Tuesday, April 30, 2013

Physical Fitness, Academics and Middle School

Physical Fitness, Academics and Middle School
Research was published on 838 middle school students who were assessed with the FITNESSGRAM and the Illinois Standardized Assessment Tests. The results indicated the following:
"1. Boys in the Healthy Fitness Zone (HFZ) for aerobic fitness or muscular endurance were 2.5 to 3 times more likely to pass their math or reading exams.
2. Girls in the HFZ for aerobic fitness were approximately 2 to 4 times as likely to meet or exceed reading and math test standards."

The researchers concluded that aerobic fitness and muscular endurance positively affect academic performance.

Reference: Bass RW et al. Physical fitness and academic performance in middle-school students. Acta Paediatr. 2013 Apr 28. doi: 10.1111/apa.12278. [Epub ahead of print]

Monday, April 29, 2013

Sensory Modulation Disorder and Behavior Symptoms


Child Psychiatry and Human Development published research on the role of sensory modulation deficits and behavioral symptoms in a diagnosis for young children.  Using clinical observation 78 toddlers were divided into two groups: 18 toddlers with regulation disorders of sensory processing and 60 toddlers with other diagnoses. The parents completed the Infant Toddler Sensory Profile and the Achenbach Checklist.  The results indicated the following:
  • the group with regulation disorders of sensory processing exhibited more severe sensory modulation deficits and behavioral symptoms
  • a strong association although not significant was seen between most sensory and behavioral symptoms
  • more significant sensory modulation deficits were seen in the group with regulation disorders of sensory processing
The researchers concluded that the findings support the validity of a regulation disorders of sensory processing diagnosis. 

I only read the abstract for this study but am confused as to how this research was conducted.  The way I read it is that the researchers used clinical observation to "diagnose" a child with Regulation Disorders of Sensory Processing and then based on parental report checked if they were correct?  If that interpretation is accurate I am perplexed as to how this supports the validity of a sensory processing diagnosis.  Please someone enlighten me...

Reference:  Ruth Pérez-Robles, Eduardo Doval, Ma Claustre Jané, Pedro Caldeira da Silva, Ana Luisa Papoila, Daniel Virella. The Role of Sensory Modulation Deficits and Behavioral Symptoms in a Diagnosis for Early Childhood. Child Psychiatry & Human Development. June 2013, Volume 44, Issue 3, pp 400-411

Wednesday, April 24, 2013

Find the Positive

Many times students with special needs receive negative comments or misconstrued negative comments.  The students or parents are frequently told to fix this, increase this or improve that.  How about finding the positive?  We all know every student has strengths.  It is our job to help students utilize their strengths and talents to the best of their abilities.  For example, if a student has a wonderful imagination utilize that during therapy sessions to increase motivation and participation.  Need some help in determining and finding positive attributes and talents in student(s) finish some of these statements (with the student and parents help):

1.  This student is best at...
2.  This student has an amazing ability to...
3.  This student is frequently recognized for...
4.  This student smiles when...
5.  This student is happiest when...
6.  This student participates the most when...
7.  This student does this better than any other student...
8.  This student is highly interested in...
9.  This student is highly motivated by...
10.  This student always takes pride in his/her work when...





Try providing positive affirmations for children to carry with them once you determine their strengths.



Tuesday, April 23, 2013

Tracking Data App

Thanks to the OTwithApps blog I heard about the TrackandShare app. This app is really amazing for tracking data over time. I had been playing around with the lite version (free) and quickly upgraded to Pro since the lite limits how many entries you can input.

This app is wonderful to track patterns or progress over time. If you want to start with the regular app settings it would be wonderful to track behavior for students.  It comes all set to go to track happiness, stress, weather, etc.

As a PT I am not usually involved for tracking behavior but it is very easy to use and customizable for any goals. I started out tracking time on treadmill. You can enter in minutes and seconds how long a child completed on the treadmill. All you have to do is write the time and hit the stamp button. Then you can view a graph of progress over a day, week or month.

