By: Linda Steed, PT
When I first started at the Little Light House in 1996, the last class of “older kids” was graduating. A few years earlier the graduation age had been changed from 10-11 to 5-6 years of age. I was working with a 10 year old girl who had learned to walk with leg braces. She still needed to work on strengthening and balance but she able to do quite well.
One day I went down to her classroom to pull her out of class and take her down to the therapy room. In the classroom I told her it was time to go to therapy and she looked me in the eye and said, “I don’t want to go, I’ve had therapy all my life and I am tired of it.” A number of thoughts ran quickly through my mind. “Whoo, that’s not a good attitude.” “Oh boy, here we go again.” “I don’t have the time or energy for this.” “She is right! She has had physical therapy all of her 10 years of life and I bet she is tired of being pulled out of class with her friends and doing boring exercises. She will hit a growth spurt and more physical therapy will be essential at that point. How can I make physical therapy fun for her?”
That encounter gave birth to a fun new way of thinking for me. First I thought “What is a child’s job? A child’s job is to have fun.” Think of how a typical baby starts to learn and develop. They basically play. They try, fail, and try again until they master the skill, under the disguise of play. So, I asked myself, how can I make therapy fun? First look at the function of the desired outcome, stronger legs and improved balance so she can walk on the cobble stone path at her grandmother’s garden by herself.
Then, what kind of activities will strengthen her legs, improve her balance, and be fun to her? I like riding a tricycle as a therapeutic activity. This will strengthen the leg muscles, help with trunk control, encourage coordination, and, it is a typical play activity for children. Also, it provides an opportunity for social and emotional development.
A few years later I was working with a 4 year old who had just gotten his first pair of braces, RGO’s. Up to this point he had been in a static, non-moving, stander, receiving very little sensory feedback. At first he was afraid because of his limited ability to feel where his legs were. But he was a boy, all boy! Quickly his motivator was discovered. He loved to step on fingers or other things. So a line of plastic ants were placed down the hall and soon he was “stomping” in his RGO’s and walker.
Don’t get me wrong, there is definitely a time for traditional clinical physical therapy, and most clinical therapists do use fun and play to motivate the children. When you are carrying out your child’s home program whether it is sitting, standing, or walking, think of ways you can turn the “work” into play. If you know a special toy or game that your child likes and motivates him to work, let your therapists know. Conversely, if you are stumped, asked your therapist what toys or games they have discovered that motivate your child.