The 4 Essential B’s of Early Childhood

When working in the homes of families as an EI therapist I notice many things about a family. The longer I’ve done this work in the family’s natural environment, I’ve become more accurate in picking up small cues about the family…things like, What they value. What time of day they like best. What they want to learn from me and our session. What their comfort level is with a therapist sitting on their floor and jumping into their daily routines. The list really could go on forever.

And as a self described people watcher, I’ve come to know that 1) These things really matter in helping me to do a good job, and 2) They vary GREATLY from family to family. There are very few consistent trends when it comes to my interactions with families in their space…with a few exceptions. The largest exception I see is a parent’s desire to make sure their child has what “they need.” This desire seems universal to me. I’m often asked to recommend toys, asked if they have the “right things,” and asked to make gift recommendations for upcoming birthdays or holidays. Despite family income, I see a trend in family’s feeling that their child needs STUFF. And I understand it. Because I am a mom.  And I also love toys. And because the companies that market to us as parents want us to think that MORE is MORE.

As therapists, we believe the opposite – LESS IS MORE. Here’s why. A child can more easily access and interact with fewer number or toys that are organized with their corresponding parts. Hear me – this does not mean designer toy organization (unless you want it to), but this could mean using bins and boxes or separate areas on shelves (more tips HERE). It just means that toys, which are the TOOLS for learning, have an intended purpose for the age/developmental stage and that we don’t need 50 toys that do the same thing. Note that the recommended toy age is not always developmentally correct. It’s being set by marketers not pediatricians or developmental therapists with different goals in mind. Just because that box says 3-6 months, does not mean the toy is developmentally appropriate for a 3-6 month old baby. (Interested in what real development looks like at each stage and how to pair it with purposeful play and creative materials?  Check out 1-2-3 Just Play With Me We have done that work for you.)

When discussing this, we often talk about THE 4 ESSENTIAL B’S OF EARLY CHILDHOOD. And we’ve challenged ourselves with this question:

What developmental milestone could you not achieve between 0-3 years of age with simply BOOKS, a BALL, a BABYDOLL, and BLOCKS? 

Literally we’ve sat around the room with other therapists and challenged ourselves with this question (desperately nerdy, I know) and we can’t find one single milestone.

Quick examples (But the options are endless):

BOOKS:  Early literacy, labeling of objects, visual focus, turning pages for fine motor activities, turn taking, pointing. (Some of our favorites HERE and HERE and Toddler Reading Tips HERE. (We REALLY love books!)

BALL: Hand eye coordination, grasp/release, turn taking, language, social anticipation and peer play, balance and coordination, joint attention.

BABYDOLL: Imaginative play skills, labeling body parts, fine motor strengthening with dressing, social emotional practice of emotion sharing.

BLOCKS: oral motor exploration, cause and effect (knocking down), stacking, jumping over, counting, role play when using as other objects (cell phone, people), patterning, spatial awareness. More on the importance of blocks HERE.

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As a parent, I encourage you to shed the cloak of stress that “my kid needs more.” Our kids need us. Embrace that thought. It’s quite freeing and leads to memory making experiences no toy can replace.

As a therapist, I encourage other therapists to spread this message. I sat with a young first time, young  mom yesterday who asked me to go through a laundry basket filled with an array of toys she had been gifted, purchased, or had been handed down. She, like many parents I know, stressed she didn’t have enough or the right things for her child. We went through that bin together and identified what he might learn from those toys at this stage of development and which might encourage him to do the next exciting thing. And she boxed up the things he had outgrown, was too young for, or had too much of. She was so relieved and I was so excited for her and her child.

Spring cleaning leaves room for new growth. That holds true for our little ones too. Shed the rest and see what fun you can experience today with our 4 essential B’s!

Reteaching my brain and listening to my body so I can help my patients do the same: A review of TMR TOTS

“Educating yourself does not mean you were stupid in the first place; it means you were intelligent enough to known there is plenty left  to learn.” -Melanie Joy

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This weekend I spent about 18 hours on the floor in yoga clothes, on yoga mats, holding and twisting baby dolls with black electrical tape on them, and rolling, rubbing, and positioning other people (some I know, some I didn’t before Saturday). PT’s are weirdly awesome. We learn by doing. By seeing. Be feeling. By proving things to be correct…to be good enough to be worth our time, but more importantly to be worthy of making a difference for our patients.