If you just want to track one student you put various measurements in different categories. If you want to track different students you can create different categories naming them for each student. This would make a great app to determine if a student's sensory diet was effective.  Basically it can keep track of any intervention. 

Now let say you want a paper record of all the data you have collected. You can share it via email. It is not graphed but in table format.

I give this app a super thumbs up for tracking progress. The pro version is only $1.99.
 

Monday, April 22, 2013

5 Gross Motor Activities with Painter's Tape


Here are 5 activities using painter's tape that encourage balance skills, jumping skills, motor planning, body awareness and aerobic fitness.  You can watch the video for ideas at YourTherapySource.com

Friday, April 19, 2013

Partial Body Weight Treadmill Training in Children Under 6



A research review was published on treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay.  Five diverse studies were included on treadmill training in 139 children.  Data was only included from three studies because the 5 studies were so diverse.  These 3 studies all had outcomes of age of onset of walking or gross motor function.  The evidence suggested that treadmill intervention could lead to earlier onset of walking in children with Down syndrome but the evidence was not clear for children at risk of neuromotor delay.  Two of the studies included children with Down syndrome and the results were inconclusive.  There was insufficient evidence regarding treadmill intervention and gross motor function.

The researchers concluded that treadmill intervention may accelerate the development of independent walking in children with Down syndrome. Further research is needed on treadmill interventions in young children at risk for neuromotor delay.

Reference: Valentin-Gudiol M, Bagur-Calafat C, Girabent-Farrés M, Hadders-Algra M, Mattern-Baxter K, Angulo-Barroso R. Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay: a report of a Cochrane systematic review and meta-analysis. Eur J Phys Rehabil Med. 2013 Feb;49(1):67-91.

Tuesday, April 16, 2013

Oropharyngeal Dysphagia, Gross Motor Skills and Cerebral Palsy

Pediatrics published research on the relationship between oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. A cross sectional population based study was done in Queensland with children ages 18-36 months with a confirmed diagnosis of cerebral palsy. Using various assessments for oropharyngeal dysphagia and gross motor skill level the following results were reported:
1. Oropharyngeal dysphagia was present in 85% of the children
2. There was a step wise relationship between oropharyngeal dysphagia and gross motor function classification level.
3. There was higher odds of having oropharyngeal dysphagia in children who were non ambulatory.

Reference: Katherine A. Benfer, Kelly A. Weir, Kristie L. Bell, Robert S. Ware, Peter S.W. Davies, and Roslyn N. Boyd Oropharyngeal Dysphagia and Gross Motor Skills in Children With Cerebral Palsy. Pediatrics peds.2012-3093; published ahead of print April 15, 2013, doi:10.1542/peds.2012-3093


Monday, April 15, 2013

Google Chrome Free Typing Games


After reading a blog post from Free Resources from the Net for Every Learner (awesome blog to follow by the way) on some new free typing games available through Google Chrome, I figured I would give them a try.  I happen to use Google Chrome as a browser often because it has some nice features that Internet Explorer does not offer (plus it crashes a whole lot less). 

The first game I tried was Type Scout.  This is no frills typing practice but keeps nice data regarding your typing progress.  Basically you just follow what is on the screen and practice.  You can modify what letters or words are practiced if you want or just follow what it sets up for you.  In addition, you can turn on audio to have the letters or words read to you.  There is a tetris type game but a bit boring compared to other typing games that are available. 

Next I tried Nitro Type.  This typing game is really fun and I enjoyed playing it although I consider myself a good typist.  You need to type the words and it moves your car along in a race.  It has beautiful, fun graphics.  It also provides nice data for words per minute and accuracy.  If you create a free account it will save your data.  This game is definitely for students who are somewhat decent typists to start.

The third one I tried was Type Fu.  This again was a basic learn to type activity.  The different thing about this game is the beautiful graphs it makes about your progress.  It can show your progress for words per minutes and accuracy over one session or comparing previous sessions.  This would be a great one to use to perhaps test a student's skills after practicing with other typing games.  If you could print the graphs to show teachers and parents this app would be amazing.  Maybe you could do a screenshot but I could not figure out how to print the graphs. 

