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“My Baby Hates Tummy Time!” Tips for Parents  

Does your little one get frustrated every time you place them on their tummy? If so, have no fear! We have some awesome alternative positions, tips, and tricks to help tummy time become an enjoyable activity for both you and your baby.

Why Doesn’t My Baby Like Tummy Time?

If your baby cries during tummy time, it is likely because lifting their head against gravity can be a huge challenge for infants. This is because they have not yet developed strength in their cervical extensors (the muscles in the back of the neck.) So, just like when we hit the gym for the first time in a while, it is important to think about starting with lighter weights. We need to lighten the load that your baby’s neck must lift! How do we decrease the weight of their head? Well, we can’t exactly do that, but what we can do is change the position of the baby to decrease the force of gravity that they are working against. To do this, we need to start practicing tummy time on an incline. Below are some ideas of how to do that.

Alternatives to Tummy Time

  1. Start by lying in a semi reclined, comfortable position. Then, place your baby on their belly over your chest facing you. This will encourage your baby to lift their head as they try to look up at you. It can be a great position for bonding with your new baby and sneaking in some snuggles while getting productive tummy time in.
  2. Grab a therapy ball and position yourself behind your baby with the therapy ball in front of you. Place your baby on their belly on top of the ball holding at either side of their pelvis or trunk. Then, if they are having a hard time lifting their head, gently roll them back towards you to place them at a slight incline. This position will make it easier for them to practice lifting their head. If your baby gets upset, you can rock them back and forth or side to side on the ball for a calming effect then continue with more tummy time practice!
  3. Grab a soft bath towel or blanket and roll it up to place it under your baby’s chest. You can also prop your baby’s chest up on a small boppy pillow, or even on the side of your leg while you sit on the floor with them. This will automatically place them in an inclined position making lifting that heavy head of theirs a bit easier.
  4. Place some downwards pressure on the back of the pelvis. If your baby is still having trouble in these positions, you can try gently pushing down on the back of their pelvis (over their bottom) to displace more weight from their chest and encourage head lifting.

Tummy Time Tips: Finding the Right Motivation!

Are you wondering how to get baby to like tummy time? Try these tummy time tips below to motivate your baby!

1. Visual Stimulation

Your baby’s vision is developing and emerging in the months that tummy time is vital. Finding fun, engaging visual stimulation can help make tummy time easier while promoting visual development. Find some black and white toys, or toys with a lot of contrast to capture your baby’s attention. Another effective attention grabber is placing a mirror in front of your baby while they’re on their tummy.

2. Face to Face Interaction

Get on the floor and get face to face with your little one. Again, they will be motivated to engage with you, and you can even practice having them track different toys/objects while lying with them in this position to get some neck rotation in as a bonus!

3. Super Baby

Hold your baby in a prone position over your forearm with their legs on either side of your elbow and your hand supporting their chest. In this position, you can fly them around the house to look out windows, check themselves out in the mirror, or say hi to siblings. This is also a position where you can control the angle that you are holding your baby. If they are having a hard time keeping their head up, elevate your hand slightly higher than your elbow so they are at an incline and can lift more readily.

In Conclusion

Remember, if your baby hates tummy time, you are not alone! This is not an uncommon occurrence but hopefully these tummy time tips and tricks will make things go a bit smoother during tummy time practice. It is also important to remember that you don’t need to feel obligated to do tummy time all at once. Begin with short bouts of a few minutes at a time until your baby’s endurance builds. Then you can slowly begin longer bouts of tummy play. If you are still having a hard time with tummy time and feel like you need some extra support, we always recommend reaching out to a physical or occupational therapist for a consult to help get you and your baby a customized plan to promote motor development.

Find Additional Resources in the NAPA Blog:

About the Author

Karleigh enjoys play based pediatric therapy as it gives her to the opportunity to create both a positive and exciting experience for children. Karleigh works at NAPA Denver and enjoys volunteering for adaptive golf, swimming, and wheelchair/bike racing programs.

It’s no secret that tummy time is important for your child’s development, but here’s the why and the how. By spending time in a prone (belly down) position, your child is working to strengthen the muscles in her upper body, including her arms, neck, and chest as he or she attempts to push themselves up off the ground to engage with their environment. 

Tummy time promotes development of proper spinal curvatures and helps to prevent plagiocephaly (flat head syndrome). The strengthening of her proximal musculature is a precursor for head control and trunk stability. Weight shifting in prone to reach toward preferred objects is a precursor for rolling and crawling.  

