Core strength is absolutely crucial for the growth and development of fine motor skills. It doesn’t seem like the two would correlate, however a child can seriously struggle with fine motor skills when their core is not adequately supporting them. This is because “proximal stability promotes distal mobility”… what????? I used to have a professor who would say this to us over and over and over again, to this day I hear his voice in my head every time I explain this to a parent! Proximal stability denotes core strength and distal mobility refers to the ability to engage in activities that require fine motor movements.
Think of proximal stability or core strength like the foundation of a house. Without a stable foundation the house might seem sturdy at first glance, but over time it gives way and the structure on top begins sinking into the faulty foundation. Children, in this case, are like a house. If their foundation isn’t strong enough, they will have significant difficulty using their arms, hands and fingers adequately. Let’s try something. Sink down in your chair, round your back and slouch slightly to one side… now try to reach for something in front of you without engaging your core or sitting up. It’s hard right! Do you find yourself having trouble reaching the item even though you’re really stretching your arms as much as you can? You feel like you can get closer but your arms won’t go any further; it’s pretty frustrating. Now sit up normally and move how you typically would to reach for the same item in front of you. Notice how you actually move from your core to extend your reach rather than just your arms. It is much easier to adjust, reach, grab and manipulate items when the core is able to support and engage with the rest of the body. When a child does not have adequate proximal stability they have to exert more effort to complete simple fine motor tasks. They may move their whole body rather than just their arms to reach for objects. You may often observe them to slouch when sitting down rather than sit upright. They may need to lean on table tops, arms of chairs or other surfaces for support to assist them with maintaining upright positions. Often times these children become tired more quickly because they are working twice as hard to complete tasks that should not require extensive amounts of effort. How can we help? Addressing core strength from the youngest age possible is the first step to building a strong foundation. Tummy time is great for little ones. They may fuss, but tummy time is absolutely crucial. It is the first step in the development of proximal stability; it engages the core, builds neck and back muscles, strengthens the spine, provides an introduction to the feel of gravity and teaches balance. For children who are past the tummy time phase, providing them with enticing items to reach for while laying down or maneuvering around the environment will help them to develop core muscles while exploring. Toddlers love to play. Adding core strengthening into their play is the best and most effective way to help them build their foundation. This can be done through therapy ball games, yoga poses, animal walks and exercises like wheelbarrow walking. For examples of these core strengthening games, go to the Gross Motor tab under the Activities and More section in the top right hand corner of the screen.
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The coronavirus, better known as COVID-19, has changed daily life as we know it. Parents have become teachers overnight, typical day to day routines have gone out the window, schools have been closed until the next school year, it is recommended that we wear masks and gloves out in public and we cannot see our friends or extended family members. All of these impactful and truly life altering changes occurred very quickly leaving little time for an adjustment period. As adults we understand the gravity of this unprecedented situation, but many children are quite confused… and for all the right reasons. Children thrive, learn and develop skills best when following a regular routine. Now that their normal daily routines have been suddenly and drastically altered, many children are having difficulty adjusting to this new normal.
Children associate school-work with school. They are used to having the school environment as their main place of learning with teachers as their main source for guidance, information and help. Although remote learning has been (or will be by the end of the month) implemented, children are still having difficulty; they do not associate the home environment with school-work and learning. For many kids, home is a place to play and relax, spend time with family and friend, eat and sleep… not spend hours doing school-work. So how do we make the home a place that can be associated with learning on a similar level as a school? Occupational therapists know how important environmental factors are for success in daily activities. The environment sets the mood and allows a child to visually understand what is expected of them within the space. For example, you walk into a room and see a bed; you recognize this is where you sleep and relax. Setting up the environment sets the child up for success. To best help your child thrive with remote learning, take an area in your home and turn it into a dedicated education (or therapy) space. It doesn’t have to be anything fancy or over the top, just something to make your child aware that this space is where school-work happens even though they are in the home. It can be as simple as putting a chair and folding table in the corner of a room, placing all needed supplies (notebook, pencils, crayons, scissors, book, etc.) on or near the table and ensuring that your child’s favorite toys are not in the room. You can have your child participate in making the space by having them make pictures to hang on the walls that remind them of their classroom in school. The overall idea is to give the child an area dedicated to learning so when they are in that space they are more in-tune with a school environment rather than home. Yes, you're reading this correctly.... we have eight senses! As children we learn about the five senses; touch, taste, sight, smell, hearing. These senses are the easiest to experience, explain and understand. The three additional senses are quite complex and have much more evidenced-based research behind them supporting that they do truly exist and are important in daily function. Many people have divided the eight senses into two categories; external senses and internal senses. The five senses we all know are considered the external senses and the 'new' senses fall into the internal category. Let's dive on in!
