Thursday, March 27, 2014

Preparing Our Little Observer to Crawl

Children with Down Syndrome get to do the same milestones that most other children do, like sit, crawl, and walk.  However, because of their low muscle tone as well as loose ligaments, these milestones often happen a little bit later than they might for other children.  

We’ve read in a number of places about children with Down Syndrome generally being either motor-driven or observers.  Here's a nice explanation by physical therapist, Patricia Winders:

“Children who are motor-driven tend to be risk-takers. They like to move fast and tolerate new movements and positions. They do not want to stay in one place and dislike being stationary. Children who are observers are more cautious, careful, and want to be in control. They prefer stationary positions and are easily frightened when learning new movements.”
While I’m always cautious about potentially oversimplified categories, it's as if Ms. Winders knew James personally when writing her observer description.

From very early on, James looked straight into the eyes of the person who was holding him, analyzing.  This child can win any staring contest.  He’s constantly watching, thinking, and listening (James can't get enough of language, books, and music!), but very, very slow to make a move and not thrilled when anyone asks him to make a move that he doesn’t want to. 

So we’ve done a lot of gentle pushing every day without (too much) frustrating. We try to find whatever motivates him the most, like snacks and things that shake, light up, and sing, and use that as a springboard to work on the next skill. If he starts crying while doing something related to gross motor movement, we’ve learned to make sure to calm him before getting him out of the position, so he doesn’t associate crying with getting out of doing things. These babies are tricky little people!

With Thomas being a PT, we thought gross motor skills would come very easily and quickly, but James has shown us that he's simply interested in other things right now, and he'll move when he's feeling ready.

The "Safe Zone"

James been a really solid sitter since he was around 10 months old, and he’s very content just like that. We refer to sitting as his "safe zone."  We’ve been trying to motivate him to move in and out of sitting through reaching for different toys on both sides of him.  

He stares at these toys, sizes them up, and decides if it’s worth taking a risk. 9.9 times out of 10, the answer is no. So then we do some hand over hand strategies with him to help him get to the toys and help him learn to get in and out of sitting by himself. Like a rubber band, he very quickly moves right back to where he was. 


It really doesn't get old for us!

Pre-crawling activities

So what do we do while we wait? SO many fun things! We could go on and on, but here are just a few from his wonderful physical and occupational therapists, including his Daddy PT:

1. Physioball/peanut ball- We have lots of fun doing tummy time on these balls, and it's a nice soft place to take a break when he wants to put his head down.  We can also roll back and forth to put weight on his feet, knees, or hands while we play!  The more we can get him to bear weight, the better. 

2. Playing on the steps- While this is something we might want to avoid in the future, for now, it's great! We can put toys or snacks a couple of steps above where James is kneeling to motivate him to bear weight on those knees and REACH up with his hands and his body. Cheerios and Puffs seem to work every time. 

3. Consecutive rolling- James has just started to really get this down! We tease him with his favorite toys across a room to motivate him to get to them.  It's great for him to see that moving gets him to something that he wants.

4. Using his mattress as a wedge- One of James' physical therapists has a nifty wedge that she uses that lets James sit on an incline and forces him to sit tall, so he won't fall down.  We've recreated this wedge at home with his crib mattress and the boppy pillow under it, though any pillow will do. While he sits (and works), we sing songs, read books, and blow bubbles together. He doesn't even remember that he's working.

Nice, tall posture!

5. Tummy time with reaching- To crawl, these babies have to be able to support their weight with one hand, so we stack toys on higher levels for James to practice this skill with both hands.

6. Time on all fours- We try to get as much time on all fours as possible, which is a little hard since he is very effective at getting out of it. BUT this kid is obsessed with listening to VeggieTales songs, so we've started putting on a 3 or 4 minute YouTube song clip on our phones or Kindle for him to watch while he stays on all fours, and we rock him back and forth.  It distracts him enough to do it for longer periods of time until it's a bit easier!

Larry, the cucumber, is a BIG motivator for our little guy.

We try to make all of these things feel like play. Again, just a few, but if you have any other ideas that really clicked with your little person, we would LOVE to hear about them!

Focusing on the process and on strengths

Though it used to bother us that James is on the later side with movement, we're learning more and more to focus on the process and not the product...the journey, not the destination...the same lesson we haven't managed to learn quite yet.  It was a New Year's resolution, in fact. :) Thank you, James, once again, for being such a great teacher and allowing us to see all of these perfect moments that we might otherwise miss. 

We're also learning to really focus on his many strengths. For example, he's a smart little cookie, and he is showing us that he's beginning to truly understand what we say.  Our current favorite is asking him, "hug?" and waiting to see if he greets us with open arms or puts his head down, if he's busy.  He's also starting to use baby sign language to show us his thoughts! He's consistently signing when he wants "more" of something, and signs for "please" and "ball" are emerging! We can't wait to see what's next. 

James has allowed us to appreciate every single step along this wonderful journey and given us the opportunity to have a HUGE celebration with each new skill gained.

Most importantly, he also gives the BEST hugs..after he's thoroughly observed you. :)

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