Stress incontinence after childbirth is common, but it is not normal. Physical therapy can help. Whether you had a vaginal birth or a c-section, a weakened pelvic floor can lead to lack of urination control. However, a weak pelvic floor isn’t always the culprit. This is why it is important to be evaluated by a physical therapist. More than 75% of women experience significant improvement in their incontinence symptoms with appropriate diagnosis and treatment.¹

How Can Physical Therapy Help stress incontinence?

• Evaluate and determine cause of incontinence
• Provide information specific to your problem
• Teach you exercises and strategies to manage your symptoms
• Develop a program to meet your goals

Furthermore, pelvic floor dysfunction can lead to other symptoms including back pain, pelvic pain, and decreased sexual satisfaction, to name a few. Physical therapy can provide the tools you need to get back on track and feeling better. Click here to learn more about stress incontinence, diagnosis, and how a physical therapist will treat it. If you know you have issues with stress incontinence, call MOSAIC today to schedule an evaluation with our pelvic health physical therapist.

Reading disability is often attributed to dyslexia. People frequently use the terms dyslexia and reading disability interchangeably. However, not every student who experiences difficulty with reading is dyslexic. The student may have a developmental language disorder which impairs reading skills. Although both impact reading comprehension, the term reading disability is part of a more general classification and due to multiple causes. Whereas dyslexia is a specific learning disability that comes with its own distinct symptoms.

dyslexia

A child with dyslexia has difficulty primarily with phonological processing, and thus confuses letters and struggles to sound out words. As a result, oral reading is slow, laborious, and inaccurate resulting in decreased comprehension.  When another person reads a story aloud, a student with dyslexia usually comprehends and remembers the information. The difficulty is with written language, not spoken language.

Reading difficulty

Kids with reading deficit due to developmental language disorder will present with deficits in understanding word meaning (vocabulary) and word order in a sentence (grammar) and how word order affects meaning. The child may sound out words easily and read fluently but will not comprehend the meaning of the words. They read fluently because they know the sounds letters make and the rules for pronouncing words. But, they cannot tell you what those words mean. For example, the sentences “The dog is on the rug” and “The rug is on the dog” have the exact same words but a different word order resulting in very different meanings.

A child with developmental language disorder may read the sentence accurately but not recognize the difference in meaning. This difficulty is not specific to written language. There are similar impairments in understanding spoken language. Spoken sentences such as “The dog chased the boy” and “The boy was chased by the dog” have the same meaning but the later sentence may not be understood because of the different word order. Thus, a differentiating characteristic from dyslexia is that difficulty with reading comprehension reflects difficulty with comprehension of spoken language.

Students experiencing reading difficulty may have over lapping characteristics but different causes. Regardless of the cause, a child experiencing difficulty with reading requires treatment to prevent academic struggles and frustration at school. You can learn more about dyslexia by reading Understanding Dyslexia. If you are concerned with your child’s reading or understanding of spoken language, we offer free screening for speech, language, and reading skills. Contact MOSAIC Health and Rehab at (406) 388-4988 for further information.

Have you ever heard of interoception? Interoception may be identified as our eighth sense. Firstly, interoception allows us to understand what is going on inside our body. Then, it helps us know what action we need to take in order to respond to what our body is telling us.

• When our bladder is full, we use the restroom.
• If our stomach growls or feels empty, we eat a meal or snack.
• When we feel cold, we wrap up in a blanket or put on a jacket.

Interoception activities for children are designed to help them learn to identify and recognize the importance of these internal cues. Therefore, it helps them to take action upon these cues. These activities can be utilized in the classroom, at home, or during therapy. These activities will help with self-regulation, flexible thinking, social skills, and problem-solving skills.

Children often struggle to make sense of what is occurring inside their body. They don’t recognize these important cues, or if they do, they do not know how to respond appropriately to them. When this disruption occurs, it can often result in frustration, excessive meltdowns, or other behavioral challenges that seem unprompted.

Does my child have interoception challenges?

Your child might struggle with interoception if they have a tendency to over or under respond to stimuli, such as:

UNDER Responsive:

• High pain threshold
• Unable to register if they are full OR hungry
• Can’t tell differences in temperatures (hot vs cold)
• Challenges with potty training

OVER Responsive:

• Extreme reactions to sensations (hunger, pain, temperatures)
• Worrisome over small events
• Difficulty with focusing due to internal sensations

what activities help?

