Adaptive CircusAdaptive Circus

Improving Gross Motor Skills

with Physical Therapy Perspectives and Circus Themes

Professional Credentials

Masters degree in physical therapy

Currently specialize in Pediatrics Trained in Neurological

Developmental Treatment and Handling Techniques

Taught two after-school special needs classes in adaptive circus skills at the South Brunswick Recreation Center in the spring of 2003

Worked my way through graduate school as a performer

Worked as house juggler at the Taj-Mahal Casino

Studied with performers from around the world (jugglers from Cirque du Soleil and mimes from the Peking Opera)

Have a one-man professional variety show called Comedy Cascade

Introduction

Therapy principles to help students improve their gross motor ability

1. Developmental Sequence

2. Motor Learning

3. Gross Motor Group Activity

Introduction

Specific techniques and activities using circus themes and props

1. Ball Handling2. Scarf Juggling3. Balance Training4. Mime

Why Is Gross Motor Play Important ? Sedentary lifestyle is a major concern for today’s youth.

Active physical play is essential in developing gross motor skills.

Children who are not exposed to physical recreational activity are less likely to engage in exercise as they get older, putting them at risk for obesity and health concerns.

Guided active play for children with disabilities fosters increased balance, coordination, and strength.

Active play improves social interaction and self confidence. 

Rising Obesity Rates

American Obesity Association Copyright © 2002. All rights reserved.

Table 1. Prevalence of Obese

Children (Ages 6 to 11) at the

95th percentile of Body Mass Index (BMI)

1999 to 2000 15.3%

1988 to 1994 11%

1976 to 1980 7%

   

Table 2. Prevalence of Obese

Adolescents(Ages 12 to 19) at the

95th percentile of Body Mass Index (BMI)

1999 to 2000 15.5%

1988 to 1994 11%

1976 to 1980 5%

Skill Types Gross Motor Skills: Activities that require large

movements and/or coordinated activity of major muscle groups. (i.e. walking, climbing, standing, balance, lifting arms to put on shirt)

Fine Motor Skills: Activities that require small precise movements (i.e. handwriting, holding utensils, tying shoes, buttoning shirt )

Most activities have fine and gross motor components

Physical therapists primarily work on gross motor, while occupational therapists work on fine motor. Some training overlaps.

Juggling helps to develop both types of skills.

Developmental Sequence: A general time table shows when kids generally develop specific skills required to interact with their environments.

- If children are delayed, they may need therapy.

Motor Learning- a set of processes associated with practice that leads to changes in performance capability (Campbell, 173)

Match Activities with Capability

Knowing normal development helps to understand how to monitor and guide children with impairments.

  Children typically acquire gross motor skills in a

specific chronological pattern called The Developmental Sequence.

  When guiding physical play, understand where

children fall on the developmental sequence and encourage activity at or just above that level, so as not to bore or frustrate them.

Normal Developmental Milestones The First Year Age 0-1 Gross Motor Fine Motor

0-2 months         Head Control at midline        Props up on elbows on prone (belly) 

 

3-4 months         Holds head from side to side        Back legs come together        Rolls from back or stomach onto side        Begins weight bearing

Squeeze grasp

4-6 months         Bears weight on extended arm in prone        Reaches for toy with open hands        Rolls         Sits propped on hands        *Protective extension anterior         Bears weight when held in standing

Palmer grasp

6- 8 months         Extends in prone lifting, chest, chin, and thighs         Sits up on floor        Sits and plays with toys        Creeps forward on belly        Protective extension side to side

Side to side wrist movement

8-10 months         Pulls self up to standing        Stands holding onto furniture        Crawls on hands and knees        Protective extension posterior

Inferior pincer grasp

10-12 months         Stands alone momentarily        Walks 2-3 steps

Fine pincer grasp

     

1 year    

Age 1-2

   Social Development

Solitary play, dependent on adult guidance, plays with dolls, refers to self by name, little concept of others as "people."  May respond to simple direction.

Gross Motor Walks independently,

Stoops to pick up objects

Runs immaturely

Seats self on chair,

Jumps up to 1 inch

Fine Motor

Toileting,

Uses spoon and fork,

Turns pages,

Attempts to dress self,

Builds tower of six cubes

Age 2-3

Fine Motor

•Unbuttons and buttons, •Builds tower of 10 cubes• Pours from pitcher• Feeds self well,

Social Development

• Parallel play,• Enjoys being by others, • Takes turns, •Enjoys brief group activities • Likes to "help" • Responds to verbal guidance.

