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11. Mama Pig, 3rd Little Pig, Brick House, Big Bad Wolf

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10. Keeping Safe from the Big Bad Wolf- Following Directions

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February- sorting Animal Homes vs. People Homes

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February- sorting Animal Homes vs. People Homes

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9. Things We Find in Animal Homes and People Homes

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February- short vowel e, consonants k r and w

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February- short vowel e, consonants k r and w

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8. Short Vowel e and Consonants k r and w

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February- Animals on the Hunt for Homes (book)

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February- Animals on the Hunt for Homes (book)

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1. Book- Animals on the Hunt for a New House

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January- Activity 5- Sounting Words and Syllables

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January- Activity 4- Patterned Sentences

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January- Activity 3- Story- In Iris's Lunchbox

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January- finish the sentence

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January- Activity 2- Finish the Sentence

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January- Activity 1- Story- Roman Can Move

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December- My Family Traditions: tracing and sentence formation

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December- My Family Traditions: tracing and sentence formation

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November- Nummber Recognition and Counting

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November- Letter Introduction:  u g and h

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November- Letter Introduction:  u g and h

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November- Introduce Letters and Sounds- U G H S

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The attached story will be used to complete several of the activities posted for October 2020.

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Level 1- help your child point to the correct animal, matching it to the animal in the window
Level 2- help your child point to the correct animal after you name the correct animal
Level 3- help your child point to the correct animal after you read sentence, placing the correct answer as you help your child point to it

This can also be printed to complete as well.

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Read the story with your child, it will help with later activities.

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October- Who Am I- guess the animal based on the given clues

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October- Who Am I- guess the animal based on the given clues

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Level 1- help your child point to the correct animal based on the given details
Level 2- help your child point to the correct animal after you name the correct animal
Level 3- help your child point to the correct animal after you read the hints and use hand-over-hand to point to the correct answer

This can also be printed to be completed

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Online:
Level 1- have your child trace the lines with their finger on the computer screen
Level 2- assist your child in tracing the lines with their finger on the computer screen

Print page:
Level 1- have your child trace the lines with a fat crayon or fat marker
Level 2- assist your child in tracing the lines with a far crayon or marker
You can laminate or place in a sheet protector and use a dry erase marker if you want to practice multiple times. Rolling out playdough to place on the traced lines is another fun activity

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Level 1- have your child trace with a writing utensil
Level 2- have your child trace with their finger
Level 3- help your child trace with their finger

Can be done on the computer or printed out.

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Level 1- have your child trace with a writing utensil or stylist
Level 2- have your child trace with their finger
Level 3- help your child trace with their finger

Can be printed or done on the computer. Another fun activity is to make each letter out of play dough!

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Print and have your child draw a face on each animal. Using pipe cleaners and other items to help make faces is a great extension!

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Level 1- ask your child to trace the numbers, write the number and then count each dot/circle
Level 2- ask your child to trace the numbers, assist when needed, and then help them count each dot/circle
Level 3- help your child use their finger or writing utensil to trace the numbers, then write and count each dot/circle

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Use the cards to run like various animals, model for each and see if your child can copy.

Extension- have your child tell you to move like an animal!

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Help your child say the sounds on each card, then help them find words that also begin with that letter. Use hand over hand, when needed. (best if printed

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Help your child determine which animal is being described.

Level 1- ask the questions and let your child point to the correct answer.
Level 2- ask the question and assist your child in finding the right answer.
Level 3- ask the question and help your child point/touch the correct answer.

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Help your child sort the items, use this as a chance to talk about each item.

Level 1- have your child sort the animals by pointing where each goes, or print and have them place in each circle
Level 2- point to one animal and ask your child if it is a house pet or zoo animal, help guide them when needed.
Level 3- point to one animal and say whether it is a house pet or zoo animal.

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Read the directions and help your child complete the activity.
(printer needed)

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Level 1- help your child label the pictures and ask them which comes next.
Level 2- label the pictures with your child and assist them in finding what comes next.
Level 3- label the pictures with your child, pointing to each ask you say it, then assist them in touching the items that comes next.

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Help your child trace the letters for each color, if you print it, have them color the crayons in as well.

Level 1- Have your child touch each blue item and then brown item, showing which circle it should go into.
Level 2- Help your child to find a blue items, then brown item, etc.
Level 3- physically assisting your child, have them touch each colored item while you say the color name.

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Have your child find each rectangle, then move onto other shapes when ready.