Interoceptive difficulties can, and often do, have a significant impact on daily functioning. It is important to keep the internal system balanced and these activities can help.

Regular body scans

Teaching your child (or yourself) how to perform regular body scans is a great first step in teaching how to recognize interoceptive input. Do a full body scan before eating or drinking, when outside in hot or cold weather, before using the bathroom, and before and/or after exercising. Then, ask them to identify the internal feelings that hunger, thirst, heat, cold, a full bladder or bowel, racing heartbeat, etc. create. At first your child will most likely need help in being able to identify these feelings. Engaging in this activity often will help them to do it independently.

sensory diet

This activity will require the professional help of an occupational therapist. An occupational therapist can help to involve interoception activities that will combine various tools, activities, and tactile input to help your child’s specific needs. By engaging in a sensory diet both at home and during therapy, your child will learn how to interpret cues their body is giving them in an appropriate manner. Learn more about sensory play ideas here.

yoga for interoception

Engaging in yoga geared towards kids is very beneficial for relaxation, mental health, focus on breath support, and heart rate. Children that struggle with being able to regulate emotions and reactions have challenges with those things. There are many free videos on YouTube showing poses. If you would like to avoid the use of a screen, Yoga Pretzels or Yogarilla are great resources.

heavy work

Otherwise known as proprioceptive input, heavy work activities involve a “push” or “pull” of the body. Heavy work provides a very calming effect on the nervous system. Therefore, it helps children with self-regulation, organization, and body awareness. Often heavy work is included in a sensory diet, so a consultation with an occupational therapist may be necessary. For example:

• Carrying groceries
• Jumping and jumping jacks
• Wheelbarrow races
• Raking Leaves or shoveling snow
• Vacuuming

If you think that you OR your child may have challenges related to their interoceptive system, reach out to your physician to discuss.

Heart disease is a leading cause of death and disability. This shouldn’t be a surprise – it’s been at the top of the list for years. You know that taking care of your heart is important. That means doing things like eating right, avoiding smoking, and exercising regularly. What most people don’t think about is calling their physical therapist. But physical therapists can improve your heart health too!

how Physical therapy can help with your heart health

Cardiovascular exercise is anything that makes you breathe harder and your heart pump faster. That could be walking, running, dancing, biking, swimming or hiking. It strengthens your heart and blood vessels. It can help control weight, lower blood pressure, reduce stress, and prevent heart disease.

If you’re regularly going for a run or swimming laps, you don’t need help from your PT. But 3 out of 4 adults aren’t exercising regularly. For those people, a PT may be just the person they need. It’s not uncommon to get injured, then never get back to the old routine. A PT can help with the old injury and design a plan to safely return to regular activity.

It’s also not uncommon for people to try to be more active on their own, only to stir up pain somewhere – like their back, hip, or shoulder. A PT can help with that too. They’ll figure out the cause of the pain, help correct it, and implement a plan to help that person reach their goals.

After a medical issue

Physical therapists can also help to safely increase activity levels after a major medical issue like a heart attack, stroke, or even cancer. Recent research has shown improvements in cardiovascular fitness, fatigue levels and even pain in cancer patients who participate in a personalized physical fitness plan from a PT.

Whatever your barriers to physical activity are, your PT can likely help you overcome them. As movement experts, physical therapists are trained to deal with a variety of conditions. They’ll help you work around whatever issues you have so you can safely elevate your heart rate and keep cardiovascular disease away.

Read more about how a PT can help coordinate your fitness routine here. Also, the American Heart Association has tons of great information if you want to learn more.

Spring! New growth, sunshine, and warmer weather are a welcome sight following winter. Along with spring comes Easter and, of course, that means a visit from the Easter Bunny! The Easter Bunny often visits homes and hides a bunch of plastic eggs filled with wonderful surprises. Somehow, each year, that one box that holds those plastic eggs goes missing… so off to the store to buy more! Needless to say, many families have a very plentiful supply of plastic eggs. Here are some fun, simple, and creative ways to recycle those plastic Easter eggs that also have a learning component.  Bonus, they can be used anytime throughout the year, and kids love them!