Gross Motor•Walk and run smoothly

•Stands on one foot up to 1-3 sec ,

•Climbs

•Rides tricycle, Bounces and catches  

Age 4

Gross Motor•Stands on one foot 5

sec,• standing broad jump,

• Throws ball overhand

•Kick rolled ball•Hop once

•Walk up and down stairs alternating feet

•Pedal tricycle

Fine Motor

• Dress self• Stacks blocks• Cut straight • Beginning drawing

Social Development

Cooperative play, •enjoys other children's company, •highly social, may play loosely organized group games - tag, duck-duck-goose, •talkative, •versatile

Age 5

Gross motor

•Hops and skips,•Dresses without help,

•Good balance •Rides scooter

•Swings self on swing•Imitates 3 movements

Fine Motor

•Prints simple letters, Handedness established,

•Ties shoes, •Cuts circle• paperclip

•Colors in lines

Social DevelopmentHighly cooperative play, has special "friends", Highly organized, enjoys simple table games requiring turns and observing rules, feels pride in accomplishments, eager to carry out some responsibility.

 

Age 6

Gross Motor•Walks 12 feet on 4 inch beam•Walks up and down stairs carrying object•Jumps rope•Dribbles basketball•Rides bicycles

Fine Motor•Sharpen pencil•Prints name•Ties shoes•Handles bread knife

Motor Learning- a Set of Processes Associated With Practice That Leads to Changes in Performance Capability

(Campbell, 173) 6 Steps of teaching motor skills

1. motivation

2. presentation

3. response guidance

4. practice

5. feedback

6. transfer

Skills and Practice Patterns

Motor skills can be classified as…• Continuous (i.e. tracking with eyes,

sitting) • Discrete, (long jump, swinging bat)• Procedural movements. (i.e. typing,

operating instruments, or maintenance

Presenting Skills: to facilitate learning

(1) Slow down the rate at which information is presented.

(2) Reduce the amount of information that needs to be processed.

Teaching Strategy For special need populations:1. Break down the gym activity into smaller parts while ensuring that each part is meaningful and achievable

2. Try to choose activities that will ensure success for the child at least 50% of the time.

3. Reward effort, not skill.

4. Try to incorporate activities that require a coordinated response from arms and/or legs (e.g.,skipping, bouncing and catching a large ball). Also encourage children to develop skills using their hands in a dominant/assistant fashion (e.g., using a baseball bat or a

hockey stick).

© Cheryl Missiuna, 2003; CanChild, Centre for Childhood Disability Research 105. Keep the environment as predictable as possible when teaching a new skill (e.g., place a ball on a T-ball stand). Introduce changes gradually after each part of the skill has been mastered.

6. Make participation, not competition, the major goals. With fitness and skill-building activities, encourage children to compete with themselves, not others.7. Allow the child to take on a leadership role in activities (e.g., captain of the team,umpire). The child may develop organizational or managerial skills that are also useful.8. Modify equipment to decrease the stress and risk of injury to children who are learning a new skill. 9. When possible, provide hand-over-hand guidance to help the child get the feel of the movement. This can be done, for example, by asking the child to help the teacherdemonstrate a new skill to the class. Also, talk aloud when teaching a new skill, describing each step clearly.10. Give positive, encouraging feedback whenever possible. describe the movement changes specifically

Practice Patterns

Long-term retention of motor skills depends upon regular practice. However, continuous practice results in less forgetting in the absence of practice than discrete or procedural skills

Sensory-motor learning appears to be the same under massed and spaced practice

Repetition after task proficiency is achieved and refresher training reduce the effects of forgetting.

Constructive Feedback

Start with a lot of hints and feedback during trial and error phase, and slowly reduce feedback as they progress.

Use continuous feedback if you are helping students master new skills that must be performed accurately in specific settings.

Have children problem solve if the task is to be recalled and transferred to a new situation.

Teaching Tips

There is evidence that mental rehearsal, especially involving imagery, facilitates performance

Group Structure Start group activities with a warm up, followed

by lesson plan, ending with Cool Down Review all activities visually and verbally

before beginning Bring a floor marker for each student Use a signal to initiate control and quiet

listening time, I.e. two claps or lights out. do not shout over students

Pause between activities to regain focus Give one direction at a time

Environment

Set up ahead of time Both low and high levels of arousal

produce minimum performance whereas a moderate level of arousal results in maximum performance.

