I Can Do It! - National Down Syndrome Society
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“I Can Do It!”: Ways to Grow Your Child’s Independence NDSS Webinar Series Tuesday, April 29, 2014 Katie Bergeron Peglow, PT, MS COO of Adaptivemall.com “I Can Do It!”: Ways to Grow Your Child’s Independence Some of my First Memories include Down syndrome (DS). My younger sister, Carrie Bergeron, was born with DS when I was 4 ½ years old. She always strived to be independent like myself and our other two siblings. Thankfully, Carrie has worked hard and has been blessed with abilities that allow her to be semi-independent at the age of 37. Carrie is a self-advocate and national speaker/performer. Our family created Adaptivemall.com & Special Tomato Brand Products. The Story Behind the Brand NDSS Webinar Series April 29, 2014 2 “I Can Do It!”: Ways to Grow Your Child’s Independence Focusing on early developmental milestones in today’s presentation Right amount of support Not too much, just enough Patience NDSS Webinar Series April 29, 2014 3 “I Can Do It!”: Ways to Grow Your Child’s Independence ROLLING SEATING CRAWLING & CREEPING STANDING WALKING TRICYCLES & BICYCLES BATHING FINE MOTOR SKILLS NDSS Webinar Series April 29, 2014 4 “I Can Do It!”: Ways to Grow Your Child’s Independence ROLLING The Facts of Rolling… Average Age for Children with Down Syndrome to Roll From Stomach to Back Independently = 6 months(1) Average Age for Children with Down Syndrome to Roll From Back to Stomach Independently = 7 months(1) (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series April 29, 2014 5 “I Can Do It!”: Ways to Grow Your Child’s Independence ROLLING What kind of products will help? Use toys, stuffed animals, people to motivate the movement Rolling from Stomach to Back Happens first Typically easier Utilize gravity with the head Rolling from Back to Stomach Happens second More difficult Engaging the core and leg muscles against gravity NDSS Webinar Series Photos courtesy of Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. April 29, 2014 6 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING For Children with DS, sitting often looks like… Wide base of support C-curve to the spine Forward head “Hanging” on their joints NDSS Webinar Series April 29, 2014 7 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING The Facts of Seating… Average Age for Children with Down Syndrome to Sit Independently = 11 months(1) Key Measurements Hip Width Thigh Depth Foot to Knee Height Bottom to Top of Head Key Measurements (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series Graphics courtesy of Adaptivemall.com April 29, 2014 8 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING What kind of products will help? Pre-sitting Full support Tilted seating surface Gradually bring chair upright as head control improves NDSS Webinar Series Photos courtesy of Adaptivemall.com & Bardum.no April 29, 2014 9 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING What kind of products will help? Upright Sitting Pelvis needs a good foundation Support for the feet Footrest Floor NDSS Webinar Series Photos & Graphic courtesy of Adaptivemall.com April 29, 2014 10 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING What kind of products will help? Active Sitting Input from environment to know where their body is in space (proprioception) “Fidgets” & “Movers” - Kore Stool NDSS Webinar Series Photo courtesy of Adaptivemall.com Curved bottom allows movement in all directions 3 different sizes of fixed seat heights – foot to knee height Encourages anterior pelvic tilt April 29, 2014 11 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING What kind of products will help? Active Sitting Working the core muscles Therapy Balls Swings NDSS Webinar Series Photos courtesy of noahsdad.com & dsamidlands.org April 29, 2014 12 “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING What kind of products will help? Active Sitting Using sitting in tasks Use a bench with slight tilt forward Grounding feet to floor Active use of leg muscles Engaging core muscles Puzzles Pieces on floor – reach down to get Puzzle on table Sit to stand to place the piece can be added to increase the difficulty level NDSS Webinar Series Photo courtesy of www.assistireland.ie April 29, 2014 13 “I Can Do It!”: Ways to Grow Your Child’s Independence CRAWLING & CREEPING The Facts of Crawling & Creeping… Average Age for Children with Down Syndrome to Crawl Independently = 14 months(1) Average Age for Children with Down Syndrome to Creep Independently = 17 months(1) (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series April 29, 2014 14 “I Can Do It!”: Ways to Grow Your Child’s Independence CRAWLING & CREEPING What kind of products will help? Use toys, stuffed animals, people to motivate the movement Crawling is with the belly on the floor Arm pulling and leg pushing Start with both sides of the body doing the same thing at the same time Work towards reciprocal movement (right side does the opposite of the left side) Creeping is with the belly off the floor, also called quadruped Arms & Legs are used Strong core muscles are essential Uses reciprocal movement NDSS Webinar Series Photos courtesy of noahsdad.com April 29, 2014 15 “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING The Facts of Standing… Average Age for Children with Down Syndrome to Pull-to-Stand Independently = 17 months(1) Average Age for Children with Down Syndrome to Stand Independently = 21 months(1) (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series April 