Letter and number practice

Write letters or numbers on a slip of paper and place each one in an egg. Kids can practice identifying them and writing them. For slightly more advanced learning, have eggs with corresponding numbers of items for them to find, count, and match to the printed number. And to expand on letter concepts. kids can name an item that starts with the letter they found hidden in the egg.

Spelling or sight word practice

Write spelling words or sight words on a slip of paper, and put one in each egg. Kids pick an egg, and read the word that is hidden inside. This can easily be expanded to writing a simple sentence using the word.

let recycled Easter eggs choose story time books

Write down favorite or new book titles and put one in each egg. Kids love the surprise factor of finding out what story will be read. This can also help with eliminating struggles of who gets to pick the story…it is all up to the egg!

chores

Sometimes having kids help with simple chores ends up being a chore itself. Fill each egg with the name of a job /chore. This is a fun way to help kids learn how they help around the house.

recycle Easter eggs by filling with money

What kid does not like money! Fill eggs with a coin, and have your child pick one egg color, and then find all the eggs of that color (hiding the eggs can add to the fun). Once you kids find all the eggs, they can match coins or add up the coins. Maybe use the money filled eggs as a reward for completing the chore from the activity above!

fill recycled Easter eggs with snacks

Fill the eggs with small snacks. Things like raisins, nuts, dried fruit, chocolate chips, and mini marshmallows work great. Let your kids choose an egg to see what special snack the egg is holding.

matching

Separate the eggs and either hide them or place them in a container, and have kids find the matching half and put them together. In addition to the skill of matching, this activity helps develop fine motor skills.

These are only a few ideas of how to recycle all those plastic eggs. Plastic eggs come in a variety of sizes, patterns, and colors that make the list endless. Check out some of more creative uses at Twiniversity. Some of them will surprise you! For more fun ideas about how to use an everyday item with your kids, check out our blog, Cups – More Than Just for Drinking.

Did you know that the CDC recently changed the ages for some of the major milestones of child development? Here are some examples. Walking without support changed from 12 months to 18 months. Crawling is no longer a milestone. Before, a 24 month old was saying 50 words. Now, the expectation is that a 30 month old will say 50 words. Milestones now include ages 15 and 30 months. So, why did the CDC make these changes, and what does it mean?

Firstly, the main goal of these changes was to make it easier for primary care providers to identify children who are at risk for delays. The previous ages were based on when 50% of children would meet a milestone. This caused many providers to take a “wait and see” approach as only half of children would demonstrate a particular ability at a particular age. So, the new guidelines represent the age that 75% of children can do the activity. Therefore, if a child is not doing something that a vast majority of children are able to do, they should receive a referral to the appropriate specialist.

Milestone criteria

Here are some of the criteria that new milestones must meet:

• Milestones ages are the age most children (>75%) will demonstrate the milestone
• No longer include warning signs
• Are easy for families from different social, cultural, and ethnic backgrounds to use
• Can be answered with yes, not yet, or not sure
• Use plain language
• Are organized in developmental areas

what do therapists think?

To be honest, we are concerned. In theory, these changes should mean that more kids will have referrals to specialists early. But, many of us have concerns that some kids who are at risk for delays will have referrals later because of these changes. Let’s use walking as an example. Previously, the milestone said your child should be walking by 12 months of age. What that meant was that by 12 months of age, 50% of children were walking without support. That hasn’t changed. 50% of kids STILL walk without support by 12 months of age.

The new milestone says your child should be walking independently at 18 months (and taking a few unsupported steps by 15 months). This means that 75% of kids are walking independently at 18 months of age. So, if you child is NOT walking by 18 months, there should be no hesitation about receiving a referral to a physical therapist. Unfortunately, this may mean that a child who would have received a referral at 15 months (or sooner) is now getting a referral 3 months later. As therapists, we always say that the earlier a referral happens, the better.

Milestones don’t always tell the whole story. While the article does not specifically state why crawling is no longer a milestone, it is very likely that it is not included because 75% of kids will not crawl, not because the skill is not important. In addition, the vocabulary average for a 30 month old is closer to 450 words, NOT the 50 that is the the current CDC milestone.

What does this mean for parents?

Trust your gut. If you have concerns about your child’s development, talk to your primary care provider. Or, call MOSAIC to set up a free screen to discuss your concerns with one of our therapists who specialize in these areas. You can view the updated CDC Milestones here.

References

1. Evidence-Informed Milestones for Developmental Surveillance Tools