Music can help. Get songs with complimentary tempos that do not compete for their attention.

Ball handling SequenceBall handling sequence  Trap= gabbing a thrown ball by cradling it between hands and forearms and chestCatch = grabbing a thrown ball with two hands only Reaching for object in different planesHand ball back and forthRoll playground ball back and forthBall on stringThrow with underhand toss ( 17 months)Bounce a ball and catch it, ( 3 years)Throw with overhead toss ( age 3.5-4), throwing form begins to mature at (4.5-5.5)Catch a bounced playground ball with two hand trap (4-4.5)Trap a tossed playground ballKinking a rolling ball (age 4-6)Catch a playground ball Throw with proper form 9-10 feet (age 5)By age 5.5-6.5 a child should be able to …Throw a bean bag or ball with accuracy ,Throw a ball in air and catch it Begin working on jugglingThrow and catch a ball tossed from further awayWork from a larger ball to a smaller ballThrow and catch a ball thrown in from side to side (20-35 degree planes)Dribble (age 6)Throw and catch a ball while standing on one foot or uneven surfacesThrow and catch while moving and multitasking

Therapeutic benefits of scarf Juggling!!!

PNF diagonal patterns,

Crossing midline, Eye hand

coordination, Sensory integration, Works of different

grip and hand strengthening,

Develops ball handling skills

Rhythmical patterns reduce tone

Improves balance Self confidence

Age equivalent 0-1

Sensory stimulus

Use to attract upward gaze for head control

Peek-a-boo

Reach for scarves

Introductory Levels (ages 2-5) Hand strengthening games Move scarves up and down, back and forth Use scarves for body part identification, more

eye catching than simply pointing “i.e put scarf on your nose”

Trace shape Throw and catch Move scarves in diagonal pattern Throw, clap, and catch Sensory stimulus for under aroused student Jumping jacks

Mid level Age 4-7 Diagonal throw and catch

with opposite hand Throw clap catch, Tricks throwing one scarf

(make shore to cross your body and lift scarf as high as possible before letting it go)

Stand on one foot throw and catch

Clap under leg and catch Clap behind back Clap under both legs Back and legs Pirouette

Blow scarf in the air, keeping it up without touching it

Two scarf tricks Crisscross the scarves

and catch them so they change hands (crisscross apple sauce pattern, make shoe scarves switch hands)

All tricks with one scarf can be done with two ,

Two in one hand

Advanced levels (Age 5 and up)

Scarf juggling introduced at age 5

(start with 3 catches and build as able)Column patternReverse cascadeUnder leg

Feather Balancing skill setsBeginning skills Sensory stimulation Balance feather in palm looking at top of feather, use

hand over hand assistance if necessary

 

Intermediate skills Balance feather while walking Bend knees and strengthen them while balancing

Advanced skills, balance feather on tip of nose or chin

The Circus lends itself to

Balance beam activities to represent the high wire

Animal walking Obstacle course Tricycle riding (Circus parade)

The Circus theme also lends itself to

Spinning plate to encourage hands to midline

Mime Works On: – Performing ADL in a fun setting, – Isometric strengthening, – isolation,– breaking synergies,

The possibilities are endless!!!So Have Fun !!!!

Bibliography/ Sited Sources Campbell, Suzann. Darl Linden, Rober j Palisano; Physical Therapy for Children, second Edition cr 2000 WB Saunders co, Ny, ny Finigan,Dave; The Complete Juggler, cr 1991, jugglebug Edmonds, Wa

Ogeraldine Borrelli November 2nd and 3rd 2002 Lecture Notes Creative Movement Treatment Based on Sensory Integration for Learning Disabled Children, from the Hampton Care’s Pediatric Symposium  Kane, Koren; Anderson; PT Activities for Pediatric Groups 1995, Psychological Press, San Antonio Preschool Gross Motor Activity Guide compiled by Tricia McCloskey, OTR and Jennifer Agresto, OTR Mrs. Weiss, Gross and Fine Motor Lesson Plans 1992 Adams, J.A. (1987). Historical review and appraisal of research on the learning, retention, and transfer of human motor skills. Psychological Bulletin, 101, 41-74. Singer, R.N. (1975). Motor Learning and Human Performance (2nd Ed.). New York: Macmillan. Marteniuk, R. (1976). Information Processing in Motor Skills. New York: Holt, Rinehart & Winston.