4/20/2018 Welcome Special Kids, Special Care NICU Consortium - PDF document

4/20/2018 Welcome Special Kids, Special Care NICU Consortium Meeting April 25, 2018 Huffington Post 9:15 am Dr. Jen’s Top 10 Fun and Easy Strategies for Primitive Reflex Integration, In Infants and Children Jennifer Spiric, PT, DPT, Kids In Motion, Of Spiric Therapies, LLC 10:30 am Benefits of Babywearing for Preterm Infants: With Special Consideration for Their Safety Brandis Rouch and Heidi Jakal, Volunteers, Babywearing Educators Babywearing International of Denver SAVE THE DATE – September 19, 2018 7:30 am to 4:30 pm Supporting Positive Social and Emotional Development for Fragile Babies and their Families: An Infant Mental Health Approach for All Providers Denver First Church, 3800 E Hampden Ave, Cherry Hills Village, CO 80113 Thank you to New NICU Consortium Fellows - Benefits • Continuation of the NICU Consortium Education Meetings/Webinars • Professional Education Certificate of Development for 2 Hours for each NICU Consortium NICU Consortium Partnership Meeting – May 18, 2018 10 am to 12 noon Jefferson County Health Department, 945 Parfet St., Lakewood, CO 80215 Special Kids, Special Care Inc. Offers  NICU Outreach: Safe Sleep Going Home Program  Halo Wearable Sleep Sacs for families in need are provided to NICU staff, public health nurses, and early interventionist to assist them with their education about Safe Sleep  Family Support Grants for Families in Need  Cribs for Kids  infant crib, safe sleep video, sleep sac  Respite care for up to 10 hours  In-home lactation support and consultation  On a limited basis we will offer scholarships for families to attend Premature Infant Massage Classes and baby carriers working with Babywearing International Contact Barbara: Specialcare@sk-sc.org 1

4/20/2018 Dr. Jen’s Top 10 Fun and Easy Strategies for Primitive Reflex Integration, In Infants and Children Jennifer Spiric, PT, DPT Kids In Motion Of Spiric Therapies, LLC Pediatric Physical Therapist Movement specialist Child-led therapist Developmental analyst Mommy Kids in Motion, of Spiric Therapies, LLC Objectives 1. Review the concept of a primitive reflex 2. Understand the importance of primitive reflex integration for ease movement and learning 3. Learn activities that you can start using today to help the infants and children you know and work with start to integrate primitive reflexes into patterns that will help them reach motor milestones and learn age-appropriate skills in other areas of development. 4. Leave today with a written reference and basic instructions for home and clinic-based activities for reflex integration in infants and kids. Kids in Motion, of Spiric Therapies, LLC 2

4/20/2018 So what is a reflex?? Stimulus Movement A reflex is an unconscious, protective movement pattern based on sensory stimuli from the environment. Kids in Motion, of Spiric Therapies, LLC And what are primitive reflexes? Kids in Motion, of Spiric Therapies, LLC Primitive Reflexes are… • Unconscious movements • Based on genetic motor programs typical for all humans • Variable in their presentation, integration, and form • Foundational for coordinated conscious movements throughout childhood and adulthood • Related to all areas of development (motor, vision, sensory system, speech/language, cognitive, emotional, behavioral) Permanent motor plans, but more or less visible/strong based • on life events Kids in Motion, of Spiric Therapies, LLC 3

4/20/2018 A few primitive reflexes Suck- swallow- breathe Automatic gait Rooting Protective extension Asymmetrical Tonic Neck (ANTR) Trunk extension Symmetrical Tonic Neck (STNR) Hands/toes grasp Tonic Labyrinthine (TLR) Robinson Hands Grasp Spinal Galant Leg Cross Flexion-Extension Pull to sit Foot tendon guard Moro Bauer crawling Landau Babkin Palomental Kids in Motion, of Spiric Therapies, LLC Babinski Spinal Perez Scrunch and Stretch (spinal galant) Finger Walks (spinal perez) Riding Horseback (spinal galant) Gentle Pull to Sit - at Wrists (hands pulling) Airplane Game (hands supporting) Reach and Roll (ATNR) Bicycle Legs and Penguin Waddles (leg cross flexion extension) Cobra (spinal perez) Partner Straight Arm Pushes (hands supporting) Duck walks (Babinski) 1. “Scrunch and S tretch” (spinal galant) For older children: For infants (any age): Use the same motion as Lay infant on his side, so that head described for infants. Invite the is in line with body and top child to “feel” the movement shoulder and top hip are pointing first cycle (7reps each side), up at ceiling. Gently bring top then “join” the movement shoulder and top hip together and second cycle (7 reps each side). apart in an accordion motion, 7x each side. Remember to hold for 2- 3 sec in each end position. Look for shirt or skin to wrinkle and then stretch. Older infants should gentle lift and lower head in response to movement. Complete several cycles daily, per tolerance of the infant. The movement should be very enjoyable. 4

