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“I Can Do It!”: Ways to Grow Your
Child’s IndependenceNDSS Webinar Series
Tuesday, April 29, 2014
Katie Bergeron Peglow, PT, MS
COO of Adaptivemall.com
NDSS Webinar Series 2
“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
April 29, 2014
NDSS Webinar Series 3
“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
April 29, 2014
NDSS Webinar Series 4
“I Can Do It!”: Ways to Grow Your Child’s Independence
ROLLING
SEATING
CRAWLING & CREEPING
STANDING
WALKING
TRICYCLES & BICYCLES
BATHING
FINE MOTOR SKILLS
April 29, 2014
NDSS Webinar Series 5
“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)
April 29, 2014
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
NDSS Webinar Series 6
“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
April 29, 2014
Photos courtesy of Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
NDSS Webinar Series 7
“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
April 29, 2014
NDSS Webinar Series 8
“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
April 29, 2014
Key Measurements
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
Graphics courtesy of Adaptivemall.com
NDSS Webinar Series 9
“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
April 29, 2014
Photos courtesy of Adaptivemall.com & Bardum.no
NDSS Webinar Series 10
“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
April 29, 2014
Photos & Graphic courtesy of Adaptivemall.com
NDSS Webinar Series 11
“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
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
Photo courtesy of Adaptivemall.com
NDSS Webinar Series 12
“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
April 29, 2014
Photos courtesy of noahsdad.com & dsamidlands.org
NDSS Webinar Series 13
“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
April 29, 2014
Photo courtesy of www.assistireland.ie
NDSS Webinar Series 14
“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)
April 29, 2014
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
NDSS Webinar Series 15
“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
April 29, 2014
Photos courtesy of noahsdad.com
NDSS Webinar Series 16
“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)
April 29, 2014
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
NDSS Webinar Series 17
“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
April 29, 2014
Photo courtesy of noahsdad.com
NDSS Webinar Series 18
“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
April 29, 2014
Photo courtesy of noahsdad.com
NDSS Webinar Series 19
“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
April 29, 2014
Photo courtesy of noahsdad.com
NDSS Webinar Series 20
“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
Floor to Elbow
April 29, 2014
Key Measurement
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
Graphic courtesy of Adaptivemall.com
NDSS Webinar Series 21
“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
April 29, 2014
Photo courtesy of billandria.blogspot.com
NDSS Webinar Series 22
“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
April 29, 2014
Photos courtesy of parentmap.com & confessionsofadownsyndromedaddy.com
NDSS Webinar Series 23
“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 Measurements if adaptive equipment is needed
Inseam
April 29, 2014
Key Measurement
Graphic courtesy of Adaptivemall.com
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
NDSS Webinar Series 24
“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
April 29, 2014
Photos courtesy of Adaptivemall.com
NDSS Webinar Series 25
“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
April 29, 2014
Photos courtesy of Adaptivemall.com & striderbikes.com
NDSS Webinar Series 26
“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
April 29, 2014
Key Measurements
(1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.
Graphics courtesy of Adaptivemall.com
NDSS Webinar Series 27
“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
April 29, 2014
Photo courtesy of myliddybug.blogspot.com
NDSS Webinar Series 28
“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
April 29, 2014
Photos courtesy of Adaptivemall.com
NDSS Webinar Series 29
“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
April 29, 2014
Photos courtesy of differentlythesame.net, noahsdad.com & lovethatmax.com
NDSS Webinar Series 30
“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!
April 29, 2014
Photos courtesy of facebook.com/ActivateHere
NDSS Webinar Series 31
“I Can Do It!”: Ways to Grow Your Child’s Independence
Katie Bergeron Peglow, PT, MS
Pediatric Physical Therapist
COO of &
Email: [email protected]
Customer Service: 1-800-371-2778
International #: 1-315-429-7112
Fax #: 1-315-429-8862April 29,
2014
Q & ATHANK YOU!
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.
