Boy Learning to Walk 2

This kiddo is 18 months old and working on taking his first steps. This is the second video from the same day. As you can see, walking is challenging and he is only able to take a few steps before falling onto someone for support. One of his next steps is to be able to walk to our hands and stop or stand and balance while playing. ...

Boy Learning to Walk 1

This kiddo is 18 months old and working on taking his first steps. As you can see, this often looks more like controlled falling than what you or I think of as walking. But we all start somewhere. He presents with extra motion in his joints and weakness throughout his muscles. These make it hard to balance and take controlled steps, but he and Mom and doing a good job practicing and keeping it fun. ...

Learning to Use a Toddler Slide

This kiddo is blind due to Leber Congential Amaurosis. She loves movement and enjoys going to the playground with her family. Many months ago we tried to introduce her to the slide but she was very afraid and so we put it away for a while. Every month or two we would talk about the slide and maybe sit on the bottom of it, but otherwise she was unwilling to try it out. She is now attending preschool and has been becoming more independent, walking more in her home and school environment and exploring outside. It seemed like it was time to try the slide again. I wish I had a video from the beginning of the session because the transformation is amazing.

One of her absolute favorite things to do is to jump on the trampoline so I used that as a positive reward while sprinkling in moments on the slide. Initially we investigated the slide with our hands since it had come in from the garage where it was cold. Because this was new and interesting to her we could use that as a starting point to learn about the slide and feel our hands move all over it. Eventually we progressed to sitting on the bottom of the slide or sliding down just a few inches of the slide before standing up on the trampoline and jumping. This gave her time to process through what we were learning about the slide. We also used lots of verbal cuing throughout the beginning of the session. After jumping a bit, I asked her something about the slide and we would practice stepping off the trampoline and walking to the slide. Little by little I would help her sit on the bottom of the slide, then I would slide her bottom up the slide at first a few inches, then a foot or more, until eventually we were sliding down from the top of the slide. The next step was to add on going up the steps and then down the slide all in one go. This process is called backwards-chaining where we start at the end of a task and add activities that build toward the beginning of the task. Sometimes starting from the beginning is just too overwhelming for kiddos.

Again, once we started the steps we gave her lots of support and many verbal and tactile cues, allowing her to feel very supported and build her confidence with this new activity. I also let her use whichever leg and body movement she felt comfortable with to start. The hardest part was learning how to move from the top step to sitting on the slide with her feet facing down. Once we practiced that a few times she became much more comfortable. At this point we had moved the trampoline away from the slide and after every slide she would walk to the trampoline, step up, and jump. Soon she was asking to change from the trampoline to the slide and was accessing the ladder and slide completely independently, without cuing or physical assistance. We even progressed to practicing leading with her non-preferred leg and stepping one foot over the other. Her progress was amazing.

Over a long time working together we have developed a good relationship where she knows I ask her to do hard things but I am going to keep her safe. This doesn't mean that what we ask her to do isn't scary since she doesn't have vision for her to learn through watching others or seeing her end-point. We complete all sessions with a lot of support initially and a very gradual and progressive removal of those supports in hopes that she will be independent. Although I knew it was time to try this activity, I could not have imagined how much progress she made in this one day. ...

Girl with 8p Inversion Duplication Deletion Syndrome working on anterior weight shifts

This kiddo has a rare chromosomal disorder called 8p inversion duplication deletion syndrome. We have been working on sit to stand during therapy and during this session we are working on a forward weight shift in order to attain standing. She is somewhat propped on the edge of a chair cushion, giving her the best chance to activate her gluts and also giving her a small range to work from perched sitting to standing. She is wearing a type of AFO of which you may not be familiar. It is called a Ground Reaction Ankle-Foot Orthosis (GRAFO). We are using this device to try to optimize her knee control and maximize her ability achieve greater hip and overall trunk extension in standing. ...

