Friday, April 29, 2011

Grant for Children with Disabilities

The CVS Caremark Grant is accepting application starting May 1, 2011. This grant provides support for children with disabilities.

"CVS Caremark Community Grants Program awards funds to nonprofit organizations for the following programs:

* Programs targeting children with disabilities
* Programs focusing on health and rehabilitation services
* Public schools promoting a greater level of inclusion in student activities
and extracurricular program
* Initiatives that give greater access to physical movement and play
* Organizations that provide uninsured individuals with needed care, in
particular programs where the care received is of higher quality and delivered
by providers who participate in accountable community health care programs"
If you are a pediatric therapist in a school based setting or other non profit organization this is definitely worth a look. They awarded 3.1 million dollars in 2010! Qualifying organizations are eligible for grants of up to $5,000. Go to CVS Caremark for more information and to apply.

Wednesday, April 27, 2011

Academics and Motor Skills in Children with LD

Some interesting research was published in the Journal of Learning Disabilities. The Movement Assessment Battery for Children (MABC) was performed on 137 children with learning disabilities (IQ>80). The following results were seen:
  • 52.6% scored below the 15th percentile on manual dexterity
  • 40.9% scored below the 15th percentile on ball skills
  • 33.7% scored below the 15th percentile on balance skills
In addition, when controlled for IQ the following small to moderate correlations were seen between:
  • spelling and math scores and overall MABC score
  • mathematics and balance scores
  • reading and ball skills
  • spelling and manual dexterity.
Reference: Pieter Jelle Vuijk, Esther Hartman,Remo Mombarg,Erik Scherder, and Chris Visscher Associations Between Academic and Motor Performance in a Heterogeneous Sample of Children With Learning Disabilities J Learn Disabil May/June 2011 44: 276-282, doi:10.1177/0022219410378446

Tuesday, April 26, 2011

Blog Carnival on Readiness

Therextras recently hosted a blog carnival on recognizing readiness (If you are not familiar with a blog carnical, it is when a topic is suggested and people submit blog posts on that topic).

First of all Therextras is a great blog to follow. The author is a pediatric OT and PT who offers excellent blog posts on neurology, functional skills and more. Make sure you read the comments where you will be directed to many more informative, first hand accounts from parents of children with disabilities. Why not start out by checking out all the submissions for Recognizing Readiness? Well worth the read.

Read my entry - Ready, Set, Go!

I also highly recommend that you read this winning post entitled Knowing When To Back Off. For children who will experience regression in skills this is a must read from a parent of a daughter with Rett Syndrome who has been there (not to mention her blog is awesome too - Adapting Creatively).

Monday, April 25, 2011

Assistive Technology and Test Scores

Assessment published research on the modification of tests using assistive technology. Sixty typically developing children ages 6-12 years old and 24 children with cerebral palsy were administered standard and modified versions of tests. The results indicated that the type of assistive technology used did not have a statistically significant effect on modified test scores. Quadrant forced-choice format tests had sufficient stability between standard and modified test versions. The researchers support the use of assistive technology and accessible procedures for some test instruments when assessing children with cerebral palsy.

This is important research to cite when we discuss modifying tests for children with cerebral palsy who use assistive technology. Teachers may need to take this into account when creating tests to even the playing field in the classroom.

Reference: Warschausky S, Van Tubbergen M, Asbell S, Kaufman J, Ayyangar R, Donders J. Modified Test Administration Using Assistive Technology : Preliminary Psychometric Findings Assessment. 2011 Apr 5. [Epub ahead of print]

Saturday, April 23, 2011

Children's Ability to Control a Mouse

Here is some important baseline research on children's ability to control a computer mouse. The journal Computers and Education published research comparing the ability to control a computer mouse at different age levels. The study looked at 221 Australian children between 5-10 years old. The results indicated the following:
  • speed and accuracy improved with age with the greatest improvements seen from 6-7 years old and 8-9 years old
  • performance plateaued between 9-10 years old
  • practice helped with speed and accuracy
  • smoothness of mouse use decreased with age
  • no significant difference between girls and boys
Reference: Orwin, Jessica. Practice more important than age in learning to use computer mouse. Retrieved from the web on 4/23/2011 from http://scienceblog.com/42805/practice-more-important-than-age-in-learning-to-use-computer-mouse/

