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Understanding Motor Planning and Coordination

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UNDERSTANDING MOTOR PLANNING AND COORDINATION

This month we are going to talk about motor planning and coordination.

Each child develops at a different rate and at Explore and Soar it’s our job to identify and offer intervention solutions to help that process. 

Developmental Coordination Disorder is what postural and motor sensory based disorders are diagnosed under, in the DSM-V. We use sensory based motor disorder definitions, information and research to help us identify behaviours consistent with this, as occupational therapists.

One of the most common reasons we find that children are referred to Explore and Soar is difficulty with gross motor skills. This could be concerns regarding poor coordination, appearing clumsy and falling over a lot, difficulty with crawling or an inability to jump with two feet at a time, to skip or to ride a bike. 

As part of our initial assessment process and during our intervention sessions, we pay close attention to how your child moves their body in various scenarios. This provides us with vital information regarding how your child is processing the varied types of sensory inputs around them.

Last year we wrote about Sensory Processing Disorders on our blog, how to correctly identify the warning signs and how to best assist your child. One of the types of sensory processing disorders that we only spoke briefly of was sensory-based motor disorders (SBMD) also commonly known as a developmental coordination disorder, as recently outlined in the DSM-V under the category of neurodevelopmental disorders.

In SBMD, we see children who have difficulties with “stabilising one’s body or thinking of/planning/sequencing or executing a series of movements based on sensory information outside and inside the body” (Miller, L.J., 2014, pg.14). SBMD can be categorised into two groups; Postural Disorder and Dyspraxia.

Postural disorder is seen in a child who has difficulty in maintaining the control of their body, to meet the demands of an activity. It involves our muscle tone, core strength and stability. It is the action part of all motor movements. 

Children who have difficulty with ideation (forming an idea in the brain), planning and sequencing (identifying what steps are involved) and execution of motor movements fall into the dyspraxia category. This can occur across all motor movements including gross motor, fine motor, visual motor and oral motor. This is known as the planning part of all motor movements.

Motor planning is an automatic subconscious process that occurs every time we seek to move our body. We tend to take this process for granted. It occurs with many common daily activities such as opening a door, putting a jacket on, writing our signature, or chewing our meals. Once acquired it becomes like riding a bike – once you know how to do it, it begins to happen without too much conscious thought. Everything we do can be broken down into steps that our brain automatically executes via motor movements for successful completion of the desired activity. Children who are experiencing difficulties with motor planning find such tasks difficult, awkward and exhausting because of the level of conscious energy they have to put into completing each and every task! 

One common result of motor planning difficulties is an impact upon the ability to form social connections and self-worth. This is often due to difficulties with oral motor (eg. speech), visual motor (eg. difficulties copying work from the board at school), fine motor (eg. difficulty with buttons, shoelaces) and gross motor skills (eg. difficulty keeping up with their peers at recess). 

So how do we address motor planning difficulties in OT sessions?

We practice all the steps involved – ideation, planning and sequencing, and execution – so that it eventually becomes an easy and automatic process for the child. We provide opportunities for the child to create their own ideas for an activity, we break skills down into smaller steps to achieve success and we provide high repetition rates to allow feed forward and feedback loops to develop around the sensory information the child receives from the world around them. This is where we apply our knowledge and skills of activity analysis as OT’s to coach and teach your child skills that allow them to increase their independence. 

This is not a quick process. It takes time to rewrite neural pathways in the brain for autonomic responses to sensory input. By addressing motor planning goals within intervention sessions, we are not only looking to increase a child’s skill level but also their self-esteem and confidence to complete activities that are meaningful to them, ultimately leading to a happier successful life!

If you have any questions around motor planning, please reach out to one of our therapists who will be able to provide more information to you.

Reference:
Miller, L.J. (2014) Sensational Kids: hope and help for children with sensory processing disorder (SPD). New York:Penguin Group.

Until next time,
Lori

ORIGINALLY PUBLISHED JUNE 2, 2021

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The Impact of Relationships on Social Development

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THE IMPACT OF RELATIONSHIPS ON SOCIAL DEVELOPMENT

Over the last few months, I have seen a consistent theme emerge with clients and families within our communities, centered around personal health, well-being and relationships. 

