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feet forward

Put Your Best Foot Forward!

When to see a pediatric physical therapist for your child’s feet?

How do you know if your child’s little feet are functioning at their very best? Here are 10 clear signs that you should have a pediatric physical therapist screen your child’s feet so they can put their best foot forward!

Pain 

If walking causes pain in your child’s feet this is a concern that should be addressed immediately. There are a number of reasons for pain in the feet and a pediatric PT can assess and address painful walking.  

Asymmetry

Any difference in one foot compared to the other foot should be seen by a pediatric PT. Feet should look and move the same at the other foot. Seek advice if you notice a difference in foot size, a heel lifted on one side, turning in or out of one foot or any other noticeable differences. 

Toe Walking

Toe walking is an abnormal gait or walk at any age at any time! We often see children raise up on their toes when they are very excited, nervous or cold but only for a few steps and then come down to their heels to walk or run. The earlier a child is seen for toe walking, the faster the treatment and the better the outcome. Don’t Wait!

In or Out Toeing (Pigeon or Duck footed)

Toe inning or outing is a common foot alignment deficit. When the feet are not aligned, the knees are not aligned which can lead to pain and inflammation. Often it can be a sign of leg, hip or trunk weakness or all three! It could also be a misalignment of bones within the joints. Seeing a pediatric PTl will determine the root cause and help get those duck feet in a row!

Flat Feet / Pronation

Flat feet is when almost the whole foot makes contact with the floor while standing. Pronation is when the ankle collapses inward when standing. Both flat feet and pronation can cause similar problems. Postural deficits are usually present as well as over use and under used muscle groups. This imbalance causes poor body mechanics which can lead to premature breakdown of joints. Flat feet and pronation cause the body to move inefficiently. It will take more energy to walk, run and jump!  

Tripping

Children are still developing their sensory systems and body awareness which can look a bit messy. It’s common to miss a crack in the sidewalk or move too fast for their feet causing them to trip and fall. Tripping becomes a problem when they are doing it so much they are hurting themselves. Tripping on the same thing over and over, on stairs or ramps, carpets or even nothing at all can be concerning.  A pediatric PT will be able to assess why they are tripping so often and help keep them on their feet!

Fatigues Quickly with Walking

Carry me! Is a phrase often used by a child who fatigues quickly when walking. A child who has good endurance, body mechanics, postural control and strength will want to walk vs being pushed in a stroller or carried. A child who struggles with one or more of these deficits will fatigue quickly when walking and ask to be carried more often. Ask a professional if your child seems to fatigue quickly when walking vs other children their age. 

Aversion to changing shoes

New shoes or any new clothing item can be stressful to a developing sensory system. Our children who are more sensitive to change will often break down their favorite pair of shoes to a thin sole, or wear shoes that lack proper support such as slip-on type shoes. A professional can help get children into good quality shoes that support the foot properly, helping them to move with better posture and efficiency. Let’s make shopping for new shoes fun! 

Sprained or twisted ankles

This painful injury literally stops you in your tracks. It’s common once in a while but abnormal if it happens over and over again, especially when doing everyday activities. Ankle weakness, misalignment or even vision could be the cause of ankle sprains. A PT can assess and address the reason for this very painful problem. 

Abnormal gait / walk

Any abnormality of a child’s gait should be addressed as soon as possible. Sometimes it’s hard to put your finger on it because the smallest thing could be affecting their gait or it comes and goes. Listen for your child’s steps on a hard surface. It should be an even beat most of the time. Rubbing the top of their foot while walking can be a sensory movement that is affecting their gait. Running instead of walking. Gait abnormalities can easily be addressed in PT. 

High Arches

High arches do not always need to be addressed but if your child has any other deficits such as any problems above, then high arches may need extra support. A PT can assess their gait and determine if treatment is necessary. 

Pediatric Physical Therapists assess the cause of these symptoms and use conservative interventions to improve their everyday function on their feet! They will also refer you to the appropriate healthcare professionals when extra attention is required for the best care of those little feet! 

Set up a free screening with a pediatric PT to ensure your child is putting their best foot forward!

Written By: Dana Bukala, PTA

 

Visual Schedules

Importance of Schedules and Routines

Just like adults, children feel more confident and secure when their daily activities are predictable and familiar. Consistent daily schedules and step-by-step routines give children a predictable, safe day. Schedules and routines help children:

  • Feel in control of their environment
  • Feel safe, secure, and comfortable
  • Know what is happening now and what comes next
  • Know how to do an activity or task

However, what happens when you have a change in schedule or routine?  Does your toddler or child melt down or show big behaviors?  An unexpected schedule change or a change in their routine can be upsetting and stressful. If your child is struggling when transitioning between tasks or with changes in schedule or routine, BDI Playhouse recommends you use simple visual schedules to make those transitions and changes smoother.