Girl with 8p Inversion Duplication Deletion learning to push to stand

This kiddo has a rare chromosomal disorder called 8p inversion duplication deletion syndrome. We have been working sit to stand during therapy and during this session we have progressed to more of a push-to-stand instead of pulling herself to stand. The main difference here is that she has to use her legs to push herself up instead of using her arms to pull. She also has to have better balance since she only has 2 points of contact (at her feet) and no additional support through her hands. Although she is concerned about staying balanced she is really excited to be standing up so tall when she gets there. She even takes a little dance break. You may notice she is wearing a type of AFO of which you may not be familiar. It is called a Ground Reaction Ankle-Foot Orthosis. We are trying to optimize her knee control and maximize her ability achieve greater hip and overall trunk extension in standing. ...

Learning to Balance with a Peanut Ball

This is a girl with visual impairment due to bilateral retinal detachment who is learning about where midline is and how to balance. She is blind and so can't use her vision to help guide her in learning what upright means. She also struggles to coordinate her movements and so is delayed in learning how to make corrections to her position when she gets off balance. The peanut ball is a great tool to help support her and challenge her at the same time. Because she is blind we want to be sure to intentionally add in extra opportunities for vestibular stimulation so that she can learn to interpret this input and use it to help her to balance on her feet some day. ...

Kneeling at a Peanut Ball

This is a girl with visual impairment due to bilateral retinal detachment who is learning how to hold herself up on her knees. She does not really enjoy tummy time and so the peanut ball is being used to provide support under her chest and arms while she learns to tolerate a modified tummy time position. At this time, she is also working on strengthening her body to hold herself on her knees. The combination of these things will ultimately allow her to be successful in quadruped, holding herself on her hands and knees. Because she is blind we want to be sure to intentionally add in extra opportunities for vestibular stimulation so that she can learn to interpret this input and use it to help her to balance on her feet some day. ...

Learning to Move from Lying to Sitting Through Sidelying

This is a little girl with delayed development who is learning how to transition from her tummy to sitting up. As you can see, she doesn't like being on her tummy but she immediately calms once she is sitting up. It would be helpful for her to be independent with this movement so that she doesn't become as distraught about being in prone (on her tummy). This move starts with her rolling onto her side and then pushing down through the floor to raise her trunk. ...

Exploring Outside

This is a girl who has historically been a toe walker, has reduced strength,
poor core activation and motor coordination along with difficulty with
attention and following directions. She has been receiving therapy for 4
years and is now working on safety awareness to reduce falls, endurance
activities, and overcoming more challenqing obstacles. She wears a
backpack with extra weight in it to provide additional proprioceptive input to
her body so that she is better able to cope with challenges and move her
body. ...

Learning to Jump on a Trampoline

This is a girl with Kabuki syndrome who is learning how to jump on a trampoline. She recently learned to jump on the floor but the trampoline gives her the opportunity to jump repeatedly and maintain her balance. Jumping gives her a lot of vestibular input that can help with her learning about how her body moves and how to control that movement. Although this is a gross motor activity, we always try to incorporate language and cognitive skills into our session when we are able. You can see that she is using sign language to communicate at this time. ...

Learning To Put On Socks

This is a girl with visual impairment due to bilateral retinal detachment who is learning to put her socks on. She has become more interested in participating in her daily routines and becoming more independent. Because she is blind, learning new things has to be more intentional for her caregivers and therapists. Body labeling and directions such as up, down, forward, backward, in, out, on all need to start at a very early age. We utilize verbal and tactile cuing along with hand-under-hand as much as realistic. ...

Rolling Prone to Supine

This little girl is 8 months old and is learning how to roll from her tummy to her back. You can see that she gets stuck rolling over her left arm. One of the key parts to helping our little ones roll off their tummy is to make sure their arms are tucked into their body and under their shoulders. This allows rolling to happen more easily and naturally as they turn their head or push with an arm or a leg. ...

Learning to Use a Z-Vibe

This is a girl with a rare chromosomal disorder called Smith-Kingsmore Syndrome causing visual impairment who is tactually exploring a Z-Vibe for sensory motor stimulation and to help build oral tone. As part of her syndrome, she has hypotonia (low muscle tone or readiness) which affects her ability to activate her muscles in her body and her mouth. Because of this she is not yet eating age-appropriate stages of food. She also seeks out proprioceptive input in and around her mouth and usually achieves this by drumming her hands/fists into her mouth. We are trying to redirect this activity into more appropriate ways of gaining this input. She appears to enjoy the Z-Vibe although she is not yet grabbing it and bringing it to her mouth herself. You can also hear her giggling one point during the video. ...

