For children with Down syndrome, physical activity and exercise can be inherently more challenging. However, our Fort Myers physical therapy team members recognize the huge role that exercise can play in reducing – and in some cases substantially improving – the many adverse health conditions associated with Down syndrome. Ultimately, exercise can boost a child’s functional ability, which helps them to be more independent.
But why start with babies? Because we already know that children with Down syndrome are going to have certain physical challenges. For instance, many have poor muscle tone (formally known as hypotonia). Some parents will describe this as the quality of being “sort of floppy,” and you’ll notice early on, they have trouble keeping up their neck or controlling their head for any significant stretch – even when other kids their age have mastered this. The earlier we start working on things like core strength, flexibility, and gross motor skills, the more progress they’ll make and the less difficult it’s going to be for them later on.
That said, it’s very important that you only start these exercises with your child after checking with your physical therapy provider and/or pediatrician. Some activities may need to be tailored to meet your child’s specific needs and abilities.
Usually around this time of year, kids’ backpacks are stuffed with supplies, books and “lost” homework. Our Fort Myers physical therapy team will hear complaints about sore backs and necks due to the daily weight of that being distributed incorrectly. (After all, most kids don’t give a second thought to ergonomics.) But for many kids this year, those backpacks are lying unused on the closet floor. An estimated one-third of Lee County’s 84,000 students were attending Lee Home Connect and Lee Virtual School as of late November, according to The News-Press.
Distance learning has come with its own ergonomic woes. Namely, our Fort Myers physical therapy office is seeing issues with aches and pains caused by poor posture as they sit for hours at a computer screen.
Prolonged time spent slouched over a tablet or laptop or hunched over the kitchen table is bound to impact not only a child’s body, but their academic performance as well. The benefits of addressing abnormal postures and positioning are numerous. When they’re no longer in pain, kids’ attention improves, they retain more – and get the most out of distance learning and virtual therapy.
The good news is, even minor adjustments can make a major difference in how your child feels and how well they do in school.
Our FOCUS physical therapists have been closely watching and cheering the historic story of 21-year-old Chris Nikic in Panama City, Florida, who recently became the first person with Down syndrome to compete in and finish an Ironman competition. It’s not a feat for the faint of heart, requiring a 2.4-mile swim, a 112-mile bicycle ride and a 26.2 mile run – all within 17 hours.
“I am going to make history by crushing it,” the Maitland man said before the competition.
And crush it, he did.
“You have shattered barriers while proving without a doubt that Anything is Possible!” Ironman Florida posted on its Facebook page.
Nikic later attributed his accomplishment to waking up every morning and committing himself to be 1 percent better than he was the day before.
“I have to work hard and give my best every day,” he said.
Our FOCUS physical therapists believe in this message 100 percent! We also believe that reaching this level of fitness is much more likely for individuals with Down syndrome with early intervention, address the most common physical health challenges and concerns in early childhood. The sooner we start, the less they have to catch up and the healthier they’ll be.
FOCUS Fort Myers Pediatric Physical Therapists Dedicated to Top Quality Treatment of Sports Injuries
"It's not whether you get knocked down, it's whether you get up." -Vince Lombardi, late American football coach and executive in the National Football League (NFL)
Our Fort Myers pediatric physical therapists know how important sports are to children's development, physical fitness and mental health. That's why we are committed to providing they highest quality care for children who have suffered sports injuries. We understand that while they may get knocked down, it's essential not just to their recovery but their overall well-being that they get back up - and the sooner, the better.
The U.S. Centers for Disease Control and Prevention estimates that more than 2.6 million children are treated in hospital emergency departments annually for sports and recreation-related injuries. Recently, one of those was 14-year-old Jett, a local baseball and basketball player in Fort Myers. He suffered a knee injury during one of his practices that sidelined him completely. Emergency department doctors referred him to physical therapy. But his mother, who just happens to be FOCUS Therapy's owner and founder, wasn't going to take him to just any Fort Myers pediatric physical therapists.
"I knew that a physical therapist who mostly sees adults wouldn't necessarily be attuned to the unique needs of a developing athlete," said Jennifer Voltz-Ronco. "But our physical therapists at FOCUS would."