10 Baby Tummy Time Toys Recommended by an Occupational Therapist

It’s no secret that tummy time is important but at the same time often a non-preferred position. While there are positioning modifications that can support improved tolerance for tummy time, we also recommend the use of highly motivating and engaging toys to encourage tummy time or equipment that offer opportunities for sensory input. Some of our favorite tummy time toys include: 

1. Water Play Mat

Offers visual, tactile and proprioceptive (movement) sensory input

2. Floor Mirror

Offers visual sensory input

3. Bubble Machine

Offers visual and tactile sensory input

4. Soft Activity Book

Offers visual and tactile sensory input

5. Suction Cup Wonder Wheel

Offers visual, auditory and tactile sensory input and encourages targeted reaching 

6. Height Adjustable Ball Drop

Encourages targeted reaching, grasp and release with an interactive cause and effect relationship

7. Musical Mat

Offers auditory sensory input with an interactive cause and effect relationship

8. Suspended O-Ball

Offers visual and tactile sensory input and encourages targeted reaching with increased support for development of grasp (plus the ball won’t roll away making it a hands free option for mom or dad) 

9. Pop-Up Toy

Offers visual and tactile sensory input with advanced dexterous skill to activate cause and effect pop-up 

10. Soft Blocks

Offers visual sensory input with high contrast colors 

Additional Resources from the NAPA Blog:

About the Author 

Samantha Cooper is a pediatric occupational therapist at NAPA Center-Los Angeles. When not engaging her clients through play, Samantha can be found balancing her love for ice-cream with spin or barre classes or trying to cuddle her dog, Cassidy, who would much rather have her personal space.  

About NAPA Center

At NAPA Center, we take an individualized approach to pediatric therapy because we understand that each child is unique with very specific needs. We embrace differences with an understanding that individualized programs work better. For this reason, no two therapeutic programs are alike. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.

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Mastering Tummy Time

Tummy time is an important tactic to help build head, neck, and upper body strength in a baby. Babies tend to spend a significant amount of time on their backs, putting them at risk for delaying their motor development and developing flat spots on the back of their skull. Without tummy time, your child may have trouble mastering skills like lifting his or her head or turning over. Moreover, it has the potential to negatively impact their ability to sit, walk, and crawl. So it is vital that you allot time out of your day to place your baby on their tummy, putting their weight on their forearms.

How do you go about mastering tummy time? By incorporating tummy time into your day! Below we have a few of our therapists’ favorite ways:

1. Use Toys

An easy way to make tummy time fun is by arranging your baby’s toys in a circular pattern in front of them. It is even better if the toys have different textures and different sensory experiences for your child.

Find our favorites here: 10 Tummy Time Toys We Love

2. Use a Mirror

As most parents know, babies get a kick out of looking at their reflection in the mirror. This is actually a great way to initiate tummy time. Simply hold your baby over your lap and place a small mirror in front of them as a distraction.

3. Use a Bolster

If your child has a tough time participating in tummy time, don’t fret! You can help solve this by adding support. Try placing a bolster, rolled-up towel, or blanket right underneath their chest. This should make it easier for your baby to support their weight. However, it is important to make sure that it isn’t too close to their neck, or else they could have difficulty breathing.

When Should You Use These Tactics?

You might be wondering when the best time to incorporate these tummy time strategies is. The answer is simple: anytime, anywhere. We recommend that you incorporate it into your daily routines, such as after a diaper change or after bath time. Remember, any sort of tummy time you do will be extremely beneficial. We like to say the only bad tummy time session is the one that didn’t happen.

Additional NAPA Resources 

About NAPA Center

At NAPA Center, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. We embrace differences with an understanding that individualized programs work better. For this reason, no two therapeutic programs are alike. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.

In 1992, the American Academy of Pediatrics advised that all babies should be put to sleep on their backs. Because of this, the rate of sudden infant death syndrome (SIDS) has decreased over 50%. While this is saving lives, parents should still be aware that having their child spend too much time on his or her back could have negative consequences.
Although there has been a significant decrease in SIDS, there has been an alarming increase positional plagiocephaly, a deformation of the child’s head where they develop flat spots on the back of their skulls. Before 1992, the rate of misshapen heads in infants was only about 5%. Recently, however, there have been news of around a 600% increase!
Aside from a flattened skull, another big concern was shown in a survey conducted by Pathways Awareness, the American Physical Therapy Association, and the Neuro-Development Treatment Association. They surveyed 400 pediatric physical and occupational therapists, two-thirds of which say that in the past 6 years, they’ve noticed an increase in early motor delays in infants. Those therapists claim that the number one contributor to these delays is the lack of “tummy time”. This also can cause developmental, cognitive, and organizational skills delays, eye tracking problems, behavioral issues, and more.

The Solution? Tummy Time!