I have be a long time internet stalker of the TMR Method – more specifically – TMR TOTS (the version for baby lovers like me!). It’s been a course that I have wanted to take for a long time, after hearing rave reviews from other therapists, and after hearing MANY refer to methods taught in this course with a sense of common vocabulary. As a PT I felt I was missing out on the secret and I wanted to see for myself.

A great slide with a great reminder!

A great slide with a great reminder!

Without getting into tremendous detail, these methods beautifully weave neurological principals long proven by science to be true, reinforcing what therapists have seen themselves to be successfully with a concept foreign and new to some (like me): making improvements in function, flexibility, posture, and showing increased range of motion without “stretching.” My brain couldn’t process this at first.

 No pain?

No “work?”

No “hold it 5, 10, 30 seconds?”

No “feel the burn?” 

I mean, they don’t call us PT’s (aka Physical Terrorists) for nothing? I was skeptical, then inquisitive, then curious (in between the 1st and 2nd days of the course, my first and favorite lab partner (my college roomie who came to take the course with me) and I assessed my children, husband, and mother in law – with a burning sense of expectation that it wouldn’t work with at least ONE of them.

Practicng at home. Sorry for the PJs - long day!

Practicng at home. Sorry for the PJs – long day!

They all improved. Every one. My mother in law could come to standing with ease and less pain. My husband and children all have increased hip motions where tight hamstrings have long limited them in various ways. So then I started questioning (long term carry over? children with neurologic tone?). And then I got to see before my own eyes and feel with my own hands one of my current patients be treated by Susan Blum – the gentle, patient, and wise PT – who teaches this career changing course. And I submitted. As I did I actually felt guilty that I didn’t have this knowledge for the past 14 years. This old dog learned a new trick and I can’t wait to practice what I learned this week and see what the results are on my patients!

If you are a therapist, I urge you to check it out. The differences we could all collectively make with this knowledge is pretty mind blowing. I’m eager to learn more and to see what we saw and felt replicated and proven in published studies.

If you are a parent with a child with challenges caused by movement – I urge you to seek out a therapist with the training. I wish every child I ever treated had the opportunity to give it a try.

A main component of TMR is to “go to the easy side,”  and “watch, listen, and feel what the body wants to do.” I sat and processed this a bit…and at a deeper level. When we feed our nervous systems with sensory input that our bodies need, we regulate, and function optionally. When we allow movement in the ways I learned about this weekend, our bodies start to correct themselves.  How many times in my life have I pushed my mind, body, and heart out of what it wanted to do? How about you?

Over worked?

Over scheduled?

Under-exercised?

Over-exercised?

Poor nutrition? and hydration?

Wrong choices for wrong motives?

Neglecting my people for reasons that don’t matter?

Judging myself by unfair standards?

My husband claims I have an “inner hippie,” and maybe he’s right (and maybe it’s laughable – go ahead) but I do think people and experiences come to you or are sent to you as you need them. Tomorrow my daughters return to school and as I’ve shared before, a new school year or more like New Year’s Day for me than the holiday. I love fresh starts and new chances for healthy starts….for chances to listen to what your body, mind, and soul are telling you.

As they go off to school, I will shift into working more and having more time during the day to pour into my “other kids.” Thanks to TMR, I have an incredible new skill set to practice and learn with. I also have a reminder to “go to my easy side” as I tackle the mom role of hectic schedules, a much quicker pace, and on the never ending quest for “balance” (in parenthesis because I don’t think it exists).

I am thankful that my body keeps telling me I have so much left to learn! What is yours telling you?

One of my favorite slides from the course.

One of my favorite slides from the course.

 

EXPLORE, PLAY, GROW: Our visit to see Winter The Dolphin

We are kicking off a new feature on our blog called Explore. Play. Discover, a series of blog posts sharing our reviews of fun places to play. We hope this series will help not just with vacation or field trip planning, but will also bring exposure to incorporating play into your travel fun.

