What do Physical
Therapists do with children from birth to 3 years of age?
We work with families to provide support to children in the areas
of Gross Motor Development, Fine Motor Development, Motor Planning
and Visual Motor Skills. These may include improving and working
with muscle tone, strength and development, range of movement,
quality of movement, eye-hand coordination, attention to task
and sensory integration.
We look at the quality of a child’s movements such as their
pace and gait when they learn to walk, their grasp of toys and
crayons, or the pressure they are able to use during play dough
play. Physical Therapists are concerned with helping children
reach their full developmental potential and realizing their full
range of motion to improve their quality of life.
Tips for parents from PT:
The following is a list of suggestions to facilitate your child’s
development. Children and babies learn through play and interaction
with their caregivers, siblings and peers. By nature, they are
very repetitive and follow the lead of others around them. They
explore their world through touch, sight and sound and learn about
the physical properties of all their toys and their own abilities
through their intrinsic curiosity and through exploratory play.
They develop all of their senses and all of their muscles while
playing.
Developmental Sequences 1-7 MONTHS:
Change the position of toys and/or mobiles in the baby’s
crib so the child will turn their head to see them. Changing the
child’s position in the crib also assists with this and
gives him/her a different perspective every day. Babies should
be given opportunities to lie on their stomach to help develop
their trunk muscles and assist them in learning to lift their
head.
One way to encourage baby to raise their head is to lay them
on your chest and talk/sing to them or, while baby is laying on
his/her stomach, shake a rattle above their head to get them to
look up. Alternating holding the baby on one shoulder and then
the other shoulder will help them learn to turn their necks in
different directions to accept visual and auditory stimulation.
As baby develops, it is important for them to begin to place
weight on their forearms while lying on their stomach. To help
with this, place a rolled towel under his/her arms when he/she
is lying on the floor (on his/her stomach). Also, a soft wedge
can be used in the same manner with a toy in front of the baby.
You can assist baby with learning to roll from their back to
their side or stomach by holding a toy to one side and taking
one leg and placing it across the body with the foot flat and
the hip and knee bent. Gently rock baby back and forth to help
develop the feeling of rolling.
Developmental Sequences 7-10 MONTHS:
To encourage baby to begin to move, place a toy slightly beyond
their reach so they have to reach and pivot to retrieve it. They
may begin intentional movement by dragging themselves across the
floor or by pushing themselves with their legs.
To help baby develop the trunk muscles necessary for sitting,
offer them many opportunities to sit up. This can be done in a
highchair with toys on the tray. If baby is not able to support
herself enough, rolled towels can be placed on either side to
make her feel more secure. If holding baby in your lap in a sit-up
position, encourage him to look up and around by shaking a toy
above his head or to the side.
You can help baby keep her back straight by tapping or rubbing
her spine, bouncing her up and down in the sitting position or
stroking the center of her back gently and rapidly. As baby becomes
stronger and is able to sit-up independently, help him learn how
to go from sitting to laying by positioning their body correctly.
As baby starts to creep and experiment with crawling, encourage
him to assume the hand-knee position by placing a rolled blanket
below his abdomen when lying on his stomach. Once he is comfortable
with this position and is able to maintain it himself, help him
to rock back and forth. This encourages him to shift his weight
from one arm to the other. You can also accomplish this by placing
a toy in front of him so he will pick up one hand to get the toy.
When baby starts to pull to stand on furniture or with assistance
from parents, make sure her feet are flat on the floor and that
her knees are apart and slightly bent. Also, always stay close
to baby as they experiment with standing on their own, even if
they are holding on to something. The child cannot sit down from
this position without assistance. Spend some time with baby standing
in your lap, holding on to her hands and bouncing her up and down.
Developmental Sequences 11-15 MONTHS:
Around a year of age, baby may start to experiment with standing
on his own, without holding on to something or someone. This is
the first step towards walking and it can be encouraged in several
ways. One way is to hold on to baby on his back and briefly let
go while he is standing. Another is to have baby stand and lean
in a corner and hold on to a large toy or give him a ball to throw.
