http://www.abtherapy.org Tue, 27 Sep 2011 16:41:06 +0000 en hourly 1 http://wordpress.org/?v=3.3.2 http://www.abtherapy.org/handwriting-without-tears-summer-camp/ http://www.abtherapy.org/handwriting-without-tears-summer-camp/#comments Thu, 21 Apr 2011 23:31:09 +0000 labott http://www.abtherapy.org/?p=386 http://www.abtherapy.org/handwriting-without-tears-summer-camp/feed/ 0 http://www.abtherapy.org/what-is-normal-gait/ http://www.abtherapy.org/what-is-normal-gait/#comments Fri, 05 Nov 2010 19:22:00 +0000 mburkhart http://www.abtherapy.org/?p=358

One Year of Age: Begin walking with a wide base of support, knees face forward and flexed or may be slightly externally rotated (until age 5 or 6). The hips are abducted and externally rotated. The pelvis is anteriorly tilted, feet appear flat (until age 3 to 5), and the arms are held in “high guard.”

18 months of age: Reciprocal arm swing emerges and the base of support begins to narrow. A heel strike becomes more consistent.

Two Years of Age: The pelvic tilt decreases, as well as abduction and external rotation at the hip. Increased knee flexion is still present.

Three Years of Age: The base of support begins to look more mature. They continue to demonstrate increased knee flexion and anterior pelvic tilt.

Possible causes for concern:

• Toe Walking: Occurs when a child walks on their toes and is more prevalent in boys than girls. There is often no cause for toe walking and it can resolve itself during childhood.  Tight gastrocnemius muscles may be a cause, in which a stretching program is indicated. Serial casting and dynamic splints may be necessary, but surgery is rare.
• Intoeing: Walking with the toes turned inward can be caused by various conditions including: Femoral anteverison: an internal rotation of the hip causing the feet to appear to be turned inward. Ligament laxity in the hips is often a cause as well as the tendency of a child to “W” sit. Children who prefer to “W” sit often have difficulty sitting cross-legged. Stretching the internal rotator muscles of the hips and avoiding a “W” sit position will help to decrease femoral anteversion. The condition often resolves itself between 7-9 years of age. Internal Tibial Torsion: an internal twist of the tibia. It is normal in newborns but can often be seen in children who are walking. It may resolve itself by 4-6 years old. Metarsus Adductus: a problem that occurs in the foot. It is characterized by a curve of the forefoot, or toes, inward. It may be rigid or flexible. Stretching can be used if the foot is flexible. For rigid feet, reverse last shoes, or serial casting may be used. Surgery may be necessary for rigid metatarsus adductus.
• Outtoeing: May be caused by increased tightness of the hip external rotators, in which case the problem resolves itself. In other cases it may be due to femoral retroversion characterized by outward facing patella. It may also occur in the lower leg caused by external tibial torsion, which often resolves by 2-3 years of age.
• Bowlegs (Genu Varus): Bowlegs is normal in a young infant and should correct itself by the age of two as increased weight bearing and walking occur. If it does not correct, surgery or bracing may be necessary.
• Knock Knees (Genu Valgus): Common at 2-6 years of age. Should resolve by age 7 as a more mature gait pattern emerges.

 Review submitted by:  Michelle Maynard, DPT  References:

1. Keen, Mary MD, Early Development and Attainment of Mature Gait; American Academy of Orthotists and Prosthetists; Journal of Prosthetics and Orthotics 1993;5:35-38.
2. Valmassy, RL, How to Recognize Pediatric Gait Abnormalities; Podiatry Today; 2002;15.
3. www.pediatric-orthopedics.com/topics/in-out-toe/in-out-toe.html. Accessed 4/26/09.
4. Bellett PS, The Diagnostic Approach to Symptoms and Signs in Pediatrics. Lippincott Williams & Wilkins, 2006.

]]> http://www.abtherapy.org/what-is-normal-gait/feed/ 0 http://www.abtherapy.org/listening-program-article/ http://www.abtherapy.org/listening-program-article/#comments Wed, 03 Nov 2010 17:37:53 +0000 labott http://www.abtherapy.org/?p=352

Occupational therapists

Speech and language pathologists

Other medical and educational professionals

The method can be utilized by:

• Children and adults that have auditory processing difficulties that can be present secondary to an illness, an injury, or a developmental disability.

Sound travels through the three different parts of the ear as a vibratory energy. Once this vibratory energy reaches the inner ear, it is then converted into an electrochemical message which travels to the brain on a neurological pathway that is designated to auditory information. When the information reaches the brain, it then perceives and interprets the messages as sound. The process of perceiving sound is complex and requires a number of skills in order for the information to be interpreted clearly. When there is a disruption during this process, the information becomes disorganized, which impacts the brain’s ability to understand the sound. Auditory processing difficulties can lead to difficulties with:

• Academic skills
• Emotions
• Cognitive skills
• Social skills

Research that has been conducted in the field of neuroscience and within other fields has indicated that difficulties with auditory processing can be improved because of the brain’s plasticity or its ability to change and adapt itself. This change has been found to occur when the brain is provided with specific sensory stimulation that is given:

• Frequently
• With a certain degree of intensity
• Over a sufficient period of time.

The brain has been found to have some degree of plasticity throughout a lifespan; however, the brain has its greatest plasticity during early childhood development. Alfred Tomatis was an ear, nose, throat physician that conducted a variety of research that identified the relationship between certain sound frequencies and their effect on functions of the mind and body. He found that certain zones of sound frequencies affected different abilities. When the music is structured, it enables the brain to better receive, process, store, and utilize auditory information. The TLP has developed psychoacoustic modified music to exercise the different functions of the auditory processing system, which was based on Alfred Tomatis’s research. The TLP music is separated into the following three zones:

• Zone 1: the listener processes lower frequency sounds, which assists with sensory integration i.e. body awareness, muscle tone, balance, rhythm etc.
• Zone 2: the listener processes mid to high frequency sounds which plays a part in the development of speech and language skills i.e. memory, language, speech etc.
• Zone 3: the listener processes high frequency sounds which helps process information for ideas, creativity, and energy etc.

The provider of the TLP would:

• Determine if a client is appropriate for the listening modality
• Expose the client to preparatory music to assess if the person would participate in the program.
• Set the client up on a listening schedule
• Monitor and make changes to their programs as they move through the cycle of music.
• Collect data to assess the effectiveness of the music on the person’s overall functioning.
• Continue to monitor the client until the therapeutic goals are achieved.

Here at Abbott and Burkhart Therapy, two clinicians are trained in this modality. This program can be set up for the home or school environment. The clinic also has equipment that can be utilized on site. This modality is found to be complimentary with other sensory integration techniques as well as other treatments that are utilized within therapy sessions. Submitted by: Michaela E. Gordon, OTR/L, MS]]> http://www.abtherapy.org/listening-program-article/feed/ 0