Pediatric PT Toolkit - Bubbles!

As inexpensive and simple as they may be, I love using bubbles during my therapy sessions.  It doesn't hurt that most young children love bubbles, as well!

Here's how I like to use bubbles:

•  Blow bubbles, then have kids practice kicking them to help them with single-leg balance.  As their balance improves, have them stomp on them.
• Likewise, older children can jump on the bubbles to pop them.
• Give kids a paddle or racket and have them work on hand-eye coordination by whacking the bubbles.
• Blow a bubble, then catch it on the wand.  You now can control the height of the bubble, so children can practice standing up on their toes to pop it.
• I also use them as a reward.  If children perform a PT-directed task, they can be rewarded by being allowed to play with the bubbles as they wish for a minute or two.

I must say that some parents have complained about my using such as simple tool to motivate their children, since they expect to see sophisticated therapy equipment such as ball pools, trampolines, and suspended swings, but when working in the schools or in a child's home, complex equipment is not at all practical or realistic.  Bubbles are a fun, cheap, and easy way to help children learn their gross motor skills!

Baby Bath Seat Recall

Summer Infant has issued a voluntary recall of their Mother's Touch Deluxe Baby Bathers due to a defect that has unfortunately led to skull fractures in babies.  The product as a label warning of fall hazards, but apparently, caregivers have not heeded this warning.

This is a photo of one style of the recalled bath seat, courtesy of www.summerinfant.com

Four kids down the line, I seem to recall reading that bath seats were unsafe.  Something tells me that infants weren't meant to be carried in these seats, either.  To me, the more moving parts something has, the less likely someone should be carrying their child in it.

Parents, if you have one of these, please go to Summer Infant's recall website to learn how to get a repair kit.  I would hate to hear of any more precious babies fracturing their skulls.

Thank You, Senator Santorum.

All politics aside, I have to thank Senator Rick Santorum for his strong defense of the unborn and those with disabilities during tonight's GOP convention speech.  I have frequently wondered why people with "acquired" disabilities are viewed as courageous, tenacious, and strong; while many unborn children with congenital disorders are considered burdensome and disposable.  To me, the only difference between the two groups is location -- outside the womb vs. inside the womb.  As someone whose practice ranges from early intervention to skilled nursing, I have worked with people from all stages of life and with widely ranging abilities, and can say that every single one of these people has had value and dignity.  Whether it is helping a child to be able to simply roll over or take those special first steps or helping someone return home to end life with dignity while surrounded by loved ones, I work my hardest to help all my patients reach their goals.

So, thank you Senator Santorum for acknowledging the inherent dignity in every person, born or unborn.  Thank you for sharing how your beautiful daughter Bella has touched so many lives.  Thank you for being living proof that choosing life is always rewarding, however difficult the choice may be.

Rick and Bella Santorum

I look forward to hearing what the Democratic Party has to say about this issue.

HABA Building Blocks Giveaway and Quickie Review

The Blog "An Island Life" is hosting a HABA block giveaway! 

photo from An Island Life

I like to use blocks in my PT sessions.  I know that my focus is gross motor and not fine motor, but they're a great way to get kids to practice gross motor skills as they build.  You can have a child practice tall kneeling or half-kneeling as they build on a table.  A child can practice rising up on his/her toes while building a tall tower.  Practice kicking by having kids kick block structures over.

Haba blocks are gorgeous and very well made.  If you don't win the giveaway, you can buy some for yourself and your kiddos here:

Support Children's Hospital of Orange County!

Enjoy early holiday shopping with Celebrating Home and yummy treats from Tastefully Simple and help Children's Hospital of Orange County!

