Sunday, April 24, 2016

What do skipping, doing, stairs, and cycling have in common?

One of my students just started a very rudimentary pattern of reciprocal skipping! Yah! He is in first grade. He has had some developmental coordination issues and aspects of ASD.  I think the harder we work on something with our students the more "over the top" we celebrate when a milestone is starting to be acheived. So I thought I would share it with some of my fav PTs. :) I am estatic. I plan to write up a little picture and verbal cue sheet to send to his parapro and to his family so they can help reinforce and perfect this new skill. He bends his knees only (instead of hip flextion) and keeps his feet behind, but he is starting to alternate the right, left pattern and doing a little hop often!

Desk Cycling and Brisk Walking Program Benefits 
This year, I have given a few PT students the option of doing 3 to 7 minutes of "power walking" (aerobic work) as part of their posture or sensory times out of the classroom. The OT and I are very fortunate in that we have some amazing paraprofessionals who will help carry out programming and keep good data. This year we have had a few more pedal desks in strategic locations that can be used universally by any student with a staff member. The benefits to some of the students have been really nice. 

In addition to that, one school's corridors are in the shape of a square so that there is an "indoor block." One of my students can choose to "walk indoor blocks" when he feels he needs some movement. We use a timer to help him stay at a brisk pace, and he has just learned to go responsibly walk 3x around the indoor block with just general supervision from someone in the classroom. Before this he has done the typical heavy lifting moving jobs or slow, meandering walks around the hallways.

He is one student that in the fall I had to place my hands over his feet to get a few repetitions of a cycling pattern on the desk cycle. I now no longer need to place my hands on his feet, but I intermitently give him a pointing cue or a visual cue (picture of feet with words to "keep pedaling"). He often chooses to do the pedaling, yet it is so hard for him to stick with that pattern for 3 minutes. His left foot gets hung up at the top and starts to "stutter back and forth" until cued to push. He is also on the ASD spectrum. Continuing a  motor pattern with focus /attention is a little objective here. He states he loves the pedaling and would really like to ride a bicycle someday. He is in grade 3. He is very hypotonic throughout the trunk. The past months he has been working vey heard with APE, with parapros, sometimes in OT, and with me in PT on alternate quadruped patterns, bird dog, planks, side planks, "blow before you go" - inner core, etc. Progress here has been a little slow - he times how many seconds he can hold the isometric positions and records them  -  BUT he keeps at it and will teach other students some exercises, too. He is taking pride in doing his work.

Circle Dances for EC and 4K
Our EC and 4K teachers went to a movement and music collab given by a music therapist. (Unfortunately, I did not attend). But on Friday the EC teacher and a few staff went outside with a small classroom where we tried some of the circle dances. They tried to remember the tunes and words and to fill me in. It was fun. It made me dig out some of my "old favorites" like Hap Palmer and Dr. Jean. For those of you who have not done circle dances in a while with your teams, it could be fun to dig these back up.



Reply back with your favorite circle dances and music if you use these. Do you have unique ways you are including those children using wcs, standers, and gait trainers?  There is something to be said for unplugging the smart boards and CDs and just having kids and staff sing and move along together acapella. 

So, back to the little guy who started skipping. Several weeks back, his walking up/down a very long staircase at school become almost 90% reciprocal with a more even pace. I was so happy for his progress. There were fever stops. I do not think is is coincidence that he was also started on a cycling program for just 2 to 3 minutes at a time the month before. I wanted to share this and encourage other pedi PTs to look at cycling with their students. With him we used the desk cycle that we purchased on Amazon. It is heavier, so it stayed in place a bit better. It's about $160, so very affordable. He would come in the resource/therapy room, help get his feet on the pedals, turn over the 5 minute sand time, and happily pedal away with intermittent cues. He has really enjoyed it, too, and the parapro is stating it is really helping his focus when he goes back into the classroom. At some point, if it continues to help modulate him and he enjoys it, perhaps he may be a candidate to use the pedaling right in the classroom. http://www.amazon.com/DeskCycle-Exercise-Pedal-Exerciser-White/dp/B00B1VDNQA/ref=sr_1_1?ie=UTF8&qid=1461508045&sr=8-1&keywords=desk+cycle

All my best for your end of year wrap ups. Feel free to email or comment with your reflections.