What is a visual schedule?

A visual schedule is an image-based tool that helps support children of all ages. It presents a sequence of events for what is going to happen during a specific task, during an activity, or throughout the day.  Visual schedules help individuals complete a sequence of tasks or activities, attend to tasks, transition from one task to another, or maintain emotional regulation in various settings.

A visual schedule may use a sequence of photographs, videos, illustrations, or other visual elements that help your child understand what they are expected to do.  The visual schedule can be virtual on your phone or printed on paper.

Benefits of Using Visuals

  • Provides clarity and predictability in routine which allows a feeling of control (reducing anxiety or confusion)
  • Provides concrete visual information for (can make something abstract feel concrete, such as the length of time before an activity will be over).
  • Reduces behaviors caused by frustration, confusion, anxiety.
  • Provides a critical avenue for visual learners to understand and retain information.
  • Serves as a virtual “contract” for completing expectations and delivering rewards.
  • Assists in building independent routines with better success (such as packing a backpack, washing hands, or cleaning up after snack).
  • Helps children know what to expect and/or what the expectation is so that they don’t have to fear what will happen or become impatient and frustrated.

How to create your own visual schedule

  1. Identify your Target/Routine for the schedule
  2. Choose the type of visual that will be most meaningful to the child: 
    • Photographs of the child/child’s environment
    • Real life images
    • Line drawings 
    • Clipart
    • Text writing only
  3. Keep language simple and direct
  4. Involve the child in preparation
  5. Involve other caregivers

Easy Resources for Visual Schedules

If you find that your child is still having difficulty when you have a change in schedule or routine or need help learning how to use a visual schedule, contact BDI Playhouse to set up a free screening with one of our pediatric occupational therapists or speech language pathologists.  We can help you help your child!

Winter Swimming

Winter Swimming

Shake Off Winter Blues in the Pool!

Consider your local pool or aquatic park this winter for all it’s amazing benefits! 

Welcome winter and all it’s fun activities like ice skating, sledding and SWIMMING! The joy of swimming doesn’t have to end when winter begins. Indoor pools are the ultimate good mood booster along with so many other benefits! Open swim, swim lessons, aqua therapy and aquatic parks are amazing ways to get some exercise and a splash of the summer feels during the cold winter months.  

Winter swimming has even more benefits than summer! Here are some cool pool perks!

  • Playing in the water makes us happy! Water is a natural anti-depressent. Prevent “SAD” (seasonal affective disorder), a common syndrome in the winter months. Water submersion stimulates our sensory system, exercise releases endorphins and decreases anxiety. 
  • Master those swim skills! Practicing safety and swimming skills in the winter months will improve skills over the summer.  Motor planning for treading water, breath control, floating and swimming takes practice. Those skills are lost during the winter months and need to be reintroduced for water safety and proficiency. 
  • Create joyful memories! The family that plays together stays together! Exercising with family is not only fun but promotes a healthy lifestyle for your children to follow as they grow older. Promote year long family fitness and a lifelong healthy lifestyle.
  • Water is magic! Water play improves mobility, flexibility, balance, coordination, strength, posture, spatial awareness, endurance, circulation, attention, sensory motor integration and confidence. It decreases pain, muscle spasms, abnormal tone, rigidity, joint compression and stress. 

Concerns of increased illness from winter swimming are common. Check out these pool facts that address common miconceptions of winter swimming. 

  • Only a virus can cause a cold or flu. Viruses are more common in winter months from school and being indoors. Any indoor activity during the winter months increases the chances of catching a virus.   
  • Risk of illness is greatly reduced from a properly maintained pool.
  • Illinois Department of Health enforces rules and regulations for water quality in public pools.
  • Several studies have shown that wet hair along with cold exposure has not been linked to increase illness.  
  • Indoor pool water temperatures must be kept at 77-84 degrees and warm water pools are between 86-92 degrees for safety all year long. 
  • Prevent chills or risk of hypothermia by drying off properly, wearing a hat, and dressing appropriately for the cold weather after a fun winter day at the pool! 

Aqua Therapy is a great way to get started with a life long love of the water in a safe and accepting environment. Ask your pediatric therapist how aqua therapy can benefit your child! https://bdiplayhouse.com/aquatic-therapy/ 

Written By: Dana Bukala, PTA 

 

toy

Tis the Toy Season- Toy Guide

‘Tis that time of year again! And all your kids want are toys, toys, toys! This can feel overwhelming when adding to an already large pile of toys in the home setting. Especially when the kids don’t even seem to play with the toys already available!  

