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What is Toe Walking?

Toe walking means that a child is walking and standing on tiptoes, and their heels do not make contact with the ground. Walking up on their toes can be a normal occurrence in children aged three and under as they continue to develop their ability to walk. Beyond that age, without any definitive medical reason, it is considered idiopathic toe walking (walking on toes without a known cause).

Toe Walking Causes

To understand, what’s not so simple about toe walking is the why behind it. There are many possible reasons that children might develop this pattern:

Developmental phase: A child occasionally walking on the balls of their feet can be part of normal development.  When children first begin walking, usually between 12-15 months of age, they often try different foot positions including walking up on their toes.  However, it is expected that typically developing children will only walk on their toes occasionally.

Neurological concern:

  • Sensory processing concerns: Children with sensory issues, including those on the Autism Spectrum related to the vestibular system, have a different awareness of their body position and feel stabilized during toe walking. The tactile system includes our sense of touch, pain, and temperature. Some studies conclude that children with differences in vestibular processing can also have tactile senses that exacerbate their toe walking. They may not like the feeling of the floor touching their feet, and toe walking minimizes this contact. Children seeking proprioceptive input toe walk because the gait prolongs stimulation of joint receptors and causes their muscles to tighten. The movement provides a calming input sensation for the child. (Williams 2010)
  • Cerebral Palsy: The most common cause of toe walking in those with cerebral palsy is spasticity, which can cause stiffness and involuntary muscle contractions in calf muscles, keeping their heels from touching the ground. Over time, without proper stretching and bracing, these muscles can become shortened, making it challenging to achieve heel contact. 

 

Idiopathic toe walking: Toe walking can occur because of an underlying anatomic or neuromuscular condition, but in most cases, toe walking is idiopathic without a discernible underlying cause. Idiopathic toe walking occurs in children between 3 and 7 years old and is more commonly seen in males than females. Idiopathic toe walking is not related to any specific diagnosis and can presenty of reasons, due to a variet including decreased stability and sensory involvement. For some families, toe walking may be a cosmetic concern, whereas it can cause pain or functional issues in other cases. (Ruzbarsky, Scher, & Dodwell, 2016)

Treatment

You may wonder how to stop toe-walking with your child. Therapeutic treatment depends on the cause, how strong of a habit it is, how tight the calf muscles have become, and what other changes have occurred in the child’s foot and ankle due to walking this way. 

Treatment can include:

  • Stretching: To improve muscle length, increase ankle mobility, and promote heel contact
  • Orthoses: Ankle-foot orthotic worn to keep the foot at a 90-degree angle and promote heel contact
  • *Turtle bracing: New bracing technique utilizing a removable, re-moldable, lightweight brace to achieve optimal ankle positioning, obtain and maintain ankle mobility, and promote heel contact
  • Serial Castings: Hard cast used to obtain and maintain a 90-degree angle at the ankle joint for extended periods (1-2 weeks at a time)
  • Night splints: Braces worn at night to keep the foot in a 90-degree angle and achieve prolonged stretch
  • Botox injections are most commonly used with those dealing with spasticity; they weaken their calf muscles and make them easier to stretch and cast.

A careful history, clinical exam, and selective diagnostic testing can be used to differentiate between different types of toe walking and determine the most appropriate treatment for each child. 

 

How Can Carolina Therapy Connection Help with Toe Walking?

Being evaluated by a Physical or Occupational Therapist can further help determine which treatment routes are appropriate for your child. Call us today at 252-341-9944 for a free screening! 

 

By: Taylor Saunders

 

Stuttering: Developmental or Disordered?

Stuttering in children is a speech disorder characterized by disruptions in the natural flow of speech. Developmental stuttering is a common experience, typically emerging between the ages of 2 and 5 when children are first learning to speak fluently and developing a large repertoire of words, phrases, and sentences. While many kids experience a phase of disfluency in their normal speech development and may outgrow it, some might continue to stutter as they grow older. In this case, speech therapy may be recommended.