Level 1- ask them to touch each rectangle they see, or circle if your print it.
Level 2- model where the shape is, ask them to find another.
Level 3- assist your child in touching each shape, while you name them.

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Have your child place one of the same image on the other image. (needs to be printed)

Level 1- have your child count as they place the item down
Level 2- help your child count as they place the items down
Level 3- help your child place each card, as you count out loud.

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Help your child count the items and find the correct answer.

Level 1- model and allow your child to work through the numbers, assisting when needed.
Level 2- model and help your child find the correct answer.
Level 3- model how to complete and assist your child in completing the activity

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Read the story with your child, encouraging them to copy the sounds.

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Common questions that parents often ask therapists are: "When should my child crawl or walk up the stairs?" and "How can I help my child safely walk up and down the stairs?"

Stair climbing may sound nerve-racking, but it is actually a great way to keep children safe. It is important to teach your child how to correctly go up and down the stairs, especially when they encounter stairs in different environments.

Make sure you have safety gates on your stairs, especially when teaching your child the correct way of walking up and down the stairs.

Initially, start practicing a few steps at a time before tackling the entire staircase.

It is easier to learn how to walk up the stairs than down.

Once your child has mastered walking up three to four steps, you can then practice on a full set of stairs.

Be sure to stand behind your child when they are walking up the stairs for optimal safety. When walking down the stairs, stand below and slightly to the side of your child.

Two years: Toddlers begin walking up and down stairs using a non-alternating stepping pattern with hand held or rail assistance

Three years: Children begin walking up the stairs using an alternating stepping pattern without the handrail, and down stairs using a non-alternating pattern.

Four years: Children begin walk up and down the stairs using an alternating stepping pattern without support.

Always remember that every child develops at their own pace, and they may achieve these milestones at different ages.

Tips & Tricks to Encourage Stair Climbing

1) Step Stool: Place a against elevated surface. Have child step up onto the step stool to reach for toys placed on top of the surface. Then have them turn around and step down with hand held assistance as needed.

2) Sit to Stand: Place the in front of elevated surface and have your child stand up to retrieve a toy. Encourage child to push through legs without upper body support to target lower body and trunk musculature.

3) Bicycle Kicks: This is a fun exercise for children and helps to strengthen the leg muscles, abdominal muscles, and improve body awareness. As the child lies on back, hold ankles and passively move legs forward and back, as if they are pedaling a bicycle. Sing a song as you pedal to keep child engaged & entertained!

4) Single Leg Balance: When a child walks up or down the stairs, they have to be able to balance on one leg in order to bring the opposite leg to the next step. While your child is playing with toys placed on elevated surface, sit right behind them and lift up one leg off the floor for 10 seconds, repeat on other leg.

To challenge your child, you can have them stand on a balance disc or pillow and perform the same leg lift.

Place stickers or tactile foot prints on stairs to help child develop reciprocal motor pattern.

Verbal commands such as "one, two" or "step and step" can help promote alternating feet when negotiating the stairs.

If your child has a difficult time alternating feet with visual cues alone, stand below the child, supporting at hips and help shift their weight to offload as they step either up or down.

6) Sensory Strategies for Stair Climbing

Tactile: Use tactile element on each step (tactile footprints, felt cutouts, fine grain sand paper) with child barefoot to reinforce foot placement

Auditory: Use auditory cues to establish cadence with clapping, egg shaker, or song

Proprioceptive: Ask child to stomp feet to provide deep input and promote full weight bearing

Visual: Strips of brightly colored tape can help encourage alternating feet on step stool, stairs, or any other surface.

Soft stairs are great for little ones to practice crawling and climbing up and can be part of playroom obstacle course!

If you do not have stairs at home, can practice with two placed back to back!

Stepping up and down from curbs in the neighborhood.

Practicing stairs in the community (playground, library, shopping center, restaurants, and friend's houses) will help generalize skill across different settings!

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Stair Climbing Tips and Tricks: Teaching Children to Climb Stairs

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Common questions that parents often ask therapists are: "When should my child crawl or walk up the stairs?" and "How can I help my child safely walk up and down the stairs?" Stair climbing may sound nerve-racking, but it is actually a great way to keep children safe.

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One of the most common requests I receive from families is how to Encourage Independent Walking. Once that year birthday mark passes it seems our "new parent" anxiety reaches its peak, questions from family and friends, "So is he walking yet?"or "Has she taken her first steps?"