Would love to hear what your favorite typing programs are? 

Thursday, April 11, 2013

Adapted Straw


A picture says a thousand words but head on over to YourTherapySource for more details and uses for this simple adapted straw holder.

Wednesday, April 10, 2013

Handedness and ADHD


The Journal of Attention Disorders published research on hand preference and its association with ADHD, severity symptoms, age, gender, comorbid psychiatric problems, or parental characteristics. Participants included 520 children (mean age of 9.04 years). Each subject was assessed for handedness, inattention severity, hyperactivity severity, oppositional behavior symptoms, anxiety symptoms, and developmental coordination problems. The results indicated the following:
  • 87.4% were right handed, 12.6% were left handed and only 4 children were mixed handed
  • no association of right or left handedness with age, gender, inattentiveness score, hyperactivity-impulsivity score, comorbid psychiatric problems, developmental coordination problems score, or parental characteristics
Reference: Ahmad Ghanizadeh. Lack of Association of Handedness With Inattention and Hyperactivity Symptoms in ADHD Journal of Attention Disorders May 2013 17: 302-307, first published on January 27, 2012 doi:10.1177/1087054711429789  

Tuesday, April 9, 2013

Know What Works - 6 Ways to Track Progress


Do you ever feel like you offer many tips and suggestions but have a hard time keeping up with how the student performs?  Pediatric therapists need to collect data to find out what is working for a specific student.  Here are 6 ways to track progress:
 
1.  Tally Marks - how many times did they write the letter B correctly out of 10?  This is a super simple way of keeping tabs on whether a strategy is working.  Allow the student to try 10 times and mark a tally on the paper each time it is done correctly.  To record the data to get a percentage based on the number of trials make two columns on a piece of paper.  If the student does it correctly simply record a tally mark on the left side of the paper.  If the student does not perform the task correctly record a tally mark on the right side of the paper.  You can then calculate percentages of how well the student is doing.  Have a smart phone or iPad?   There are several apps that allow for simple data collection such as TxTools where you can make tally marks or calculate percentages.   
 
2.  Standardized Testing - obviously this is an effective way of tracking progress from year to year although "year" is the key word.  On a week to week basis this is not an effective way of tracking progress.
 
3.  Rubrics - Create your own scoring systems for different skills to track a specific child's progress over time.  Break a skill down using task analysis and assign scores for each specific piece of the overall skill.  Here is a sample rubric for walking in a line.
 
4.  Goal Attainment Scaling - This is a method of quantifying whether a goal is achieved based on a scale of -2 (much less of expected outcome) to 2 (much more of expected outcome).   
 
5.  Graphs - Nothing shows progress or decline like a visual image such as a graph.  By plotting a student's progress over time teachers and parents can see very clearly the progress a student is making (or not making).   ie Progress Monitoring Forms make a chart and record tally marks - very nice visual to represent progress.  Here is an example for catching skills.
 
6.  Software - There are a few software programs to track progress.  For example, the Scale of Sensory Strategies (S.O.S.S.) Tool Kit™ enables automatic data entry within minutes using the Sensory Strategy Software program to generate a sensory strategy summary, a narrative report that summarizes the data taken during sensory trials.
 
Any other suggestions for collecting data?

Monday, April 8, 2013

5 Ways to Communicate with Parents and Teachers



It can be difficult for school based therapists to communicate with all the team members at the school and home. Frequently, we dash in and out of schools and classrooms rushing to the next student. Effective communication is one of the keys to success with school based occupational or physical therapy.  Therapists need on going background information for what is going on at home or in the classroom.  Carry over of activities requires direction and follow through.  In addition, don’t always offer criticism or problems.  If a student does particularly well on a task during therapy let the teachers and the parents hear about it.  Here are  5 ways to communicate with parents and teachers:

1.  Communication Notebook - some students have notebooks that go back and forth from home and school.  This makes it easy to keep all communication in one organized location.  If everyone writes in one notebook, therapists can see what the teachers and parents write about as well.  You can purchase template notebooks for communication, write in a regular notebook or create your own template to use.