As we are focusing on the importance of mental health this year, I thought it would be good to talk about the impact of relationships on social development – especially in that of our children in their early stages of life. 

Modern life seems to be filled with more stresses as humanity progresses. From a social emotional perspective, as a society, many of us are struggling. Our emotions are high, and we are feeling anxiety and uncertainty more than ever before. Once felt, this stream of thought and instability transfers to all aspects of life. But what if I told you that there is an intervention model designed by a psychologist, Stanley Greenspan that acknowledges our emotional social development and how it stems from relationships developed soon after birth? As health professionals we can use this model to support our families, both parents and children in developing the skills to maintain healthy relationships from the first 3 months of life! At Explore and Soar, we reference this model and use it as a guide in our intervention sessions. It is called the DIRFlootime Model; a Developmental, Individual Differences and Relationship based model that acknowledges each child’s unique differences and uses relationships and connections to establish a strong emotional social connection to further enhance development. This model is integrated into our sessions by following the child’s lead and adapting their ideas to enhance these skills through play. 

So why DIRFloortime? 

Well for us it aligns perfectly with our core values and supports our ability to develop connections and relationships with all our clients. But most importantly, it is an intervention model that acknowledges the emotional social development from birth into our adult years. It allows us as clinicians to work through developmental milestones from an early age. It is also a model firmly based on parent coaching; supporting our client’s parents/carers to further develop the skills needed to support healthy relationships. 

So how can we support our communities and families in developing these skills from birth to increase emotional development, resilience and social engagement, in order to avoid seeking intervention at an older age? This is done through awareness, education and acknowledging that the first months up to two years of life are of great importance when developing healthy relationship skills. 

In the first 3 months of life the foundational skills of regulation begin. This is the beginning of co-regulation between the parent and child and fosters shared attention; where the baby can seek the mother’s attention and they respond or vice versa. This then becomes the child’s foundation to a secure attachment. Attachment between the caregiver and the baby. The start of co-regulation is around the caregivers/mother’s ability to understand the baby’s wants, needs and desires. It’s the ability to answer cues and answer questions like are they hungry, uncomfortable, do they require a nappy change or are they in fact tired? The connection and relationship is based on love and learning to soothe the baby, creating a positive experience and strong connection. This ability comes from the baby having their own unique cries or cues to indicate to the mother or caregiver what they need. This is where the baby and caregiver become entrained with one another forming a bond; the foundations to co-regulation.

In an ideal world this seems simple, easy and realistic. However, every baby enters this world differently, every mother has a different experience and every baby has different sensory processing capacities that then impact their own biological rhythms. There simply is no one size fits all when it comes to taking care of an infant. 

As a new baby comes into the world, parents are presented with an array of challenges. Difficulty sleeping, reflux and feeding concerns, high stress births, babies being unable to settle or babies that simply do not enjoy being touched or soothed. These difficulties that arise for every parent, have a flow on effect with little to no sleep, stress, anxiety, self-blame and hormonal changes being merely a few of the impacts on our parents. This too then has an affect on the relationships that surround mum and dad, including their relationship with one another.  

This is all normal. But why don’t we talk about it more? Why do we gloss over the early stages of parenthood and try to make it look as easy as possible to the outside world? I remind my clients and friends that as parents, you simply are NOT a failure for not being able to soothe your baby. The only way you will ever fail is when you stop trying to understand your child. It is about asking questions and seeking medical advice when required, but also not being afraid to ask for help from your family and friends. 

It takes a village to raise a child. 

As OT’s we provide an extra level of support to parents, children and families. We understand and work with children in motor movement patterns at a young age to support their discomfort and the development of their sensory systems, including their sleep-wake cycles. We have the skills and ability to discuss with you your routines and support in identifying cries and ability to connect with your babies. We also acknowledge where other health professionals’ unique strengths can provide positive impacts for you and your child. But most importantly for us, our skills lie in the development of connection. We look to support our parents/caregivers by building the skills to interact, laugh, smile and play together with your child from a young age. We work with you to build upon the ability to co-regulate emotions, to keep you calm in challenging circumstances and to be present in order to assist in the soothing and engagement of your child. 