One of the first reassurances I can give families is that Motor Milestones exist on a continuum. Each child achieves these skills at their own time, in their own way. Though we learn motor development from textbooks positing neurodevelopment theory to explain skill acquisition and motor patterning, the manifestation of this progression takes on distinct characteristics when we look at each child as a unique creation.

There are differences in personality, some children are always seeking, searching for new sensory experiences, investigating each new noise, new scent, new image. Other children are happy to be more sedentary, allowing the objects and people in their life to come to them, engage with them on their level. Sometimes we, as parents and caregivers, need to encourage a bit more exploration to facilitate not only gross and fine motor development, but language acquisition as well.

Our own son and Dinosaur PT mascot, Abe, was not yet walking at his one year birthday and what follows are some helpful suggestions that I have had success with both as a Pediatric Physical Therapist and a mom!

Tips to Encourage Independent Walking

Barefoot standing and navigation also promotes more natural weight shifting and weight bearing which helps child build both static and dynamic balance necessary for independent walking. So take off your shoes and socks and join in the barefoot walking on grass, sand, padded mats, solid floors...the possibilities are endless!

Abe has been really motivated by the shape sorter, so that is placed at the most elevated level these days!

To reach certain objects Abe gets up on his toes (check him out in this Activity of the Week!), then squats down low to reach others. As he brings certain items to me, either a book to read together or the colorful coins to help him put in his piggy bank, he is encouraged to let go of his upper body support, rotate his body, stand independently, and ideally take a short step or two.

This will promote less reliance on upper body external support as the child reaches away from outside support they will activate their own base of support, engaging dynamic balance reactions, promoting trunk strength and weight bearing through stable lower extremities.

Promoting standing and walking while child is holding object with bimanual grip using both hands will discourage reaching for support and encourage more activation of trunk and lower extremity muscles. O-Ball offers some great options, two (one for each hand!), a large stuffed animal, anything motivating that requires both hands to be engaged and active so that the child's trunk and lower body are called upon to maintain balance and stable support.

As you can see in the above photos, Abe is holding one in his right hand, reaches across midline to grab the other musical toy with his left hand and with both hands occupied, he stands independently!

Sit to stand transitions from low bench, cube chair or foam roller, promoting knees over toes pushing up into standing(vs using upper body to pull up to stand).

Floor to stand transitions rising from sitting to tall kneel to half kneel to stand (promoting development of trunk and lower extremity musculature).

Tip#6: Introduce idea of "dynamic support". Pushing weighted shopping cart, toy car, or large therapy ball all help to encourage weight bearing and moving through space with less reliance on static source of stability.

Promoting weight bearing through legs, weight shifting, and less reliance on stable support as the child has to begin to anticipate the movement and adjust their body accordingly.

Tip #7: Encourage independent walking by climbing ramps and stairs, to promote trunk and lower body dissociation and strengthening.

Different settings bring different experiences, new challenges and new incentives to interact physically with surroundings! A great way to encourage independent walking, generalize skills and prevent any degree of complacency.

Each skill acquired no matter how big or small is a great accomplishment that should be relished and applauded for you and your child!

Tip #10: Ask for help. If all else fails, ask for help. Pediatric Physical Therapists can offer activity suggestions, equipment ideas, and help to assess any underlying reasons for the developmental concerns you may have. No judgments, just helpful guidance await if you reach out to the right professional!

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Teaching Children to Walk Independently!

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One of the most common requests I receive from families is how to Encourage Independent Walking. Once that year birthday mark passes it seems our "new parent" anxiety reaches its peak, questions from family and friends, "So is he walking yet?"or "Has she taken her first steps?"

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Toe Walking is defined as the failure of the heel to contact the floor at the onset of stance during the gait cycle, resulting in a bilateral toe to toe gait.

Idiopathic Toe Walking (ITW), as its name implies, refers to the manifestation of this gait pattern without a known underlying pathological cause. This is a diagnosis of exclusion, in which other conditions causing an equinus gait have been ruled out.

Differential Diagnosis

In considering differential diagnosis, it is important to take into account any potential underlying neuromuscular or musculoskeletal conditions. Toe walking may be caused by Cerebral Palsy, congenital contracture of the Achilles tendon or paralytic muscular disorders such as Duchenne Muscular Dystrophy. Idiopathic Toe Walking may be associated with developmental disorders such as Autism or other myopathic or neuropathic disorders.

