Original Article By Eric Ries | July 2018
Synopsis/Review by Athena Bellio, PT, DPT, CMT, HHP for Oceanside Therapy Group
Physical therapy services have been a widely accepted form of treatment for decades across multiple populations. However, the role of a physical therapist (PT) in the lives of our children with Autism or Autism Spectrum Disorder (ASD) has not always been emphasized or well-known. In fact, within the last two decades, treatment options for this population of children and families were not as readily available. But, as the treatment paradigm is constantly evolving to encompass the whole child, so is the importance and role of physical therapy in their daily lives.
In this article, written by Eric Ries, he presents the experiences of pediatric PTs working with this wonderful population and how they approached treating and caring for these kids.
Karen Tartick, a school-based PT and parent of a child with Autism, explains her take on the importance of physical therapy in the life of a child with Autism. She shares her own experience with her now adult son, and his limited experience with physical therapy treatment growing up. Tartick goes on to describe that when they first received her son Eric’s diagnosis in 1993, there was less of an emphasis placed on his physical activity during his therapeutic care. She attributes that limited exposure in his youth, in part, to the current challenges Eric faces with poor physical health and limited exercise tolerance. Tartick explains how “tapping into whatever is motivating to the child” is key to having them understand the importance of movement and exercise outside of the therapy world.
Physical therapist, Liliane Savard, also describes her experiences working with children with ASD, claiming that, “most if not all, children with autism have movement difficulty.” She goes on to explain that because PTs are considered movement system experts, they are very adept in figuring out how to design interventions to help these kids participate more in appropriate movement patterns that will allow them to engage in life. Savard emphasizes three main cornerstones to promoting motor learning including: positive expectancy, autonomy support and external focus. In short, if we help our kids to believe they can do something, allow them the freedom and opportunity to make appropriate decisions, and channel their attention and focus to specific elements of a task, we can achieve growth and progress.
The “whole-child approach” is also emphasized in today’s physical therapy treatments. Anjana Bhat, PT, PhD, MS, emphasizes this in her practice with the belief that motor play encourages communication and engagement in a child’s environment as well as with his or her peers. By providing creative play environments, there is, what Bhat calls a “cascading effect” in which PTs help to promote productive solutions and preferred outlets to dealing with maladaptive behaviors. Physical therapists not only treat a movement pattern dysfunction, but also take part in the larger discussion of advocating for children with ASD by enabling and empowering them to “participate in their world.” Bhat goes on to applaud the families and parents of these children, whose determination in empowering their child is inspiring to her as a PT working in this field. She goes on to describe the complexities of this diagnosis with the understanding that our knowledge of best practice for PT and ASD is constantly expanding.
Jan McElroy, PT, PhD, describes the role of a PT best. In a population that is so often misrepresented or “narrowly seen as minimally expressive, behaviorally difficult, and challenging to engage”, PTs bring the fun to these children and families whose lives can often feel stressful. PTs work to address the whole child, find what is salient to him or her and encourage social connections and movement patterns to gain confidence in their newfound independence.
For access to the full article, please see the attached link.
Our OTG family is made up of talented and creative therapists and staff, all working together to facilitate progress and life skills across all disciplines (occupational therapy, speech language therapy and physical therapy). Please contact our PT department for more information on how we can help you and your child reach their gross motor and functional movement goals.
Source: Ries, Eric. “Physical Therapy for People With Autism.” APTA, 2018, www.apta.org/PTinMotion/2018/7/Feature/Autism/.
Q & A with OTG Physical Therapists
Question 1: What's the average length of therapy a child will receive for PT?
KC: The average length of physical therapy will vary child to child. We can possibly see a kiddo for a month or many years. The great thing about physical therapy is that we work on so many areas of the body that a child's sessions are constantly changing and evolving based on what the child is doing.
Chris: Time will vary. Orthopedic-based conditions tend to be weeks/months and developmental-based can be months/years.
Question 2: What's your favorite part about being a PT?
KC: My favorite part of being a PT is helping children and families reach their goals through movement. Improving how a child moves can help them improve social interactions, increase attention, and open up new environments for them to explore. Activity and movement is great for all members of the family and I love helping everyone lead healthy, active, lifestyles!