If you have any questions around the foundational skills of co-regulation and shared attention please don’t hesitate to reach out. The first three months with your baby’s life is the starting point to all engagement, self-regulation and social skill development for life. My hope is that in having these conversations, we will increase our ability to ask for help when needed. We will foster strong, resilient children who have confident, calm parents who are a little kinder to themselves in challenging circumstances. If we make an effort to start from birth, we can positively impact the mental health of our children as they get older. I know I’d love to see our children’s quality of life, self-esteem and love for themselves be greater in future generations. 

In our socials this month we will go through some examples of challenges and strategies that can help to support you. Take a look at our instagram or facebook to see more. Please don’t hesitate to reach out if you need a helping hand or would like further information on how we could help you!

Until next time,
Jess

ORIGINALLY PUBLISHED APRIL 7, 2021

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Gross Motor Skills

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GROSS MOTOR SKILLS

Whilst we continue to navigate the current disruptions and changes to our everyday life, I thought I would focus on a term we regularly see in our referrals from parents, caregivers and teachers. Gross motor skills. The development of these skills allows a child to participate in everyday activities such as self-care, school work and socialisation.

What are Gross Motor Skills?

By definition, Gross Motor Skills are the physical abilities acquired during early childhood, those which require whole body movement such as standing up, walking or running.

Gross Motor Skills develop through the use of large muscles in the body in a controlled and organised manner including the torso, arms and legs to complete whole body movements. It involves both the coordination of muscles and the neurological system in the body. The development of these skills impact upon balance, coordination, body awareness, physical strength, endurance and reaction time. They are developed through experience, practice and repetition during everyday life and impact upon confidence and the execution of further skills such as; walking, running, skipping, sitting, jumping, hopping, hand-eye coordination (catching a ball), dressing, bathing, feeding oneself and even academic skills such as the ability to sit at a desk, manage a full day of school or carry a heavy school bag. 

Children need to be exposed to a range of diverse opportunities in order to move freely and practice their Gross Motor Skills, with each skill building on the one before and preparing your child for the next challenge. They are a vital part of childhood development for movement during daily activities and also provide a stable base for the development of fine motor activities, such as writing. As a child continues to develop their Gross Motor Skills and overall body awareness, their self-esteem and confidence grows, allowing them to explore the world around them, interact socially and develop relationships. 

The development of Gross Motor Skills:

It’s important to remember that each child develops at their own pace, however the development of Gross Motor Skills usually occurs in stages with each skill building upon the next. Categorically by age, your child should be:

  • At 3 to 4 months an infant can raise their head and chest when lying on their belly.
  • At 6 months an infant can roll over, both ways (from the stomach to back and back to stomach).
  • At 8 to 9 months an infant can sit without support and may start to crawl.
  • At 12 to 18 months a child can walk on their own. They’re a toddler now!
  • At 2 years of age a child learns to run, jump and throw a ball.
  • At 3 years of age a child can walk on their tiptoes, climb, attempt to balance on one foot, gallop, jump, kick a ball and try to skip.
  • Between 3 and 4 years of age a child can pedal a tricycle.
  • By 5 years of age, a child can leap, hop, skip and run. Proceeding this age we continue to grow and develop our motor movements which aid in the development of Fine Motor skills.

There are three types of Gross Motor Skills:

  • Locomotor skills: those used to move your body from place to place such as running or walking.
  • Manipulative skills: those that involve moving an object such as a bat, ball or skipping rope. 
  • Stability skills: those that are related to balance and body weight transfer, including standing on one leg or manoeuvring around an obstacle. 

How to encourage Gross Motor Skill development:

Infant development: Infants have very little control over their bodies, so they rely on their parents for support to move safely and comfortably in the world. Whilst a baby’s head needs support in the first few months of life, as they continue to grow they will slowly begin to strengthen the muscles in their neck. To support this strengthening and confidence in movement, hold your child to your chest so they can begin to peer over your shoulder. 