For our first entry, we are sharing our recent visit to Clearwater Marine Aquarium. This marine rescue center and aquarium is located in Clearwater, Florida, and although it has been in operation for years, it was made famous by the Dolphin Tale movies. The popularity of the movies has certainly increased the number of visitors to the aquarium and has increased funds to improve the facilities and services.

Clearwater Marine Aquarium was easy to find and we were able to find (free) parking close to the entrance because we arrived early. Visitors arriving later park farther away. General Admission pricing is $21.95 for adults, $16.95 for children, $19.95 for seniors, and children under 2 are free. The kids were super excited to see the actual houseboat filmed in the movie outside the aquarium and loved pointing out the features they remembered.

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While my 9 and 11 year old were overly excited to see Winter (the Dolphin famously rescued), we were all pleasantly surprised by the other experiences offered. We got a tour of the animal hospital and the well educated volunteers showed us a huge board that tracks when animals were brought in, from where, what their injuries are, and when their expected release is planned. We saw a sea turtle brought in a few days earlier with a cracked shell that was bandaged and resting. We learned that sea turtles are at risk for a virus similar to HPV in humans and that their center is one of a few in Florida that perform laser surgery to remove harmful growths caused by the virus. Our daughters got to hold a bucket filled with the amount of fish a dolphin eats daily. We learned that anyone from the Coast Guard to boaters can call if they spot injured marine life and that Clearwater Marine Aquarium goes out to rescue them.

Next, we made a beeline for the VIPS of this place, Winter and Hope (we could hardly hold the kids back). They are in the tanks that they were filmed in during the movie and were separated at first and then joined together. Trainers on a microphone shared with the crowd the daily routines and care of both dolphin and we got to observe Winter getting therapy to help his prosthetic continue to fit. She didn’t seem to mind the stretches! The kids got to hold an examine one of Winter’s prosthetic tales, which was incredibly cool!

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Next to their tanks were sea turtles with missing limbs, damaged shells and several sea otters. One was paralyzed when hit by a car and could swim with only the top half of his body. Another was raised by a man living on a fishing boat for a year (frowned upon by marine staff) until it “got a bit out of control” and they explained this sea otter acts very odd due to it’s early experiences (See what we do in those first few years really is THAT important!). We also saw the loud and noisy bird, Ricky, that was in the video and another dolphin that had been injured similarly to Winter. There were several stations where we could touch and see small aquatic animals and plants, including sting rays (75% of us was brave enough), and ask questions There were also several tanks with a variety of fish and even some sharks.

This location also included (of course) a gift shop with a variety of souvenirs. We didn’t buy any but my favorite was a plush Winter whose tail could come on/off. We did cave to buy photos of the kids made using a green screen, which were pricey but precious at $30 for both, but too cute to pass up! Towards the entrance of the aquarium they sold limited drinks and concessions and snow cones for enjoying outside under a tent.

Fairly new to Clearwater Marine Aquarium is a second spot a few miles away where they showcase features from the Dolphin Tale movies called Winter’s Dolphin Tale Adventure. We took an open-air trolley to this location (included with the general admission) and did not have to wait long for the ride there or back. At this location, we saw artifacts from the movie (Sawyers bike, the kitchen and bedroom from his house etc.) and could walk through a simulated hurricane (full with high winds, noise, and water). This only took a few minutes but was fun! This location did have a slightly larger refreshment stand, where we enjoyed ice cream and popcorn. I believe there may have been hot pretzels and hotdog type foods too. There was a hands on area for younger children where smaller climbing structures were available and children could write a letter to Winter.   A nice surprise was that Cozi Zuehlsdorff, the actress that played Hazel Haskett in Dolphin Tale was visiting and did a Q&A session and a meet-n-greet.

I would certainly recommend Clearwater Marine Aquarium as a great option for a family activity. Here are a few details to consider:

 

TIME NEEDED: I’d allow ~2 hours if you only do the main animal hospital and ~3-4 hours if you visit the location dedicated to the movies.