Below are some tips and ideas for bringing new toys in this Holiday season. 

1. Balance of educational and choice toys; balance of seated and movement activity gifts

    • Teach your kids from a young age that they may not get everything on their wish list.
    • Provides them with opportunities to learn about toys they may have never seen before.
    • Encourages seated attention or physical activity. 

2. Hide toys and rotate them

    • Hide old toys before new toys come out.
    • When child appears bored of toys that are available, switch toys out with the hidden box of toys. Children will forget about some toys they have, making them feel new and exciting again!
    • Continue this toy rotation as child displays readiness with multiple boxes as options. Allow child to peek into boxes and choose box, if they wish.

3. Incorporate multiple skills per toy

    • Challenge the child to create different ways to use the toy.
    • Model your own creative ways to use the toy
    • Encourage exploration of new toy.

4. Use toy in obstacle course

    • Toys that appear more challenging for a child are great to incorporate into a fun movement activity. This helps break up the challenge and decrease frustration.
    • Great for toys with multiple pieces.
    • Encourages physical activity, especially in those cold months!

5. Keep toys simple

    • Simple toys encourage creativity and imagination!
    • Toys don’t need to have a lot of lights or songs to be fun. These can actually become over-stimulating for a child.
    • Allow child independence for exploring toys with only interrupting activity if unsafe.

6. Favorite educational toy companies

    • These websites allow you the ability to choose toys based on age range so you know what activities are developmentally appropriate for child

If you want some more ideas check out our website or amazon idea page!

 

Preschool: Top 5 Reasons Why Preschool is Important

Questioning whether or not to send your child to preschool? From a therapist perspective, preschool is such an important piece to practicing skills required later down the road. It facilitates structure, independence, social-emotional learning, and the foundation for higher level skills. 

1.  PLAY AT PRESCHOOL

Play is how kids learn! They learn to use their imagination, be creative, socialize with others their age, share, and problem solve when an obstacle arises. It also provides various play experiences through structured and unstructured activities, all of which allow children to build confidence, a sense of self, and critical thinking skills.

2. STRUCTURE

Preschool is where children start to participate in more structured routines like stations, lining up, singing a morning song, or learning the days of the week. Consistent routines are important for understanding expectations, predictability, and at the same time adapt to any changes that may arise. 

3. FOUNDATIONAL SKILLS

Preschool helps you develop: 

      • Fine motor skills (pre-writing strokes, grasp, stringing beads, scissor skills)
      • Visual motor skills (building block structures, coloring)
      • Gross motor skills (catching, jumping, playing on the playground)
      • Communication skills (having conversations with others, identifying colors, asking questions)

4. INDEPENDENCE 

Preschool instills independence and provides an opportunity for children to develop self advocacy skills and personal interests. Within preschool, children start learning how to take responsibility for their actions and provide numerous occasions to complete simple tasks on their own. 

5. SOCIAL-EMOTIONAL LEARNING

The preschool environment gives children the chance to engage with others, navigate conflict, understand their own emotions, and learn about empathy. Building on these skills at a young age provides children opportunities to grow and reach their full potential and beyond. 

If you find that your child may have trouble in one or more of these areas, reach out to the BDI Playhouse office to schedule a free OT, ST, or PT screen. 

 

Written By: Kiersten Robertson, MOT, OTR/L

 

Undistracted eating- Meals without the iPad

It has become a common occurrence to see a child on an iPad while out to eat, and often enough we hear families telling stories about iPads at meals. We get it. It is hard! Kids don’t want to sit still; kids don’t want to eat right now; my kid is super picky; there’s more than one kid to take care of so the iPad acts as a babysitter. The reasons go on and the iPad makes these small parts of the day run a little bit smoother. But here are some important reasons why undistracted eating is best and tips how to try and ditch that iPad altogether while at the table. 

