Wednesday, August 1, 2012

The Vertical Chair Climb

What a wonderful commercial by Pampers featured during this year's Olympic games!  The "vertical chair climb" truly is an important developmental milestone for all children.  What a joy to see it during prime-time.

Monday, July 16, 2012

Walking Shoes

The big debate continues regarding whether or not babies/new walkers should wear shoes.  It's easy to see why most parents are confused with mixed messages from commercials, stores, doctors, friends, family members and therapists!  I wanted to weigh-in on where I stand with this issue from a professional view.

Bottom line, "walker" style shoes are not necessary!

In my career, I have never once recommended this "type" of shoe to a patient.  And, I cannot think of an instance that a typically developing child would require the amount of support that these shoes supply.

So, where does that leave us?  Current research suggests that barefoot is best for new walkers.  Being barefoot allows the child to weight bear without support and assist in foot and ankle development.  Walking without shoes will promote strengthening of the ankle and foot musculature.  As a child toddles, looses their balance and catches it again, the body will learn to make necessary adjustments in balance and muscle activation.  As a child grows and continues to walk, their arches will naturally develop.  
*It is completely typical for a new walker to have flat feet.  The arches do not fully develop until close to 7 years of age!*

What about walking outside of the home?  Community outings are a great time to introduce shoes to your child.  For the typically developing child (child without an underlying diagnosis, no complaints of pain or frequent falls) there are a lot of options for shoes.  I like to recommend a shoe that either has laces, velcros or buckles.  Most importantly, the child should not have to work to keep the shoes on.  For example, croc-style shoes or flip flops are challenging to walk in, as the child has to squeeze their toes to keep their foot in. See the following examples of good choices for young toddlers:

 **Please note, these are not brand specific, just examples of positive shoe choices for toddlers**

For the child that does frequently fall - I recommend a discussion with the pediatrician and likely a referral to a physical therapist to rule out underlying reasons.  But, a great starting point is a solid pair of tennis shoes. I find it best to avoid fully mesh-style shoes as they won't give the foot any extra support.  New Balance brand is my favorite, but certainly not necessary.  I've seen great tennis shoes at both Wal-Mart and Target.  Something similar to this:
*Note that this shoe does have mesh, but is leather along the base and sides - where most children need added support*

As a mom,  I understand the confusion that surrounds purchasing your child's first few pairs of shoes.  There are so many options and conflicting views. So, I recommend allowing your child to gain strength by going barefoot indoors and then try to make smart, sensible choices for outdoor shoe wearing.

Please let me know if you have a favorite brand of shoes that you found for your new walker!  I'd love some to add to my list of recommendations.

Monday, July 9, 2012

Why Crawl?

The general public, and even the professional world, has mixed opinions on the importance of crawling as a developmental milestone for children.  I feel strongly that this is a skill worth teaching to our children!

 Almost everyone has a brother, cousin, friend, fill-in-the-blank that never crawled.  If you are the parent of a 6-12 month old child that is not crawling, you've probably been told by someone that "they know Judy and Judy never crawled and Judy turned out just fine."  And, they are probably aren't lying.   However, crawling has many many benefits that make it worth the extra effort to encourage your child to crawl. 

First, I want to take a moment to address and define crawling.  At this site, crawling is hands and knees crawling.  The child reciprocally (one hand, one leg at a time) advances arms and legs forward.  The head and stomach are off the floor. Please take a moment and view this video:

Typically, babies will crawl between 7 and 10 months of age.  Although, with the wonderful "Back to Sleep Campaign" (we can talk more about this another time), children are often acquiring skills about a month later than previous research suggested. 

Here are some of the biggest, most important, reasons that all babies should be encouraged to crawl: 

1. Crawling helps with fine motor skills: the weight bearing through the arms encourages strengthening of the wrists and shoulders to help with handwriting and fine motor control 

2. Crawling strengthens the core muscles: the back, abdominal and neck muscles are stronger which allows for improved sitting posture and endurance in school aged children.  Additionally, kids will have better balance for hopping, bike riding, etc. 

3. Reciprocal crawling improves motor control and coordination by increasing the communication and integration between the left and right hemisphere of the brain: children are able to cross mid-line with control.  This will help your child be able to do higher level skills that require moving both arms and legs together such as: climbing playground equipment, jumping rope and participating in sports.  Being able to keep up with their peers in a few years will be important to them! 

4. Crawling improves visual skills: specifically binocular vision where a child focuses ahead and then back down. Similarly to how they will attend to teachers/computers in front of them and then look down to take notes when in school. 

Scooting, being forward or backward, or modified crawling (perhaps only one leg is bent) are effective in exploration of environment.  However, they lack the important aspects covered above that are useful as your child continues to grow. 

So, while the child that typically skips crawling will often catch up to their peers, I encourage you all to help assist your child in learning to crawl.  They'll have lots of time to stand and walk, but only a short period to practice crawling.  And, with all the benefits - what do you have to lose?

 I would love to hear from some of you.  How old was your child when they first crawled?