In this episode, pediatric physical therapist Jeff Elrick breaks down how movement helps young children grow—not just physically, but in how they think, feel, and connect with others. He shares fun, everyday ways families can support physical development at home, and explains why inclusive play matters for all kids. Whether your child is walking, wobbling, or just starting to roll over, this conversation is full of helpful tips and encouraging insights for every stage of early childhood.
Transcript
Robin (00:33)
Hi everyone, today we’re talking with Jeff Elrick. A pediatric physical therapist practicing at Its Ability in Concord, New Hampshire. Jeff graduated from Ithaca College with a BS in clinical science and his MS in physical therapy. He’s worked with patients from birth through young adulthood in home, school, community, and clinical settings. His areas of interest include pediatric fitness, bicycle training, and community-based recreation for all ability levels. Welcome, Jeff. It’s great to have you on the podcast.
Jeff (01:03)
Thank you.
Robin (01:04)
Let’s start off by just learning a little bit more about you. What inspired you to become a pediatric physical therapist?
Jeff (01:10)
Well, growing up, my mother ran a daycare/preschool in our house. So, I was around kids since I was that age. So, playing with kids and having them around is just felt very natural to me. And as a high schooler, I volunteered to coach some youth soccer teams in town. And then as well in college, did some volunteering. And the internships I had through my school, they helped strengthen that desire to work with kids and to really make a difference.
Robin (01:40)
Great. I grew up in a home daycare too. So, I can really relate to that experience. You just learn so much about children of all ages and developmental stages and become really comfortable with kids before you’re even considering a career. So that makes a ton of sense. You do work with children in many different settings, home, school, clinics, and community. How does your approach change depending on where you are supporting a child?
Jeff (02:06)
Well, the settings change, but really my approach doesn’t change too much at all. It’s really a saying that one of my professors in college said and stuck with me for years. It’s treated what you find. you look for a deficit, you look for a functional limitation, you look for somewhere you can help, and then you treat that. In the schools, there is some limitations for lack of a better term for educational relevance. It has to be appropriate and supportive of the child’s education, their plan. Typically, the kiddos we work with are either on a 504-accommodation plan or an individualized education plan, an IEP. And it has to support that whether that means physical access to the building physical access to their curriculum materials mobility around the school grounds, but it does have to have educational relevance. Whereas the clinic setting. We have a little more freedom to find deficit and treat it. If there’s a weakness in a joint. That we feel would benefit from strengthening we can treat that it doesn’t have necessarily have to have an educational relevance. But really everything we do has a functional significance in the child’s life.
Robin (03:12)
Great, and so, are there benefits to working with kids in their natural environments like home or school?
Jeff (03:18)
Definitely. I think it’s most meaningful when PT happens where life happens. Where we really see the kids’ lives. See what they need to do in the course of a day. See what they like to do. See what their family likes to do. And it really helps with what we call generalization of skills. So, working on stairs, for example, if we’re working on balance and control going up and down the stairs, they can maybe do it in the six stairs, we call it the stairs to nowhere in our clinic, it goes up to a little platform on the side of the clinic. But can they do it at home? Can they do it? at the doctor’s office? Can they do it at school? Where stairs vary from height and depth to the accessibility of railings. So yes, working on that in the clinic is great, but can we get out where life happens? Can we work with them on the stairs they’re doing every day?
Robin (04:07)
That makes sense. like, if you’re working with them, doing the stairs at school would also be like navigating because a lot of times in transition periods during school, there’s a lot of students out, you know, going from one class to another. So, they would have to navigate that as well, I would think, right.
Jeff (04:22)
Exactly. So, within a skill, there’s so many different levels that add challenge kiddos and certainly the environment. Doing it alone without any distractions is one thing. Can they do it with lots of other people while conversations are going on and that sort of thing? That’s a whole other challenge.
Robin (04:38)
Makes sense. How is pediatric physical therapy a proactive approach? I’ve heard people refer to it as a proactive approach, but I’m not sure what that means.
Jeff (04:46)
Well, when we’re treating kids and really any physical therapy patient of all ages, we’re looking to mitigate or eliminate potential deficits in the future. So when they’re kids, we want to make their lives as easy as possible when they’re older. So physically, that’s looking at what we can do now in order to make them more functional and more independent when they’re older. An example, and it’s quite common, it’s becoming more common in our clinic, we’re getting referrals for torticollis in kids. And that’s where the shortening of the neck muscles occurs either at or shortly after birth it can look as simple as just a little head tilt in a baby. But if left untreated, going down that road, it could lead to what’s called plagiocephaly, which is a malformation of the skull. the flat side on their head, the back or in the back can lead to vision or hearing. deficits, can lead to balance concerns as they start to develop because of the tilt of their head. So again, it’s something we see a lot and in most cases with some very simple modifications and some simple treatment, it can be resolved and again, that’s helping to set that little one up for better development down the road.
Robin (05:56)
Yeah, that makes a lot of sense. So adult physical therapy is more of like treating response to injury or response to deficit where pediatric physical therapy is really thinking about how a deficit could impact the future in a bunch of different ways.
Jeff (06:13)
Definitely.