  • Promotes obesity OR child may not be eating enough
    • When deeply focusing on the iPad it is common to robotically continue to place food into our mouths without realizing just how much food we’ve eaten. Adults do it too!
    • Children may become SO distracted they minimally eat anything at all! Later you find them irritable and “always hungry”, as some parents report.
    • This impacts a child’s ability to listen to cues from their body (interoception) on when they feel full,  if they are still hungry, or if they need a drink of water. This is SO important! Lack of attending to our body cues can begin to impact our emotional awareness and control.
  • Promotes poor posture
    • Increases risk of future musculoskeletal problems such as back and neck pain due to leaning position
    • Carry over poor seated posture to school and play
    • Increases choking risk due to decreased attending to oral feedback telling us we’ve chewing enough times prior to swallowing and poor posture impacting alignment of swallowing mechanisms impacting ease of food movement down to tummy
  • Decreases social interactions
    • Discourages learning about others, asking questions about the world, discussing our emotions, working on back and forth conversations, discussing foods presented on plate
  • Minimizes exploration with foods 
    • “Well my kid is picky anyways…”, but that is okay!! (and may actually be a result from all the table iPad use)
    • Kid gets busy touching iPad and not exploring or playing with the food options
    • When a child gets “bored” sitting at the table they will be encouraged to fidget with anything…including food. Encourage this, even if it doesn’t get eaten.
  • But what can I do besides an iPad?
    • Fun plates (Amazon “kids maze plates)
    • Silly utensils (sometimes comes with the plates and can be found on Amazon)
    • Specified “table toys” if they absolutely need something to do while eating (especially out at restaurants)
    • List of questions to discuss with parents or siblings (best/worst part of day, what else do I want to do today…)
    • Exploring then reporting the senses of each food – smell, lick/taste, color, visual presentation (bumpy, smooth, fluffy…) and
    • comparing one strawberry to another one, feel (wet/dry, tough/soft…)
    • If you haven’t started providing an iPad at meals, don’t start it!! Even if the older sibling is stuck on the iPad at meals use. Eliminating 1 iPad will be better than having to eliminate 2.
    • If your child has trouble rapidly transitioning to no iPads at meals, then start gradually. Start with only half the meal where they can have the iPad, then decrease that time length every day until they can tolerate no iPad throughout the entire meal.

If your child absolutely cannot separate themselves from having an iPad at meal times even when attempting the above listed suggestions, has a tough time transitioning away from iPads in general, or displays additional difficulties with feeding with or without an ipad present don’t hesitate to give us a call. BDI Playhouse Children’s Therapy offers free screenings and consultations through Telehealth or at one of our child-friendly therapy gyms in Orland Park and Aurora, IL

Written by: Rebecca MacKenzie, M.S., OTR/L

Bedtime Routines

Bedtime routines are essential for getting the appropriate amount of sleep each night. Lack of sleep within children can disrupt the important cycles their bodies go through to help with development, attention and so much more. Creating a bedtime routine doesn’t have to be difficult, just utilize these tips and your child will be snoozing in no time.  

Consistency

Whichever tip you decide to implement, the most important is consistency. Providing a predictable bedtime routine that is consistent allows your child to understand the sequence of events that lead up to the point of going to sleep. Utilizing verbal reminders, prompts or a visual schedule of the tasks that need to be completed before bed, help with active engagement as well as relieving anxiety. 

 

Calm Down Time

Relaxation is an important step in falling asleep. Provide a time before bed where your child is away from alerting stimuli like a TV, iPad, or phone screen. Reading books, picking up toys, or listening to calming music is much more appropriate for a bedtime routine. 

 

Meditation

Meditation is a great way to clear the mind to decrease anxiety before going to sleep. Here are some examples to implement within your bedtime routine:

  • Deep breathing
  • Progressive muscle relaxation
  • Guided imagery

 

Environmental Changes

Changes to your child’s sleep environment is an easy and great way to make your child comfortable enough to fall asleep and stay asleep.

  • Weighted blanket/compression sheets: Utilizing a weighted blanket or compression sheets can provide the proprioceptive input children crave as they sleep. This simple change can decrease anxiety and provide a calming effect to better facilitate a good night’s sleep. 
  • Light level: Utilize curtains to block out light. A dark room helps the body recognize that it is time to sleep.
  • White noise: Static noise can block out other sounds within the environment that may be disruptive.
  • Soothing Scents: Scents like lavender or other calming smells can help relax your child before bedtime. 

 

If your child has difficulty following a bedtime routine or has continued trouble falling asleep, please do not hesitate to contact the office at BDI Playhouse Children’s Therapy to receive a free occupational therapy screening

Written by Kiersten Robertson, MOT, OTR/L

Elbow

Hypermobility in Children

What is Hypermobility?

Hypermobility is a term used to describe joints that move more than normal and can place the joints in increased stress.  

How can Hypermobility affect my child?

Risk of Injury

Increased joint movement can cause joints, ligaments, and tendons to be at higher risk of injury.  Joints are less stable and can strain all the structures attempting to make the joint more stable.  In addition to joints moving more than normal the signals to the brain about where the body is in space can be impaired due to the ligaments requiring increased stretch before the message is sent to the brain making it harder for children to know where they are in space and making it harder for them to correct the joint position prior to exposure to extremes of  range of motion.  