As a speech-language pathologist, Voltz-Ronco knows a thing or two about providing therapy to kids. So when the need arose for physical therapy for her own son, she trusted the team she put in place.
Pediatric Physical Therapist Julie O'Conner virtually oversaw Jett's evaluation and first session with Physical Therapist Assistant Tabitha Baxter. Voltz-Ronco said the experience - as a patient parent rather than provider - was invaluable. She noted that it was great to see how a physical therapist could work well virtually with an assistant (and noted that not every session with physical therapist assistants must be monitored). She watched how, as a caring, professional team, they worked so well together to provide Jett with the best care.
"We treat all of our patients like family, but experiencing this not just as the owner, but also as a parent was so insightful," she said. "It made me even more confident that I hired the most knowledgeable, loving, super-amazing people."
Dr. O'Conner, who has five years of experience treating children, explained that the goal with treating pediatric sports injuries is not to get an athlete simply to the strength and endurance of their typical peers. She wants them to be at their peak level of performance.
"I want him to get to the point again that he can pivot quickly, change direction and bear as much weight as he did before the training," O'Conner said. "So that this doesn't happen again, and he can get back to playing the sports he loves."
FOCUS offers pediatric physical therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
Sports Safety, Key Prevention Tips, U.S. Centers for Disease Control and Prevention
More Blog Entries:
Fort Myers Physical Therapy Tips & Tricks to Prevent & Reduce Toe-Walking, June 8, 2020, Fort Myers Pediatric Physical Therapists Blog
Toe walking is a pattern of walking wherein a child walks on the balls of their feet, with no contact between their heels and the ground. As our Fort Myers physical therapy team can explain, it’s common among children who are learning to walk, but most kids outgrow it after age 2, when they assume the typical heel-to-toe gait.
However, when toe walking persists beyond that, it could be a sign of an underlying medical condition, such as cerebral palsy, muscular dystrophy or a spinal cord abnormality. (Children with autism spectrum disorder and related conditions often toe walk more frequently, but there isn’t any direct link between the two conditions. There is some speculation that it’s related to sensory issues.) Sometimes, the causes are idiopathic, meaning we don’t know why it happens.
In any case, regardless of the cause, toe walking can result in complications. Children who spend a lot of time on their toes can develop stiffness, tightening and pain in their Achilles tendon and calf. In turn, this can lead to poor range of motion in the ankle, which is going to have a snowball effect. This can be treated by our Fort Myers physical therapy and occupational therapy teams.
Proprioception is a medical term that refers to the body’s ability to sense itself. It is the sense that allows us to perceive the location, movement and action of our own body parts and their relation to external objects and forces around us. Our FOCUS physical therapists usually explain it with a simpler term: Body awareness.
Proprioception is what enables us to judge how we move and position our limbs, how much force to use and how best to balance. An example might be one’s ability to kick a ball or walk without looking at your feet, move a spoon to your mouth without looking at it or touch your nose even though your eyes are closed. It’s closely tied to our ability to control our movements, and it’s guided by the body’s receptors (skin, joints, muscles) that connect to the brain via the nervous system. Vision can play a role in proprioception, but it’s not inherently necessary. In fact, some evidence suggests it’s already present in newborns.
Many things can impact proprioception. Drinking alcohol is one example. (That’s why one of the standard field sobriety tests involves testing the ability to touch your nose while you’re standing on a single foot.) Some injuries and certain medical conditions can impact it too. Our physical therapists at FOCUS have treated many kids whose parents and caregivers report them to be “clumsy,” “uncoordinated” or “sensory seeking.” They might report their child is pressing too hard on the paper when writing or unable to apply the right amount of pressure for tasks like brushing their teeth or hair.
Often what these kids are experiencing is proprioceptive dysfunction.
Identifying, Treating Pediatric Vestibular Dysfunction Involves Occupational, Physical Therapy Collaboration
Once upon a time, vestibular dysfunction in children was thought to be exceptionally rare. Our occupational and physical therapists know, however, that pediatric vestibular disorders, which affect as many as 35 percent of adults, are increasingly being identified earlier than ever. Symptoms include chronic dizziness and imbalance. In children, vestibular system disorders can also cause problems in early development, impacting:
- Ability to maintain an upright position when sitting;
- Delays in crawling and walking;
- Difficulty with steady vision when moving the head (for example when copying words or letters at a chalkboard when seated at a desk);
- Diminished balance and motor function.