My oldest son and I are raising funds for the annual CHOC Walk in the park, benefiting Children's Hospital of Orange County.  Our fundraising effort is our way to saying "Thank you" to everyone at CHOC who has helped diagnose and treat his Failure to Thrive, pancreatic insufficiency, and ADHD/ODD.  These special people include gastroenterologist Dr. Idries, Nurse Practitioner Robyn Robinson, geneticist Dr. Zadeh, neurologist Dr. McIntosh, nurse Barbara who helped with his EEG, and everyone at the lab who had to suffer through trying to give him a sweat chloride test 3 times.

25% of the proceeds will be donated directly to Children's Hospital of Orange County. 

To order from Celebrating Home online, go to www.celebratinghome.com, click on "Shopping with a party code?" and enter TanaJimenez333004.

You can order Tastefully Simple products at www.tastefullysimple.com/web/sschmid and enter my name as the hostess when you place your order.

Thank you in advance for your support!

 

Assess it Before You Report it!

To all my PT, OT, EI, and SLP colleagues:

I just wanted to post a reminder that it is prudent to only report on things that you have either assessed yourself or have observed directly.  I know that I am preaching to the choir, but I had a little incident recently where another clinician on a child's IDT reported that the child has lower extremity hypotonia based solely on the fact that the child was determined to be ineligible for CCS services.

I have worked with this child for over a year now and have felt a catch with quick stretch to her hamstrings and adductors.  I have felt the tightness into straight leg raise, hip internal rotation, and hip abduction.  I have been addressing the occasional scissoring when performing pre-gait and gait activities.  The other therapist only has worked with this child for 2 months and the sessions take place while the child is sitting in a high chair.  How on earth could she write in her report that the child has hypotonia in her lower extremities?  She has not tested it.  She has not observed it.  To me, that is completely irresponsible and doing the child a disservice.

Unfortunately, I am now going to have to call this therapist to discuss our report that is due to Regional Center today in the hopes of coming to an agreement on this child's muscle tone.  I hope that you all will have the courage to charitably open a dialogue with any clinicians with which you have a conflict such as this in the hopes that we can all become better therapists.

Product Review: Serola Sacroiliac Belt

photo from www.serolabelt.com

 I am 21 weeks into my 4th pregnancy and have suffered from Diastasis of the Pubic Symphysis since the 3rd trimester of my second pregnancy.  The pain is so severe, my ability to get dressed and undressed, get into and out of a vehicle, and walk up and down stairs is severely limited. Basically, if it involves unilateral or reciprocal lower extremity movement (especially against resistance), it's excruciatingly painful!

Briefly, diastasis of the pubic symphysis occurs when there is a separation between the two pubic bones where they meet in front.  This joint is called the pubic symphysis and is held together by thick, fibrous cartilage and ligaments.  Pregnancy will often cause a diastasis as the hormone relaxin causes the surrounding ligaments to loosen.  Since I have a history of sacroiliac joint problems, I was prone to diastasis.

Physical Therapy treatment during pregnancy didn't help, so I tried the Serola Sacroiliac Belt.  It's very easy to don and doff and feels like a bearhug around my hips.  While wearing it, I am able to continue working as a Physical Therapist without being crippled with pain at the end of the day.

photo from www.serolabelt.com

 Pros:

•  Easy to don and doff
•  Comfortable to wear
•  Helps decrease pubic and sacroiliac pain, at least during the first 2 trimesters of pregnancy.  (I'll let you know how the third trimester goes!)

 Cons: 

•   At $38-41, it may be cost-prohibitive for some.

 

Pediatric PT Toolkit - Beads!

A favorite item in my Pediatric PT toolkit is a string of Mardi Gras beads.  Not only are they shiny and brightly colored, but they are easy for young children to grasp.  They are a small, inexpensive treatment tool, which is great for therapists who perform home visits.  I use them to achieve several goals during my treatment sessions:

• When performing a procedure that children do not like or are reluctant to perform, such as stretching, balance training, or positioning, the beads serve as a useful distraction while the therapist works with the child.
• Since infants and young children are attracted to the beads, they are a great motivator for reaching tasks and early mobility such as rolling, crawling, and creeping.
• I use beads to help with squatting and pulling to stand by alternately placing them on the floor, then on a table.  When children are a bit older, they can squat down to pick up a string of beads, then stand up to put them into a container.