Flip that baby over! Tummy time is the time a baby spends on his or her belly, aka in prone position. This should be while the baby is awake and supervised to prevent any possible SIDS. There are numerous benefits for placing your baby on his or her belly. It strengthens neck, shoulders, upper back, and core muscles because babies will want to pick their heads up to see what’s going on. Being able to move their head reduces the risk of SIDS since they’d be able to move away from anything smothering them. Tummy time helps with the flat areas on the back of the babies’ head to develop more round and helps to build the muscles babies need to roll, sit, and crawl.

When to Introduce Tummy Time

You can introduce tummy time to your baby as soon as you bring him or her home from the hospital, but definitely by the time he or she is a month old. Need some tummy time ideas? Here are some helpful tips to make the most of tummy time with your baby:

Three ways to incorporate tummy time at home

I’m here to share some ways to incorporate tummy time into your every day life.

1. Use toys!

This one is my favorite! To make tummy time fun, arrange toys in a circular way in front of your child.

  • Bonus points if the toys have different textures and colors (OT’s like that!)

2. Incorporate into daily routines

A lot of parents ask me when they should incorporate tummy time. To be honest, you can incorporate it any time and anywhere! It’s good to start to incorporate it into your daily routines — after a diaper change, after bath time, etc. Here, I’ve put Maxton over my lap and I’ve set up a mirror because babies love to look at themselves in the mirror. This is something easy – you don’t need anything, and you can do it anywhere.

3. Use a rolled up towel or blanket

Now, if your child has a tough time participating in tummy time, you can help support them by modifying it. Putting something like a bolster, or if you don’t have that, any sort of rolled up towel or blanket will do. Make sure it’s not too close to their neck so they can breathe and it might be a little easier for them to support their weight that way.

It’s important to remember that any type of tummy time you do will benefit your baby!

We did it!

Looking for more NAPA fun? Click here to view more videos!

Resources:
  • http://pathways.org/images/random_pdfs/TT_Brochure_Larger_v_web-fnl.pdf
  • http://www.parents.com/baby/development/physical/putting-baby-on-belly/
  • http://www.webmd.com/parenting/baby/sleep-naps-12/tummy-time
  • http://www.sciencedaily.com/releases/2008/08/080806122422.htm

In this blog, we will discuss what occupational therapy for babies may look like at NAPA Center. Would you believe me if I told you babies have occupations too? Despite what it sounds like, occupations aren’t just jobs. An occupation is anything that occupies your time. For babies from birth to 1 years old, their main occupations are eating, learning to interact with their environment through their senses, moving their bodies, bonding with their caregivers and playing. During infant occupational therapy sessions, you will likely find your OT focusing on these occupations to help your baby!

While it is important to remember each baby develops at their own pace, it’s also important to keep an eye on their developmental milestones. If you believe your child is falling behind in their milestones, it may be time to talk to your pediatrician and they will determine if therapy is necessary. Below you will read about specific developmental milestones occupational therapists are looking for at NAPA and ways that baby OT sessions will address them.

Occupational Therapy for Babies by Age

Ages 0-3 months

During infancy, babies are adjusting to their new environment on earth-side. That means they should start to visually track objects or people and explore their bodies by moving their hands. Your baby should start to have emerging control over their head (head control) and start pushing up during tummy time. The bond between baby and caregiver is flourishing, as a lot of your time will be spent feeding (I.e. breastfeeding, formulas, etc.)

As OT’s, our priority in this stage of infant occupational therapy will be parent education by teaching tips and tricks to reach these milestones. That may look like ways to incorporate tummy time in your daily routine, introducing you to specific toys that are visually stimulating, oral motor exercises to improve control in eating, and ways to encourage bringing hands to midline during play.

Ages 4-6 months

In this stage, babies are learning how to use their eyes and hands together to reach for their favorite toys or for their caregivers. Toys are being explored by shaking them or bringing them to their mouths. Your baby should start to roll from tummy to back, which may be scary for them at first. They should continue to grow stronger with their head control and pushing into hands during tummy time.

To strengthen these skills, occupational therapists will show you ways to encourage rolling such as where to position toys or how to use your own body to facilitate their movement. OT sessions will provide sensory experiences by exposing to toys with various textures, sounds, and visuals to help motivate them to reach and play with toys in a variety of positions (I.e. on their side, back, or in sitting.) Parent education will also address positioning throughout the day, so your child isn’t spending too much time on their backs or in chairs.

Ages 6-9 months

Woah, did you see that! In this stage, motor skills are bursting. From starting to sit independently, army crawling and 4-point creeping your baby is learning how to get around to where they want to go. Babies in this stage are transferring items between their hands such as toys or their bottle, and even starting to use their fingers to pick up small objects. Be careful, they may be quick with their hands so make sure to get rid of any choking hazards.