 

AGES APPROPRIATE FOR: There’s really something here for everyone and I did see small babies that would enjoy the visuals, but overall, I’d say this is most appropriate for 2-3 years old and up, with 6 and up likely able to fully understand the educational component (of course we believe even babies learn from their environment).  ** The hurricane simulation might be scary for younger children.

 

ADDITIONAL TIPS: If going in prime sun hours, take sunscreen. The top deck and waiting areas for the trolley are outside. We enjoyed lunch afterwards at Frenchies with cousins we were visiting. They suggested this beachy local chain (and it was quite good). Interestingly, the kids insisted on watching Dolphin Tale that evening and noticed Frenchies is mentioned in the movie, so I guess you could say we had a fully authentic Dolphin Tale adventure.

 

DEVELOPMENTAL SCORE: (we decided to add this is a potential 5 star rating system, scoring how many developmentally appropriate, hands on, movement or sensory based activities are offered). We give Clearwater Marine Aquarium 5/5 stars! ★★★★★

 

BANG FOR THE BUCK: Considering there were two locations to visit, multiple hands on experiences, major educational experiences, well educated engaging volunteers and staff, and that we were in Florida at an attraction and we didn’t stand in line or feel Closter phobic, it was certainly worth the money we spent. When you consider that part of your admission funds care of these animals — it is icing on the cake!

 

Most interestingly to me, is that in the movie many children with physical and mobility challenges, including amputees visit Winter and Clearwater Marine Aquarium. While this touched both myself (a PT) and my husband (an OT), we figured it was sprinkled in as Hollywood’s “glitter” to bring he movie full circle. I was pleasantly surprised to see for myself that it was actually true, as many times during our visit I caught myself checking out a kid’s sleek gait trainer or wheelchair and noticing orthotics.   I have to say it was even sweeter in real life to observe the look on these little warriors faces as they watched animals preserve the same ways they do. So if you are a therapist, or simply a sucker for underdogs winning big time, you may experience the same joy on your visit!

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Here at Milestones & Miracles, LLC we BELIEVE that PLAY is the way we all learn, but especially young children and most certainly when encouraged by an involved parent. If you believe in play to learn too, check out 1-2-3 Just Play With Me (the perfect resource made by therapists and moms!).

Milestone or Modern Convenience Part II: What to do when the convenience becomes a hard habit to break

Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

 
If you haven’t read it yet, be sure to check out the first blog post in this 2-part series, Milestone or Modern Convenience? – Part I: Overuse of the Sippy Cup and Pacifier, to learn important information about an infant’s need for sucking and the risks involved with overuse of the pacifier and sippy, cup!

 
Now that you are familiar with the pluses and minuses of pacifier and sippy cup use, what about when the parents are ready to help baby “give up” the sucking habit? Again, as the resource for all things infant and toddler, we can suggest the following tried and true strategies.

 
Cut back – When ready to begin weaning, cut back on the time that the pacifier and/or sippy cup is available to the child. If the pacifier has been available to the child all day, every day suggest cutting back its availability to only nap and bedtime. As for the sippy cup, cut back its use to only when the family is out and about. When at home suggest offering the child a straw or open cup in its place.

 
Go cold turkey…if the child is ready – If going cold turkey is the method of choice pass along this wisdom: if the child is not ready, he may find something else to suck on, like a thumb or fingers. However, if ready, this method may work just fine. Suggest that, if going cold turkey, it is a good idea to rid the house (or at least baby’s line of sight) of all pacifiers and/or sippy cups. If they remain in the cabinet or drawer, baby will know and will want them!

 
Provide additional comfort – In preparation of weaning a baby from the pacifier and/or sippy cup, provide him with an additional comfort item. If the child’s only “lovey” is the pacifier or sippy cup, having a back up “lovey” will still allow the child a comfort when his first choice is gone.
Understand that routines may change – Warn your families that routines may change when weaning baby from the pacifier and/or sippy cup, especially if it is used as the child’s primary comfort item. When the pacifier/sippy cup is gone, the child may need assistance with calming, temporarily; swaddling, rocking, singing and some extra cuddles may be necessary until baby learns how to calm himself without the help of his pacifier or sippy cup.