 

 

Causes of Stuttering in Children

The exact cause remains unclear, but it’s believed to arise from a combination of genetic, neurophysiological, and environmental factors. Children with a family history of stuttering are more likely to develop it. Some kids experience stuttering due to differences in brain structure or function related to speech production. Emotional factors like stress, pressure to communicate quickly, or a hurried environment can also increase stuttering. Stuttering occurs at the initiation of voice, which is why we typically hear disfluencies at the beginning of words and phrases.

 

According to Johns Hopkins Hospital, A child is more likely to stutter if he or she has:

 

  • A family history of stuttering
  • Stuttered for 6+ months
  • Other speech or language disorders
  • Strong emotions about stuttering or family members with fears or concerns

 

Types of Disfluencies

Stuttering manifests in various ways, such as repetitions (repeating sounds, syllables, or words), prolongations (elongating sounds), and blocks (inability to produce sounds). These disruptions can lead to tension and anxiety, causing the child to avoid certain words or situations where they might feel pressured to speak.

 

Speech Therapy for Stuttering:

Speech therapists play a crucial role in assessing, diagnosing, and treating stuttering. Here are some primary approaches utilized in speech therapy:

 

Speech Modification Techniques: Therapists teach children to use gentle starts to sentences, and employ smooth, relaxed breathing patterns. This helps in reducing the frequency and severity of stuttering moments. Continuous phonation, for example, is a technique where speakers learn to keep their voice on and vocal folds vibrating throughout speech. 

 

Fluency Shaping: This technique focuses on reshaping the child’s speech patterns by teaching smoother speech movements. It involves controlled breathing, gentle voicing, and gradually increasing sentence length to enhance fluency.

 

Stuttering Modification: This approach concentrates on changing the child’s emotional and cognitive reactions to stuttering. It involves desensitizing the child to the fear and anxiety associated with stuttering and teaching strategies to manage and accept disfluency.

 

Parental Involvement: Educating parents about stuttering and how to support their child’s speech development is key to increasing the child’s success. Therapists often teach parents techniques to practice at home, creating a supportive environment for the child’s progress.

 

Communication Skills Training: This includes enhancing overall communication skills, like turn-taking and using pauses effectively. It helps in building the child’s confidence and reducing the pressure associated with speaking.

 

Long-Term Outlook

Many young children outgrow developmental stuttering; however, some might continue to stutter into adolescence and adulthood. In such cases, ongoing therapy, support groups, and strategies for managing stuttering in social and professional settings become vital.

 

How can Carolina Therapy Connection help?

Children who sutter often benefit from therapy from skilled Speech-Language Pathologists. Stuttering in children is a complex speech disorder that necessitates early intervention and specialized therapy. Speech therapists employ a variety of techniques focusing on speech modification, emotional support, and overall communication enhancement to help children manage and, in many cases, overcome stuttering. Family involvement and a supportive environment are fundamental in the child’s journey towards improved fluency and confidence in communication. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any disfluencies, and our therapists will work with you and your child to develop a plan for enhancing skills to build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

 

By Ashley Holloway, MS, CCC-SLP, CAS

 

 

Winter Activities for All Ages! 

What are Some Winter Activities When the Weather is too Cold Outside?

Ever wonder what you can do to keep your Kiddo occupied and safe while providing the necessary sensory input when it’s too cold to play outside? It is recommended to take indoor breaks every 20-30 minutes when the temperature outside is between 13-30 degrees; however, some kiddos tolerate cold weather better than others. Here are some tips for activities that can be done indoors when it’s just too cold to go outside this winter!

A Fun Winter Activity: Play Board Games

This is dependent on your child’s age and skill set. If you have some board games tucked in the closet, break them out and have family fun! This will work on building your child’s reciprocal play skills, following multistep direction skills, coping skills, and emotional regulation. Check out our Amazon storefront for some of our recommended board games! 

Build a Pillow/Blanket Fort

Who didn’t love making a fort under the kitchen table as a kid? Build a fort in the kitchen and living room, then place some of their favorite books, toys, and stuffed animals inside. This can be a fun way to get your kids into critical thinking mode and build their visual perceptual and motor skills! 

