
 one another and her back is supported by your legs.

Position Baby on thighs
Play Peek-a-Boo Games

You can recline in bed or a favorite chair and put your little Prince on his tummy across your chest.  Tummy Time is extremely important so that babies will develop head and trunk control in preparation for crawling and other activities. Babies will enjoy the contact of their skin on yours, if you place them on their tummy across your thighs. 

Skin on Skin, Baby on Dad's Chest
Babies Love Skin on Skin Contact!

Activities to try with your baby include singing and talking.  If you know a children’s song or nursery rhyme, great.  If not, sing whatever song you like and gently sway with the rhythm of the music while holding your baby securely.  Or get a great musical toy and sing along! Your baby will love hearing your voice—talk to her about your day, what your dreams for her are, why you named him what you did, stories from your youth….whatever!  The important thing is to talk with her! 

Play Peek-a-Boo, Pat-a-Cake, and other hand motion games and songs.

Take your baby on a “Tour” of the house or yard (in nice weather!)  Show him different items in the house and tell him about them.  Take her hand and let her feel the texture of the bark on a tree, the fabric on the couch, the cool glass of the window.  Describe the things you see, hear, and feel.

Get yourself and baby in a comfortable position and gently stroke her leg, arm, or back.  Use slow, rhythmical motions with gentle pressure.  Watch his face and body for signs that he is enjoying the massage or when he has had enough.

Dad Stroking Baby's skin
Babies Usually Enjoy Gentle Massage and Stroking of Their Skin
As you spend time with your young child, you will develop confidence and experience.  Continue to play with your child as they grow.  Cuddle, chat, discuss, laugh.  Carve out time each day to be exclusively with them. Playing with children is extremely important.  Having a one-on-one time with no distractions is important for building levels of self-esteem, confidence, and communication. 

Significant touch is very important and needed for emotional growth. (Harlow, a psychologist who did research in the 1950’s and 1960’s, studied behavior in monkeys and showed the importance of feeling love, affection and acceptance from a caregiver and the importance of touch.) 

Set up special routines together with your child.  They might include:  back rubs, foot rubs, songs, special meal made together every Friday, dance parties, breakfast out together, or taking a silly selfie once a week.

Remember—every new skill takes time and patience.  Your baby is worth getting to know!  Make your time together count!  Make memories that will last a lifetime! You CAN do this!

Father and Baby Bonding

Author:  Trisha Roberts

Copyright © 2016 TNT Inspired Enterprise, LLC, All rights reserved.

Unauthorized duplication is a violation of applicable laws.

Saturday, May 14, 2016

Toe Walking Treatment by Trisha Roberts

Twinkle Toes The Toe Walker
My Baby Walks on Their Toes—What Can I Do?
 by Trisha Roberts

Do you have a little “Twinkle Toes” that Walks on their Tip Toes? Then this article is for you! 

Tippy Toes
Beautiful If You Are a Ballerina, But.......

It is important to understand normal ambulation to better understand the problems associated with Toe Walking. Children usually begin walking around the celebration of their first Birthday. The beginning walking pattern for a child is typically with their feet flat, legs open (wide base of support) and hands in the air for balance like a mini Tight Rope Walker (Hands at High Guard).  Over the next several months the Beginning Walker should develop a more mature gait pattern that consists of three phases:  Heel Strike or Contact Phase, Foot Flat or Mid-Stance, and Push-Off or Propulsion Phase. The heel of each foot should strike the floor first, followed by a foot-flat stance position as the child moves forward and places their weight on the foot, and then pushing off on the toes as the child propels themselves forward. 
Gait Phases Explained
Phases of Gait

 As this walking pattern develops the child will also start to swing their arms reciprocally with their legs, or in other words, the right arm and left leg move forward and alternate with the left arm and right leg, enabling them to perform a fast walk. By 18 months of age, or after a child has been walking for 6 months, they should consistently be striking the ground with their heels when walking. Children will sometimes rise up on their toes, but this should not be their primary position in standing or when moving.

Children generally develop the ability to walk on tip toes at about 3 years old, but they should always be able to get their feet flat on the floor at any age and should never be using Tip Toe walking as their primary method of locomotion. The philosophy that “they will grow out of it” is not a good philosophy to adopt. 

Standing on Tip Toes Consistently
Walking Consistently on Tip Toes is NOT Typical

In my work as a clinician, I am frequently asked to treat children who have been toe walking for months, and in some cases, years.  It is extremely difficult to undo years of toe walking, especially if the muscles and bony structures of the feet and ankles are tight or contractured. Toe Walking changes the child’s entire body—posture,  balance, bio-mechanics (how a child uses their body to move), and strength.

Walking consistently on tip toes can be an indication of a more serious problem and should be discussed with your Pediatrician. Toe walking can be caused by Cerebral Palsy, high muscle tone, or weakness.  It is frequently associated with Autism or sensory issues (children who have increased or decreased tolerance to sensation). Sometimes there is not a specific cause for the toe walking and it is referred to as Idiopathic Toe Walking or ITW.  Most physicians will refer your young child to an Early Intervention Specialist—A Physical Therapist that specializes in working with children birth to three years old.  Your Physical Therapist will have lots of ideas, activities, massage, and exercises for you to work on with your child.  It is vitally important that you follow your therapist’s treatment plan. Exercise and braces (night time and/or day time use) are typically the “First Line of Attack” when addressing issues surrounding Toe Walking. In severe cases or in cases of Toe Walking that have not responded to exercise and bracing, other, more aggressive treatment options might be considered that may consist of Serial Casting, Botox Treatment, or surgical procedures to lengthen tight/shortened muscles and tendons.