2.  Progress Reports - Most districts and Medicaid require progress reports for therapy goals.  In New York state it is required quarterly.  Offering more frequent progress reports can be helpful.  Perhaps every two weeks send a quick note or overview of how the student is doing towards their goals.  If a student is failing in math class parents hear about it before the report card is issued.  Therefore, if a student is not progressing towards their goals in therapy don't wait until the quarterly report to let a parent know.  School and Home Communication Forms for Therapists offers 21 forms to increase communication between therapists, school staff, students and parents.    

3.  Team Meetings - This can be very difficult to schedule but team meetings are wonderful.  I have worked with some students who had monthly team meetings on the IEP therefore we all had to find the time.  It was an excellent half hour for all of us to collaborate to help provide a more well rounded approach during therapy sessions.  It is especially helpful when a student receives many services ie OT, PT, speech, assistive tech, adapted PE, etc.

4.  Webpage or Blog - You could start a webpage or blog with tips and suggestions for parents.  It obviously could not be student specific but many suggestions work for all children.

5.  Good Old Fashioned Telephone Call - I know it takes more time and privacy to make an actual telephone call but it is always helpful to actual speak to someone.  Email can always be interpreted differently since there is no inflection involved.  Sometimes what is written can be taken the wrong way whereas with a phone call there is less room for interpretation. 

Friday, April 5, 2013

5 Adaptations for Tying Shoes



Tying shoes is a complex skill to learn requiring fine motor skills, visual perceptual skills and motor planning.  Some children may need extra help to learn how to tie shoes and some may need permanent adaptations.  Here are 5 suggestions to adapt shoe tying:

1. commercial shoe laces that are different colors to help learn shoe tying http://www.loopeez.com/index.php
2. Velcro hidden inside shoe http://pinterest.com/pin/143693044332911985/
3. commercial products that use elastic shoelaces http://www.locklaces.com/
4. elastic shoe laces - once tied shoe slips on and off
5. commercial Velcro shoes or slip on shoes

What is your favorite idea to adapt shoe tying or to teach tying shoes?

Thursday, April 4, 2013

Color Ball Game


Go to Your Therapy Source to learn how to play this group activity that encourages motor memory, following directions and coordination skills. 

Wednesday, April 3, 2013

Long Term Effects of Physical Therapy on Children with Cerebral Palsy


Developmental Neurorehabilitation published research on the long term effects of physical therapy on children with cerebral palsy.  A retrospective review was performed on 56 children with cerebral palsy (GMFCS levels I-V) who were treated with physical therapy from 2008-2011.  Their motor function was assessed every three months.  The results indicated the following:
  • significant improvements on the Gross Motor Function Measure in all levels
  • children at the GMFCS Level II exhibited faster progression of skills
  • younger children with CP had better PT efficacy 
  • improvements were seen at 8.4 years old in the older group
The researchers concluded that long term conventional physical therapy for children with cerebral palsy was effective even in older children but especially in younger children and GMFCS Level II.

Reference: Chen YN, Liao SF, Su LF, Huang HY, Lin CC, Wei TS. The effect of long-term conventional physical therapy and independent predictive factors analysis in children with cerebral palsy. Dev Neurorehabil. 2013 Mar 11. [Epub ahead of print] 

Tuesday, April 2, 2013

Shoes 4 Kids

Shoes4Kids is an organization that was started in 2006 to help provide shoes for underprivileged or under served children. Brad Thuringer is a PTA and founder of Shoes4Kids. Each year he coordinates a shoe drive in conjunction with the APTAs annual meeting. Here is more information if you would like to help:

In conjunction with APTA's Annual Meeting - PT 2013- Salt Lake City, UT., Shoes4Kids will be visiting The Neighborhood House, The Road Home, and the YWCA. I too am pleased to announce that the students and faculty of the Department of Physical Therapy at the University of Utah have agreed to accept and transport the shoes to the sites. I am extremely grateful to Dr. R. Scott Ward, PT. PhD and his students for their help with this year’s efforts.