 
Give the pacifier or sippy away to a new baby – Sometimes parents can convince the child to give up these items with some incentive. However, it is suggested that the new baby receiving the child’s old pacifiers/sippy cups not live in the same house. It will be more difficult for the child not to suck on a pacifier if there is one nearby. Some parents are also able to negotiate a trade with their child: “If you leave your pacifier under the Christmas tree, Santa will take it with him and leave you a present!” If the child is ready, this trick is a gem!

 
Some tips to warn parents to not try are:
Never, ever cut the pacifier nipple and give it to the child – Yes, if there is no nipple for the child to latch onto they will be less interested in sucking the pacifier. However, the risk of choking is too great to ever recommend this as a means of pacifier weaning. Pacifiers have to pass what is called a “pull test” during manufacturing. A cut nipple would not pass this pull test and would be deemed as unsafe for a child to have.

 
Do not shame the child for wanting to suck on his pacifier or sippy cup – Toddlers and preschoolers typically do not respond to being shamed into giving up the pacifier or sippy cup. Telling the child that in order to be a “big kid” he must give up his most prized possession may just make him want it more. And who can blame him, who really wants to “grow up” anyway?!

 
Do not recommend putting something that tastes bad on the nipple of the pacifier and/or sippy cup – I have known families to dip the nipple in chili powder to convince their toddler to stop sucking on his pacifier. One sweet little guy I knew still wanted his pacifier so badly that he licked the chili powder off, little by little, chased it with water and eventually got his paci back. Again, this is a case of the parent wanting the child to make the decision to give up the comfort item. Not gonna happen! Sometimes the parent has to be just that and take control.

 
So we wish you good luck as you head into the magical world of the paci and sippy cup. It holds a strong spell on many little ones, but with the right guidance and when our families are ready, we can help them help their children kick the habit!

 
Do you have any suggested weaning methods to add to this list? What would you say to encourage your families to follow through with weaning their child?
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Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.

Milestone or Modern Convenience? Part 1: OverUse of the Sippy Cup or Pacifier

Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

Although shocking to many, the sippy cup is NOT a developmental milestone. Nor is sucking on a pacifier, for that matter. But why do we (therapists,??????????????????????????????? parents and caregivers) celebrate these acquired “skills” as developmentally appropriate achievements? Why do we allow these “skills” to happen for much longer than they should? Is it just easier to always have a pacifier (aka mute button) in the baby/toddler’s mouth? Sippy cups are so easy to take along with us everywhere, how can it be harmful if a preschooler continues to exclusively drink from one?
The pacifier is a great thing for infants. It meets a physiological need to suck and allows baby a way to comfort himself. It may reduce the risk of SIDS as it appears to allow baby’s airway to remain more open and prevent baby from falling into a deeper sleep. Not to mention the other fringe benefits like quieting rowdy babes, helping them sleep longer and making outings and car rides more enjoyable for all. It certainly has a “place” in an infant’s world! And the sippy cup is an awesome convenience must-have. Drinks can be toted everywhere with baby/toddler and a sippy’s use means less spills to stain the carpet! Beautiful!
But aside from these benefits, there are risks associated with the over-use of both. Pediatricians and family physicians recommend weaning or stopping pacifier use in the second six months of life. Shocking I know considering how many toddlers we see with pacifiers in their mouths! The sippy cup can be skipped all together if natural development is occurring with no issue. Created for convenience, the sippy cup now has an entire market (and aisle in most stores) devoted to it! However a baby can transition to a straw (as early as 9 months) or open cup just as easily and drinking from both of these IS developmentally appropriate.