The majority of disorders causing toe walking can be ruled out through the history and physical examination, resulting in a diagnosis of Idiopathic Toe Walking. A child with a diagnosis of ITW will present with a normal neurological exam with respect to muscle tone, reflexes, sensation and strength. The child may or may not have a passive limitation in ankle dorsiflexion. Idiopathic Toe Walking will always exhibit bilateral and symmetrical presentation, as opposed to some other neurologic conditions which may cause unilateral or asymmetric toe walking.

A study by Sobel et al revealed that the majority of child who present with Idiopathic Toe Walking had a normal birth weight, walked on time, began to toe walk immediately in their gait development, stood mostly in plantigrade (feet flat), were able to demonstrate heel-toe gait when instructed, and only toe walk intermittently.

It is theorized that ITW may be one element of a more global neurodevelopmental condition, since many of these children present with other diagnoses concomitantly. Many young children are recognized as having a toe-walking tendency when they first start to walk, which is not considered an anomaly. However, if this pattern persists beyond 2-3 years of age, it should be labeled as ITW in the absence of any other pathology. A study by Le Cras et al reported a higher incidence of ITW in males as compared to females, and that a family history of ITW often exists.

Idiopathic toe walking may be linked to hyper or hyposensitivity. Some children may not like the feeling of different surfaces on their bare feet, which cause them to rise up on their toes to avoid having the full surface of their feet contracting floor. For children who are seeking more input, toe walking increases the force of impact felt during ambulation, as the ground reaction force is distributed through a smaller surface area at the metatarsal heads.

In order to best determine an ideal treatment protocol, a comprehensive history should be taken. Children who ambulate later or skip developmental milestones which limit weight bearing, often present with ITW later on.

Does the child toe walk when wearing shoes?

Do you notice more or less toe walking when ambulating barefoot on different surfaces? For instance sand at beach, grass at park, hard wood floor, carpet.

Is the child able to achieve and maintain full range of motion at ankle?

Evaluate passive vs active range of motion of gastrocnemius, soleus and hamstring complex.

Assess the child's overall lower extremity biomechanics from position of pelvis, knees and feet.

Assess child's static vs dynamic arch formation of foot. Often times children with ITW will have weak intrinsic plantar muscles, and use toe walking to compensate.

1.Passive Range of Motion

Calf Stretch (Ankle dorsiflexion/plantarflexion): With the child lying on back or seated, hold child's foot in hand. Apply light pressure flexing foot up towards child's head. Once you feel resistance, hold for 15 seconds, alternate feet and repeat stretch.

Hamstring (Knee flexion/extension): With the child lying on back or seated, with opposite knee bent or flat on floor, lift child's leg with knee straight until you feel resistance. Hold for 15 seconds, alternate legs and repeat stretch.

Have child stand supported/unsupported without shoes on dynamic surface. The and 2. Active Range of Motion balance board are all great tools!

As child shifts body weight to maintain balance, the child will experience an active stretch of the affected musculature.

Animal walks are helpful to encourage active range of motion while still having fun!Some examples include:

Bear Walk (with hands and feet on floor, knees not contacting surface)

Crab Walk (start in bridge position, keeping bottom off floor, moving forward or backward using hands and feet to propel)

Frog Jump (start in deep squat, encourage full foot contacting surface during jumps).

Penguin Walk (with heels contacting floor and toes up)

Intrinsic Plantar Muscles: you can target these small muscles by picking up objects with toes. Try "toe basketball" lifting small pompoms with feet and placing into cup to score!

Anterior Compartment Musculature: we can promote active dorsiflexion with "bean bag elevators" using . Allow child to flex ankle to target lower body strength and active range of motion of ankle and foot musculature.

Navigating seated Scooter Board helps to engage anterior compartment musculature and provide additional weight bearing element to heel as child propels forward.

Stepping or jumping overoroffer additional ways to activate trunk and leg musculature!

Abdominal Musculature: dynamic activities which challenge core strength include seated/standing balance on dyna-disc or

Sitting on therapy ball or peanut ball shifting weight back and front, side to side will help activate abdominals and obliques.

Bridging exercises are great not only for trunk strengthening, but utilizing the dyna disc as seen above also incorporates arch activation of both feet!

4. Weight-Bearing Activities

Encourage barefoot standing using a variety of textures, promote squat to stand with fun activities to facilitate weight bearing. We always love dyna-disc orfor these activities!