Furthermore,  you can encourage your child to learn how to move their body through tummy time.  Through this activity, you are allowing them to build strength and become mobile. To do so, put them down on a comfortable mat or blanket on the floor on their stomach, and walk around the room to motivate your little one to lift their head and continue to develop their neck muscles to see you. 

As OTs, part of our method to support engagement within a session is to play on the child’s motivations and interests. As your child continues to grow, I encourage you to do the same. Place toys nearby so that they can move and reach for them. Play games and songs with movements that they can imitate to develop an understanding of their body. Play parades or follow the leader to explore their surrounding environments. Throw or roll a soft ball back and forth. The ideas are endless and unique to each child. 

Toddlers and young children: Skills develop through practice and repetition. Children are more likely to repeat activities that are fun, supportive, encouraging and promote success. Always encourage trial and error, rather than the attainment of perfection. Break harder asks down into smaller steps and allow plenty of rest breaks when needed. Remember that children develop at different rates, gently encourage but don’t push your child to do things if they are not yet ready.

How OT’s support the development of Gross Motor Skills?

I love how fun my job is as an OT. We use a variety of games, equipment and toys to support the development of these necessary foundational skills. There are done through a variety of activities such as:

  • Visiting environments where children feel safe (at home or school) and exploring movement-based tasks that can be transferred to everyday skills.
  • Providing education to parents, carers and teachers to assist the collective understanding of supporting the child to best achieve their goals.  
  • Individually supporting sensory processing capacities to allow the child to work through challenging activities. This supports regulation and attention, as well as ensuring the body is receiving and interpreting the correct messages from the muscles in terms of their position, their relationship to each other, the speed at which they move and how much force they are using. 
  • The strengthening of core muscles in order to move the body confidently, as well as expanding upon balance, coordination, crossing midline activities, body awareness and motor planning. 
  • The breaking down of tasks or skills to become simplified components, gradually expanding the skill in its entirety to support participation and success.
  • Exploring varying duration and intensity of activities to support endurance. 

Building Gross Motor Skills at home:

In light of the current situation we are all living in, our families are asking for a greater array of ideas and experiences to continue to build upon these Gross Motor Skills. Here are some that you can do at home:

  • Skipping rope 
  • An obstacle course in the home or backyard to explore different surfaces and a variety of different movements including running, hopping, jumping, crawling etc. 
  • Bouncing, rolling, throwing, kicking or batting a ball
  • Balancing on uneven surfaces like different sized pillows or an air mattress
  • Keeping a balloon up in the air by hitting with their hands or head 
  • Water play! Splashing about in water strengthens leg muscles 
  • Dancing, walking or skipping to music, improving coordination and balance 
  • Bike riding 
  • Using body weight to gain momentum on a swing
  • Hopscotch 
  • ‘Simon Says’, which can assist in following visual cues, body awareness and motor planning 
  • Bouncing on a trampoline
  • Chasing bubbles can provide lots of fun while using arms, legs and eyes together 
  • Hula-hoops, which encourage children to activate their core muscles, ensuring further development.

That’s all for now! If you’d like some help or have a question, please don’t hesitate to reach out to our team at Explore and Soar! We are always happy to help and find the right solutions for you and your child! 

Madeleine Simms

ORIGINALLY PUBLISHED JUNE 3, 2020

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Flying with Children

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FLYING WITH CHILDREN

As I write this, I am currently sitting in my economy seat on a Boeing A380. I am making the 13-hour flight from Los Angeles back to Sydney after a wonderful time with friends exploring a country I’ve never ventured to before. 

Here’s a solemn truth though, flying has always been hard for me. The anticipation and anxiety of the flight itself, the dreaded thought of hours of boredom, the stiffness, claustrophobia and the plane food i cannot eat… It’s a lot to overcome. 

The experience of flying long or short haul is different for everyone though. Some dislike it and avoid flying all-together and for others, flying is an exciting, enjoyable experience, no matter the distance.