Proprioception: This sense allows the body to recognize where it is in space and assists us with knowing how much strength we need to complete an action. The proprioceptive system and the brain work together to assist us with self-regulation, coordination/balance, body awareness and the ability to attend and focus. But how does this work? Think about the brain-to-body connection. In order to complete an action, let’s say lift up a gallon of milk, the brain needs to help the body plan how to move. In order to do this, the brain gets signals (what we OTs like to call input) from the muscles and joints about how the body is positioned in comparison to the gallon of milk. The brain then uses the input to plan when muscles need to contract or stretch, in what order (which muscle does what first) and for how long in order to lift up the milk. This process happens in seconds thanks to proprioception! This sense is tricky though as it can be different for everyone. Some people find proprioceptive input calming and they seek it out (either consciously or subconsciously) during times where they need to be comforted or calmed down. For example, you're feeling ill and you wrap yourself in a blanket, you go for a walk when you're stressed, you seek out comfort during times of sadness by being hugged or held. On the other hand, for some people proprioceptive input can be alerting and help them to focus. For example, you bounce your leg after sitting at a table for an extended period of time, you tap your pen on the desk during a meeting, you squeeze a ball when you need to focus on something important. These are all ways of getting input to satisfy your body’s individual and unique need for the sense of proprioception. Interoception: This allows us to be aware of our internal bodily states. Knowing when you need to use the bathroom, that you're hungry, thirsty or tired all comes from the sense of interoception. It can be very difficult to potty train a child if they have a decreased sense of interoception. Kids may wait until the very last second and then stop whatever they are doing to run into the bathroom, or they may constantly have accidents because they truly don't feel their bladder is full (after ruling out other possible medical causes). Interoception also helps you to identify and respond to what your body is trying to tell you from the inside on an emotional level. When a person has trouble internally understanding emotions, meaning they have trouble recognizing what anger, excitement, pain, happiness, pain, etc. feels like, they can have significant difficulty regulating those emotions appropriately. Often times they will not respond to emotions until they have reached the extremes. For children this often looks like extreme meltdowns that are very difficult to calm down from. The meltdown is often caused by the smallest incident which would not typically warrant such an extreme response. When you are unable to properly communicate with your own body it can also be difficult to understand how others are feeling and why; leading to deficits in social skills and social communication. Vestibular: The vestibular and proprioceptive senses are very similar and easily confused with one another. The key difference is that the vestibular sense provides the body with a sense of spatial orientation and balance while taking gravity into account. It is directly related to the inner ear as the inner ear provides us with equilibrium (keeps us balanced) with the use of tiny little crystals. Yes, there are little crystals inside of your ear called otoconia. They shift in the ear and let your brain know how you're body is moving, in what direction and how fast. The vestibular system responds to the information and assists the body with making the necessary adjustments to maintain balance during an activity. For example, when walking on a balance beam the body needs to make constant adjustments with every step to keep your body upright and on the beam rather than letting you fall with gravity to the ground. Those who have difficulty processing vestibular information can appear lazy, hyperactive, clumsy, inattentive, impulsive, or anxious and a mixture of everything. These three internal senses are actually the foundation for the five senses we all know so well. Without our vestibular, proprioceptive and interoceptive senses, we would not be able to use our senses of taste, sight, smell, touch and hearing as accurately! There are many activities you can do with your child in order to address these senses, you can find them under the sensory section of the activities and more tab above. If you have concerns about any of your child's senses, speak to your pediatrician or contact a local occupational therapy clinic to schedule an evaluation. Occupational therapy, better known as OT, is not a widely known profession. When asked what OT is the most common responses people often give are "you mean PT (physical therapy) 'cause I know what that is," "they give older people baths at the hospital," "they are the hand people, they fix people’s hands" and my favorite answer "they help people find jobs." It can be frustrating to work in a profession that is so widely misunderstood; however the field of OT just recently celebrated its centennial in 2017, so it makes sense that it isn't as well-known as other professions.