Once baby is standing and holding on to furniture, encourage
them to start cruising along the furniture. This helps them develop
the rhythm of walking and the muscles necessary for success. Also,
by placing two chairs next to each other and asking baby to walk
between them, she begins to gain confidence in her abilities.
Soon you can move the chairs further apart and she will let go
of one, take a step and grab hold of the next one.
At this age, baby can be encouraged to throw balls overhand,
which assists her with developing balance while standing. As baby
becomes more comfortable with standing on her own and possibly
taking steps, let her stand/walk on different textures such as
grass, gravel, sand, etc. Baby will walk between two adults when
they begin to take steps and can be encouraged to walk longer
and longer distances in this way. As she progresses, help her
to walk up and down small inclines or hills.
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When
Should a Parent Refer a child to Physical Therapy?
Birth to 2 months:
-Doesn’t lift head in prone position (while lying on their
stomach)
-Does not turn head to one side in prone position
-Does not turn head to both sides in supine position (lying on
back)
3 Months:
-Does not hold head up 90 degrees in prone (lying on stomach)
-Does not extend both legs or kick reciprocally
-Does not roll to back when placed on their side
4 Months:
-Does not place weight on forearms in prone position
-Does not rotate or extend head
-Is unable to grasp a rattle
-Cannot bring both hands together
5 Months:
-Does not roll over one way
-Does not hold head up when pulled to sitting
-Is unable to hold head steady in supported sitting position
-Does not bear weight on legs
6 Months:
-Is unable to keep head level with body when pulled to a sitting
position
-Does not demonstrate balance reactions
-Cannot bear weight on hands in prone position
-Does not move head actively in supported sitting position
7 Months:
-Does not roll over either way
-Does not bear weight on legs
-Cannot lift head or assist when pulled to sitting position
-Demonstrates little balance reactions or protective extension
of arms
8 Months:
-Does not roll over both ways
-Cannot sit with little or no support
-Does not hold weight on one hand while in the prone position
-Cannot bear weight on legs and bounce
10 Months:
-Cannot get to sitting position without assistance
-Does not assume crawling position (hand-knee position)
-Does not show interest/motivation to crawl
-Cannot sit on own without hand support
1 year:
-Does not pull to stand using furniture
-Cannot switch positions from sitting to prone
-Does not creep on hands and knees
-Cannot pivot while in sit position to retrieve toy
-Cannot pass an object from one hand to the other
-Cannot stand holding on to someone or something
-Cannot pick up small object
15 Months:
-Does not walk with one hand held
-Cannot stand alone well
-Does not demonstrate balance reaction while in the kneeling position
-Does not walk alone one to two steps
-Does not demonstrate motor planning by climbing on furniture
-Has a hard time picking up small objects
18 Months:
-Does not attempt to creep upstairs
-Does not walk without support
-Cannot throw ball
-Does not bend down to retrieve objects
-Does not demonstrate balance reaction in standing
24 Months:
-Does not run
-Cannot walk upstairs with one hand held
-Cannot carry large toy while walking
-Does not squat in play
-Cannot retrieve toy off of floor from standing position
-Does not climb onto furniture, turn and sit
-Cannot build tower of 6 blocks
-Does not use utensils well
30 Months:
-Does not jump in place with both feet
-Does not stand from sitting by rolling on side
-Cannot catch large ball
-Has difficulty with gait and balance
-Does not walk downstairs using rail for support
-Does not have wide range of movement
-Does not run and stop without holding
-Does not avoid objects when running
36 Months:
-Cannot kick stationary ball
-Is not able to stand on one foot for 2 seconds
-Cannot build tower of 9 blocks
-Cannot complete 5-6 piece puzzle
-Is not using utensils properly
-Does not attempt to ride tricycle
-Does not demonstrate grasp of crayon
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