Overcoming Low Muscle Tone: Playing at home

This post is fourth on the series "Overcoming Low Muscle Tone". To read the previous post on the series, Gear, please click here.

Setting of the play area:

During Patrick's first year of life, his playing area was our living room. We had this puzzle foam mat in both numbers and shape sets. I liked them because they were thicker than most so it was extra safe when he was learning to sit on his own and would occasionally fall to the sides.

By the time he was a little over one year old, we had our basement fully finished, which included a big playing area for Patrick. By then he was scooting around (not crawling, let alone walking!) so I bought these gates on Craigslist to make sure he wouldn't scoot to other areas in the basement that were not safe for him. Well, it turned out that was a bad idea.

His playing area looked like a gated area with tons of toys on the floor. His physical therapist then pointed out that I was better off securing the particular places I didn't want him to get to, and open his space so that he would be more motivated to move. So I put away the gates (a few of them went to surround the TV stuff) and I bought baby gates to block the stairs and the hall to the bathroom. With this changes, he had a more open space to move around, but that wasn't enough. I had to move all the toys from the floor and place them on a table so that Patrick would make the effort to stand.

A couple months later he had mastered standing and going back to the floor. The next step was to make him to give steps. That's when his therapist suggested to change the layout of the playing area, and add a few more "tables" close to each other, each with toys on top, so that Patrick would move from one "table" to the other one. I can't find any pictures of how it used to look back then, but if I come across one later, I will update this post with said pictures. In the meantime, I'm posting a picture I took just for this post. Below you can see the "table" which is nothing but one of the plastic shelves I stole from my husband's shed.

These shelves are very sturdy so I never worried about falling over Patrick, yet they are light enough for me to move around easily. They provide plenty of surface to place many toys, and the height is just perfect for toddlers 1-2 years old (Patrick is 29 months on that photo.) Best part is, I didn't have to pay for them! And even if I had to buy them, they can be stacked later to use for what they are meant: Shelves!

You have to keep children entertained and encouraged to crawl, stand up, and later walk to reach things of their interest. Putting some toys away, and bringing new ones every month or two is a great idea. I'm not saying you have to buy toys every month, but, kids get toys constantly and not only from parents, (think Christmas time, birthdays, when the grandparents are around...) so don't give him all the toys at once, rather, give him a few and put away the rest. In a month or so, you can put away the ones he has mastered playing with, keep his favorite ones, and bring in a few more from the closet. Once you have ran out of new toys, bring back some old ones that are still age appropriate. To get some ideas on what toys are good for your child, you can read this post.

It's important that you change the layout of the playing space in a way that meets your child's needs. As children grow, they are able to do more things, so you have to keep challenging them. Is he sitting up? Then is time to work on making him crawl. Is he crawling? Time to work on making him stand. Is he standing? Then is time to make him walk. Is he walking? Provide plenty space for him to run. It doesn't matter how big or small your house is, you can always find a way to re-organize your furniture so that your child has the appropriate space to fulfill his needs.

Overcoming Low Muscle Tone: Gear

This post is third in the series Overcoming Low Muscle Tone. To read the previous post in the series,  "Toys", please click here. To read the first post, in the series, "Activities", please click here.

GEAR:

a) Ankle/Foot Orthotics (AFOs)

One thing that helped Patrick to stand and walk were his braces. I was told by the Physical Therapist that Patrick needed ankle support, because his feet pronate quite significantly. She said this was common in low muscle tone children, and recommended me to take him to Hanger Prosthetics and Orthotics, to get his measurements. When I called to make the appointment, I was told that a prescription by his Pediatrician was needed beforehand.

That was because they don't necessarily diagnose, rather they just take measurements and order the product. Their expertise helps them decide which type of AFO will be best for your child. The price you pay for the braces includes the appointments needed (measurements, pick-up and any follow-ups) so all these office visits are free of charge. The person who sees Patrick there told us that after using the braces for a little while, we would start seeing significant improvement in Patrick, and he would be walking in no time. He was right!

They suggested that Patrick used the SureStep brand, and while all the information is on the website, let me tell you our personal experience. I'm happy with the product. Patrick didn't mind using them at all, and they seem comfortable. Definitely provided the support he was needing. For some reason I thought the braces would help to correct the problem, but later I was told that mostly they provide support (his body is definitely more stable when he is wearing them.) I think my only complaint is that the straps on his second pair ripped... for something that's billed so high to our insurance (2k+) you would think the straps would be made of a better material.

The first pair of AFOs lasted about 6 months until he outgrew them. He is now on his second pair since the beginning of February. He had to wear the first pair almost all the time, but he isn't required to wear it as much now. I was under the impression that he would need to use the braces for a number of years, but surprisingly we have been told that this may be his last pair. As his muscles get stronger, his ankles should get better, but the problem won't disappear completely. It isn't so bad, considering that there are many people, including athletes that have pronation but are able to perform physical activity just fine.

b) Shorts (Hip Helpers)

One thing that got Patrick started on the crawling were this shorts. They were suggested to me by his physical therapist. This shorts help kids force kids to crawl, or at least, prevent them from scooting, which was Patrick's favorite way to move around, as you could see in the video I showed on the first post on the series.

On the Hip Helpers website you will find that the shorts are also a good aid for children that like to sit with their legs wide open or in W position. Patrick used them briefly, but I think it was worth buying them... he really couldn't scoot the way he wanted, so he had to figure out other ways! It's too bad I actually don't have pictures/videos of him wearing them so you could see, and right now they are too small for him. I hope you can get a good enough idea on what they are like on their website!

c) Chewy Tubes

Also, per suggestion of Patrick's therapist, we bought him a chewy tube, more specifically, a "P" chewy tube. That's the website that was suggested to us, but I believe I found it cheaper (or at least with free shipping!) on Amazon, so you can check there too.

Chewy tubes are great alternatives for little ones who need to practice their biting and chewing skills. Patrick had low muscle tone in his mouth -it was difficult for him to chew food that wasn't soft. Also, he liked (still does to some extent) putting everything in his mouth, more so than the reasonable stage that every baby goes through when exploring new surfaces. The chewy tube is hard, and has some scent/flavor that makes it more attractive to the child, giving the sensory input needed to aid in the mouthing.

I have to say, though, Patrick wasn't a fan of the chewy tube. His jaw eventually got stronger, mostly by the fact that we kept introducing progressively food that wasn't too soft, and by the fact that he likes mouthing so much to the point that anything would go to his mouth, including blocks and other hard things. If you do try it, I hope you get better luck with this product!