Friday, April 22, 2011

Equine Therapy and Center of Pressure

The American Journal of Occupational Therapy published research on measuring the center of pressure (COP) during equine therapy. Using an electronic pressure mat, the study compared the center of pressure in 4 children without disabilities to 4 riders with cerebral palsy when riding. Significant differences were noted in anteroposterior range of COP motion, mediolateral range of COP motion, and mediolateral COP velocity. No significant difference was measured in anteroposterior COP velocity. The researchers concluded that measuring the center of pressure could be utilized as an indicator of core stability.

Reference: Clayton HM, Kaiser LJ, de Pue B, Kaiser L. Center-of-pressure movements during equine-assisted activities Am J Occup Ther. 2011 Mar-Apr;65(2):211-6.

Wednesday, April 20, 2011

Easter Egg Plinko Fun


I got the inspiration for this activity from a Twitpic on Twitter. Basically we used a cardboard box opened up with the sides up. A child worked on pulling apart all the plastic easter eggs. We glued them down pressing hard to adhere each one. We added three slots to catch the ball at the bottom. Our Easter Plinko game was ready to play. Prop the game up against a bench, drop the ball and see where it lands.

Writing Tips for Young Ones

The Center for Early Literacy Learning has published several hand out on scribbling and writing tips for young children, infants through preschool. Each tip sheet has some good ideas although encouraging a child to mark, scribble or write when they are not developmentally ready may not always be beneficial. It is my opinion that children should be exploring kinesthetic and multi-sensory play instead of "writing practice". What do you think about these tip sheets - too much too young or just right?

Especially for Infants with Disabilities - Mark My Word: Marking and Scribbling

Especially for Toddlers with Disabilities - All...Write: Scribbling and Drawing

Especially for Preschoolers with Disabilities - Write On: Drawing and Writing

Saturday, April 16, 2011

iPads and Job Security for OT's

After reading an article that some kindergarten classes in Maine, will be getting close to 300 iPads, I began to think about how this will effect the fine motor skill development of young children. And, how younger children's use of technology may provide an unfortunate sort of job security for pediatric occupational therapists. The rate of children receiving pediatric occupational therapy seems to rise year after year along with the amount of screen time for children. Check out these numbers:
1. Preschool children spend 32 hours per week with screen time (television and computer use) (1)
2. Forty percent of 3 month olds are regular viewers of screen time (1)
3. Nineteen percent of one year old's have a television in the bedroom (1)
4. Screen time for a toddler is associated with lower school achievement and decreased physical activity later in childhood (1)
5. Thanks to their parents, the average age a child gets a digital footprint is 6 months old (2)

A recent study from AVG indicated that more children are learning technology skills before life skills. Check out these numbers from a study of 2200 mothers of 2-5 year old children:
1. More kids can play with a smart phone than tie shoelaces (3)
2. More children can play a video game than ride a bicycle (3)
3. More children can open a web browser than swim unassisted (3)

What will this do to children with regards to the acquisition of motor skills and motor programs? If used in moderation, I am sure that the latest technology offers many learning opportunities for children. The key word is moderation. Considering the latest screen time statistics referenced above, moderation is obviously lacking already. Therefore, children's achievement of functional skills will most likely be delayed and some skills possibly eliminated all together. The arches of the hand can not develop properly by never picking up objects or manipulating items besides a computer mouse. Body awareness and motor planning are learned through movement. The tiny movement involed in the clicking of a mouse with the index finger does not offer any sort of motor practice or proprioceptive input. With the lack of three dimensions of computer technology, how will stereognosis develop? How will visual perceptual skills be effected? How will children develop the skills to button, zip, tie shoelaces and ride a bike? Unfortunately there's NOT an app for that! Correction there is an app for that...a referral for pediatric occupational therapy.