Rolling Back To Tummy

When a kiddo is first learning to roll they often draw their legs up into the air and use the momentum as they fall to one side to learn to roll onto their tummy. This technique keeps the trunk (shoulders through hips) moving together; we call this log rolling. Later on kiddos develop a more advance way of rolling by rotating their body in order to roll. You can see that once this kiddo rolls onto his side his mom rolls the ball out of his way to encourage him to reach for the ball in order to bring his trunk over his shoulder and be more balanced on his tummy to complete the roll. ...

Stepping into Shoes in Standing

This little guy is 19 months old and is learning how to balance on one foot and step the other foot into his shoes. This process includes him needed to use his lower visual field to scan for his shoes and coordinate placing his toes into those shoes. He currently needs a lot of prompting but is learning this skill quickly seeing how this is his fist attempt at it. ...

Rolling Supine to Prone

This little girl is 8 months old and is learning how to roll from her back to her tummy. You can see that she is reaching over her right side for a toy and as she makes that reach her mom moves the toy above her head so that she finishes rolling her body over her right side and lifts her head. ...

Crab Walking Over an Obstacle for Core Strengthening and Motor Planning

This video is of a girl who was born prematurely with a maternal history of drug use who currently is being seen for strengthening, coordination, and endurance activities. She is demonstrating sideways crab walks over an obstacle and this is her first time attempting this task. While activating gluts and abdominals is important, when working with kids it is also important to have fun. Although this task took multiple times to complete, she enjoyed the challenge and was eventually able to be successful. ...

Girl with Rare Syndrome Practicing Balancing on One Leg

This is a kiddo with Charge syndrome who is practicing balancing on one leg. This skill is important for standing from the floor, dressing, and managing stairs safely, to only name a few. Balance is a skill that requires information from our visual system, vestibular system, and proprioceptive system to integrated is not fully mature until 12 years old. Kiddos with Charge Syndrome have changes in many different areas of their body. This kiddo has colobomas which affect her vision along with changes to her inner ear which affect her vestibular system. Despite these difficulties, she is walking independently on level and uneven surfaces, ascends stairs one foot on each step independently, and is nearly independent with descending steps in the same manner. She gets stronger and better with every session, but we spend a fair amount of our time working on progressing her balance skills and independence. In addition to helping her get better at functional skills, we want to try to keep things fun so that she remains engaged. During this video she is trying to tap the small block off the cups without knocking over the cups. We have used progressively smaller blocks and higher stacks, each of which make the task more challenging. ...

Learning to Sit Up

This is a little girl who has just learned how to move from lying to sitting independently. There are a couple of ways that kiddos learn to sit up. One is demonstrated here, where the kiddo rolls from their back to their tummy and then moves onto hands and knees and pushes themselves back into sitting. She just recently mastered this skill and is very proud of herself once she is all the way up. The position you see her in at the end is called side-sitting and is a wonderful position for helping kiddos to engage their core muscles while sitting and easily move between sitting and hands and knees, also called quadruped. In addition you may have noticed that she is wearing a helmet to help correct plagiocephaly that resulted from torticollis. ...

Learning to Vision and A Button

This is a girl with a rare chromosomal disorder called Smith-Kingsmore Syndrome causing visual impairment who is learning how to use her vision to engage with people and her environment. As part of her syndrome, she has macrocephaly (a head that is larger than normal) and so struggles to control her head. She is using a borrowed chair that has allowed her to try to access her postural control muscles more and try to turn her head to see things more. She also has visual impairment and so we are using a bright colored toy with music and movement to gain her interest. You can also see that she has a button/switch on her tray. She has been learning to use buttons to access toys and to communicate with others over the past couple of months. The button is placed off to her side in order to reduce accidental contact but not so far too the side that it wouldn't be within her available reach. You will also see that she seeks proprioceptive input, as seen by her drumming her hands against her mouth. You can also hear her attempting to verbalize at one point during the video. ...