Really the majority of what we do with our patients, it’s not rehabilitation. Teaching them to do something that they always were able to do before. habilitative therapy. So, they’re learning these skills for the first time. Whether it’s jumping and balancing, whether it’s lifting their head, thinking of that infant with torticollis, lifting their head up in their belly position.
Robin (06:31)
Yeah.
Jeff (06:33)
So, it’s really looking at it as how are we going to teach this child to do something that they have no idea what it feels like, what it looks like, and to guide them through that process.
Robin (06:43)
Great. And that kind of takes me to, I’ve heard you say pediatric therapy is a lifespan therapy. What did you mean by that?
Jeff (06:50)
Well, in our practice, we see a lot of kids with childhood onset disabilities. It was either something that happened at birth or shortly after birth, a lifelong impact on their function.
Robin (07:04)
Okay.
Jeff (07:04)
as we’ve been around the company itself has been around for over 40 years and a lot of the kids that we see, they become adults. They have some of the same needs and certainly physical therapy is physical therapy regardless of the patients. they are, they’re still in our practice. It says on the side, but we have patients well into their thirties actually coming to our office. So, it, it really,
Robin (07:21)
Okay.
Jeff (07:28)
allows us to see what we do with younger children and how it impacts kiddos with lifelong disabilities, how it impacts their lives further on in life. And that actually helps us being able to be part of these children, or excuse me, young adults live for so long, it actually helps us work with the younger kids because we can see that they may have similar needs.
as an older patient had when they were younger. And we know, and we’re seeing the older patients experience the challenges that might lie ahead for these younger children. So, it’s really a great, great thing to be able to see that.
Robin (08:08)
Yeah, that is great and kind of unusual, like to have that kind of long-term therapeutic relationship in this kind of a setting. It must be really interesting to develop deeper relationships with your clients because of that.
Jeff (08:23)
and the families as well. I mean, the individual has the disability, the family is going through everything as well. And so, we make a lot of good friends. really, it almost feels foreign sometimes to call them patients. My friend Josh is coming in.
Robin (08:36)
Yeah, absolutely. Yeah, that’s very unique. I love that though. When you think about the families that you have relationships with and families that will come to you in the future, what’s something you wish every family knew about supporting their child’s physical development?
Jeff (08:54)
And I think one of the key points is that there’s no magic formulas or strict guidelines to helping kids move and play and learn. I think from a PT standpoint or from a physical development standpoint, think just incorporating movement into their lives and having fun, whatever that looks like, is important. I think if we can provide the opportunity for kids to move and we can provide the encouragement for them to move, the rest will kind of fall into place. And I think it goes for everybody, but I think in our practice, one of the important things is we celebrate every success, how small, no matter how big. It’s a step forward and celebrated. Sometimes it’s with throwing balloons around the office. Sometimes it’s with a dance party, you know, just, and sometimes it’s just a congratulations and a way to go. But I think just celebrating each success is important and so is with every child as they develop, so just encourage them and point it out.
Robin (09:44)
especially with like we’re focused on the early childhood development span for this podcast in particular, thinking about like really encouraging kids to, you know, try different things that they haven’t tried before, making sure they have like a safe environment to do so in, of course, but yeah, encouraging them, you know, they take their first steps, they
fall down, it’s OK, things like that. So, when you think about physical development in the context of early childhood, what do you think about? I’m sure there’s like categories here that generally we don’t know of.
Jeff (10:17)
Well, I think with physical development, I really see it as skill development.
Robin (10:21)
Mm, okay.
Jeff (10:22)
developing just a series of skills that is going to build you or allow you to grow and build upon as you get older. And so when babies grow into toddlers and toddlers grow into school-aged children, their bodies are developing skills. It’s based on a complex interaction of all their senses, their brain, their nervous system, their muscles, how they’re moving, some of the movement senses. That you may hear are stimulator system, which is how we sense gravity and movement. It’s based on our inner ear. The proprioceptive system is just a fancy way of saying how our muscles and joints take in information. And it allows us to sense the movement of our body, the position of our body that can know that my knee is bent by not looking at my knee, just feeling that my knee is bent. And also force control during movement. How hard do I push? How light do I have to throw this? Those kind of feelings of movement. And certainly, the tactile, the sense of touch. We’re taking in constant information about our environment and how.
Robin (11:08)
Okay. Got it.
Jeff (11:23)
how we’re moving and how that the touch is impacting our movements. And certainly, mean, all the others, vision, hearing, even taste and smell play a role in physical development. Locating something as simple as I smell chocolate chip cookies and I try to figure out where those smells coming from. So, I’m turning my head and moving my body. So, it’s a small example, but it really shows that we’re taking in information from everywhere.
Robin (11:45)
like that’s something parents could do at home, right? Be like, you know, you know, do you smell the flowers? Where are they? Where are the flowers? Like, just like kind of those every day, integrating the senses. Okay.
Jeff (11:57)
in typical development, children’s bodies, they’re constantly reacting to the outcomes of their movements. If they start to lose their balance, then they say, okay, well, I’m not going to step that far. So they adjust their movements accordingly. And then they fine tune the skills that they have and build upon that. it’s, it’s just sensing, okay, was that a little mistake or was that a successful venture? Whatever I just did. And then fine tuning it from there.