Occupational therapists will continue to address and strengthen the milestones above, while also teaching ways you can set up your environment to promote independent movement and transitions. For example, placing suction cup toys on a vertical surface such as a mirror encourages reaching in independent sitting. OTs can help show you toys that are age appropriate to work on those fine motor skills and bringing hands to the midline. Some of our favorites for this age are pop tubes, bubbles, and books.

Ages 9-12 months

Just like that, your baby is inching toward the one-year mark! Not only are they showing more of their personalities, but they are also showing more purposeful play. You should see them start to understand the concept of in and out, whether that’s putting their blocks into and out of a bucket or stacking household items like tub-a-wear containers. They should start copying your actions, so it’s time to break out a game of peek-a-boo.

Babies at this age are becoming more independent eaters, as they are starting to finger feed and drink by holding their cup all by themselves. In terms of movement, babies in this stage should start to pull to stand, cruising by holding onto furniture and may even start taking a few steps independently. Therapy sessions may address working on those fine motor skills to help with finger feeding and working on their core and upper body strength to help them gain the strength to pull to stand and maintain their balance when taking steps.

Occupational Therapy for Babies to Support and Encourage Parents and Caregivers

What do occupational therapists do with babies? Throughout all developmental stages, the most important focus in occupational therapy for babies will be on supporting and encouraging the parents’ relationship with their own child. Occupational therapists wear multiple hats, so we are here to listen to your concerns, problem solve and give you the tools to be successful at home.

 Find Additional Resources in the NAPA Blog:

About the Author

Mary Kate graduated from Boston University with a Bachelor’s degree in Therapeutic Studies and a Master’s of Science in Occupational Therapy. Before joining NAPA, Mary Kate worked at a specialized school in New York City for children with brain-based disorders and with an early intervention agency. Mary Kate is a kid at heart and connects best with children through playing and finding what motivates them.

About NAPA Center

NAPA Center is a world-renowned pediatric therapy clinic, offering pediatric therapy for babies, toddlers, and children of all ages in traditional or intensive settings. With six clinic locations and intensive therapy pop-up sessions worldwide, NAPA is committed to helping children lead their happiest, healthiest lives. At NAPA, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. For this reason, no two therapeutic programs are alike. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.

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Before you click ‘purchase’ on that online order or grab your keys to drive to the nearest Target, look around your home first. You may already have some physical therapy equipment in disguise! Wonder what those household items are? Read on to find out more! 

1. Couch Cushions and Pillows

Not only do pillows provide more comfort when lounging or sleeping, but they’re also a great tool for practicing dynamic balance in sitting, tall kneeling, quadruped, and standing. By utilizing an unstable surface, it assists with developing balance reactions through challenging and activating the proprioceptive, vestibular, and visual systems to maintain body’s equilibrium, thus maintaining balance. Depending on the which position your child is in, it will also strengthen the abdominals and different muscles of the lower limb, such as the quadriceps, hamstrings, gastrocnemius, tibialis anterior, and peroneal muscles. Give this idea a go by placing a pillow underneath your child’s bottom in sitting, knees in tall kneeling, both hands and knees in quadruped or under each foot in standing. 

 

2. Rolled Towel

Finding tummy time a bit tricky? Try placing a rolled towel horizontally across your child’s chest and underneath the armpits. This will make it easier by providing more elevation. The bigger the roll, the more support it provides. The smaller or flatter the roll, the less support it gives. Engage with your child in this position to promote head lift, thus strengthening the neck muscles that is needed for head control. Tummy time is also essential in developing back and shoulder strength. 

 

3. Paper Plates

Ever been skating inside your home? Grab those paper plates from the cupboards! This tool can be used to improve lower limb dissociation, which is important in gross motor skills such as crawling and walking where one limb moves while the other one is static. Place your child in standing and have one paper plate under each foot then move one limb forwards and backwards at a time. You may or may not need a second person to support your child at his or her trunk throughout activity. 

 

4. Masking Tape 

From creating zig zag lines to a maze or hopscotch on the floor, masking tape can be used to make obstacles courses, which targets motor planning and gross motor skills development. Below are some activities that you can create: 

  • Ninja course: tape diagonal lines at different height and angles between the two walls of a hallway and challenge your child to climb over or under each “laser beam” without touching it. 
  • Racetracks: place vertical, diagonal, and horizontal lines on the floor for your child to walk heel-toe, sideways, or backwards along the lines at different speed. 
  • Kangaroo jumps: tape either horizontal lines or boxes on the floor and challenge your child to either jump and land on the same target or jump over the target. 