Personally, I tend to become overwhelmed and anxious when flying. Full disclosure, I may be a little claustrophobic, so sitting in seats next to people with no way of being to get out when I would like to and feeling restricted makes or breaks a flight for me. It’s important that I am able to get up regularly and move around as the change in air pressure has different impacts on my body. I never really spoke to anyone about what I was feeling whilst flying, I thought I was the only one who felt changes that made me uncomfortable. But the more I’ve began to open up about how i feel, the more I realized I wasn’t alone in this. 

So let’s talk about the physical changes that flying brings to your body. For me, I experience earaches from the fluid moving in my inner ear and vestibular system, to increased bloatedness and pain in my stomach whilst remaining in an upright seated position for an extended period of time. Despite being somewhat uncomfortable as a result, I still make the choice to do long haul flights, reminding myself that the journey is worth it to get to the destination of choice.

Along with the physical changes, I also experience a range of emotional and social challenges whilst flying. I am quite observant and that can be somewhat detrimental as it’s hard to switch off during a flight. With concern about those around me, young children perhaps crying and even having to sit with my own thoughts – it can create an unhealthy environment mentally. As an adult, I have learnt to employee strategies to manage my own emotions and mental health on a flight. Watching a film, journaling, having a conversation here and there with those seated next to me to feel more comfortable, having playlists at the ready and trying to get sleep in to pass the time.

But what about how our children cope with the anxiety of flights? With the holidays fast approaching, it’s important to think about strategies to keep them happy whilst contained in a seat for a long period of time. 

Keeping children physically and mentally entertained on a flight can be challenging. All the physical changes that I mentioned above can also occur in young people, so it’s important to prepare for physical and emotional discomfort.  

So what is the best way to cope with this? And how can we prepare them for flights? How do we inform them and describe what is going to happen and why it happens in order to help them cope? And how do we help them through the physical and emotional changes in the moment? 

Let’s begin with the discomfort that you may feel as a parent or caregiver. Let’s face it, we have all been on planes where children have cried, whinged or acted out. As parents, you try and soothe your child or tell them to stop as the engrained societal pressures, worries and expectations of what others think begins to cause undue stress. We begin to take on social anxiety whilst dealing with the physical or emotional discomfort of a child. In this moment of great discomfort, try to remember that these feelings aren’t permanent and that your child comes first. Your child is only expressing that they need help. We need to allow them to express themselves to help them work through their feelings in a positive manner to recover and be present for the rest of the flight.

Now let’s talk about some strategies to help you through the experience together. You may want to try;

  • Preparation; Explaining what will happen, how long the flight may be but what the reward will be at the end.
  • Layout the expectations, for example we need to sit for 3 hours in our chair, how do you think we could do this? What games, books or toys should we take?
  • Physical discomfort; our ears may feel funny or blocked at take off and landing; the feeling is different for everyone. There are a few things to help our kids in this instance:
  • Drink water before and during take off to help with swallowing and keeping the Eustachian tubes clear,
  • Eating a fruit snack, chewing gum or foods and/or sucking on a candy to increase swallowing and keeping the Eustachian tubes in our ears open,
  • Practice our yawning and pretend sleeping games; it helps equalize the pressure in our inner ears,
  • If you have or are prone to ear infections, see a doctor beforehand to ensure safety when flying as it can be very painful for our kids and their ears,
  • Staying awake at prime times; staying awake during take off and landing will help with swallowing, if your child is sleeping, they may not swallow as much and could wake up in pain,
  • Let them cry; believe it or not letting our children cry for a few moments actually relieves the pain for their ears and helps equalize the pressure. Soothing them and comforting them too will help them in moving past this uncomfortable feeling faster, and
  • Most importantly, be kind to yourself – you’re doing the best you can. And so is your child! This experience may be very new and unfamiliar to your children, so comfort them and where possible make them feel at home in the space. 

The end of the year is nearing. We are all planning our Christmas / New Year holiday adventures. Don’t be afraid to fly and travel if you can. Don’t let what other people think or say stop you from living the life you want to live and going somewhere you have always wanted to go.