Robin (12:03)
Mm-hmm.
Jeff (12:23)
So, balance is a great example for that
Robin (12:25)
Yeah. That makes does physical development impact kind of overall growth and learning at the Parent Information Center, we’ve built some content around these early childhood milestones and connecting, trying to help connect how physical development might relate to cognitive development or any other kind of development as kids are growing up and getting ready to enter school.
Jeff (12:51)
So, when physical development happens, a child’s better able to explore their environment. They can try new things, go, and touch new things, and meet more people, and in turn then develop more skills. They’re just moving around the earth just better.
Robin (13:03)
Okay.
Jeff (13:04)
so, at the skeletal level, the bones, and muscles, they will grow and develop their shape, their size, their strength based on the forces we put upon them. So that is, it starts with crawling. Then it goes to standing. The hips are a great example. The shape of the hip joints changes as children crawls and then learn to walk and then learn to. I should say develop more into young adults. So, the forces that are put upon those hips actually deepen and strengthen the hip joint. They deepen, it deepens the socket, it changes the angle of the hip. And kiddos who don’t have that weight bearing or don’t have the ability to weight bear in a typical fashion, their hips are in danger of becoming dislocated. There’s a Surgery that is common with with kiddos with neuromuscular impairment to improve the integrity of their hip joint. So that’s a small example is the hips. But really, I mean, I think the simplest form of that is muscles get stronger the more we do. So, you know, with five pounds now in a month and a half, you can lift 10 pounds, your muscles gotten stronger. So, children are constantly moving a larger body. They’re constantly growing. So, if they’re moving, then you know if they’re moving a 40-pound body, you know in a year if they’ve put on three inches and 10 pounds, then they have to be strong enough and coordinated enough and have enough control to move that larger body. Movement is important because at any time during development, if movement ceases, then it takes that much more to catch up, so to speak.
Robin (14:22)
Okay. So, how does physical development, connect with other developmental areas, such as like emotional regulation? So, parents of children who are either just learning to walk or, you know they’re walking, is there anything they could do at home to strengthen that? are we waiting until they’re further along?
Jeff (14:52)
I think it goes back to just encourage movement. See the skills that your child has.
Robin (14:55)
Okay.
Mm-hmm.
Jeff (14:59)
Practice those and build on those. Let’s today let’s try to run a little faster, jump a little further, and not necessarily get caught up in the level skill, but just the fact that they’re moving.
Robin (15:09)
Okay.
Jeff (15:12)
Yeah, any movement that involves both sides of your body is great. So whether that’s a game, whether that’s something simple as crawling, moving both sides of your body is very important.
Robin (15:21)
So how are movement and motor skills connected to things like emotional regulation?
Jeff (15:27)
Well, for emotional regulation, can be as simple as just movement and exercise. Movement and exercise help release serotonin and dopamine. And it releases those chemicals help regulate our mood. So, any of us, I’m goanna go out for a walk, I’m goanna go for a run, that sort of thing in order to help de-stress. So, it can be as simple as that. But on a deeper level, also, movement helps improve children’s executive functioning. And with executive functioning, that’s basically it’s how we plan and perform motor skills.
Robin (15:55)
Okay.
Jeff (15:55)
and how we react to events in our lives. And if your executive functioning is higher, it has a direct impact on how you respond emotionally to life’s events and life’s stressors. So really, movement’s important for all of us.
Robin (16:08)
Got it.
That’s right. What are some things that parents can do every day to support their baby or toddler’s physical development?
Jeff (16:19)
think keeping it simple, there’s so many different, again, working on taking in information from all those senses. And have fun is the key. going back to what I said before is providing that opportunity, move, have fun together. You can make up games in almost any environment with anything. You could have a tennis ball and have hundreds of different games, hundreds of different games to play with a tennis ball. Obstacle courses in the house using couch cushions and bed pillows. Dance to videos that are on the computer. YouTube is filled with videos, dance videos that just get kiddos moving. It’s a big tool for us during the pandemic when we’re seeing a lot of kids over Zoom, send them links and have the family dance together. And go for walks
Robin (16:59)
Okay.
Jeff (17:05)
encouragement is really.
Robin (17:06)
And I also think kind of what you’re alluding to is making movement like a lifelong, something that’s fun and that they’ll want to continue to do for the rest of their lives, being active.
Jeff (17:16)
So there’s a ripple effect there. mean, as far as small changes now that can make huge changes in kiddos’ lives when they’re older. Just incorporating movement and if exercise and movement is just a typical part of their lives, then it becomes easier as adults to keep that going.
Robin (17:33)
What skills should families look for or work on as their child transitions into preschool or kindergarten?
Jeff (17:41)
Well, the three-year-old year, it’s a huge year. It’s very significant for growth in gross motor skills. They’re beginning to attempt more to challenge their skills, and that’s how kids’ skills get better, is those skills are challenged. Similar to a muscle, a muscle will get stronger when it’s challenged.
Robin (17:57)
What’s a gross motor skill for those in our audience that might not know what that means?
Jeff (18:00)
Sure, gross motor skill is a larger body movement.