 

5. Empty Bottles or Canned Food

Before throwing those empty milk or juice bottles in the recycling bin or opening a canned good, set at least two aside as they can be utilized as weights. Resistance training, where your muscles work against a weight or force, has been shown to improve cardiovascular fitness and functional strength. By adding water into two 1.5 liter bottle or grabbing two cans of food (around 420 grams each), you have a set of homemade dumbbells. Make sure you check with your child’s physical therapist to ensure that this progression is appropriate! 

Looking for More Ideas? Find Inspiration in the NAPA Blog:

About the Author 

Pauline Chuang is a physiotherapist at NAPA Centre Sydney. She is passionate towards helping kids reach their fullest potential through creating a fun, inclusive, and empowering environment. When not at work, you can find her indulging in some ice cream, embracing her sweatiness at the gym, or exploring another coastal walk. 

You’ve probably heard your therapist, your pediatrician, or your friend who’s a parent talk about gross motor skills. But what are they, and why are they important? Babies learn so much through movement, and gross motor skills are a major aspect of their overall development. Movement is important to all of us, but especially to our developing little ones. In this blog, we’ll discuss the importance of gross motor skill development and share gross motor skills examples by age. 

Jump Ahead for Gross Motor Skills Examples:

What are Gross Motor Skills? 

Gross motor skills are the abilities required to control the muscles of the body for large movements such as crawling, walking, jumping, running, and more. They also include higher level skills such as climbing, skipping, and throwing and catching a ball.

Motor Skills and Motor Development

What are motor skills and how do they develop? Babies learn from head to toe. Our upper body muscle control develops before our lower body muscle control. As babies grow, they first develop control in their neck (head control) and trunk (sitting balance) and then they learn to control their shoulders, then elbows, wrists, and finally, their fingers. The same goes for the lower body, starting at the hips first, then learning to control their legs, feet, and eventually toes.

Fine vs. Gross Motor Skills

Gross motor development involves the large muscles of the arms, legs and trunk, whereas fine motor skills involve small muscles of the body, typically thought of as the movements that involve the fingers and the hands. 

Importance of Gross Motor Skills 

In the area of gross motor development, we know that often times, rolling leads to crawling, and crawling leads to walking. We start with foundational skills and work through a developmental progression.

Gross motor skill development helps children to build strength and confidence in their bodies. Kids also enjoy the same benefits of exercise and physical activity as adults do, which is important for a healthy lifestyle, no matter your age.  Developing gross motor skills helps a child grow in the ability to do more complex skills, such as navigating a new playground environment or playing a team sport.

As kids gain control of their body, they start to build up strength. Little ones need lots of opportunities to practice movement, because that’s how they learn and grow!

3 Different Types of Gross Motor Movements:

1. Locomotion, which means movement!

Anything a child does to get from one spot to another is locomotion. Examples of gross motor skills in the locomotion category can include rolling, belly crawling, crawling on hands and knees, scooting, walking, running, climbing, leaping, jumping, and hopping. 

2. Stationary skills,which refers to movement in a stationary place.

Gross motor skills that are stationary include head control, sitting balance, standing on one or both legs, rising, falling, bending, stretching, pushing, pulling, swinging, swaying, twisting, and turning. 

3. Manipulation, which means moving objects in a variety of ways.

Think about all the things a child can do with a ball – they can roll, throw, catch, kick, stop, or bat a ball. All of these actions are manipulative gross motor skills. 

Gross Motor Skills for Infants

We typically see a range of development for each gross motor milestone, where kids may develop that skill in the few months before or after their peers. If you notice your child continuing to struggle with development of an age-appropriate milestone, please see your pediatrician to request a PT evaluation. Listed below are examples of gross motor skills by age.

Gross Motor Skills Examples 

Generally, gross motor development milestones for infants and toddlers are as follows: 

Newborn to 2 months:

  • Head lag with pull to sit 
  • Lifts head and able to turn to both sides while on belly (View our guide for mastering tummy time!)
  • Kicks both legs and moves both arms equally while on back 
  • Turns head to both sides while on back 

3-4 months :

  • Raises head in line with trunk when pulled to sit   
  • Pushes up on forearms and turns head side to side while on belly   
  • Rolls from belly to back  (Use these 3 tips to help teach your baby to roll over!)