 

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As trusted resources on development, it is our job as early interventionists to inform families of both the positives and negatives of (prolonged) sucking. Some points to keep in mind as you discuss these “milestones” with parents and caregivers:
Prolonged sucking on a pacifier puts children at (a higher) risk for misaligned teeth. As those tiny white pearls are erupting, the pressure of the nipple of the pacifier can cause teeth to move around and shift. Also, the pressure can cause their hard palate, the roof of their mouth directly behind the front teeth, to change. It can push the palate forward, again changing the position of the teeth. In his research, J. Poyak concludes, “The greater the longevity and duration of pacifier use, the greater the potential for harmful results.”
A sippy often allows access to drinks all day long for a toddler. Not necessarily a bad thing, depending on what is in the sippy. If it is a sugary drink, the sugar increases the risk of developing cavities. The Medline Plus article titled, “Tooth decay – early childhood” states, “When children sleep or walk around with a bottle or sippy cup in their mouth, sugar coats their teeth for longer periods of time, causing teeth to decay more quickly.” Also, if a sippy is the only way a child gets liquids the developmentally appropriate skills of drinking through a straw and open cup are inhibited.
If children are allowed to have a drink (in a sippy or other cup) all the time, they may fill up on liquids and not eat meals as well, negatively impacting their nutrition. 

 

Although inconsistent, research suggests a relationship between prolonged sucking and speech delays. Barbosa et al. (2009) concluded in their research of 128 Patagonian preschoolers that, “The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.” When speech sound development is negatively impacted, so is the child’s intelligibility of speech making it difficult for others to understand them.
Sucking on a pacifier increases a child’s risk of developing otitis media (ear infection). The AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Physicians) advocate for limited to no use of the pacifier in the second six months of the child’s life to decrease this risk.
A pacifier or sippy cup that is always in the mouth of a child, even when the child is walking around, puts him/her at a higher risk for mouth injuries. A 2012 study by Dr. Sarah Keim of Nationwide Children’s Hospital in Columbus, found that “a young child is rushed to a hospital every four hours in the U.S. due to an injury from a bottle, sippy cup or pacifier.” When little ones are just learning to walk, doing two things at once requires a bit more coordination than they are capable of!
Besides the physical risks, beyond the age of 1 a stronger emotional attachment to the pacifier (or sippy cup) makes it increasingly difficult for the child to detach. The pacifier/sippy goes from meeting a physiological need during infancy to providing emotional comfort to the toddler when scared, upset or sleepy.
However, it is our job to know and respect the individuality of each child. Therefore it is best practice to reassure parents that we recognize they know their child best. We all want our children to be happy and if using a pacifier and/or sippy is what’s best for them and their family, that is okay. Our job is to inform the families we serve the best we can. Equipping them with knowledge on why prolonged sucking may be detrimental to their child allows the family to make the final call. Education and Support, that’s what we are there for.
Have you ever had the “prolonged sucking” discussion with any of the families you serve? How might you begin this conversation with a family?
Today’s blog is Part I of a two-part series on prolonged sucking and what we can do to educate families about it. Stay tuned for “Part II – What to do When the Convenience Becomes a Hard to Break Habit” next week featuring ideas you can share with families who are ready to wean their child off of the pacifier or sippy!
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References
Barbosa, Clarita, Sandra Vasquez, Mary Parada, Juan Carlos Velez Gonzalez, Chanaye Jackson, N David Yanez, Bizu Gelaye, and Annette Fitzpatrick. “The Relationship of Bottle Feeding and Other Sucking Behaviors with Speech Disorder in Patagonian Preschoolers.” BMC Pediatrics. N.p., n.d. Web. 20 Mar. 2015. http://www.biomedcentral.com/1471-2431/9/66
EG, Gois, HC Rubeiro-Junior, MP Vale, SM Paiva, JM Serra-Negra, ML Ramos-Jorge, and IA Pordeus. “Influence of Nonnutritive Sucking Habits, Breathing Pattern and Adenoid Size on the Development of Malocclusion.” Angle Orthod.4 (2008): 647-54. Print. http://www.ncbi.nlm.nih.gov/pubmed/18302463
Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents (n.d.): n. pag. Web. 18 Mar. 2015. http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf
Hauck, Fern R., MD, MS, Olanrewaju O. Omojokun, MD, and Mir S. Siadaty, MD, MS. “Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis.” PEDIATRICS5 (2005): E716-723. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis. PEDIATRICS. Web. 17 Mar. 2015. http://pediatrics.aappublications.org/content/116/5/e716
Keim, Sarah A., MA, MS, Erica N. Fletcher, MPH, Megan R.W. Tepoel, MS, and Lara B. McKenzie, PhD, MA. “Injuries Associated With Bottles, Pacifiers, and Sippy Cups in the United States, 1991-2010.” N.p., n.d. Web. 19 Mar. 2015. http://pediatrics.aappublications.org/content/129/6/1104.long
Natale, Ruby, PhD, PsyD. “Risks and Benefits of Pacifiers.” American Family Physician79 (2009): 681-85. – American Family Physician. Web. 18 Mar. 2015. http://www.aafp.org/afp/2009/0415/p681.html
Poyak, J. “Effects of Pacifiers on Early Oral Development.” Int J Orthod Milwaukee4 (2006): 13-6. Print. http://www.ncbi.nlm.nih.gov/pubmed/17256438
Regulatory Summary for Pacifier (n.d.): n. pag. U.S. Consumer Product Safety Commission. Web. 18 Mar. 2015. http://www.cpsc.gov//PageFiles/120645/regsumpacifier.pdf
“Tooth Decay – Early Childhood: MedlinePlus Medical Encyclopedia.” S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 17 Mar. 2015. http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm
Zardetto, CG, CR Rodrigues, and FM Stefani. “Effects of Different Pacifiers on the Primary Dentition and Oral Myofunction Structures of Preschool Children.” Pediatric Dentistry6 (2002): 552-60. Print. http://www.ncbi.nlm.nih.gov/pubmed/12528948
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Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.
Website: www.milestonesandmiracles.com
Blog: www.milestonesandmiraces.com/blog/
Facebook: https://www.facebook.com/milestonesandmiracles
Pinterest: https://www.pinterest.com/milestonesm/
Twitter: https://twitter.com/MilestonesM
YouTube: https://www.youtube.com/watch?v=HmuWPFDcqZ4