29, 2014 16 “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING What kind of products will help? Start with Supported Kneeling or Tall Kneeling Increases the strength of the hip, leg and core muscles Helps increase balance Right & Left Legs are doing the same thing Use your couch with cushions removed as a working surface NDSS Webinar Series Photo courtesy of noahsdad.com April 29, 2014 17 “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING What kind of products will help? Half-Kneeling Precursor to Pulling To Stand Legs are doing opposite motions NDSS Webinar Series Photo courtesy of noahsdad.com April 29, 2014 18 “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING What kind of products will help? Pulling to Stand Use benches, stable toys or furniture to encourage the movement Standing Independently Cruising NDSS Webinar Series Photo courtesy of noahsdad.com April 29, 2014 19 “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING The Facts of Walking… Average Age for Children with Down Syndrome to Walk Independently (at least 3 steps unsupported) = 26 months(1) Key Measurements if adaptive equipment is needed Key Measurement Floor to Elbow (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series Graphic courtesy of Adaptivemall.com April 29, 2014 20 “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING What kind of products will help? Hypotonia makes this an extra difficult task Going through the typical sequence of physical developmental milestones will help strengthen all of the muscles needed for walking Children will most likely need a push toy to start NDSS Webinar Series Photo courtesy of billandria.blogspot.com April 29, 2014 21 “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING What kind of products will help? Some may need support for longer Walker – no positioning accessories Gait trainer – positioning accessories added on as needed and taken away with progress NDSS Webinar Series Photos courtesy of parentmap.com & confessionsofadownsyndromedaddy.com April 29, 2014 22 “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES The Facts of Tricycles & Bicycles… Average Age for Children with Down Syndrome to Ride a Tricyle Independently (15 Feet) = 61 months(1) What is the end goal? Independence! Success Fun Next level challenge Key Measurement Key Measurements if adaptive equipment is needed Inseam (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series Graphic courtesy of Adaptivemall.com April 29, 2014 23 “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES What kind of products will help? Tricycles Work on Reciprocal Motion Muscle Strength Social Skills Many sizes available through adult sizes Accessories available with some models if needed Look for a wide turning radius to prevent tipping NDSS Webinar Series Photos courtesy of Adaptivemall.com April 29, 2014 24 “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES What kind of products will help? Bicycles Work on Reciprocal Motion Muscle Strength Social Skills Balance Start with a balance bike to focus on balancing first Progress to a bike with pedals NDSS Webinar Series Photos courtesy of Adaptivemall.com & striderbikes.com April 29, 2014 25 “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING The Facts of Sitting in the Bath… Average Age for Children with Down Syndrome to Sit Independently = 11 months(1) Sitting independently in the water takes on a whole new set of challenges Key Measurements Hip Width Bottom to Top of Shoulders Key Measurements (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. NDSS Webinar Series Graphics courtesy of Adaptivemall.com April 29, 2014 26 “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING What kind of products will help? Sitting independently is one thing, sitting independently in water is another Bouyancy Slipperiness “Dream Baby Deluxe Safety Infant Bath Seat” Bar folds forward out of the way for easy transfers in and out Suctions to floor of tub Great kiddie pool option NDSS Webinar Series Photo courtesy of myliddybug.blogspot.com April 29, 2014 27 “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING What kind of products will help? Similar support for older children Holds trunk secure for safety while allowing sitting Great kiddie pool options NDSS Webinar Series Photos courtesy of Adaptivemall.com April 29, 2014 28 “I Can Do It!”: Ways to Grow Your Child’s Independence FINE MOTOR SKILLS Many toys help with… Strengthening of Hand Muscles Finger Isolation Muscle Control Life Skill Development Problem Solving Color & Shape Recognition NDSS Webinar Series Photos courtesy of differentlythesame.net, noahsdad.com & lovethatmax.com April 29, 2014 29 “I Can Do It!”: Ways to Grow Your Child’s Independence GOAL = INDEPENDENCE Find Key Motivators Right Amount of Support Practice Patience Challenge at the Next Level Be Creative Celebrate Successes & Have Fun! NDSS Webinar Series Photos courtesy of facebook.com/ActivateHere April 29, 2014 30 “I Can Do It!”: Ways to Grow Your Child’s Independence Q&A THANK YOU! Katie Bergeron Peglow, PT, MS Pediatric Physical Therapist COO of Email: katieb@bergeroncompanies.com Customer Service: 1-800-371-2778 International #: 1-315-429-7112 Fax #: 1-315-429-8862 NDSS Webinar Series & April 29, 2014 31 Please understand that although I am a licensed physical therapist, I cannot act in the capacity of your professional therapist(s). An in-depth knowledge of your child’s medical condition and abilities are required to make any final product recommendations. Your therapist(s) is best qualified for this reason.
