Physical Therapy

Choose activities from the list that are within the child’s scope of ability and yet are challenging for them. Remember that if the child has gravitational insecurity any disturbance of his/her balance is frightening for them. They like to have their feet planted firmly on the ground. Anything that challenges their balance can be therapeutic for them if they can be successful – they should not feel threatened, they should be rewarded with praise and hugs when ever they participate.)

• Walk on a rope that is placed in a straight line on the ground (tape on floor if done indoors). Progress to walking on 6” wide balance beam or curb.
• Walk between two ropes (or two lines of tape) that are laid out in a zig-zag course.
• Walk up and down a ramp without holding onto handrail.
• Step up and down one step (such as a curb or stepping up on a 4”- 6” block or box). Progress to walking up and down several steps, using handrail then without handrail. At first child can use a step-to pattern but progress to step-over-step pattern (one foot on each step).
• Step over low objects (Progress to jumping over object).
• Stand on one foot (Try to give the child as little support as he/she will accept such as just touch fingers rather than holding his/her hand).
• Swing (gently at first so as not to scare child).
• Climb ladder and slide on low slide (don’t choose the tallest slide on the playground!).
• Scoot board – sitting or on stomach.
• Bounce on trampoline – A small trampoline with a handle may make your child feel more secure. Have him/her jump with both feet simultaneously – not a skipping or galloping motion. Use appropriate supervision and safety measures.
• Rolling on mat or large wedge – progress to somersault.
• Walk on large pillows (such as the cushions off of the sofa – put them on the floor and have child walk on them, maintaining balance).
• Have the child sit straddling a large roll or barrel and rock from side to side. You may also use a large therapy ball and have the child roll on it on his/her stomach but make sure the ball is controlled.
• Have the child push or pull open a spring-loaded door and enter it and/or hold it for someone else.
• Tug of war – using a sheet or other bedding, play tug of war with your child allowing her to modulate her force by pulling harder or easier on the other end of the sheet.  You can use a timer set for about 2 minutes and have her continue the play until the timer rings.
• Dribble a basketball – use a basketball that is well-inflated so that it bounces fairly easily. Warm up by doing only one bounce at a time and then try to get your child to bounce 3 or more times in succession.
• Bounce a tennis ball and catch it independently – she may use both hands.
• Have him/her catch a tennis ball thrown gently to him/her from a distance of about 6 feet with a bounce in between.  When he/she masters this, throw it gently to him/her without a bounce in between.
• Throw bean bags at a target (large bucket or other target).  If target is on the ground, the child may throw underhanded but if it is higher or on the wall, the child should throw overhanded.
• Help your child learn to throw a basketball upwards, as if shooting it into a basket or goal. Also help him/her learn how to throw a chest pass with a basketball.
• Have your child imitate motor movements as he/she faces you and you demonstrate the position or movement. Keep them simple at first, such as standing on one foot or putting both hands on your head. Later you can combine positions using arms and legs and trunk. Try to cross the midline of your body such as touching right hand to left knee.
• Have your child kick a ball rolled to him/her. As his/her ability improves, roll the ball so that it does not go directly to the child so that he/she has to adjust positioning in order to line up properly to kick the ball.
• Riding and balancing as required on various riding toys (tricycle, bicycle, scooter, Roller-Racer, pedal cars, etc. – Not battery operated vehicles or 4-wheelers).
• Climbing and playing on various playground equipment. It is good to go to different playgrounds with your child so that he/she can have varied experiences in play. You will need to supervise and monitor your child closely.
• Roller skating, using appropriate safety equipment (helmet, gloves, elbow and knee pads).
• Swimming and water play activities are good for sensory-motor integration.
• Lift 3 - 5# barbell or weight above her head using both hands. Have her stand in one place and lift the weight 10 times in succession.
• Play with clay or putty. Roll into ball or snake. Pinch it and roll it into little balls.
• Pin spring-type clothespins on side of plastic bowl.
• “Heavy work” activities – pulling or pushing heavy object (use good judgment and beware of safety concerns) or carrying a box with handles weighing about 8 - 10 pounds. He/she can practice carrying a bookbag that is snug and secure on his/her mid-back with about 8-10 pounds in it. Or have him carry two small zippered bags with about 4-5 pounds in each one (one in each hand). Set out a distance and have him move them from one place to another.
• He can push a cart with weight in it.
• Have him assist with functional activities during the week such as pushing the grocery cart and bringing in the bags of groceries from the car. Have him assist in putting the groceries away. Choose items that are not breakable.
• Have him/her fold washed cloths, hand towels, and dish towels and put them away.