Making New Ways To Play In Dad’s Old Shop

My Dad is a plumber and a contractor. When I was a kid I loved playing in his shop. I used to stack wooden scraps, bang things together, and pretend copper pipe was my wedding band. (Princesses hang in tool shops too).

Today I got to be a bit of a kid in Dad’s shop again and it was so fun!

I have a few “go-to” gifts that I LOVE giving to my “therapy kids” when they turn 3 and are no longer eligible for my services. They are part “graduation” gift and part birthday gift. Every once in a while though, I have a kid who needs something that is specifically made just for them.

It’s nice having a handy Dad when you are a self employed early intervention physical therapist, creatively making things work for therapy visits in the homes of children. Dear Old Dad has helped me out a few times and today was no exception.

Together (well mostly him), we made this fun board for my special guy and I wanted to share.

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I liked it so much I decided “we” needed to make 2 so I could keep one for work too!

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I’ve always admired these boards and while they are very focused on fine motor work, I’ll be able to incorporate them into sitting and standing play…maybe even as a motivator for my little ones who are almost crawling but need a bit more motivation!

So if you are interested in making something like this, I’m happy to share that it was not overly expensive. Total cost was about $20 each.  I basically strolled up and down the aisles of Lowe’s choosing mismatched things that were interesting to turn, twist, flick, or flip. (This made the regulars at Lowe’s a wee bit nervous I think).  That part of easy. I will say if you are going to try it you need someone handy and with a few basic tools (electric drill, small saw, nail gun), which worked out much better than my original plan to glue gun everything down!

Here are some of the items I used.


I can’t wait to gift my special guy with his “one of a kind, made with love by my Dad” creation and to try mine out too. Even more fun that playing with these might be the fun I had playing today in the shop.

Like my ring?

 

board ring

The Secret of “The Hot Pink Tape”

This post was originally written for Child Guide Magazine.  Check out the many resources Child Guide offers as well as this article and others HERE.

If you are a runner, or have watched a race or even perhaps a professional sporting event lately, you may find yourself asking, “What is that bright colored tape people are wearing? And why is it cut in crazy patterns?” That trendy tape, often seen in bright pink or blue or sometimes black, is called Kinesiotape and it isn’t exactly new, even though it may have gained popularity in recent years in the US. But did you know that Kinesiotape is not just for athletes? This versatile tape is actually a very effective tool for children with motor challenges as well!

