Aquatic therapy is a fun and engaging way to incorporate the five therapeutic properties of water into treatment sessions. At the Children’s Rehabilitation Institute TeletonUSA (CRIT), therapists provide a specialized approach to tailor each session to meet every child’s therapy goals through interventions that sometimes cannot be achieved on land.

What are the five properties of water?

1. Buoyancy is the ability of water to keep the body afloat. Water decreases body weight, making it easier to move. 
2. Viscosity/cohesion: Water is thicker than air, and its resistance helps strengthen while promoting ease of movement. 
3. Hydrostatic pressure is the pressure that water exerts on the body when submerged. This improves circulation, decreases swelling, and provides sensory input. 
4. Turbulence is the unpredictable motion of water when a liquid is disturbed. It produces a massage effect, which can reduce pain. 
5. Heat: Higher water temperatures aid in reducing spasticity/muscle tightness and soothe pain.

Who can provide aquatic therapy?

• Physical Therapists 
• Occupational Therapists
• Speech Language Pathologists
• Recreational Therapists

At CRIT, all therapists undergo specific aquatic therapy training to provide optimal treatment focusing on many areas, including strength, respiration, fine motor skills, tone management, sensory processing, coordination, social communication, range of motion, balance, language, and much more.

Although many children can benefit from aquatic therapy, it is only appropriate for some. If you are interested in trialing aquatic therapy to see if it will help your child, contact your therapist for more information. 

A sensory bin is a shallow container filled with a base material and various small objects to encourage and enhance play. Some sensory bins utilize a dry material for the base, such as sand, dried beans, or rice. Others are designed for messier play and may use water, shaving cream, or whipped cream as the base. 

Sensory bins can be an excellent tool for targeting a variety of skills, including: 

• Sensory exploration: Of course, sensory bins provide an opportunity for your child to explore touch, but they can also be an excellent way to explore sight, sound, smell, and even taste with certain mediums.
• Visual perceptual skills: Seeking items hidden inside a sensory bin is a simple way to work on a variety of visual skills, including figure-ground perception and visual discrimination, all in one activity. 
• Social skills: Playing in a sensory bin with a therapist, parent, or peer offers natural opportunities to increase joint attention, practice cooperative play and turn-taking, and share items.
• Fine motor skills: By including tongs, spoons, and other simple tools in your sensory bin, you can increase opportunities for digging, scooping, pouring, and stirring – all of which help strengthen hands and build fine motor skills! 
• Regulation and calming: Sensory play can be calming for many children, especially when coupled with a lower-stimulation environment (low lights, soft music, etc.). 
• Language development: Sensory bins provide a naturally rich environment that encourages engagement and connection for increased imitation and building of communicative intent. 

Making a sensory bin at home is a great way to engage with your child while working on skills they’re practicing during therapy. Here are a few things to keep in mind when creating a sensory bin: 

• Avoid choking hazards, especially if your child frequently mouths items during play. 
• Ensure that all materials are non-toxic. 
• Supervise your child while playing with a sensory bin to ensure safety. 
• Do not force your child to engage with the materials if they are scared or hesitant. Often, if you begin to play, they will slowly join you on their own! If you still need to, you may introduce a texture they are not ready for. 
• Swapping out items helps keep children interested and builds connections to seasonal celebrations and holidays. 
• Sensory bins do not need to be expensive to be beneficial. Simple, natural materials such as dried pinto beans, rice, or plain water make excellent bases for a sensory bin. 
• Be creative and have fun! 

If you want to create a sensory bin at home and don’t know where to start, talk to your child’s therapist about recommendations and suggestions to support your child’s goals.

For people with children, car seats are a part of your daily routine. You harness them into their car seat or booster, put your seat belt on, and off you go. But did you know that studies have found that almost 46% of observed car seats and boosters are misused? That means nearly half of the car seats on the road are used or installed incorrectly. Correctly used car seats and boosters decrease the risk of a fatal injury by 71% in infants and 54% in toddlers.”  

Below are a few things to know about car seats: 

• A child restraint is required for everyone under seven years old and under 57 inches (4ft 9 inches) 
• A child can use a seat belt only at eight years old and over 57 inches (4ft 9 inches). 

