Think about how to set up your child's play environment when you are NOT working with them. Setting up your child's play environment for success is very useful in helping your child progressively move their level of skill up to standing, walking and beyond.
Sometimes without even realizing it, we encourage our children to stay "stuck" in a developmental level because of how we have the play environment organized, and where we put the toys and objects they want. We tend to leave toys right where they can easily play with them and don't give it much thought.
To use this tactic successfully you will need a good working knowledge of the developmental levels and positions discussed in Tip 5. Here's a little table to help refresh your memory.
Levels Developmental Positions
Level I Supine (back), Prone (stomach), and Sidelying
Level II Sitting (on the floor), hands/knees (crawling), and kneeling
Level III Standing, cruising (walking while holding on to furniture), and walking
Simply put, observe what level your child plays in most, and set up the play surroundings to encourage movement up to the next developmental level. Decide what position(s) your child is moving "from" and the position(s) you would like them to get "to."
An important note: I am keeping this tip simple to stress the importance of moving up, against gravity, for your child to reach a new developmental level. However, I realize your child may not be physically able to move independently between levels, and we do not want them becoming frustrated. As a step along the way, we can still encourage progress by setting up a play environment that encourages your child to move within a given level. Again, I highly recommend you consult with a physical therapist if you are having difficulty figuring out the best way to set up the play environment for success, or to teach your child how to move between positions and levels.
As an example, perhaps you would like your child to move from Level II to Level III but the spasticity in their legs doesn't allow them to go from kneeling to standing without help. We would encourage them to move independently between the positions in Level II (sitting, hands/knees, and kneeling) by virtue of the way you set up their play environment. As they gain strength functionally and through the use of other therapeutic techniques to reduce the effects of spasticity, the goal would be to eventually work towards changing the play environment to promote moving up independently to Level III.
Things to keep in mind when setting up the play environment:
What exactly is the "play" environment?
When I am referring to the "play" environment, I'm mostly talking about where a younger child spends time during the day, such as your home, daycare, Grandma's house, etc... When considering play surroundings for grade school age children, think about where they like to hang out after school or on weekends, and what activities they enjoy doing. Inside or outside? Does it depend on the weather? Does their favored environment include other children?
Keep them focused on what you would like by setting up a "corral."
It's better to limit the amount of stimulation your child has in the level from which you would like them to move. In other words, if you give them access to anything remotely interesting to do in the "from" developmental level, they will often choose to be there instead of working to reach the "to" level.
This is an issue that comes up a lot when trying to get your child to move up to Level III (standing, walking). Children that move well within Levels I and II are very good at escaping to other places in the home to play with objects, and they will often avoid doing anything more challenging.
If, for example, your son crawls well but is not yet that interested in standing, your goal would be to help him transition to standing at furniture. The challenge is that when you put the objects that he wants on the couch or coffee table to encourage him to stand, he simply crawls someplace else within the home and plays with things that require less effort on his part. This is where a "corral" is helpful.
The "corral" can surround him with furniture, walls, gates or other barriers to keep him directed and focused on where you would like him to play. Things like a circle of chairs, half of a room, or a gated-off hallway work well. The reason corrals are so helpful is that it is simply not practical to move all of the objects in your home out of the way or somewhere your child can't reach them.
Here's one way it can work: we use the corner of a room (two walls) as part of our corral and then place a piece of furniture diagonally (a couch or a few chairs) to make the last side of a triangle. Then we place your child inside the triangular area with the objects he wants on top of the furniture. By containing him within this area having nothing to play with on the floor, he will usually start trying to stand - we are directing him toward the only source of play.
In situations like this, expect to get inside the corral with your child at first. You may need to show them how to play in the level you would like them to achieve, and then you can begin to come and go with regularity.
Try to avoid moving a lot of furniture and objects from room to room for your set-up.
Being ambitious is great, but being over-ambitious can backfire. I have had clients who rearranged furniture from different areas of the house on a daily basis, until they lost steam and just stopped. Doing a daily major overhaul just isn't practical. I recommend you study each room where your child plays and decide how each room can be set up and positioned in order to challenge your child to move to the next level. Try one arrangement, leave it like that for a while to see how it works, and then make adjustments as needed.
How long do I have to do this for?
It depends on your child's diagnosis and which body systems are affected, but typically you are not going to have to arrange your home in the described manner for months and years. This is because once your child is used to playing at more challenging developmental levels it is natural for them to be internally driven to want to play there more without needing much (if any) encouragement from you.
Continue to use your creativity with how you set up the play environment, and your child will progress more rapidly. Again, if your child is making progress and then all of a sudden gets "stuck," review some of these tips to help re-evaluate whether or not you need to make a change in your practice routine. Perhaps you may find that the play environment set-up needs a little adjusting.
Are you a parent trying to provide the best possible life for your child with special needs? Go to our website http://www.professionaltherapies.com and sign up for our FREE monthly teleseminar designed to train parents, answer questions and give valuable information about topics such as physical therapy treatment, therapy equipment and other resources to help you become more self-sufficient.
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