Chris: I definitely echo the creativity/spontaneous aspect to peds, it's very motivating. Diversity and the apparent need within the peds specialty were specific draws for me coming out of PT school. The diversity in population/background and different family structures we serve are motivating.
Athena: The BEST part about being a PT for me is that it calls for creativity and flexibility with each treatment -- every kiddo is different and special in their own way, which encourages new avenues for exercises and activities. I'm constantly learning from each child and family we treat. Plus, I have yet to find another profession in which busting out in random (Disney) songs is considered appropriate, if not encouraged :)
Question 3: What are your favorite exercises/activities in therapy, what conditions do they treat?
KC: My favorite exercises are SQUATS!!!! Squats are awesome for children with any and all conditions. Working on the gluteal musculature (aka the booty muscles) helps with stability, single leg balance, jumping, running, and walking.
A Final Word from Our PTs
Physical therapists are always here to answer any questions! Don't be afraid to ask anything, even if it seems like a silly question. If we don't know the answer we will do the research and look it up! Our PT team loves to solve any puzzle and are happy to help you with anything for your child's development. Physical therapists are trained and matriculate at a clinical Doctoral level. They are experts in assessing/treating movement-based disorders/pathology in order to restore and maximize function and quality of life.
Written by: Natalie Shilling & the PT Dept. at Oceanside Therapy Group
Saturday, April 21, 2018 @ Mission Bay Park in San Diego
Event Schedule - Saturday, April 21, 2018
Here's how to register...
Click the link below to get to the ACT/Autism Walk website for registration
-Remember to choose the category: Adult 5K
-Select Create/Join Team - then click on Oceanside Therapy Group from the drop-down.
-Our password is: WalknRoll1
-We can't wait to see you there!
For some added fun...
Oceanside Therapy Group will be handing out team capes for the event. Please plan to wear your team cape for our group photo!
For questions and help registering...
Stop by the front desk for help on registration or for any questions or concerns you may have. There is additional informational also provided on the Race website, for more details click below.
An exercise ball is a fun piece of equipment that we frequently use in physical therapy for strengthening and balance exercises. It comes in a wide ranges of sizes and can be easy and quick to purchase for home. Here are some fun activities you can do at home with use of an exercise ball...
Trunk Strengthening in Sitting
This is a great exercise for kids of all ages! Help your child to sit on the exercise ball and stabilize them at their hips. Gently bounce them up and down. This is great for bringing about body awareness, as well as teaching your child to engage their core muscles to maintain their sitting posture. You can also rock your child forward and back, side to side, or along a diagonal for them to work on their balance and core strength.
If you have an older child you can have them sit on the ball while performing school work or any table time activity. Just make sure their feet are planted on the floor while on the therapy ball. Give cues to have them sit up tall in order to increase core strength and improve posture.
Prone Walk Outs
With a smaller sized ball, have your child lay on their tummy on the ball. Then have them walk out forward on their hands so that the ball rolls toward their knees, then have them walk their hands back. Try having them complete a puzzle or a game in this position by walking their hands forward to obtain a piece and then walking their hands back to put the piece into the puzzle.
Having your child lay on their back and propped up on their arms (make sure their arms are on the floor). Encourage your child to bring both legs up to 90 degrees in the ready position. Stand in front of them with a medium sized therapy ball. Lightly toss the ball towards their feet and have them kick it back to you. This will help their core and leg strength.
On a smaller sized ball, have your child lean the ball against the wall with their back. Have them sit down and pretend they are sitting in a chair. Repeat this movement for leg strengthening and balance. This can be incorporated with a throwing and catching activity in which the child catches the ball in sitting and throws when standing.
With medium sized ball, stand about 5 feet away from your child. Encourage them to use both hands and lift the therapy ball above their head then throw it forward and bounce on the ground one time. You can play throw-and-catch and see who can make the louder noise! Make sure to watch your child’s posture and encourage them to stand up tall without leaning back or arching their back in order to engage their abdominals and increase their core strength.
For Questions & More Information
If you have any questions on ball sizing or need more information about any of these exercises feel free to ask one of your friendly OTG Physical Therapists. You can work with your child and their therapist to think up more fun games to play at home with the therapy ball.