5 months :

  • Brings feet to mouth laying on back   
  • Rolls from back to belly  
  • Pushes up on hands with arms extended while on belly   
  • Pivots in a circle on belly 

6-8 months:  

  • Catches self with loss of balance in sitting    
  • Crawls on belly   
  • Reaches for toys to play in sitting    
  • Sits independently    

9-11 months:

  • Crawls on hands and knees 
  • Cruises around furniture     
  • Moves between laying down and sitting upright without help   
  • Pulls to a standing position with one foot leading   
  • Walks with two hands held 

11-12 months:  

  • Walks with one hand held 
  • Stands independently for a few seconds 

13-14 months:  

  • Crawls up stairs   
  • Stands up from the floor without support    
  • Walks independently: Yes, walking is a gross motor skill! (Peek at our tricks used to help children who are on the verge of independent walking!)
  • Squats and stands back up without support   

15-18 months:   

  • Walks up stairs with hands or rails to help   
  • Crawls down stairs on belly, feet first   
  • Kicks a ball forward 

Gross Motor Skills for 2, 3, 4, and 5-year-olds Develop as Follows: 

Gross Motor Skills for 2 Year Olds:

In addition to the skills listed above, gross motor skills for 2 year olds include:

  • Walks and runs fairly well 
  • Kicks a ball with either foot 
  • Walks up and down stairs alone   
  • Jumps in place (both feet off the ground)   

Gross Motor Skills for 3 Year Olds:

Examples of gross motor skills for 3 year olds include:

  • Balances on one foot for a few seconds    
  • Catches a large ball    
  • Jumps forward 10-24 inches    
  • Rides a tricycle 

Gross Motor Skills by 4 Years Old:

  • Runs, jumps, and climbs well 
  • Hops on one foot   
  • Catches a ball 
  • Somersaults 

Gross Motor Skills by 5 Years Old:

  • Skips and jumps rope   
  • Starts to skate and swim   
  • Rides bicycle with or without training wheels     

Again, each child develops at their own pace, so these gross motor milestones are approximate. As gross motor skills development happens at these approximate ages and stages, they build upon each other. For example, a baby needs to be able to pull up to standing before they can walk. We hope this blog was helpful in sharing examples of gross motor skills in child development. 

Gross Motor Delay

When a child’s gross motor development is delayed, pediatric physical therapy is often prescribed to help a child work towards gaining gross motor skills. A physical therapist works on an array of foundational skills to help a child maximize his or her gross motor potential including:

  • Balance
  • Muscular Strength and Endurance
  • Motor Learning and Planning
  • Body Awareness
  • Sensory Processing
  • Coordination
  • Postural Control
  • Muscle Tone (Addressing low muscle tone or high muscle tone)
  • Crossing the Mid-Line (moving arms or legs across the middle of the body to perform a task)

Find Additional Resources in the NAPA Blog:

About the Author 

Cait Parr is a pediatric physical therapist at NAPA Center. Her favorite animal is snails, because they remind her to slow down and enjoy the beautiful details about life. She loves desserts almost as much as she loves long walks on the beach with her husband.  

About NAPA Center

At NAPA Center, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. If you’re interested in learning more, send us a contact form and our team will be in touch shortly!

contact us

In this blog, NAPA OT Courtney shares her favorite toys for kids with Down syndrome. Not only are these toys a ton of fun, they will also benefit your child in various developmental areas!

Therapist-Approved Toys for Kids with Down Syndrome

Children who have Down syndrome need the same play-based materials and toys that any other child needs. What makes a toy beneficial for a child with Down syndrome is often the same as what makes a toy helpful for any child. Toys that encourage social interaction as well as cause & effect are beneficial in early stages and as a child ages, finding toys that foster language, gross motor and fine motor development will be best. Also, many children with Down syndrome love music. Singing and dancing are excellent ways to work on language, social interaction and motor skills!

While picking out toys for any child, it is important to keep a few things in mind to ensure suitability for the child’s development and growth. Try to disregard the age range written on the toy. These are often not accurate and you may not be able to depend on the item’s suggested age suitability, as your child may be achieving milestones at a different rate than their age-equivalent peers.

Just remember that a toy is suitable if your child’s interest is stimulated and they are drawn in to engaging with the item.

Also keep in mind that your child’s low muscle tone can make reaching, grasping, and handling certain toys more challenging. Finding toys that target these areas of growth, but are not too difficult or frustrating to engage with, is key. The following are some of our favorite toys to use when playing with children who have Down syndrome.  

Our Favorite Toys for Kids with Down Syndrome

Listed below are our favorite toys for kids with Down syndrome. If you are looking for toys for babies or toddlers with Down syndrome, the first two are must-haves. Happy playing!

Play mats

Play mats are a great place to engage your child in tummy time activities for gross motor development as well as reaching and grasping objects. Play mats also have visually engaging items as well as some activities requiring fine motor skills such as grasp and release. You can also use play mats and items with the play mat to promote exploration, cause & effect, body awareness and object permanence by hiding items and playing peekaboo.  

Floor mirror

This is a great item for tummy time which is incredibly important for gross motor development, strengthening and eventual fine motor development. Visual attention and social engagement are also great for development and can be done looking at each other in the mirror! In early infancy, utilizing high contrast items such as pictures with black and white items is a great way to develop the visual sense.  