In a general sense, OT is a medical profession that provides services to everyone across the lifespan. From newborn babies to older adults; we work to promote independence, skill development and facilitate the best possible quality of life for everyone we work with. We utilize occupational science, psychology, neurology, sensory integration and an understanding of human anatomy (among many other 'fancy' scientific based methods) to help people restore and develop the skills they need to function as independently as possible on a daily basis. Yes, these are very general explanations of OT... you're probably looking at this saying "but Bri, I still don't understand what OT is." Let’s break it down a little further. The field of OT has many different focuses, or branches as I like to call them, that each practitioner can decide to follow. For example, an OT practitioner can focus on pediatrics, geriatrics, psych./mental health, hand therapy, vision, burns, driving, sensory integration, feeding, school systems, environmental modification, lymphedema, assistive technology, seating and mobility, strokes, brain injury, hippotherapy, and the list continues. Unlike other professions, an OT does not have to stick to just one branch; much like when you climb a tree and grab multiple branches to get to the top, an OT can specialize in more than one thing throughout their career. The best way to understand OT more in depth is by looking at it by population. Pediatrics: OT for children focuses on building skills through play. Yes, I said play! The idea is to have the kiddos engage in something that is fun and meaningful to them. Play is a child's main occupation; it is what they do day in and day out to learn about themselves and the world around them. Research has shown that children learn best through play and movement activities, so OT’s use play-based techniques to help children develop skills that will allow them to engage age appropriately with their environment and others. This can be done within the home (early intervention), in school, at out-patient clinics and in hospitals. Pediatric OT is where sensory integration comes into play. A major part of pediatric OT is centered around the idea of meeting a child's sensory needs (more on this in the "we have 8 sense" blog) to help build skills. This is also where feeding difficulties can be addressed when they are related to food aversions (based on sensory sensitivities), motor planning (bringing food to mouth), fine motor skills (using utensils), visual perception/visual motor skills (being able to differentiate the food from the plate) and muscle strength of the jaw/tongue. Everything done in pediatric OT looks a lot like play, including feeding, because it is 100% play! OT’s will use ball pits, trampolines, swings, balance beams, obstacle courses, board games, scooter boards, play-doh, dolls, dress up clothes, books, puzzles, paint, white boards, chalk, craft supplies, resistance tunnels, crash-mats... basically a kids paradise. For older children, OT can assist them with the development of life skills (cooking, budgeting, medication management, etc.), transitioning to work or furthering their education, social skills and more age appropriate daily skills needed to become independent. The idea is for the OT to find what is motivational for each individual child and use those items to build skills that improve the child's overall functional independence. Adults and Older Adults: OT’s work with adults and older adults with disabilities as well as those recovering from injuries and illnesses. The goal is to assist each individual in achieving the greatest amount of independence possible for all areas of daily life. A common saying in the OT world is that we “put the ‘fun’ in functional.” When it comes to adults and older adults, ball pits and resistance tunnels just won’t do. However, OT’s still utilize unique and fun methods to develop and regain skills with this population. Some of the focus areas that OT’s address are activities of daily living (bathing, dressing, grooming, toileting, self-feeding), home management, work-related tasks, body mechanics, community activity, adaptive equipment needs, driving, hand/upper extremity rehabilitation, orthopedic rehabilitation, vestibular treatment, chronic pain, safety awareness, neurological reeducation, aging in place, visual skills and mental health. Caregivers: Across all populations OT’s not only work with and address the needs of their clients/patients, but their caregivers as well. Those caring for an individual can also have significant lifestyle changes that impact them as well as the people they are caring for. The kind of care that individuals need varies greatly- from managing physical and cognitive changes as a result of disability or illness, to managing medications and doctor’s appointments. Taking on the needs of a loved one can often leave caregivers overwhelmed, leading them to stop caring for themselves while they focus all their energy on the needs of their loved one. OT’s provide information and support to caregivers to assist them with caring for their loved ones while also continuing to maintain their own quality of life. As you can see, OT is a very unique profession. No matter what population, the overall goal is to add meaning to life by increasing independence in daily tasks. OT is an extremely rewarding profession that although not widely known, makes a huge impact on those who receive the services. So next time someone asks you what OT is, hopefully you can say something a little more accurate than "they find people jobs." |
AuthorOT Bri (Brianne Font)- Categories |