Robin (18:04)
Okay.
Jeff (18: 05)
It’s thinking large muscles, large movements, running, jumping, throwing, sort of movements. And the three-year-old are going to start to do that. They’re going to jump more. They’re going to try to balance on things and challenge themselves in that way. They’ll like to, I’m sure like to climb, whether it’s playground equipment or whether it’s rocks on a hike or anything like that. They’re running more. It’s slowly developing more of a mature run and less of that toddler looking side to
Robin (18:26)
Yeah.
Jeff (18:32)
as they move through preschool towards kindergarten, really the range for skill development is very wide. Generally, a four- or five-year-old would most likely be able to jump with their feet together in any direction,
keeping their feet take-off and landing. Go forward, backwards, down from a small step or over a small obstacle. They may be able to hop a few times on either foot. Stand on one foot for five to 10 seconds. Probably walk on a four-inch-wide balance bean.
Robin (18:46)
Okay.
Mm-hmm.
Jeff (18:59)
So, they can gallop, skip.
Robin (19:01)
Mm-hmm.
Jeff (19:03)
They’re certainly climbing playground ladders and using slides. They can most likely walk downstairs with one foot on each step, and using the railing is fine. Having to use the railing is fine. As far as ball skills, they can probably catch a tennis ball with two hands when tossed from six feet away or so. They’ll trap it to their body, but just having that ability to catch a ball is something you’ll probably see in a typical four or five-year-old as well. And honestly, if there are questions, ask.
Robin (19:10)
Okay.
Nice.
Jeff (19:30)
ask doctors, ask physical therapists. If you ever have any concerns, that’s the most important thing.
Robin (19:35)
Nice. Okay. Are there any activities or play ideas that can help strengthen those specific motor skills that you talked about, the gross motor skills?
Jeff (19:44)
There are, think in PT we target specific skills, so we’ll do specific activities or exercises to target a specific skill. But when encouraging overall development, think cross training is the key. Not necessary unless it’s a prescribed home exercise program from a doctor you know, the of play and move.
you can make a physical movement or physical activity out of almost anything. You can balance on one foot while you’re brushing your teeth. You can go to the grocery store and you’re in charge of loading the gallons of milk into the cart. Again, you can make an obstacle course around your house. so just, think just moving and doing lots of different kinds of movements is the key. So different activities, different environments, different challenges. I think that’s the most important thing is to keep moving. And one thing, one nice thing you could add to an activity with kids is called cognitive load, meaning to get them to think about something else while they’re doing their activity.
Robin (20:37)
Mm-hmm.
Jeff (20:44)
I like to talk to the kids about moving, like, this is what you’re doing. You’re crawling through the tunnel. You’re going to go get the ball. But also, while they’re doing one thing, asking them about other things. So, an example would be, let’s sing a song while we’re balancing on one foot. That is shown, going back to the executive functioning, that is shown to help strengthen executive functioning in kids and adding to load while they’re performing post-mortar skills.
Robin (21:08)
Great. Okay. How can families, and I’m mostly thinking we’re coming off the winter here, you know, so a lot of times we are stuck indoors. How can families encourage physical development in small spaces or with limited resources? Like there’s a lot of focuses on, or there’s a lot of discussion, I should say, on what you can buy to have your child build more developmental skills and things like that. What are your thoughts?
Jeff (21:33)
Well, you certainly don’t need to spend a lot of money in order to do gross motor skills. Like I said before, anything can be made into a game. I think in small spaces, you certainly want to be aware of the safety of the surroundings. But you don’t have to think small movements. You can use a balloon and play a game of balloon volleyball. And that’s not going to break anything. And you can pass back and forth. You can do those videos.
put them up on the TV and do a little dance video with your family at night, after school, whenever. So, you know, certainly again, safety of the surroundings, but you don’t have to think tiny movements for a tiny space.
Robin (22:08)
Okay.
Jeff (22:09)
There’s lots of things you can do for those gross motor skills, the larger movements. And with limited resources, my encouragement to the families is to utilize the community. go to parks, go to libraries. Libraries often have passes to attractions that families can use for free. The recreation departments have activities year-round, more so in the warmer weather, but certainly year-round. And we live in a great state where you can walk and hike and climb almost anywhere in the natural environment.
Robin (22:37)
Right, right. Are there any common myths about movement or developmental milestones that you wish families knew about?
Jeff (22:46)
one myth would be that there is a hard and fast guideline for gross motor skill development. Those guidelines are just that, they’re just guidelines. Babies develop at different rates across all skill areas. It could be affected by your environment. It can be affected by the baby’s temperament, their height and weight ratio, their sleep patterns, and even their birth order. So really everything is a range. No set time. One thing I hear often is that babies need to be walking by a year. And it’s not true. The typical range for a baby to walk is 10 to 18 months.
Robin (23:20)
Okay.
Jeff (23:21)
So, there’s a wide range. And that actually leads me to another myth that early walkers are going to have advanced motor skills because that’s not necessarily the case. I’ve worked with a number of children with developmental coordination disorder and there are some very young walkers in that population, months. So even before what you consider a typical walker. That doesn’t necessarily, early walking doesn’t necessarily predict advanced motor skills.