 

What are the common signs of hypermobility in children?

Knee HyperextensionElbow HyperextensionHands to the Floor with

Straight Knees

Flat Feet
ELBOWHands to floorflat feet

NOTE: These are all postures that can occur in typically developing children with no cause for concern.  However, when multiple joints are impacted and your child twists their ankles or knees frequently, or reports leg pain this may be a sign to follow-up with your physician. 

Who can help my child?

BDI Pediatric Physical Therapists create a strengthening and proprioception program that can improve your child’s participation in recreational activities as well as lower their risk of injuries. Exercises consist of 

  • strengthening the muscles around the joints
  • working on postural control
  • sport specific training 

 

Next Steps

Do you think your child is at risk for injury due to hypermobility?  Schedule a free screening with one of our pediatric physical therapists.  When hypermobility is identified and treated with a proper development regimen, your child will report less pain, improve balance, strength, and functional performance.  In addition, your child can prevent future pain. 

Written by: Lisa M. Wood, PT, DPT

Potty Accidents

Potty Accidents

Why is my child having potty accidents?

Potty accidents aren’t fun for anyone. It can impact a child’s relationships with their family and friends.  Here are 5 common reasons children have accidents

Constipation 

Chronic constipation is the main cause of pee and poop accidents in children that have been potty trained. This is a great handout to see if your child has any of the main signs of constipation. Did you know that pooping every day doesn’t mean they aren’t constipated? “The Poo in You” is a video with a great explanation of what happens inside the body. 

Lack of Awareness 

Many kids may not have any idea that they have to go. They may not realize that they have to use the bathroom until it’s too late, or until they’ve already gone. Knowing what is happening inside the body can be a hard concept for kids with difficulty with sensory awareness. 

Poor Potty Posture 

Poor potty posture makes it hard to clear out the bladder and bowels. The Squatty Potty  or other step stool helps support the feet which lets the pelvic floor muscles relax. Therapists can also help with postural awareness and strength to help with the proper potty posture for successful toileting.

Scary Bathrooms

The bathroom can be a scary place for kids! Sitting with dangling feet, the noise, and the smell can all make kids avoid the potty. Many children avoid public bathrooms because of these fears. 

Medical Reasons

There could be a medical reason your child is having accidents. If you have concerns about your child’s accidents talk to your pediatrician. They can help decide if a referral to gastroenterology or urology is needed.

 

Who can help my child?

If you think your child might have constipation or is struggling with accidents, please reach out for a free screening! Sometimes, you may need the help of a physical, speech, or occupational therapist to help identify the reasons for your child’s accidents and/or constipation. 

Pediatric Therapists

Therapists trained in pediatric incontinence can provide treatment with:

    • Core strengthening
    • Biofeedback
    • Bladder re-training
    • Behavior and diet strategies
    • Body awareness to help realize the urge to go 
    • Posture training
    • Increasing fiber rich food intake 
    • Increasing variety of foods
Halloween

Halloween Activity

Happy Halloween month! At BDI, the therapists have been incorporating Halloween vocabulary throughout their sessions!  This simple activity of stickers and real image vocabulary card can be used to target all different areas of communication, fine motor skills, and visual processing.  Targeting holiday specific vocabulary can help your child communicate in their community.  Why?  Because our kiddos are seeing Halloween items everywhere (i.e pumpkins on walks in their neighborhood to spooky spider displays at the grocery store)!   The following are examples of ways to achieve different developmental goals by using the same activity.

Halloween Bingo

Matching

Starting out, simply matching the animated sticker to the real image is a perfect way to help teach reality vs. fantasy and to make sure the child isn’t just memorizing one specific image!

Imitation

The child imitates the vocabulary word and receives the sticker to mark as “complete”.

Independent labeling

The child labels the Halloween card or sticker independently

Receptive identification

If your child is a great talker but needs to work on his/her listening skills, you can ask your child questions!  For example, you can ask your child “where is the cat?” or “which one is round and orange?”.  Columns or rows can be covered to reduce the amount of items he or she is scanning.

Image description

After basic labeling is mastered, you can have your child be more descriptive with their request.  The child can request the “black cat” sticker, “scary spider”, “two bats”, “silly pumpkin” etc.

Simple requesting

“I want + vocabulary word” or “Can I have + vocabulary word”

Complex requesting

“I want the purple hat”; “I want the scary ghost”

Articulation

Try finding all the final /t/ sounds in these fun Halloween words!

Are you looking for more ideas on how to make every day activities a little more festive?  Join our Talk and Groove class to learn about more ways to help your child develop their language and fine motor skills at home!