Long-term, this can have significant and painful social, educational and economic impacts for kids. Professionals on our FOCUS Fort Myers occupational and physical therapy teams are committed to identifying and addressing these issues early on, promoting the highest possible level of relief and function and ultimately mitigating the worst adverse impacts.
What is the Vestibular System and How Do I Know if My Child’s is Dysfunctional?
Many parents think of crawling as the simple progression between head up/rolling and standing up/ walking. But as our FOCUS Fort Myers pediatric physical therapists can explain, crawling is in fact a major motor milestone requiring strength, coordination and motor planning. It is the first step toward independent mobility, which in turn will open new worlds and discoveries as well as lead the way to increasingly more complex movement.
Crawling is one of those skills that requires a child to use both their mind and body. The muscles in the arms, shoulders, neck, back and core need to be strong enough to support one’s weight. Vision is also key, as both eyes are needed to focus on a single target. Mentally, a crawling child is working to memorize facts and build navigation skills (“How can I get past the chair and around the coffee table to get to the toy box?”)
Although every child develops at a varying pace, most babies learn to crawl by about 6 and 10 months. Some babies breeze right on past crawling and go straight to pulling up and walking (read more below about our physical therapists’ take on this). So while each baby is different, we do encourage parents to ask their pediatrician or one of our FOCUS Fort Myers pediatric physical therapists if your baby hasn’t shown steady progress in becoming mobile by the time they reach 12 months. It may also be worth asking if early intervention is needed if his or her “crawl” tends to involve dragging one side of the body.
Premature babies (aka “preemies”) born earlier than the 37th week of pregnancy, are more likely to survive today even compared to the 1990s – and they are more likely to have less severe disabilities. That’s according to research published in the British Medical Journal. Globally, about 15 million babies every year are born before the 37th week, placing them at higher risk for conditions like cerebral palsy, delayed language, speech and motor skills. Study authors further concluded preemies who receive early intervention therapy have a much better chance of catching up to their peers.
Preemies are already starting out behind the curve. The earlier a baby is born, the higher the risk of serious illness and disability. The U.S. Centers for Disease Control and Prevention reports preemies who survive those early weeks and months in the NICU (neonatal intensive care unit) may still struggle with breathing trouble, intestinal/digestive problems (including feeding and swallowing) and developmental delays. About half of all children born more than eight weeks early or at a very low birth weight develop problems with language, learning and executive function.
As our FOCUS Fort Myers therapy team can explain, early intervention therapy involves a combination of separate but interrelated services, tailored to meet the specific needs of each child, with the core aim of helping a child develop skills that will allow them to reach their full potential. This generally includes some combination of speech and language therapy, feeding therapy, occupational therapy and physical therapy. Although many preemies benefit from this therapy up to age 5 and sometimes beyond, commitment to therapy now reduces the struggles preemies will face down the road.
If there was ever such a thing as a real-life Santa’s workshop for children with disabilities, it’s probably a bit closer to the equator than the North Pole. At the University of North Florida, pediatric physical therapy students have been partnering with those in the school’s engineering program, pooling their talent to create specialized toys for children with special needs.
The Florida Times-Union reports the pediatric physical therapy students have been working to help develop solutions from battery-powered ride-on cars for children with mobility issues to voice-activated toys for children who need speech therapy to electronic fidget cubes for high school students with autism.
Our FOCUS Fort Myers pediatric physical therapy professionals applaud the UNF Adaptive Toy project, first started in 2014 to help meet the needs for toys for local children with disabilities. The program has already become a model for nearly a half-dozen higher education programs across the country, with professors of electrical engineering and physical therapy at the college leading the way. Since the program was first launched, it has produced 31 cars for children with special needs, and two new toys were added just this year.
The pediatric physical therapy and electrical engineering students are continually working to resolve glitches and dream up ideas for new toys, specifically for children who suffer from disabilities such as cerebral palsy, genetic disorders and spinal muscular atrophy.