Robin (23:41)
Okay.
Jeff (23:46)
Recently the Center for Disease Control, they removed crawling as a developmental milestone. They did. And they did that not because babies don’t need to crawl, because in my perspective, they absolutely do. They did it because there wasn’t enough data to show when a child should crawl, because not all children do crawl.
Robin (24:06)
Okay.
Jeff (24:07)
So, some kids, they skipped the crawling phase, they pull the stand and then they start walking. However, again, it doesn’t mean that crawling is not important.
Robin (24:15)
Mm-hmm.
Jeff (24:16)
Developing gross motor skills, It absolutely is. Sub works on core stability, it works on arm and leg strength, it works on head control. So in my mind, it is critical for developing future gross motor skills. It’s just when the CDC removed it from the guidelines, it made it appear as if it wasn’t, they didn’t have enough data to make, to set a milestone for it. I will often get kids back to the ground,
Robin (24:43)
Mm-hmm.
Jeff (24:44)
a toddler who doesn’t have great core stability, we’ll go back to the ground and we’ll do a lot of crawling
Robin (24:48)
Okay
Jeff (24:49)
as part of a therapy program and moving around.
Robin (24:51)
families should still look for that crawling stage. However, if a child goes right from standing to walking, is that a cause for concern or?
Jeff (25:01)
It’s not necessarily cause for
It’s not to say that the child isn’t getting enough of enough movement and strengthening elsewhere a kid lives and playing in order to develop typically. I just when I helping a child develop motor skills will use crawling as a tool.
Robin (25:19)
Yeah.
Jeff (25:19)
So, I would encourage parents that certainly don’t be concerned if your child doesn’t crawl, it’s a great thing to incorporate into play.
Robin (25:27)
Right. Yep, that’s a great opportunity.
Jeff (25:29)
to that connecting both sides of the brain.
Robin (25:31)
Yeah, right. What about keeping babies off their bellies when they sleep?
Jeff (25:36)
Well, we’ll go back to more federal government guidelines. National Institute on Health, they still recommend putting babies to sleep on their backs. Originally, when my kids were little, it was called the back to sleep program. They’ve changed that. It’s now called the safe to sleep program.
Robin (25:51)
Okay.
Jeff(25:52)
And it talks about more than just putting the child on their back. It talks about the firmness of mattresses, not having toys and blankets in the crib. Along with some other environmental conditions for sleep. And that certainly that information can be found on their website. But because of that, there are often some families who will avoid belly time altogether. It makes them nervous to put them on their belly, or sometimes it just makes the baby cry. Developmentally, it is a tough position. You put a child on their belly and they’ve got to lift their head and they’ve got to do a lot of work and that’s something that they might not like.
Robin (26:25)
Okay.
Jeff (26:27)
So, they may cry. So a parent may avoid putting their baby on their belly for that reason. They don’t want to upset them. But because it’s a tough position, that’s exactly why it’s needed. So supervised belly time with when they’re awake is actually part of the Safe to Sleep program. those skills because it strengthens their head and it strengthens their control, they are less likely to be stuck in a position in their crib where it would be difficult to breathe.
Robin (26:54)
All right.
Jeff (26:55)
So actually, belly time is important. And it’s important in more than just the safe to sleep program. It’s good for all of us, actually. I encourage parents when they’re doing belly time, get right down on the floor face to face with their child. Our entire lives are in front of us. We’re flexed forward, we’re driving, we’re hunched over the phone. postural muscles need stretching in the other direction too. So, it helps stretch us out as well as while our baby is strengthening theirs.
Robin (27:24)
Great. now if the baby, if we put the baby on their belly and they are uncomfortable, like you said, they are starting to cry. What’s your recommendation? Do we try to kind of play with them for a little while anyway? Do we?
Jeff (27:36)
you’re provided by putting them on their belly, you’re providing them that opportunity to strengthen those muscles. And certainly, by being face to face with them, you’re encouraging them to look up to, know, to play with mom or dad and so kind of try to work through that. Certainly, you know your child the best, the parents know their children the best. So, if they’re struggling after a few minutes, give a break.
Robin (28:02)
Right. Okay.
Jeff (28:03)
There’s no certainly, talk to a doctor or physical therapist if you have questions about a prescribed amount of time or anything like that, just incorporate it into play. When they get
upset, then, we’re going to sit back up and play with a different toy and then revisit that. Because any little bit, even if they cannot physically lift their head off the floor, their muscles are trying.
Robin (28:26)
Okay.
Jeff (28:27)
So, they’re trying, their muscles are working and getting stronger. And then the idea is in time we’ll see the benefit of that and they’ll be able to lift their
Robin (28:34)
Great. That’s great. What are your thoughts on things like baby equipment such as bouncers or walkers? Do those help or hinder development?
Jeff (28:44)
There’re definitely different schools of thought on this. I’m not a huge fan of either of those, but I say that after we use the Nexor Saucer for both of my kids.