If you answer no to one of the following, your child should still be in at least a booster. 

1. Do your child’s knees bend at the edge of the vehicle seat? 
2. Is the lap belt snug across your child’s hips or upper thigh? 
3. Does the shoulder belt lay across your child’s shoulder and chest and not rub up against the neck? 

Labels and manuals 

• All car seats have labels with quick tools and information on the side of the car seat. The labels typically include height and weight limits and instructions on leveling the car seat. It is essential to know that every car seat is different.  
• Every car seat comes with a manual. The manual has detailed instructions on properly installing the car seat and harnessing the child for that particular car seat.  
• Every vehicle has a manual, which is important in determining which vehicle seats are allowed to have car seats on them, the location of top tethers, and other specifics for child safety.  
• You can usually find them online if you still need a car seat or vehicle manual.

Harnessing your child 

• Rear-facing car seat:
  • Harness straps are at or just below the child’s shoulders.
  • The chest clip should always be snug and buckled at the armpit level. 
• Forward-facing car seat:
  • Harness straps are at or just above the child’s shoulders 
  • The chest clip should always be snug and buckled at the armpit level. 

Installation 

• A best practice is to follow the car seat manual exactly how they say to install it. There are many different types of car seats, multiple ways to install each car seat, and essential steps for each.  
• If you are unsure if your car seat is installed correctly, find a local Child Passenger Safety Technician to check your installation. 

When will my child be ready for the next car seat? 

All car seats are crash-tested and have guidelines for minimum and maximum heights and weights for each position. Once your child has met either the height or the weight maximum, it is best to switch to the next position or the following type of car seat. 

As you can see from the information above, many intricacies are critical regarding car seats and keeping your child safe. Most people don’t double-check their car seats routinely or even after they initially install them. However, car seats expire, children grow quickly, and straps can loosen over time, so it is imperative to check your car seats.  

Did you know CRIT has its very own Child Passenger Safety Technician? If you haven’t had your car seat checked recently, contact us to schedule an appointment to assess them and learn how to keep your child safe on the road.

Taking steps and walking are significant milestones for functional mobility that many parents get excited about. But did you know that even walking backward is an important milestone? There are many benefits to taking steps or walking backward. 

When do children typically start walking backward?

Typically, developing children begin walking backward between 16 and 18 months. Once they start walking forward, they will also begin attempting to walk sideways and backward as they explore their environment. Exploration is a good sign because it means they are actively trying to control their bodies and coordinate their movements to engage in purposeful play.

What if my child cannot walk forward by themselves? 

Some studies have shown that working on backward walking in children with cerebral palsy has improved walking speed, symmetry, step length, and overall postural stability. Therefore, learning how to walk backward can improve walking forward.

What are some of the benefits beyond improving walking?

Besides challenging overall balance, backward walking helps develop balance reactions to prevent falling backward and strengthens the glute, quad, and back musculature. Backward walking also improves motor planning and coordination and promotes spatial awareness. 

How can I assist my child when walking backward?

1. Hold their hands: With you kneeling before them, hold both hands. Ask them to try walking backward and provide a gentle push back through their hands to cause them to take a step backward. Perform over a length of about 10 feet, 3-5 times each.
2. Use a stick: Kneel before them and hold a stick (broomstick, pool noodle, etc.) at chest level. Ask them to try walking backward and provide a gentle push back through the object to cause them to take a step backward. Perform over a length of about 10 feet, 3-5 times each.
3. Use a toy cart: With you stabilizing on the other side of the toy cart, have them hold onto the cart handle. Ask them to try walking backward and provide a gentle push back through the object to cause them to take a step back. Perform over a length of about 10 feet, 3-5 times each.
4. Pull a heavy object: Start with your child facing the heavy object (toy kitchen, weighted wagon, etc.). Have them attempt to pull the object backward, taking steps to move the object over about a 10-foot distance. As needed, assist by helping offset some of the object’s weight. Perform 3-5 times.

Remember that the time frames provided for milestones are guidelines based on research on children from birth to 5 years old. Every child is different. While some children may hit a milestone early, some may be a little later. If you have concerns about your child’s development, contact your pediatrician or physical, occupational, or speech therapist.