 

Kinesiotape is a progression of Kinesio Tex, which was invented by Dr. Kenzo Kase in Japan in the 1970’s. Dr. Kase was searching for an alternative tape to traditional athletic tape. He noticed that traditional tape often restricted movement, did nothing to aid healing, and could potentially cause additional injuries. Out of his hard work, Kinesiotape was born. What makes it different? Kinesiotape is elastic, latex free, cotton based tape that can stretch up to 30-40% of its original size. These properties allow it to be more versatile than traditional tape. In additional to allowing full range of motion and being very comfortable on the skin, the elasticity of the tape allows it to perform many functions. Kinesiotape is meant to be placed very strategically depending on the reason why someone is wearing it. Depending on placement it can increase healing, decrease inflammation and swelling, and support weak muscle by encouraging activation, or increase function lost by spastic muscle by encouraging a decrease in muscle tone. In addition posture can be improved with use.

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Sounds pretty incredible, right? Here’s how it works. Our muscles are each individually covered in a think filmy layer called fascia. Between the skin and this fascia are layers of connective tissue. When Kinesiotape is applied strategically to the skin, it tugs on the skin, which pulls on the connective tissue, which pulls on the fascia, which tugs on the muscle. The result is either an increased “fascial envelope,” allowing for 1) increased removal of toxins (lactic acid and waste) and increased space to allow fresh blood to restore tissue or aid in healing or 2) Encouragement of activation of a specific muscle for a specific purpose., improving posture or strength through increased use.   When used this way, the tape is like a constant tapping on weak muscles saying, “Use Me!”

kinesio-tape-diagram

This can potentially best be illustrated by looking at something concrete like a bruise.

In the images below, Kinesiotape has been used to increase the space between the fascia and the skin and allow quicker healing in the places where the tape was placed.

How is this used with children or anyone with motor challenges? In many ways! Children with atypical muscle tone (either hypotonia (low tone), hypertonia (high tone) or any sort of weakness may benefit from Kinesotape. When the tape is applied strategically over the muscles that need assistance or strengthening, the result is a slight tug that encourages the child to use their body in a specific way. When used this way, Kinesiotape can be used as a bridge to encourage strengthening or function through active participation. The child wears the tape, the tape encourages the child to move their body in a way that strengthens, stretches, or improves function, and eventually the child may get strong or functional enough to not need the tape. An example would be using the tape on the abdominal or back muscles in a child with Downs Syndrome who has trouble sitting alone or on the hand of a child with Cerebral Palsy who has a hard time opening the hand to grab for things.

Owen Ruffner is a 2 year-old child has benefitted from Kinesiotape in large ways. Owen has Mitocondrial Disease and as a result has weakness and low muscle tone, which challenge him when moving and attempting to control his body. Owen is learning to walk with a gait trainer and without tape, tends to drift to his left weaker side. When Kinesiotape is placed on the left leg, encouraging full activation of his muscles, he able to walk in a straight path. These results were immediately noticed after 1 application by his Physical Therapist. His mother Kasey McDaniel has been thrilled with the progress. She shares, “Kinesiotape has helped Owen by giving him a chance to use his muscles on his weaker side. I have noticed a huge difference with daily function and with helping him as he learns to walk.”

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The possibilities are quite endless with Kinesiotape as it is relatively low cost, is easily tolerated on the skin, is waterproof, and usually lasts 3-5 days per application. It is very important that anyone using the tape is initially taped by someone with strong knowledge of anatomy, such as a licensed physical therapist, and by someone who has had training on the Kinesiotape method.  Once a few applications are applied, tweaked as needed, and monitored, a successful method can be taught to a willing parent, who could continue the taping at home, with the help of a physical therapist.
It is true that Lance Armstrong was one of the first to expose Kinesiotape to the United States, swearing by the pink tape specifically for his knee injury, but your child may benefit as well. If you haven’t tried it yet, the risks and cost are low, but the benefit is often quite high. Ask your pediatric PT about Kinesiotape at your next visit.

 

For more information about Kinesiotape and the Kinesiotaping method, visit: http://www.kinesiotaping.com/ and http://www.kinesiologytapeinfo.com/pediatric-kinesiology-taping/