4/20/2018 2. “Finger Walks” (spinal perez) For infants (any age) and Tips: children:  Use the soft pads of your fingers, not finger tips. In a tummy-lying (prone) or seated  Make sure you are walking position, walk your fingers up the along spinal muscles, NOT two muscles along the spine, from the spine itself. diaper line (sacrum) to base of skull (occiput). Keeping your  If infant or child is ticklish or fingers on the infant or child, flinches, go more SLOWLY . switch directions to walk fingers out to elbows along backs of shoulders. Use flat hands to “wipe” from shoulder blades to diaper line (sacrum). Start over. Complete 3 cycles in a row if possible. Complete several times daily. *Adapted from Brain Gym Spinal Walks 3. “ Riding Horseback” (spinal galant) For infants (who can sit with support at waist) and children: Sit the child on your leg and gently lean the child to one side and then the other. Pause on each side so the child uses his own muscles to return to upright. Look for one side to “scrunch” or wrinkle skin/shirt. Increase the amount of lean as the child gets stronger. Challenge: straddle your leg or seated on top of a large ball with adult holding the child’s waist or thighs. 4. “Gentle Pull -to- Sit” (hands pulling) For infants (2 months and older) and children: Pull gently at the infant/child’s WRISTS (just below the thumb). Look for chin to tuck and elbows to bend actively pulling to start movement. Tips:  If chin tuck is tricky, start on a pillow, incline, couch arm, etc. to give a gravity advantage.  Excellent activity for children who have difficulty with speech and communication delays, frequently hit their head when falling backward, have difficulty sharing, have difficulty pouring or scribbling/writing. **Infants should tuck their chin and actively pull to sit by age 4 months (adjusted age). Children of all  Try pulling to sit at a variety of ages should instinctively tuck chin, pull by bending different angles for babies and children both elbows, and sit up when they feel the input with low abdominal muscle tone or at both wrists. babies with torticollis. 5

4/20/2018 5. “Airplane Game” (hands supporting) For infants (who can hold their head up while on tummy and push up onto straight arms): Hold the infant face- down and practice “landing” hands on a variety of surface types. Gently rock the infant’s body forward and backward or side -to-side and make sure she keeps arms straight with weight shifts. For children: Help the child lay facedown over a large ball and practice reaching arms to the ground as the ball rolls her body forward. Rock the ball forward and backward or side-to-side and make sure the child keeps arms straight. OR Encourage the child to walk hands forward off the edge of a couch or toddler bed. OR Hold the child at the ribcage and legs and encourage wheelbarrow walking (make sure the child does NOT arch through low back). 6. “ Reach and R oll” (ATNR) For infants (any age) and children: Tips: Try rolling the child up into a Encourage rolling several times blanket “burrito” in a row with arms reaching Encourage rolling down soft forward. inclines or hills. Dangle a toy in front of an infant to encourage forward reach. Encourage child to hold a small ball or stuffed animal overhead while rolling to encourage arms overhead. Remember to roll sometimes toward the Right side and sometimes toward the Left side. 7. “Bicycle Legs” (leg cross flexion-extension) For infants (of any age): Bicycle legs so that one knee bends while other is straight. Pause for 1-2 sec at each endpoint. For older infants and toddlers: Lying on her back, help or instruct the child to bring one knee to chest and keep other leg straight. Switch back and forth so that one leg bends at the same time as the other leg straightens. For older children: Gently resist the bottom of the foot near the heel during bicycle legs so the child has to push against slight resistance to switch leg positions. 6