Scavenger Hunt

Another fun winter activity is to hide some items in your house and have your kiddos find them! This can be graded according to skill level and age. For example, for a younger kiddo, have them locate items they would typically use. For older kiddos, give hints to the item they are looking for. “Find two things mom uses to stir within the kitchen (utensils)” or “Find something round and blue in your bedroom (ball).” This will work on their figure ground skills and get their body moving!

Bake/Cook

Have your kiddos help you bake/cook your favorite snack or dessert in the kitchen. Have your kiddos follow the directions given or help with the messy tasks. This can be great for our sensory-seeking kiddos and those resistant to messy play!

Dance Off!

GET MOVING with a fun dance-off! Put off some of your favorite music and have a contest to see who dances best to the song! This is a great way to work on gross motor skills, coordination, and auditory processing, and it’s just plain fun!

Watch your Favorite Movie and Act Out the Scenes.

Many kids like to watch movies; however, do you ever notice that they get bored halfway through and are on to the next thing? Get them involved with the movie. Have that pause button ready and have them act out a scene to see if they can recall what happened! 

Indoor “Snowball” Fight

Do you have some extra tissue paper lying around after wrapping those Christmas presents? Make snowballs and toss them at each other! This is a great way to get kiddos moving without fear of knocking things off tables/counters and breaking things! 

Keepie-uppie with Balloons

Everyone knows this one! Can we keep the balloon off of the ground? Try it! It is so much fun, works on your kiddo’s hand-eye coordination, and has less risk of damaging something in your home!

How can Carolina Therapy Help?

With winter in full swing, ask your therapist about tips/tricks to have fun indoors with adaptations specifically for your child’s sensory-related needs. A therapist at Carolina Therapy Connection can help adapt the activities listed above and give more ideas for your specific child! Also, check out our link for Amazon storefront to find fun toys/activities to make the indoors fun! Many great toy ideas and sensory-related tools can be used when your child needs to get some energy out!

I hope these tips have helped build some fun ideas for you and your family for this winter season! Stay happy, healthy, and warm!

By: Shelby Godwin, COTA/L, AC

Navigating Neurodivergence

How Occupational Therapy Helps Different Brains

Occupational therapy has long been recognized as a vital therapy for providing neurodiverse individuals with the tools and strategies to lead fulfilling lives. In recent years, the focus on neurodivergent occupational therapy has gained momentum, emphasizing the unique needs and strengths of individuals with neurological differences. This blog aims to explore the transformative role of occupational therapy in supporting neurodivergent individuals on their journey toward independence, empowerment, and a higher quality of life.

 

Understanding Occupational Therapy for Neurodiverse Individuals

Occupational therapy helps neurodiverse individuals by helping them discover who they are, what they can contribute to society, and how they can live their best life.  We start by making a personalized plan with the individual on how to make their life easier for them. 

 

Taking Care of the Whole Person With Occupational Therapy 

Occupational therapy looks at everything – the body, the brain, feelings, and even how someone experiences the world around them. It’s important to consider an individual’s life’s physical, cognitive, emotional, and sensory aspects.  Together with the individual and caregivers, occupational therapists take a holistic approach to help figure out what areas of their lives are challenging and what are their strengths.

 

Making Senses Work Better

It’s common for neurodiverse individuals to have differences in how they experience sensations in their world- they may feel sensitive to things like touch or sounds. Occupational therapists work to identify sensory sensitivities or challenges and implement strategies to regulate and adapt to different sensory inputs. For example- working with the individual to develop adaptive strategies for sensitivities related to food textures and picky eating. Occupational therapists can help progress through different food textures using various techniques that first start with foods the individual can tolerate and eat frequently.  Then, we start adding foods that are similar in texture, color, size, etc.  

 

Skill Development and Independence

Occupational therapy helps learn practical life skills, social skills, and executive functioning abilities.  It could be learning how to tie shoelaces or even making friends. It’s essential to take a strength-based approach to help build trust, confidence, and independence with daily tasks that allow them to engage in meaningful activities.  A strength-based approach is when an occupational therapist builds upon a person’s strengths instead of focusing on their weaknesses.