Robin (28:53)
Hahaha
Jeff (28:54)
It certainly has its place in a family’s daily routine. toys that they can interact with, and it can certainly be appropriate. But so, I’ll never tell a family that they can’t use one. When it comes to Nexor Saucers and bouncers. But I’ll certainly offer my opinion. Specifically, the bouncers and the Nexor Saucers, they’re fun. They can be useful because you know the child is safe for a certain amount of time. you have something to do, they can help in a lot of ways, but they don’t necessarily teach standing. They don’t teach weight bear appropriately because of the position. of the legs because how the legs are taking weight in those devices. It doesn’t really allow for a typical motor pattern of the leg trunk muscles to develop.
Robin (29:36)
Okay, that’s interesting.
Jeff (29:37)
So, it’s, like I said, it can be useful
Robin (29:38)
Mm-hmm.
Jeff (29:40)
for all the stories that they have a purpose but shouldn’t necessarily be relied upon as a positioning device or and exercise device working towards standing or walking. And when it comes to walkers, I usually capital N, capital O. NO.
Robin (29:49)
Got it.
Jeff (29:55)
And that’s, and again, Nexor Saucers are similar to walkers, same but if your child is developed enough to want to move around and explore their environment, but they’re not walking lot safer ways to do that. Supervised crawling, even rolling.
Robin (30:10)
OK.
Jeff (30:10)
The walkers, have inherent safety hazards when a child is allowed to move themselves around the house,
Robin (30:18)
Mm-hmm.
Jeff (30:19)
their, but stoves and cabinets and that sort of thing. There’s a lot of safety hazards that are involved. So again, if your child wants to be upright and playing with some toys, Nexor Saucers would be great for short amount of time. But if your child is looking to explore their environment by moving
Robin (30:35)
Mm-hmm.
Jeff (30:36)
is not a safe way to do that in my opinion.
Robin (30:38)
Okay, yeah, great. What are some signs that a child might benefit from a physical or pediatric physical therapy evaluation? What should a family do if, you know, they know the milestones are, you know, guidelines, recommendations, like you said, but they still have concerns about their child being in that range?
Jeff (30:57)
I’d say first and foremost, talk to your child’s pediatrician. should be going over milestones, both motor cognitive and otherwise
Robin (31:06)
Mm-hmm.
Jeff (31:07)
at the well child visits. But also, there’s plenty of things you can look for and you’re certainly within your right at any point in time to request a motor evaluation, you’re specific from your doctor, whether that’s a referral to a physical therapist. So, beyond the milestones, you might notice the quality or symmetry of your child’s movement change or just not something not look right. If again, no set things to look for, but if you feel there’s just something not right, then.
Robin (31:33)
Okay, so go with go with your gut.
Jeff (31:35)
Go with your gut and ask because the worst thing that can happen is that you’ve talked to a professional, you’ve had some consultation and if nothing is nothing is wrong or if nothing is needs to be addressed, then your mind is at ease. But if there are things that need to be addressed, then they can be. I would say for babies, some red flags to look for would be their head position, the tilt of their head, can they move, some everybody holds their head in a comfortable position, but can they move out of that.
Robin (32:02)
Okay. So, you do you mean like if the baby’s head is kind of tilted towards their shoulder and
it’s not lifting they’re not lifting their head up to center is that kind of what you’re thinking of?
Jeff (32:13)
With what I talked about earlier with torticollis. It is both a head tilt and a head rotation and opposite so it’s usually a tilt to one side and a rotation to the opposite side
Robin (32:23)
Okay.
Jeff (32:24)
There their head is tilted towards their left shoulder their head may be rotated towards the right side And it’s more an inability to move out of that So if you were to try to get them if a baby is looking up into their right if you were trying to get them to look up into their left
and you can tell that they want to, but they can’t necessarily get there, that’s definitely something you want to bring up to your pediatrician.
Robin (32:46)
Okay, got it.
Jeff (32:48)
Certainly, the shape of their head
Robin (32:46)
Mm-hmm.
Jeff (32:50)
is something if you notice a flat spot on one side or an asymmetry in their head shape is something to bring up. Their arms and legs,
Robin (32:57)
Mm-hmm.
Jeff (32:58)
they seem very, very stiff. That is certainly something to bring up with your pediatrician, as well as any lack of improvements in arm and leg control. So as babies develop, you’ll be able to see it as your child develops that they can better control typically their arms first and then legs, reaching for toys, that sort of thing. And if you see a lack of improvement in that area, certainly bring that up to your doctor.
Robin (33:20)
And when you say if their arms or legs are stiff, that not, you know, they’re not bending their arms at the elbow or their legs at the knee?
Jeff (33:28)
Yeah,
Robin (33:29)
They’re like straight out.
Jeff (33:31)
Yeah So, a lot of times when parents are playing with their kids, they’ll move their arms back and forth and move their legs up and down and picture a baby laying on their back looking up at their mom or dad and you’re kind of doing a dance with them. And if you feel some stiffness, babies typically will be able to, their arms and legs will move pretty freely.
Robin (33:47)
Mm-hmm.
Jeff (33:48)
So, if you feel that, that’s certainly something to bring up to your doctor. And for toddlers, again, more upright movements, but you want to look for balance concerns if they’re starting to fall more than you noticed in the past. If they have some difficulty coordinating movements, again, just go with your gut, like something looks off. Or any apparent loss of strength or range of motion that you felt was there and maybe is not there anymore.