Written by: The Physical Therapy Dept. at Oceanside Therapy Group
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Children can be difficult to shop for once hitting a certain age where they no longer show interest in all the toys and games that they once couldn't put down. Now that the holidays are around the corner, and relatives are inquiring about what to get your kids, you find yourself stumped. You're just not sure what will be worthwhile and keep your child's interest for more than a few days. What will keep their minds stimulated so that they are learning something AND having fun. What are the best educational gifts out there that promote learning in a fun way? Our therapists at Oceanside Therapy Group have given us their expertise when it comes to toys, games, and activities that are perfect to get your child for the holiday season.
Card & Picture Games
Zingo is a game of bingo works on picture identification, incorporates turn taking, and visual/matching skills. Card games are always good for fine motor and manipulation skills. Kids can work on shuffling, dealing the cards, counting, and holding the cards. A simple game of Uno is fun, but 2 other great games are Blink and Spot It. These games work on visual perceptual skills, matching, and sorting by color/shape/number, etc.)"
Board Games & Interactive Games
Cranium Hullabaloo - sold on Amazon and Ebay - Hullabaloo is great for auditory processing, visual-motor, and gross motor skills. Headbandz & Apples to Apples - These games help with social skills and turn taking. Mancala: It’s a strategy and cognitive processing game. Chinese Checkers is a great activity for fine motor skills, problem solving, and turn taking.
Other Resources for Toy Ideas
Written by Oceanside Therapy Group
Wondering what to buy your child this holiday season? The OTG Speechies compiled a list of their favorite toys that can provide a variety of ways to expand speech and language development during play at home! Hear from our expert team on their favorite picks that promote learning and play that are perfect gift ideas for your little ones or other family members. Many of these can be purchased online or locally in some of their favorite stores.
Jessica: My two favorite toys are Mr. and Mrs. Potato head and Pop-Up Pirate.
1. Mr. and Mrs potato head helps kids identify and label body parts on themselves and objects. It helps children understand where body parts our located and can describe what we use them for. (e.g. eyes are for looking, ears are for hearing, etc). You can also put the body parts in the wrong places on purpose which is very silly!
2. Pop-Up Pirate! helps build turn-taking skills with children. Since it is random when the pirate pops, there is no predicting who wins until he pops. It helps kids understand the concepts of winning/losing and helps promote appropriate social skills (e.g. what to say when we win/lose, what to say to others when they win/lose, etc.). Additionally, kids are able to label and count the colored swards they put inside the barrel.
Shari: Two of my favorite toys are baby dolls and echo-microphones.
1. Baby dolls encourage children to act out familiar routines and engage in pretend play, and both boys and girls love to play with them! Baby dolls often come with accessories like clothing, brushes, strollers, bottles, etc. but even if they don’t, use familiar toys and items from around your home to facilitate pretend play.
2. Echo-microphones are so fun and so affordable! Echo-mics amplify your voice when you speak into them without being too loud. Kids love to sing and talk into them and just be silly. You can find them at stores like Walmart and Target, or online through Amazon.
Kylee: My favorite toys to encourage language are Interactive books (lift the flap books) and farm houses/farm toys. These items are usually very inexpensive (especially if you buy them used) yet great tools to encourage your child to use language.
1. Lift the flap books are a great way to get your child interested in books and keep them engaged while reading. Reading with your child is a great way to increase your child’s language skills. Interactive books help your child to understand cause and effect concepts (e.g. opening a flap reveals a picture) and are great reinforcers for when your child does use language. Books are also a great way to work on pointing and increasing your child’s vocabulary. My favorite lift the flap books are “The Very Hungry Caterpillar” by Eric Carle, and “Where’s Spot?” by Eric Hill
2. Farm houses/farm toys are another great and simple toy that encourage pretend play and language in children. Examples of pretend play that can be targeted are: making the animals eat/drink, putting them to bed, and making animal sounds. You can also introduce location words (e.g. putting the pig on top of the house, or inside the farm) and even fact based yes/no questions (e.g. is this a pig?).
Maegan: Two of my favorite toys for promoting speech and language learning are Pop the Pig and Play-Doh.