References:

1. Fact Sheet Kids and Screen. Commercial Free Childhood. Retrived on the web on 4/16/2011 from http://www.commercialfreechildhood.org/factsheets/screentime.pdf

2. AVG. Would You Want a Digitial Footprint Since Birth? Retrieved on the web on 4/16/2011 from http://jrsmith.blog.avg.com/2010/10/would-you-want-a-digital-footprint-from-birth.html

3. AVG. Forget Swimming and Riding a Bike - Young Children Today More Likely To Have Mastereed Computer Games. Retrieved from the web on 4/16/2011 from http://free.avg.com/ww-en/news.ndi-106

Thursday, April 14, 2011

Sensation Following Forearm Cast Removal

A recent study in the Journal of Orthopedic Science reports on the short-term after-effects of forearm cast removal in children. Thirty three children (mean age 10 years old) experienced a forearm fracture. Seventeen children were treated with an above elbow cast and 16 were treated with a below elbow cast. Following removal of the above elbow cast, all 17 of the children reported a short term sensation that the hand felt weak and they needed the contra-lateral hand to help support it. In comparison, only one child with the below elbow cast reported this sensation. The researchers recommend that the children and parents should be informed of this possibility before removal of the cast.

Reference: Kalman Katz, Daniel Weigl, Tal Becker, Joseph Attias and Elhanan Bar-On Short-term after-effect of forearm cast removal in children Journal of Orthopaedic Science DOI: 10.1007/s00776-011-0054-2

Wednesday, April 13, 2011

Ready, Set, Go!

After reading the request for a blog carnival over at Therextras regarding readiness in children, I pondered the topic a bit. What does make a child ready to achieve motor milestones? Many parents and therapists follow the typical developmental sequence of rolling, sitting, crawling, standing, walking and off they run. The theory is that if you build each skill upon the previous skill the child will move along the progression. The problem is the theory doesn't hold true. There are many more factors besides muscle development and control that play a role in achieving motor milestones.

Motivation: In order to move on to the next skill, a child needs to be motivated. This is clearly seen in typical development. For example, a 6 month old baby usually needs assistance to get into a sitting position. The baby is motivated to stay in the supported sitting position and works hard at maintaining an upright posture. The degrees of freedom available to the arms and hands increases significantly compared to the prone or supine position.

Socialization: A child may choose to attempt to try a new skill in order to experience a new social perspective. Sitting and standing change the eye contact of a child compared to supine or prone. A recent study indicated that independently walking infants spent significantly more time interacting with toys and mothers, made more vocalizations and directed gestures than age matched, crawling peers in a baby walker (1).

Novelty: Children have short attention spans. A change in position can result in a renewed attention span. The forces of gravity on the hands, postural muscles and legs change significantly based on different positions. Toys can take on new properties when the hands are freed up to play with them.

For example, I once worked with a 5 year old girl with quadriplegia. She required adult assistance to propel her manual wheelchair. She only tolerated a standing frame for short periods of time. We decided to try a mobile stander. Once in the mobile stander, the girl could actually propel herself around the room in standing. She not only tolerated standing now, she loved it. Her motivational level was increased. Her socialization increased once she could achieve level eye contact with her peers. The novelty of the mobile stander also added to her increased motivation.

In addition, I worked with a 7 year old boy with athetosis. He was unable to sit unsupported for longer than a few seconds but he could walk throughout the entire school without an assistive device. This boy's motivational drive to achieve independent walking was amazing.

Or how about a 5 year old boy who had the motivational drive to negotiate playground equipment to socialize with his peers but he was unable to walk long distances without his rolling walker. This boy taught me never to assume that a skill can not be achieved. He was able to climb ladders, walk across moving bridges and go down slides!

Therefore, the question arises should you wait to try the next motor skill in the developmental progression until the one before it has been mastered? Absolutely not! By using adaptive equipment or external support, children can benefit from the socialization and novelty factor of new skills. If the child recognizes these benefits, the internal motivation to continue to practice will help to drive the achievement of the new motor skill.

