Newsletter - August 2016

COVER STORY

Gross Motor Skills- Significance in Cognition & Communication

The key to overall development is physical development. For children developing normally, the skills are learnt so spontaneously that they even get unnoticed. But for our children with physical or perceptual difficulties, the gross motor milestones are delayed, and might also be a reason for impaired cognitive functions. We have often dealt with cases where the parents are majorly focused on their child's cognitive development, whilst the child doesn't get enough stimulus to enhance the physical skills. And that is where the therapy begins.

Key Factors to consider -

1. Posture: All activities involved in a day require some stable posture of the body, including sleeping too. Wrong positioning of joints and abnormal postures (like W-sitting, Windswept position, etc) bar the normal movement patterns, which in turn affects the global development of the child. Its important to promote upright and symmetrical posture during the basic activities in children.
Children with spasticity and abnormal movements show drastic improvements in their cognitive abilities, once a suitable adaptive sitting position is achieved. Besides, a good body posture naturally boosts the self esteem of a person.
The usage of the hands and fingers or better known as the fine motor skills, also tremendously contribute towards cognitive and social development in children. This is the reason why Graphology and stuff like "Abacus" have come to limelight. The use of both the hands and correct positioning of the finger joints have ample importance in shaping the brain in the right way.

2. Body image: Children perceive their own body first in terms of dimensions, and then relate other spatial concepts with it. When asked to draw a human figure, a child with hemiplegia (a condition in which one half of the brain and alternately one half of the body gets affected) finds difficult to draw a symmetrical figure. Children with dyspraxia and dyslexia also often exhibit this difficulty of understanding body image.

Resulting in clumsy habits, poor dressing sense and reluctance towards learning any sports. It requires a lot of physical drilling to get these children understand the concepts of spatial relations like prepositions, distance and speed.

3. Mobility: Mobility is one of the crucial factors of creating the medium for learning. For children with difficulty in mobility, the usage of buggy or wheelchair should be a priority. Every child needs to readily explore his/her house, neighborhood and visiting places. Schooling also requires mobility and needs to be encouraged even for children with severe physical deformities. Traveling too should be considered as an important method of spontaneous learning for every child.

4. Self Help Skills: Not to overlook, children who are more independent are smarter in their group. Acquiring independence in daily activities instills confidence in children. Most of the early learning skills are covered by the daily self help skills. Hence it is always recommended to focus on life skills even before literacy skills are learnt.

5. Creative activities and Sports: Sports and activities like dancing and Yoga are undoubtedly great ideas for enhancing body image and learning new concepts. For every particular physical difficulty, there is always a specific physical activity, that can eradicate the issue. For children with special needs, the physical therapists are the best experts to tailor the activities to suit their needs.
Activities like action songs and rhymes with actions have shown tremendous improvements in developing speech and communication skills in young children. The generalization of movement with auditory inputs enhances memory and promotes learning. Children love to involve movement as the fun element in executing regular instructions in classroom. Many teachers also use physical actions for teaching various concepts.

To wrap it all in a nutshell, gross motor development lays the foundation for every learning to happen and hence cannot be neglected. It can be modified to suit the needs of every child to promote healthy and holistic learning.

Author

Soumali Dutta

Developmental Therapist

Special Educator

Soumali has been working with children with special needs for more than 10 years. She has a vast experience in working with individuals with cerebral palsy and other neurological impairments.

ASK THE EXPERT

Dr. Neha Didolkar

Physiotherapist

(NDT Certified)

Dr. Neha has been working since 13 years. Her expertise involves diagnosing and treating individuals with Neurological impairments.

QUESTION - How to enhance Gross Motor Skills in kids with delays?

Development may be delayed due to many reasons-conditions like cerebral palsy, Down’s Syndrome,etc or just Global delay. A lag in development of milestones of more than 3 months is considered as a Delay. Normal development is a range, a spectrum, and cannot be assured in a particular month.

To aid or enhance development in a kid, there are certain points to be kept in mind by all, not just the therapist or mother/caretaker, but the whole family.

In this article, we would enumerate few such tips, which are not exercises,but add-on to therapy, and generally neglected.

1] Positioning

Positioning the kid in a position that would aid the next step of development or milestone is important.

For instance-

Giving tummy time or floor time to a kid who is just in the first phase of development, ie supine position and not yet turning. (Tummy time has numerous effects though).

Supported corner sitting to a kid with less neck control.

Table top activities to a kid who has sitting control, but to aid transition to standing.

2] Handling

Proper handling of a kid in static positions and transitions is therapy in itself.

For instance-

Holding a child over the chest wall (not from the shoulders) with palms and not fingers, and turning to a side while picking from bed or floor.

Giving support to the vertex of the head and not nape of neck while feeding.

Dressing, feeding, reading, watching TV(if at all!), in sitting or upright positions, though supported, should be encouraged.

Taking active help from kid while dressing, feeding, etc.

3] Conducive environment

We should have an accessible, but adequately challenging environment at home.

For instance-

Keeping different heighted cushions, bolsters and pillows around the kid during play time and later on, various stools and tables, to encourage transitions of kneeling, standing, walking, etc.

Keeping different textured toys.

Keeping things that may hurt like sharp or glass objects away, rather than limiting their exploration by saying a NO to whatever he does. (Saying a NO in petty issues has long-term psychological effects).

Exploration of environment by touch, is vital in progress.

4] Communication

Talking to the kid throughout stages and ages of development is key to encourage speech,, cognition, emotional attachment, apart from physical development.

For instance-

Even to a 3 month kid, you must keep communicating, different activities like

Now we will change diaper.

Oh! It is wet.

We shall have a bath now.

We shall have a banana.

Give me your right hand in the shirt.

5] Playing Games

Games, books and toys, can be used effectively.

Turn-taking games, hiding objects at different places and giving hints to find them out, sorting vegetables and fruits, obstacle crawling or walking.

Such games are very important in gross development, and also add to fine motor development, cognition, speech, social interaction, etc.

Therapy is a one-hour event daily, but how we follow-up in the remaining 23 hours, is the main key to global development.

SPOTLIGHT

Yoga to promote Gross Motor Development

Yoga is a great activity for children of all ages and abilities. An increasing number of paediatric experts recommend Yoga as a super way to promote and aid development of Gross Motor Skills (Skills which involve the movement and coordination of large body parts like legs, arms, torso etc.)

Frequent practice of Yoga will help your child achieve a wide range of attributes like -

Flexibility
Strength
Body Awareness
Balance & Coordination
Attention & Behaviour Regulation
Cognitive Skills
Language Development
Social Skills

Here is a pictoral depiction of a few Fun Poses for children to start with!

ACTIVITY OF THE MONTH

'Shape

Hop & Jump'

This month's Featured Activity is a simple, engaging game that is bound to get your child to concentrate and move! This game promotes the following skills -

Gross Motor Skills
Cognitive Skills
Auditory Attention Skills
Joint Attention

What you need - Colourful paper cut out in various shapes. Make sure the shapes are cut out big enough for your child to stand/ sit on

What to do - Place the different shapes on the floor. You can keep them far apart for kids who are still learning to stand. Start the game by giving verbal instructions like -

Jump on the Triangle
Hop to the Circle
Jump twice on the square and then once on the heart
Hop on the red star, then on the pink star

Make it challenging as you go! Count how many times your child is correct. Reward and praise abundantly.

Play along yourself and ask your child to give you instructions instead. This would make the activity more interactive and would help in improving your child's expressive language skills too!