Robin (34:13)
Okay.
Jeff (34:14)
Their body, So those are the big things to look out for in a toddler and certainly bring up to your doctor.
Robin (34:19)
All right.
Jeff (34:20)
And I would say it’s definitely easier said than done. But before you talking to a health professional, don’t go onto Google for
Robin (34:26)
I know.
Jeff (34:27)
I say that having been guilty of it.
Robin (34:29)
Right, right. We all have.
Jeff (34:31)
There’s plenty of rabbit holes that if you jump down, can be very stressful for a parent. Not necessarily the best use of your time and energy.
Robin (34:38)
Right, so talk to a doctor first before trying to figure out every little thing yourself.
Jeff (34:44)
Exactly.
Robin (34:45)
OK, got it.
Jeff (34:46)
as has its place, but.
Robin (34:47)
For sure, for sure. What does pediatric physical therapy actually look like? Can you describe what a pediatric physical therapy session, what might happen in that session?
Jeff (34:57)
Sure. Well, our clinic, well I’ll talk about our clinic a little bit. Right. it’s, there’s lots of, we have an indoor playground, there’s lots of toys and games, and mats. And so it’s really, it’s a place of play.
Robin (35:07)
Okay.
Jeff (35:08)
That’s what pediatric physical therapy really is. It’s playing with a purpose.
Robin (35:14)
Okay.
Jeff( 35:15)
You’re playing in order to develop skills in a child’s life. So, what will happen is, there’ll be a referral from a doctor typically. A family will come in for an evaluation and talk to the physical therapist about things that they want to see addressed. The physical therapist will talk about what he or she wants to work on for a treatment plan is developed from there. And typically, kiddos will come in once a week, sometimes less often, sometimes more often depending on their need. And sessions typically last anywhere from 45 to 60 minutes. And again, it’s a lot of just playing. There are many kids that will come in and they don’t necessarily know why they’re there,
Robin (35:52)
Right.
Jeff (35:53)
but they know that they’re there to work and play.
Robin (35:56)
Okay.
Jeff (35:56)
And that’s really what it’s all about. Because if you can do that, you can develop skills and go from there, I think parents also need to know that they’re always welcome because carryover is key. Seeing a child for an hour a week is not necessarily enough.
Robin (36:11)
Right.
Jeff (36:12)
Certainly, way to stay guided, to stay focused for a family on the child’s need, but they really need to carry over, whether it’s exercises or certain activities or just certain concepts about playing with
Robin (36:22)
Okay.
Jeff (36:24)
With what they need, parents should see.
Robin (36:26)
whatever you’re doing in your therapy office, you want parents to kind of practice that at home with their kids in between sessions.
Jeff (36:33)
It gives them ideas. It doesn’t have to be exactly what we’re doing in the office.
I like to say is that we’re not looking to kid, looking to make kids’ lives one long therapy session.
Robin (36:44)
Right.
Jeff (36:45)
We are looking to make their lives as therapeutic as possible.
Robin(36:47)
Okay.
Jeff (36:48)
So again, parents are welcome and it’s a great way to get ideas and to see what your child’s working on. So it’s a wide open office. We do have some private treatment rooms if needed, but almost any pediatric therapy clinic that you go into will look the same as far as toys and open space.
Robin (37:07)
And fun! Just looks like a lot of fun.
Jeff (37:10)
Lot of fun. Haha
Robin(37:11)
That’s great. So, you’ve worked with children of all ability levels. How can families create inclusive play and movement opportunities either at home or in their communities?
Jeff (37:22)
I think the most important part about inclusive play, inclusive recreation in people’s lives is to focus on what we all have in common. We all like to have fun and we all benefit from movement, whatever it’s like for individuals. So I think from there you want to think about individuals, their abilities, not their disabilities. So what they can do, not necessarily what they can’t do.
So, what they can do and then in a group what they can they do together
Robin (37:48)
Mm-hmm.
Jeff (37:49)
and in some cases what can they do differently but in the same space?
Robin (37:53)
Jeff (37:55)
They’re playing together often we’ll see that in a physical education class. You know the games might look different for kiddos with disabilities but they’re doing it in the same space.
These foundations, I mean, the possibilities are really, really endless. You can have fun with your family, with your friends and your community. A great community resource is the Special Olympics Young Athletes Program.
Robin (38:14)
Mm-hmm.
Jeff (38:15)
That’s something that is, know, lots of people have heard Special Olympics and they think athletes with disabilities and it’s true but the Young Athletes Program that they run. Its community based. is all ability levels from age two to seven.
Robin (38:29)
wow.
Jeff (38:30)
It’s gross motor play. It is all families, all children welcome. And it’s a great environment, great, great experience.
Robin (38:38)
How do we find out more about that, there a website?
Jeff (38:39)
Yep. if you Google, going back to Google, you search solo Olympics Young Athletes Program,
Robin (38:46)
Okay.
Jeff (38:47)
it will come up and there should be a database of the different programs in the state. I know there’s a father that I’ve worked with, he runs the program up in the Lakes region.
Robin (38:56)
good.