How can you help? Your help is needed by either purchasing a pair(s) of "NEW" youth athletic shoes (toddler sizes 3-4 to teenager adult sizes up to 13-14) or sending a monetary donation to help purchase shoes. You can also spread the word in your chapter, collect shoes at your spring meeting, notify the PTA programs in your state and encourage their participation, etc. We need 1500 shoes for Salt Lake City!

Mail financial donations to: “Shoes4Kids” Brad Thuringer, PTA Instructor, ACCE Physical Therapist Assistant Program Lake Area Technical Institute 1201 Arrow Ave PO Box 730 Watertown, South Dakota 57201

Mail Shoe donations mail to: Shoes4Kids c/o Dr. R. Scott Ward, PT, PhD Department of Physical Therapy University of Utah 520 Wakara Way Salt Lake City, UT 84108

Deadline for ALL donations shoes and monetary gifts is June 1st, 2013. No donation is too small.

On behalf of S4K, thank you! Thank you for believing that every child deserves a new pair of athletic shoes! For more information, please contact Brad Thuringer, PTA Founder, Shoes4Kids at 800-657-4344, ext. 325, or brad.thuringer@lakeareatech.edu .

See how S4K has made a difference. (photo links below)

"It was such a pleasure to meet you and the Shoe Crew!!! Not only did our children enjoy this wonderful experience, but staff was so impressed by the positive spirit and teamwork displayed by your volunteers! It takes special people to come together to serve those less fortunate and Dover feels quite blessed to have been chosen this year. Thanks again for assisting our children and allowing us to keep shoes to serve many more. May God bless you and continue to guide you in this wonderful journey! We hope to work together again in the future!!!" ` Evelyn Pearce-Fearon, LCSW, Migrant School Social Worker, Dover Elementary/ Plant City FL

PT 2012 ~ Dover Elementary School, Dover, FL http://www.slideshare.net/thuringb/dover-elementary-school-shoes4-kids-pt-2012-tampa-fl-13295661?from=share_email

PT 2012 ~ Salvation Army, Tampa, FL http://www.slideshare.net/thuringb/salvation-army-shoes4-kids-pt-2012-tampa-fl

“I've heard from many families that their kids LOVE the new shoes. One little girl told us that her shoes were extremely comfortable and the only pair that fit well. Another little boy told me last week that he had the "coolest shoes in his class." - Amy White, Program Director, St. Margaret of Cortona Transitional Residences, Arlington, VA

This is the biggest gift our shelter has ever received. All the children now have a new pair of shoes. I hope you know how meaningful your donations were to our children and their mothers. ~ Sheila Baker, Spring Road Family Program, Washington, DC

On behalf of our children and their families, I want to say thank you for your time and generous donations of shoes and socks. As I continue to fit children with shoes after your visit, I was overwhelmed with the smiles from the children. It was wonderful treat not only for the children, but their families were very appreciative. Thanks so much! ~ Chris Bramante, Director, Mondloch House, Alexandria, VA

 PT 2011 ~ National Harbor, MD http://www.slideshare.net/thuringb/2011-shoes4-kids

 PT 2010 ~ Boston, MA http://www.ccab.org/unlinked/Shoes4Kids/index.php

April 2013 Digital Magazine for Pediatric OT and PT




Here is the latest issue of the digital magazine for pediatric occupational and physical therapists.  If you can not view it go to YourTherapySource.com to download the pdf version.

Monday, April 1, 2013

Rite Aid Grant


The Rite Aid Foundation is accepting grant applications for programs that focus on health and wellness in communities that Rite is present.  The grants range between $1000 and $20,000.  Do you have a health and wellness program that you would like funded?  Why not apply?  The current due date is April 15th but according the website if you miss the due date the application is rolled over to the next quarter.  You can find out more at Rite Aid Foundation.
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