I cannot wait to hear about all the holiday adventures being planned for the Christmas and New Year holidays and I hope that the above strategies are helpful in keeping your children calm and enjoying a wonderful holiday period!

Jess.

ORIGINALLY PUBLISHED NOVEMBER 6, 2019

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Roughhousing

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ROUGHHOUSING

Hello Spring! It’s officially the season of change and us finally getting to enjoy being outside again. I thoughtshare my favourite play activity with you; roughhousing. 

I don’t know about you but I find winter really hard. The cold inconsistent weather, leaves you no choice but to be inside more often than not. This becomes quite stifling and finding ways to play only inside can be challenging for parents. But Spring is here and it’s time to get outside once again.

Spring; the time I most enjoy going to the park, beach or coffee dates with friends and letting that fresh air move through my home again. What I also love about this time of year is we all start getting active again. Either exploring in nature with bush walks, playing outside and/or roughhousing with our siblings. 

Growing up, our family was known for being active. We loved moving our bodies and were always outside entertaining ourselves. Our parents were always thinking about how to keep us busy, entertained and having fun. Now this was not an easy feat as all 3 of us have very different inside game preferences but lucky for us when we were all outside, we all loved to move! 

Now don’t get me wrong some days this worked beautifully and we played nicely. On other days, well we fought like cats and dogs to put it nicely.  And some days we still do! Boy did we roughhouse. But, it was exactly what our bodies needed. We were also lucky, that growing up dad was a big kid himself and loved to wrestle and rough us up!

When we would go and visit our cousins (being 5 to 9 years older and all boys), again we would wrestle and play with them. Now did they happen to just hang us upside down in the air, hold us down so we had to figure out how to get out? Of course they did! Did we find ways to get out? Not always truth be told. But did we have fun? Absolutely! And still to this day, they are honestly some of my favourite and memorable times. 

Looking back and with the knowledge of play and OT that I have today, roughhousing is such an integral part of our development and growing up. It works on so many different skills but it is also so much fun! I do find that today most parents tend to bubble wrap their children with concerns of being injured or dealing with the emotions and safety. But managed well it is safe form of play and the benefits are fantastic.

It can be used to support your children in;

  • Activating the body and the sensory systems, processing and responding to the input
  • Increasing child to parent connections
  • Helping to build trust and safety
  • Getting their body moving for core, postural and gross motor development
  • Helping to enhance non-verbal social skills, tuning in and engaging to the other people’s emotions and body language and then to respond accordingly
  • Expanding skills on co-regulating emotions and self-regulating emotions within the games; having self-control. Learning how to independently increase and decrease  interest levels and controlling emotions. These skills can then be transferred into your child’s everyday social interactions with siblings, parents, friends and into the community.
  • When playing these games, you may have a chaser and a catcher, negotiations, sharing of ideas, winning/losing. These decisions only expand their social skills, and develop a greater understanding of cooperation, respect, and empathy.
  • Activates the higher executive functioning skills all kids need for academic development, such as ideation, problem solving and creativity.
  • AND my personal favourite…. It is a form of play that allows kids to make mistakes without fear or punishment.

And remember, when there is fun and laughter, your child is actively learning new skills at a faster rate!

If you want to learn more about roughhousing, you should read ‘The Art of Roughhousing’ by Anthony T. DeBenedet. It is one of my all time favourite books and it has many different games and ideas on how to play with our children and develop the skills I mentioned above through roughhousing. So go check it out if you are interested!

Also, for a fun quick way and guide to get started in roughhousing and supporting your children in engaging in this play, click on this link and get your free hand out today. It is all my rules and favourite games I play with the kids to help them develop their motor skills and their emotional, social development. 

Have a go, see what works for you and your family. Stay safe, create structures and boundaries to support everyone when playing and simply just go for it. It’s Spring, so play outside in the backyard and wrestle on the trampoline, in the park or anywhere! But most importantly have fun whilst doing so. I hope you can have fun connecting, laughing and building great memories for you and your family. 

If you would like more ideas, supports or strategies, feel free to contact us and we would love to chat to you about it today.

Jess.

ORIGINALLY PUBLISHED SEPTEMBER 4, 2019

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