These are just a few examples of the myriad of uses for Mardi Gras beads during pediatric PT sessions.  Be creative and find other uses for them!  I'd love to hear how you use them in your comments.

*Since the beads can be a choking hazard if the string breaks, please make sure that children are closely supervised at all times while using the beads!

   

This link is from amazon.com, where you can buy Mardi Gras beads year-round.  Seasonally, you can also find them at OrientalTrading.com or at party stores.

Safe Sleep for Infants -- Don't Trust Everything You See Online!

I read an interesting article today about how the information that people find online about safe baby sleeping configurations may not be accurate, or correct.  (Web Information on Safe Infant Sleep Often Wrong)  Yes, we all know that we can't trust everything we see online, but when reading parents' blogs, health websites, and childrearing websites, we can't help but trust those with plenty of experience raising children.

I just wanted to share that we co-sleep with our babies, but we use a co-sleeper.  Basically, it's a rectangular bassinet that attaches to our bed so that baby is nearby, but not in the bed.  One of the sides folds down so that the baby is easily accessed during the night.  When baby gets a bit more mobile, you can put the side back up and still have baby nearby so you don't have to trudge down a dark hallway in a semi-alert state.  Our particular co-sleeper has a strap that you run under the mattress and pull taut to prevent a gap between the co-sleeper and the mattress that baby can fall into.  A photo of it is below:

As parents, we have the right to make your own decisions regarding childrearing, but our decisions must be prudent and in our children's best interest, safety included.

I knew I loved these guys for a reason!

Book Review - The Last Dance, But Not the Last Song

I just finished reading The Last Dance, But Not the Last Song, the autobiography of Renee Bondi.  Renee is very familiar to me since she lives locally and often performs in Southern California.  I had known a little bit of her story and I really wanted to read this book to learn more about her journey, since I have yet been able to attend one of her her talks in which she shares her testimony.

I do not want to spoil the book for any of you, so I will keep this purposely vague.  When Renee was 29 years old, engaged to be married, and enjoying a successful career teaching music, a freak accident left her with quadriplegia.  This book does a fantastic job of sharing the emotional and spiritual journey of someone who has suddenly become severely physically disabled.  As a Physical Therapist, I know all too well the physical challenges that people may face, but this book really helped me to understand what someone goes through emotionally from the very moment of their injury.

I think that the "Ask Me Anything" chapter is fabulous.  She lovingly and charitably answers a lot of questions that people may feel embarrassed to ask and she addresses some topics that people wouldn't normally think of, like how she buys clothes and how someone who is paralyzed is able to mother a child.  She also gives startling advice on why we shouldn't ask people how they became wheelchair-dependent.

One thing I'd like to mention is that Renee is a very spiritual, very faithful Christian woman.  She writes about God and prayer and priests and hymns quite frequently, so if topics of faith are uncomfortable for you, I thought I'd give you adequate "warning."  I found it all to be very inspirational!

Recommended Reading for Parents of Children with Special Needs

I came across this reading list on another blog several months ago and thought that I'd share:  The Coffee Klatch Parent’s Holiday Book Wish list

Other Books I'd recommend:

• What Makes You Tic by Marc Elliot 
 
• Expecting Adam by Martha Beck
• A Mango-Shaped Space by Wendy Mass
• The Heartsongs series by Mattie J.T. Stepanek

I am a 10th Annual Parenting OC Reader's Choice Winner!

OH MY GOSH. I just received word that I was voted Parenting OC's best Physical Therapist in south Orange County!!!!! I have no idea who voted for me, but THANK YOU SO MUCH! I am both absolutely stunned and honored.  Here's a link to the listing: The 10th Annual Parenting OC Reader's Choice Winners