 

Family and Community Involvement

Families and friends are essential in the therapeutic process, too! Occupational therapists work with families to implement strategies at home and collaborate with community organizations and schools to create supportive spaces for neurodivergent individuals.

 

Technology and Innovation in Therapy

It’s common for a neurodiverse individual to process information differently than we expect; therefore, it is important to utilize various interactive tools and technology to enhance the therapeutic experience and cater to individual needs. Many apps and digital devices are available to help create independence in daily tasks.  Occupational therapists look at ways to support learning through apps, games, and other devices.

 

How Can Carolina Therapy Connection Help With Neurodiverse Individuals?

At Carolina Therapy Connection, all of our therapists are neurodiversity-affirming.  They recognize that neurodivergence is not an illness or disability that needs to be corrected or fixed. They recognize that neurodiverse individuals come with their own set of strengths that can be fostered. Occupational therapy can have a transformative impact in empowering individuals to overcome challenges, embrace their strengths, and lead fulfilling lives.  At Carolina Therapy Connection, we believe it’s all about making sure everyone, no matter how their brain works, can be a part of the fun and excitement in life!

 

 

 

Not Your Average Toy!

Not Your Average Toy offers a transformative approach to pediatric therapy, catering to the different needs of our pediatric patients in occupational, speech, and physical therapy within our clinic. These specialized toys aren’t just playthings; they motivate children to develop essential skills like fine motor control, visual perceptual abilities, grasping techniques, following multistep directions, stimulating ‘what’ questions, fostering color and shape recognition, encouraging problem-solving, and refining hand-eye coordination. What makes these toys exceptional is their unique ability to grasp the children’s attention while integrating therapeutic goals into engaging activities tailored to each child’s journey toward progress and achievement. Check out some of our favorite “Not average toys!” 

Examples of Not Your Average Toy:

Water Beads: 

What sets water beads apart? Water beads stand out for their fun way of developmental skills. They offer an enjoyable sensory and messy play while enhancing color recognition and sorting abilities. These beads serve as a tool for reaching milestones. Children can play by using a spoon for scooping into a cup, counting exercises, and even hiding items like toy fish or other objects within the beads to engage both hands in a tactile search. These toys facilitate various developmental goals, from color recognition and sorting to refining fine motor skills, in-hand manipulation, bilateral coordination, and sensory play. They also stimulate counting skills and engage in figure-ground activities.

 

Building Blocks: 

Building blocks are known for making a tower and watching it fall, but did you know that they offer various developmental opportunities? These square toys build structures with two hands, allowing a child to work towards bilateral coordination, midline crossing, and fine motor skills. Playing with blocks can also help with color recognition, shape learning, spatial orientation, and teaching concepts through block positions. 

Building blocks can also help with emotional regulation. If a task is challenging or the tower does not stay quite the way intended, this is an excellent opportunity to discuss the feelings raised and allow your child to have a voice.   

 

Puzzles: 

Puzzles are a fun, versatile learning tool for children. They can help children learn about shapes and colors, expand their vocabulary, and identify different types of animals. Puzzles also help children learn to act like put in and take out. You can add a multi-step direction to make a puzzle more challenging, like putting the cow and horse puzzle pieces together in their correct spot. For more engaging questions, ask your child, “What does a cow say?” or “Where is the cow?” Puzzle helps achieve milestones that involve enhancing visual perceptual skills, grasping technique, mastering multi-step directions, and developing problem-solving abilities. 

 

How can Carolina Therapy Connection Help? 

At CTC, we are committed to supporting our families and the child’s developmental journey and helping them achieve these goals at home. Please explore our website (https://www.carolinatherapyconnection.com/) or our Amazon Storefront (https://www.amazon.com/shop/carolinatherapyconnection). These are not your average toys; they are carefully innovative toys that can help foster growth and development. To further understand these toys’ impact, ask your therapist if you can sit in during a session. By watching the interaction between the child playing and the therapist, parents can gain insights into how effective these tools can be and bring these Not Your Average Toys into their home.

 

By: Lauren Hodges, COTA/L, and Allison Hicks