Squigz

This incredibly versatile toy can be used in so many ways and comes in many forms. From the PipSquigz in rattle form to the MiniSquigz there are endless ways to engage with these fun little suction cups through the lifespan. Using these little suction toys can help promote core strengthening, fine motor, gross motor and communication skills. You can use Squigz during activities targeting balance and coordination, such as sticking them to a vertical surface while standing on a wobbly surface (couch cushion or Bosu ball) or working on reaching, developmental transitions (sit-to-stand, etc.) or stepping up/down. They can also be a great bath time toy as they are silicone and easy to clean. These multi-sensory toys target the visual system with their vibrant colors, auditory system with the fun suction popping sounds they make when pulling apart, tactile systems with their fun textures and more! The possibilities with these little suckers are endless!    

Rody Horse

Rody is a big NAPA favorite! You can often find Rody wandering around our clinics. Using Rody can help promote improvements in balance, strength and coordination. You can use Rody in a number of ways and movement on Rody provides great sensory input to the proprioceptive and vestibular senses. They’ve also created an even bigger and more stable Rody with the RodyMax if your child needs a bit more support. Rody can also be turned into a rocking item with the rocking base or scooter item with the speedy base accessories. 

   

Ball Poppers

These fun items can help increase hand strength, fine motor coordination and visual motor integration. They come in many different animals (and mythical creatures) and can be used with one hand or both depending on what you’d like your child to be working on. From a distance, you can also try to target catching skills, though this may prove to be very challenging!   

 

Putty

There are many forms of theraputty on the market these days but all help to target hand strengthening and fine motor coordination. Placing small items inside the putty to find can be a fun and an engaging way to work on various grasp patterns and hand strengthening. 

 

Sturdy Birdy

The game of perfect balance can be the “just right” challenge for an older child with difficulties following directions, decreased body awareness and impaired balance. This fun filled, active game can help enhance coordination, core strength, social interaction and self-esteem.  

 

Puzzles (varying levels of complexity)

Puzzles of all kinds work on so many great skills! There is a bit of a developmental sequence to puzzles that begins with large peg puzzles with underlying pictures and ends with jigsaw puzzles with many small pieces. Each will work on visual perception, visual motor integration and fine motor skills. Depending on the puzzle, you will also be working on matching, visual discrimination, form constancy, visual memory, and problem solving which can all be linked to reading and writing as well as cognitive and language development. Working on any puzzle will promote bimanual skills, hand-eye-coordination and can also incorporate gross motor skills (i.e. putting a puzzle piece at the end of a tunnel to crawl through, before placing it into the puzzle).  

Interested in reading more? Find related blogs here!

About the Author  

Courtney Shea is a pediatric occupational therapist at the NAPA Center in Boston. In her free time, she enjoys being outdoors with her family and their dog Kolana. She is often caught overpacking for weekend getaways and adventures. If staying local she enjoys long distance runs along the Charles River alongside her husband taking turns pushing their son in a jogging stroller!

What is Container Baby Syndrome?  

Simply put, container baby syndrome is when a baby spends most of their day within some sort of device, such as a car seat or stroller, that limits their freedom to move and explore their environment on their own.

Infant development is amazing! Every movement your newborn makes serves a purpose in their development.  It is very important for your baby to have the opportunity to explore and play in all developmental positions such as on their back, tummy, side, or supported sitting.  Opportunities to play in these positions furthers their development both physically and cognitively. When children are confined to a container, they lose out on freedom of movement to play and explore.

What is Considered a Container? 

A ‘container’ is anything that confines the child from being able to be on the floor have freedom of movement. Some common containers are:  

  • Car seats
  • Swings
  • Jumparoos 
  • Bumbo chairs
  • Highchairs
  • Exersaucers 
  • Walkers
  • Strollers
  • Vibrating chairs 

What Does it Matter? 

When children are just moved from container to container throughout the day, they run the risk of developing certain conditions: 

  • Plagiocephaly: flattening of their head 
  • Torticollis: tight neck muscles resulting in a neck tilt 
  • Delay in motor milestone acquisition 
  • Impacting development of hips and spine 

How Do I Prevent Container Baby Syndrome? 

I get it, life is busy with a newborn!  You do not feel as if there is enough time in the day to cook, clean, take a shower yourself, and take care of your sweet new baby!  There is a place for containers to help you get things done around the house throughout the day. 

Keep in mind, the total amount of time the infant should be in a container should be minimal in comparison to their awake floor playtime.

