TOMT Thoughts About Therapy

A collection of thoughts, new ideas, research updates 

  • In this TOMT Blog I will be looking at some of the ideas that have  influenced and challenged my own thinking, and show how I have integrated them into my clinical decision making. 

  • A common assumption, held by physical and occupational therapists, is that balance is a generic process that can be improved by a set of activities that challenge balance responses/reactions.

    An example is exercises standing on a rocker board to improve "balance" in a child who falls a lot. Therapists will often have favorite set of exercises to improve a child's balance. 

  • Stepping up 20m step 11_1.jpgI am busy working on an article covering the assessment and training of stepping up and down in toddlers. To this end I was doing a frame by frame analysis of stepping up onto steps of different heights and was thrilled to find a wonderful example of how a toddler adapts the motor plan to suit the context of the task. 

  • prone kneel weigh shifted back_1.jpgThis is the third installment of my answer to Mindy's question: Why do kids bunny hop?  In this blog I briefly review my approach to assessment of an infant who has an atypical crawling pattern. 

  • W 13m crawling 51_1.jpgThis is the second installment of my answer to Mindy's question: Why do kids bunny hop?

    For me any assessment of an infant's task performance always starts with a review of the  basic postural and movement abilities needed for performing the motor task. In this blog I provide an analysis of the kinematics of crawling. 

  • W 6m transition to prone kneeling 4_1.jpgMindy Silva asked the question: Why do kids bunny hop?  Here is the first installment of my answer to this question.

  • L 6m rolling 21_2.jpgIn a new series of TOMT 0-3 blog posts I would like to share with you some video clips of my three grandchildren that have led to Ah Ha!  moments, shifted my perceptions, challenged my assumptions or illustrated a  particular principle.  

  • M17 threading 3.jpgEach time I review a video clip of  one of my grandchildren engaged in a new manipulation activity I am impressed by how they use a combination of repetition and exploration. 

    In this video clip you see Max (16 months) exploring different ways to playing with a serviette ring and threader attached to a ribbon. 

  • max 4m2w manual neck elongation 6_1.jpgActive mobilization and stretching use the same basic principle as PNF hold/contract relax: select a position that that lengthens the soft tissue structures that are restricted, and then maintaining the stretch on the elongated structures, encourage active movement that induces a contraction in the surrounding muscles. 

  • Using enactive and phenomenological views on cooperation, attention and intentions  Hakstak et al (2017) investigated how PTs scaffold and use play in physical therapy interventions with preterm infants. 

  • After reading the study by Ragnhild Håkstad and colleagues research article Let's Play.  I thought it would be interesting to take a closer look at my own play skills and ability to play in a cooperative manner with infants and toddlers. 

  • In this week's Lets Play video clip you can watch two video clips illustrating the power of mirroring to engage an infant. 

  • T 9m sit tip back 9.jpgTwo important questions
    What lies at the heart of every encounter between a therapist and an infant or child? And what is it that we as developmental therapists wish to achieve? 

  • Will4m2w sitting with caregiver support 1_1_1.jpgIn this video you see Will (4 months 2 weeks) sitting with support on my lap. He makes use of all the available support surfaces to allow him to continue playing with the toy in his hand. 

  • Will8m2w standing with support 2_1.jpgIn this weeks video clip you see Will, aged 8 months, who is new to standing with hand support. I was particularly struck by how he "knows" how to lean on his forearms when he needs to increase his base of support and free his hands for exploring a toy.