Squats on the are great for lower extremity strength, stability and weight bearing through full plantar surface of foot!

Use tactile footprints to promote alignment during obstacle course or navigating stairs. Offering helpful visual and tactile cue to encourage full foot weight bearing.

A hoop ladder is great for weight bearing with focus on strengthening anterior compartment musculature and focus on motor planning!

Hopping across offers great dynamic weight bearing work. Encourage forward, lateral & backwards hopping skills to increase challenge.

5. Sensory Integration Strategies

Joint compressions

Encourage barefoot exploration of different surfaces (sand at beach, grass outside, soft gym mats, hardwood floors)

Use of tactile material inserts in shoe

Heavier shoes/high tops with ankle cup to control foot alignment

Proper shoe selection can make a big impact on toe walking as well! Learn more about What a Difference a Shoe Can Make here!

References:

1. Le Cras S, Bouck J, Brausch S. Evidence based clinical care guideline for management of idiopathic toe walking. Cincinnati Children's Hospital Medical Center. 2011.

2. Sobel E, Caselli M, Velez z. Effect of persistent toe walking on ankle equinus. J Am Podiatr Med Assoc. 1997 Jan; 87(1):18-22.

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Toe Walking in Children: Physical Therapy Treatment Ideas

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Toe Walking is defined as the failure of the heel to contact the floor at the onset of stance during the gait cycle, resulting in a bilateral toe to toe gait. Idiopathic Toe Walking (ITW), as its name implies, refers to the manifestation of this gait pattern without a known underlying pathological cause.

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This post will explore fun activities for children using the Peanut Ball! The Peanut Ball is a great piece of equipment that comes in a range of sizes to suit each child's unique size & therapeutic needs! It is a great dynamic sitting option, providing a bit more stability than a standard exercise ball. Encouraging weight bearing through lower extremities, while leaving the upper body free to engage in crossing midline, reaching and manipulating objects. The peanut ball can be used to promote developmental positions such as prone propping, quadruped, and tall kneeling. It is also a fun tool to incorporate in dynamic balance challenges for older children!

We use the as an alternative sitting option to address trunk strength & stability as well as postural awareness and alignment. Note in straddle sit the child is able to maintain feet flat with hips, knees & ankles at approximately 90 degree angles, which is optimal for active sitting. Pictured above, the child is able to engage abdominal & back musculature while interacting with toy placed on top of .

We can change the size of the to facilitate proper positioning for each child. Here we utilize the peanut ball to promote postural control as child uses to engage upper body strength & stability.
2. Prone Extension
Prone over the peanut ball is a wonderful way to encourage shoulder stability and strength as the child pushes up off the surface using upper extremities as well as trunk musculature. Note the extension of the head & neck as well!
3. Quadruped
We can use the peanut ball to promote quadruped positioning (weight bearing through hands and knees).

Utilizing the peanut ball as a dynamic support during bridging exercise is a fantastic way to challenge lower extremity & trunk musculature. We also promote full weight bearing through feet, which is especially great for children who present with toe walking providing additional proprioceptive input through lower extremity joints!

The peanut ball is a wonderful dynamic surface to practice sit to stand transition. We start with child side sitting on peanut ball. We can use visual cues on floor for foot placement like these . The peanut ball encourages child to begin transition by engaging trunk musculature before weight bearing through legs to rise into standing, promoting proper biomechanics, weight shifting and motor planning.

We hope you enjoyed our Five Fun Activities with the Peanut Ball! For more activity ideas check out Five Fun Activities with Dyna Discs!

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Five Fun Activities with the ...Peanut Ball! - DINOSAUR PHYSICAL THERAPY

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This post will explore fun activities for children using the Peanut Ball! The Peanut Ball is a great piece of equipment that comes in a range of sizes to suit each child's unique size & therapeutic needs! It is a great dynamic sitting option, providing a bit more stability than a standard exercise ball.

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W-sitting in Children; Wsitting Treatment Strategies for children; Alternative Sitting Positions to W-Sit; Pediatric Physical Therapy Wsitting

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Novemner- Fine Motor- Tracing Lines Letters

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November- Number Recognition and Counting

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November- Number Recognition and Counting

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November- Nummber Recognition and Counting

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November- Introducing Letter Sounds U G H S

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November- Introducing Letter Sounds U G H S

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November- Introduce Letters and Sounds- U G H S

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December- Traditions Day at School (story)

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December- Traditions Day at School (story)