1. Pop the Pig is an interactive game that every child loves (for ages 4 and up due to the presence of small toy parts). Roll the die to see what color hamburger you should choose, look at the number on the back of the hamburger, and then feed and pop the pig’s head until his belt pops off! Pop the Pig promotes turn-taking, color identifying and labeling, counting, preposition understanding and labeling (just place or label the hamburgers around the pig before a turn) and verb use to describe actions (e.g., “I am feeding the pig, I am popping the pig”). If your child is working on speech sounds you can also have him/her practice speech sounds in words, phrases or sentences before each turn. You can buy Pop the Pig online or find it at your nearest Target or Walmart.
2. Play-Doh is a wonderful hands-on toy that children of all ages (2 and up) enjoy. Play-Doh is great to work on direction following, describing actions (e.g., “I am rolling, cutting, squishing, etc.”), answering “what” questions to label what animal or object was made, preposition labeling and turn-taking with shared use of Play-Doh utensils. There are a plethora of Play-Doh store and food kits too, which add a layer of imaginative, pretend play. Additionally, Play-Doh can be helpful in talking about and identifying your child’s smooth and bumpy speech if he/she stutters. Besides being fun and versatile, Play-Doh is also inexpensive and can almost always be found on sale at HomeGoods, TJMaxx or Marshalls.
Amanda: My two favorite toys are the Brown Bear, Brown Bear, What Do You See? book and the Just Like Home pretend microwave with foods.
1. Brown Bear, Brown Bear, What Do You See? Book: The repetition of language in the Brown Bear book makes it easy for kids to sing along with me (yes, you can sing it instead of reading which makes it fun for kids!) and they can fill in the words as they become more familiar with the book. It's also great for learning basic animal vocabulary and colors. I use a magnet board and magnet pictures I found online and made to increase the interaction as we read.
2. The Just Like Home Pretend Microwave is always a hit with kids because it simulates a real microwave at home. You can push the buttons and watch the food go around inside as it “cooks” it. It's great for having kids make requests “I want + food item” and sequencing steps to cook the food. You can find it on Amazon!
Pam: Some of my favorite toys are dress up costumes and puppets.
1. Dress-up costumes are great for targeting pretend play skills, building vocabulary within a theme (e.g., firefighters, princesses, etc.), and can be used for social role-playing. WH questions can also be incorporated in play, such asking a child what they are wearing, who they are pretending to be, etc. Post-Halloween sales are a great time to find fun costumes and accessories.
2. Puppets are fun and engaging! They can be incorporated into any language activity and are sure to grab your child’s attention. They can be used to encourage interaction skills such as joint attention in a peek-a-boo game. You can model spatial concepts in a game of hide-and-seek by moving the puppet around the room and asking where the puppet is hiding. Also, puppets can make doing flashcards an exciting and silly activity by having your child feed the puppet a card after each turn.
Vanessa: Two of my favorite toys are Food Play Sets and a Doctor Kit.
1. Food play sets are one of my favorite toys to use in language building activities and to promote play skills. You can target food-related vocabulary and understanding and use of action words, such as “cut, roll, eat, slice, drink” etc. Melissa and Doug have a few great wooden sets that are fun and durable. They can be found at any big chain store, but I’ve always found the best prices at Marshalls/Ross/TJMaxx/Homegoods.
2. Doctor Kits are a great toy to practice pretend play skills, target functional vocabulary, and even get kids familiar with doctor visit routines to make the the real-life encounters a little less stressful. You can practice taking turns playing the doctor/patient and incorporate body part vocabulary in your game (“Let me check your ears/mouth, etc.).
Written by: The Speech and Language Dept. at Oceanside Therapy Group
Physical Therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility. Physical Therapists teach patients how to prevent or manage their condition utilizing treatment techniques to restore function and prevent disability. Importantly, physical therapists work with individuals to prevent loss of mobility before it occurs by developing wellness-oriented programs supporting healthier and more active lives.
Common Exercises in Physical Therapy
Physical Therapy treatment and fitness-related programming/education are critical for conservative management of pain per recent CDC guidelines. Walking, step-ups/downs, and sit-to-stand-go (Up n Go’s) are good functional activities that address strength, balance, coordination, and cardiovascular function. Please join OTG Fit Families and join our collaborative step program! It is fun, exciting, and rewarding!