Jeff (38:57)
There’s a number in the state.
Robin (38:58)
That’s great to hear about.
Jeff (38:59)
certainly, inclusive play.
Robin (39:00)
Okay. What kinds of adaptations have you seen or used that help children participate more fully? I’m kind of thinking about the example you gave me about gym class where they might be playing a game. It’s not the same game, but they’re in the same space. But is there a way to really just be even more inclusive than that?
Jeff (39:20)
Yeah, I think so we work a lot with adaptive equipment,
Robin (39:23)
Okay.
Jeff (39:24)
physical support, but I think the most important adapt adaptation involves the people and the people’s approach, the
Robin (39:31)
Definitely.
Jeff (39:31)
the participants approach. I mean, can we all be a little more encouraging? Can we all be a little more patient for a kiddo to take their turn? I think expectations is a word we use a lot. Can we get rid of our expectations about what a successful participation looks like?
Robin (39:47)
Yes.
Jeff (39:48)
It’s just being there, success, and often, you know, do I need to hit the target with the ball to be participating successfully? Not necessarily. Just kind of finding that sweet spot of can everybody participate meaningfully and in the same environment.
Robin (40:02)
Yeah, can all kids say they have a good time when they leave?
Jeff (40:05)
And one of my personal favorites is biking. Think there’s just something about a child and riding a bike. And at our office, we do a lot of biking and whether it’s trying to help kiddos lose the training just can’t quite get there on their own, or whether it’s a child with more significant disabilities on an adaptive tricycle
Robin (40:23)
Mm-hmm.
Jeff (40:24)
as part of their warmup for their therapy session. The faces that children have when they can ride a bike and be as independent as possible is something great to see.
Robin (40:32)
Yeah, that feels like a very, it’s funny that you say that because I was watching a TV show the other night and this dad was reminiscing about when his child first learned to ride a bike. And I’d say that’s kind of this, it’s not a quote unquote milestone, like a developmental milestone, but it is a milestone in a child’s life too, Yeah.
Jeff (40:51)
It’s a life milestone.
Robin (40:52)
Definitely. I’m so glad that you guys do that. That’s really wonderful. So as we close, do you have any, I know I’ve just picked your brain for advice and things like that, but do you have a favorite success story or a moment that kind of captures this amazing work that you do or why you do it?
Jeff (41:08)
Well, I enjoy what I do, think, because everybody has a story. And everybody’s story is unique to them. And by doing the work that I do and working with the families that I do, I get to be a part of a lot of different stories. mean, there’s, there’s hundreds that I’ve been a part of lucky enough to have been a part of over the years, but a couple come to mind, a boy that I worked with in kindergarten, he was diagnosed with autism. And Developmental Coordination Disorder. And he made his high school varsity basketball team the last three years in a row.
Robin (41:39)
wow.
Jeff (41:40)
It’s in it’s just again, it’s just his story.
But I got to witness it and see it. And it’s just, it was amazing. And
example would be 14-year-old girl was able to take her first independent steps.
after having to use a walker for the previous 12 years from when she was 14.
Robin (41:57)
Wow.
Jeff (41:58)
And it took her that long to take her first step, independent step. And there’s lots of firsts that I’ve been able to witness. And I think that’s really a neat part of the job.
Robin (42:08)
It makes me think too back to the beginning of our conversation when you talked about how with a lot of your clients, you’re with them for the lifespan and just like those deep relationships of also you are being there for those life milestones and just kind of being like becoming like a trusted member of their whole experience. It’s a really beautiful thing.
Jeff (42:28)
Yeah, it is a great thing to be a part of. I think I’ve used the word expectations in our conversation. I think if we can get rid of a lot of the expectations, it’s not put timelines on them.
Robin (42:39)
Mm-hmm.
Jeff (42:40)
A 14-year-old taking her first independent step. I mean, that’s a celebration. It is so easy to celebrate those sorts of things if we have not had expectations. And every new skill that a child develops, whether it’s at two months or whether it’s at 32 years old, it’s a celebration.
Robin (42:55)
Yeah, take in the good, celebrate the wins. For sure.
Jeff (42:58)
I’ll tell kids when they start working with me, my only expectation, I’ve used this with my kids in the past too, is that we want you to work hard, and we want you to have fun. And the successes will come after that.
Robin (43:11)
Absolutely, that’s childhood too, you know, really want them to have fun, work hard. That’s great. Jeff, I really want to thank you for your time today and talking to us about physical development in this way because. We do have a lot of content on those milestones and these very particular things. And I think you’ve helped our listeners kind of expand. One, have a sense of relief that they do not need to be checking boxes for every specific thing. We know that kids are all different, just like humans, all humans are different. And I think this conversation has really kind of enlightened us to that, right? That we can relax a little bit around those things. And that play is a very important part of physical development for children. Keeping it fun, that’s another message I really got from our conversation. It’s a really important part, too. And I also want to thank you for the work you do. I think that what you’re doing is really, really important. your messages and what you hold true to your job is also really important for all families that you work with. So, thank you so much.
Jeff (44:15)
Well, thank you all, Robin. I appreciate the opportunity to speak with you and to maybe help a few more families have some fun.