Reference:
1. Melissa W. Clearfield Learning to walk changes infants’ social interactions. Infant Behavior and Development Volume 34, Issue 1, February 2011, Pages 15-25

Posture Education

A recent study from the International Journal of Sports Medicine reports on postural education on daily habits in children. One hundred thirty seven children (average age 10.7 years) were randomly divided into an experimental group who received 6 sessions of postural education over the course of 6 weeks and a control group who did not receive any intervention. Following the 6 week intervention a sum score was established from the following: correct use of sofa, stooping correctly, take care to sit correctly at home/school and frequent posture change on chair at home/school The sum score was significantly increased in the experimental group following the 6 week session and at 3 months post test compared to the control group. The researchers suggest that postural education in children may help to prevent low back pain later in life.

Reference: J. Vidal, P. A. Borras, F. B. Ortega, J. Cantallops, X. Ponseti, P. Palou Effects of Postural Education on Daily Habits in Children Int J Sports Med 2011; 32(4): 303-308 DOI: 10.1055/s-0030-1270469

Tuesday, April 12, 2011

Design A Game



Here is a fun activity idea to play with children - Design A Game. Just gather up some various objects and let the child create a brand new game to play. You can view and/or print this helpful sample to get your creative juices flowing at Your Therapy Source.

If a child from the age of 6-12 years old, designs an outdoor game, try entering the CLIF Backyard Game Contest. All you have to do is enter your outdoor game idea. You may win a Trek bike, trip to NYC and a $10,000 scholarship! Good luck.

Monday, April 11, 2011

Two New Free Apps

Here are two, new free apps for a limited time that I found from FreeAppAlert.


The first one is Write&Say. This app will read aloud words and documents with natural voices. Therefore, you can type and then have it read aloud to you. It can also translate your text and read it aloud in different languages. This was lots of fun to test.














The other app which is free for just 7 days is iWhatIsThis. This is a fun, simple app to practice visual perceptual skills especially visual closure. Basically, you pick a picture or type in text, then the picture or word gets covered up comletely by different shapes that you choose. When you tap on the shape it disapears revealing a small part of the picture. By tapping on the shapes, little by little, the picture is revealed. When you think you know what it is you can press the light bulb to show the entire picture, letter or word. Lots of fun!

Sunday, April 10, 2011

Birdwatching

If you follow this blog you know I am always posting about the importance of children being active especially outdoors. For the first time on this past Friday night, we went birdwatching. Now, my first thoughts when we decided to sign up for a guided birdwatching walk were not too positive. I love the outdoors - but birdwatching sounds a bit dull. Much to my surprise, it was a unique, multisensory adventure. Since it was a guided tour, we started out with a brief PowerPoint of the species of bird we were looking for which happened to be the American Woodcock. To those unfamiliar with the bird world, this species does an amazing call and flight during mating season at dusk. I really enjoyed the brief presentation so we knew what to look and listen for on the hike.

So off we adventured, ages 7 months though about 70 years old on this guided hike. While we were hiking I realized how beneficial this was for the young children. Not only were we outdoors enjoying the fresh air and nature there was lots more to learn:
  • visual skills: keeping our eyes on the sky, we needed to be focused as to where the birds were spotted. This particular bird flies very high up into the sky out of sight and then spirals back to the ground at upwards of 30 mph. You had to keep watching to keep the bird in your sight. On one occasion the bird swooped directly over our heads. We tried using binoculars but the birds flew so fast that it was too hard to track their paths.
  • auditory skills: the guide taught us to cup our ears to be able to hear the birds better. We needed to fine tune our listening skills in order to determine if we were hearing the bird we were searching for or was it a different species.
  • self regulation: we all had to sit and wait quietly to not startle any of the birds. Since it was a guided hike, it was scheduled for the best time to see the birds. Therefore, the wait was not too long for the young ones.
  • balance skills: walking along on the uneven terrain while looking at the sky at times challenged all of our balance skills
So the next time you are looking for a different, outdoor, multi-sensory experience try birdwatching. If you can not find a guided hike, research a common bird to your area including pictures, audio of the bird call and when it is best viewed. Then off you can go with binoculars in hand to search for the species.