A balance disc/tilt board/Bosu ball can be used strategically to address balance and sensory impairments. Many variations and uses of these tools can greatly assist restoration in function.
Treatment and prevention of strains/sprains. Theraband will provide resistance in specified ranges of motion as prescribed by your physical therapist to strengthen weakened muscles.
Walking and physical activity such as biking, swimming, and running have been shown to significantly improve physical, emotional, and social health for all ages. With our busy schedules and increased screen-time the challenge is finding the time and meaningful motivation to achieve a balanced lifestyle to stay active.
How many steps are recommended for children? Why is it important? What are some strategies to stay motivated as a family? Where can these ideas be implemented?
HOW MUCH WALKING IS RECOMMENDED FOR MY CHILD?
A systematic review from 2011 indicated that elementary school aged boys should be taking 13,000-15,000 steps/day and girls 11,000-12,000 steps/day. A pedometer is a portable device, such as a FitBit, that counts steps. This will give the most accurate reading of actual steps taken. The correlation of steps is in accordance to evidence-based recommendations of 60 minutes per day of moderate to vigorous activity for children.
WHY IS WALKING SO IMPORTANT?
Increasing physical activity can lead to improved cardiovascular fitness, improved metabolism, and an increase in caloric expenditure, which can decrease the risk for obesity, improving the overall health of our children and families.
WHAT CAN FAMILIES DO?
OTHER FUN WAYS TO STAY ACTIVE
Written by: The PT Dept. for Oceanside Therapy Group
Source: Tudor-Locke C, Craig C, Beets M, Belton S, et al: How many steps/day are enough? For children and adolescents. International Journal of Behavioral Nutrition and Physical Activity. 2011, 8:78.
Do you have questions about your child's IEP?
If your child has an IEP (Individualized Education Program), you may have questions about its contents and what rights you have as a parent. On Saturday, September 30, 2017 from 9AM - 2PM, North Coastal Consortium for Special Education is hosting a workshop to help parents/guardians understand the special education process including IEP (Individualized Education Program) process, meetings, and components. This is a FREE workshop for parents/guardians/family attending NCCSE member districts (Download the registration form below for more details).
Resources for Families - NCSSE Website
Kindergarten is a big step in every child’s life. It’s exciting and possibly the first real experience a child has in a classroom setting. With the new school year fast approaching, many parents may be wondering if their child is ready and how they can help their child be successful in their first year.
Below is a checklist of skills your child should have or should be working on as they enter kindergarten...
What your child should understand:
• Understands ordinal words such as, “first, next, and last”
• Understands time concepts such as, “yesterday, today, and tomorrow”
• Understands spatial concepts such as, “under, in back of, next to, in front of”
• Follows 2-3 step directions in the correct order with qualitative concepts such as, “Pick up your pencil and draw a circle on your paper around something you drink
• Understands most of what is said at home and outside environments
• Recognizes 8 basic colors and shapes
• Recognizes first and last name
• Recognizes some letters
• Sits still and listens to a story
• Pretends to read a book
• Good attendance
Speech and language your child should use:
• Says all speech sounds in words, although it’s okay if mistakes are made on later developing sounds such as L, R, CH, SH, TH
• Says alphabet
• Says days of the week
• Says or shows age
• Sings songs or nursery rhymes
• Counts to at least 10
• Names some letters, numbers and colors
• Uses pronouns such as, “I, me, you, mine, yours, he, she, him, her”
• Answers simple WH questions such as, what, where, when, who, why
• Uses sentences with action words such as, “jump, play” and “get"
• Tells a short story
• Keeps a conversation going
• Talks in different ways depending on the listener and place, such as speaking in shorter sentences to younger children or talking louder outside than inside
Let’s set our kids up for success! If you have any questions or need any suggestions, please reach out to your OTG SLPs.
By: Oceanside Therapy Group's Speech/Language Department
“Four to Five Years.” ASHA, http://www.asha.org/public/speech/development/45/. Accessed
25 July 2017.