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