The following are activities that I use in my Physical Therapy practice that I find fun and effective:

  • Have your child stand on a Wedge or Incline while playing at the refrigerator, mirror, or wall. 

Standing on an Incline
Standing on an Incline Promotes Heels Down

With their feet in an “uphill” position, their heels are in a better position to weight bear.  You might try using a re-positionable marker board or other toy to encourage play in this position.

  • Have your child sit on a Scooterboard and propel themselves forward using their heels. 

Scooter Board Encourages use of Dorsiflexors
Scooter Board Encourages Heels Down and Feet Up Position

This activates and strengthens the Dorsiflexors of the foot (muscles responsible for lifting the foot).  Using the feet in this position counters the Plantarflexors (muscles responsible for pointing the foot down) and are the muscles that get tightened in Toe Walkers.

  • Pedaling a Tricycle can also be useful in getting a child to use the foot with their heel down and in a flattened position. Most children by 2 or 2 1/2 years old can ride a small tricycle. Younger children can benefit from a Ride On Toy that they propel "Flintstone-Style".

Folding Tricycle for Decreasing Toe Walking
Feet Flat on a Tricycle

Make sure that your Toe Walker has their feet flat on the pedals.  If they are trying to cycle using just their toes, you can try using an Ace Wrap to secure their feet to the pedals in a flattened position or even using a large sock placed over the pedal and the front of their shoe.

  • Play games that encourage your child to Walk Backward
    “Simon Says” take 10 steps backward. 

  • Do a dance that requires lots of heel stompin’! 

  • Take a walk at a park and look for Climbing Hills.  It is difficult to walk uphill using just your toes!

  • Kicking a ball is an action that requires standing on one leg and swinging through with the other leg.  

Practice Kicking Balls to improve Toe Walking
Balance on One Foot While Kicking a Ball
Foot Flat when Kicking a Ball
Kicking a Ball

It is very difficult to kick while standing on tip toe!

  • While your child is standing, lift one of their feet or tilt your child in standing so that they have to weight bear on a flat foot on the supporting leg.

Standing on 1 foot decreases toe walking
Lift One of Baby's Feet so that She has to Stand on a Flat Foot

Treatment for Toe Walking by Standing on 1 Foot
Standing on One Foot with Heel Down

  • Have your child sit on a small step stool with their feet flat on the floor during a play activity. 

 Place a puzzle or other game on the floor and have them lean forward to play with the game while making sure that their heels stay in contact with the floor. Have your child sit on the step stool and then ask them to stand up while you hold their feet flat on the floor.

  • The heels of our feet should make contact with the floor when we are in a Squat position.  

Decrease Toe Walking by Playing in Squat Position
Squatting in Play Gets Heels Down 

Toe Walking Decreased by Playing in Squat Position
Squat Position for Play

Reduce Toe Walking by Playing in Squat Position
Making Playing in Squat Position Fun

Scatter Blocks or Legos on the floor.  Have your child squat to pick up a block and walk (heels down!) over to the ‘Construction Zone’ and add to their architecture. Repeat until their tower is complete or they run out of blocks!

  • Get a pair of child-sized Swim Flippers

Use Swim Flippers to Improve Toe Walking
Walking in Swim Flippers

 Have your child walk with the flippers on their feet—impossible to walk on your toes!

  • Animal Walks

Everyone squat down and “Walk like a Duck”!  Make it a fun game—put out food for the ducks (crackers or other small snacks) in different places and have your child Duck Walk to each ‘feeding station’. 

Duck Walk to Decrease Toe Walking
Duck Walk

"Walk like a Crab"--feet flat, tummy toward the ceiling, and hands behind the back and on the floor.

Walk like a Crab to Improve Gait Pattern
Crab Walking

"Walk like a Bear"--feet flat on floor, hands on floor, bottom in the air. 

Walk Like a Bear
Bear Walk
Improve gait by Bear Walking
Feet and Hands Down--Bear Walk

Walking Like a Bear Exercise to Decrease Toe Walking
Improve Gait-- Bear Walk

"Walk like a Penguin"--toes up and waddle forward! 

Walk Like a Penguin
Toes Up and Walk Like a Penguin!

"Jump Like a Frog"--Squat down with feet flat and hands next to your body and then 'spring' forward like a frog, landing on flat feet again.

Frog Jumping Reduces Toe Walking
Jump Like a Frog!

Your therapist will have other suggestions, but this should get you started walking along the road with heels down!

Author:  Trisha Roberts

As always, we welcome any suggestions, questions, comments or concerns!

Copyright © 2016 TNT Inspired Enterprise, LLC, All rights reserved.
Unauthorized duplication is a violation of applicable laws.