Friday, April 8, 2011

Walking and Girls

There is so much discussion and promotion of getting children physically active and outdoors especially in the adolescent age range. A recent study evaluated data on the self reports of mode of transportation to school and extracurricular physical activity in 1700 adolescents (892 girls) ages 13-18.5 years old from Spain. The results indicated that girls who actively commuted to school had better cognitive scores but that was not the case with the boys. In addition, the girls who actively commuted more than 15 minutes per day to school had better cognitive performance that the girls who actively commuted less than 15 minutes per day.

Need to improve cognitive performance at school - try walking there. It is free and healthy for the mind and the body!

Reference: David Martinez-Gomez; Jonatan R. Ruiz; Sonia Gomez-Martinez; Palma Chillon; J. Pablo Rey-Lopez; Ligia E. Diaz; Ruth Castillo; Oscar L. Veiga; Ascension Marcos; for the AVENA Study Group Active Commuting to School and Cognitive Performance in Adolescents: The AVENA Study Arch Pediatr Adolesc Med. 2011;165(4):300-305

Wednesday, April 6, 2011

Pain and Cerebral Palsy

Pain Medicine published research on age related changes of pain experiences in individuals with cerebral palsy. Pain, touch sensitivity and quality of life was evaluated in 86 individuals with cerebral palsy compared to 115 healthy volunteers. The subjects were grouped by age: 6-10 years, 11-17 years and 18-30 years old. The results indicated that the individuals with cerebral palsy experienced more pain, reduced touch sensitivity and reduced quality of life compared to healthy volunteers. For the individuals with cerebral palsy age did not influence the results whereas with the healthy volunteers, pain, touch sensitivity and quality of life where influenced by age. In addition, age was the best predictor of current pain intensity in healthy subjects but that was not the case in the individuals with cerebral palsy. The researchers conclude that it is important to consider the pain levels of individuals with cerebral palsy even at an early age.

Reference: Riquelme, I., Cifre, I. and Montoya, P. (2011), Age-Related Changes of Pain Experience in Cerebral Palsy and Healthy Individuals. Pain Medicine, 12: no. doi: 10.1111/j.1526-4637.2011.01094.x

Tuesday, April 5, 2011

Your Therapy Source April Issue

Here is the latest edition of the Your Therapy Source News. If you can not view it below you can download the magazine here.

Monday, April 4, 2011

Evidence Based Guidelines for Pediatric OT and PT

Thanks to @otnotes on Twitter who tweeted about this EXCELLENT, FREE resource. The Cincinnati Children's Hospital offers evidence based care guidelines for many pediatric occupational and physical therapy interventions. The guidelines for each intervention describe the target population, target users, introduction (theory/ research), guidelines recommendations, decision tree charts and references. The topics include constraint induced movement therapy, idiopathic toe walking, serial casting, torticollis and more. In addition, they have produced Best Evidence Statements. These research based briefs offer recommendations regarding evaluation tools for clients with autism, interventions for children with hemiplegia, partial body weight supported treadmill training, wheelchair delivery and sensory processing deficits.

This is a gold mine of resources to guide your practice and offer research to back up therapeutic interventions. Check it out at Cincinnati Children's Hospital.

Saturday, April 2, 2011

Transitioning Students to the Job Market

For those of you who help older students with disabilities, you may want to check out this free web based program called JobTips. This website, brought to you by Do2Learn, offers the following:
"JobTIPS is a free program designed to help individuals with disabilities such as autism explore career interests, seek and obtain employment, and successfully maintain employment. JobTIPS addresses the social and behavioral differences that might make identifying, obtaining, and keeping a job more difficult for you".

Basically, JobTIPS can help students determine their interests, find a job, get a job and keep a job. There are video examples, printables, step by step directions and more. Worth a look for sure for anyone who helps students with disabilities transition out of school into the job market. It is especially geared toward individuals with autism.

Check out JobTIPS.