Here Are Some Ideas:

  • Outside of transport, limit container use to 15-20 min, 2 times throughout your baby’s day. 
  • Limit the use of containers to when you need to keep your baby safe while you are trying to do something productive around the house! 
  • Create a safe space on the floor for your baby to play, whether that be with foam mats, partitions to keep them away from pets; create an area where your baby is free to explore and play. 
  • Supervised Tummy Time – The more tummy time the better! Work towards a goal for at least 10-20 minutes during each of their awake hours of the day.  If this is a lot at first, set small goals and break up the time more throughout the hour.  
  • Baby Carriers! Opt to use a baby carrier more often than a container.  Baby carriers are less restrictive than a container.  There are still some restrictions, however it provides the infant with more opportunity to move and there is typically not pressure on the back of their heads as well.   
  • Cuddle time!  Take more time to engage in physical touch with your baby.  It is bound to put a smile on you and your baby’s face! 

Related Reading

About the Author

Dana Thomsen has been a pediatric physical therapist for 8 years, with experience in working with a wide range of diagnosis.  Her favorite part of working in the pediatric field is being able to get paid to play with such adorable children! She enjoys spending her time cuddling with her lovable dog and reading a good book. 

About NAPA Center

NAPA Center is a world-renowned pediatric therapy clinic, offering pediatric therapy for children of all ages in traditional or intensive settings. With six clinic locations and intensive therapy pop-up sessions worldwide, NAPA is committed to helping children lead their happiest, healthiest lives.

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When Should Baby Roll Over?

Rolling over is one of the first milestones of a baby’s gross motor development.  Babies typically begin rolling over on a consistent basis around 6 months of age (both back to belly, and belly to back), though infants begin practicing as early as 3 months. Rolling is an important skill, as it is a transition from one position to another, and the first mode of mobility for a child to explore their environment outside of their immediate surroundings. Rolling has many foundational components that prepare the body for higher-level skills as baby grows, including head, trunk and pelvic rotation, weight shifting, and strengthening of core muscles (abdominals, back extensors). 

How to Teach a Baby to Roll Over

If your baby is having difficulty with rolling, here are 3 therapist-approved tips on how to teach baby to roll from tummy to back or back to tummy

1. Use visual and auditory motivators

Where the head goes, the body will follow. Using toys/music can be very helpful to entice your little one to look and follow with their eyes (or orient to sound), which will result in head rotation, and then rotation of their trunk. If you are using a toy to visually motivate your baby, you can start by placing a toy in their field of vision, then slowly bring it to one side in the direction you want them to roll.  (Take a peek at this blog: 10 Tummy Time Toys Therapists Love)

 2. Let gravity help

Does your child have difficulty starting a roll?  Initiating rolling (whether on their back or their belly) requires movement against gravity which can be difficult for your little one to start if their muscles are not yet strong enough.  One strategy that can be helpful is to start them lying on their side, so they can be successful to complete the last half of the movement.  In this position, gravity will help them rather than work against them.  As your child improves, you can begin to increase the amount of the motion they are doing within the transition.  If starting on their side is too easy, another strategy is to place them on a wedge or prop that declines, and practice rolling down.  This decreases gravity while allowing your child to experience the full transition. 

Related video: How to Teach Baby to Sit Up (Supine to Sit Transitions During Diaper Changes)

3. Weight shifting is key! 

Often times a child has difficulty rolling because they aren’t properly shifting their weight to roll.  Because of the weight of their head, it is common that their weight is distributed more on their shoulders, chest, and arms.  This results in them looking “stuck”. To help baby roll from belly to back, you can provide support at your child’s hips to shift more weight through their pelvis, and shift from one hip to the other as needed to complete the motion.   

How to Teach Baby to Roll From Tummy to Back or Back to Tummy

These strategies are great to use separately or all together to help baby roll from tummy to back or back to tummy and become more successful with this foundational gross motor skill.

The best way to help your baby learn to roll over is to give them many opportunities to practice and perfect throughout your day.As with any skill your child is learning, repetition is key!

Find More Information to Help Your Baby in These Related Blog Posts by NAPA Therapists!

About the Author

Lindsey is the lead trainer and physical therapist at NAPA Boston.  She is trained in NDT, Kinesiotaping, and CME.  She graduated with her doctorate in physical therapy from Northeastern University in 2009.

About NAPA Center

NAPA Center provides the best pediatric therapies from around the world to help children live their best lives. NAPA Center has four US-based clinics located in Los Angeles, Boston, Austin, and Denver in addition to two Australia-based clinics located in Sydney and Melbourne. As a leader in intensive pediatric therapy, NAPA Center attracts patients from around the world to participate in three-week intensive therapy sessions bringing unparalleled growth for children with a variety of neurological and developmental disabilities. To discover how NAPA can help your child, view our program offerings and contact our team to learn more.

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