Do’s and Don’ts for Protecting Your Child’s Joints

Joints

Written By:  Hannah Taylor, DPT
Brightsong, LLC Physical Therapist

Joint protection is important for children in order to prevent damage to their growing bones.  A joint is defined as the point where 2 bones are attached in order to permit body parts to move.  So, joints include the elbow, wrist, etc.   Here are some tips to protect your child’s joints.

ARMS:

  • Don’t pull on your child’s arms when assisting them from lying flat on their back to sitting.
  • Don’t swing your child by his or her arms, this can cause shoulder or elbow dislocation.
  • Do use proper hand placement to assist your child to sitting from lying flat or side lying (i.e. place hands behind head, back or on hips).
  • Do hold your child at their waist or trunk when lifting them up from surface or ground.

LEGS

  • Don’t allow “W” sitting (i.e. when child sits on floor and knees are bent and out to either side of body).  “W” sitting places increased pressure and stretching on hips, knees and ankles.
  • Don’t pull on their legs, knees or ankles aggressively during dressing or play to prevent hip or knee dislocation.
  • Do provide good support of ankles and feet with proper shoe wear.
  • Do encourage proper sitting habits and posture.
  • Do monitor your child’s hips, knees and ankles in standing.  Are their knees hyperextended? Do their legs rotate in or out?
  • Do call your doctor if your child complains of pain in joints.

NECK & BACK

  • Don’t allow your child to participate in high impact sports activities or intense jumping without asking their doctor. This is especially true for children with Down syndrome – they are at risk for increased laxity in neck and vertebrae.
  • Do provide proper seating positions for your child. Make sure that chair is appropriate height for child; if needed place small stool or stack of books under child’s feet for proper support.

With proper care, we can help ensure that your child’s joints are protected in order to promote good growth and development. If your child complains about joint pain or if you have concerns about their posture, gait, balance or coordination – please talk to your child’s pediatrician.  They might need to see a physical therapist for an evaluation.

3 Types of Evaluations and What They Tell Us about Your Child’s Development

When you have concerns about your child’s development, you want answers.  You might choose to have a screening completed to briefly assess your child’s development. If concerns are noted following the screening, a formal evaluation will help answer your questions.

During the evaluation, the pediatric professional will ask questions about your child’s birth history, health history, daily activities, current skills and challenges. There are several types of evaluation protocols available, but most often therapists combine evaluation tools to gather more information and to look at your child as a whole.

The 3 most common types of evaluation tools used by therapists include:

1. Clinical Observations – Therapists will observe your child as he or she plays with toys and interacts with others.  These observations tell therapists about your child’s play skills and social interactions.

2. Questionnaires and Checklists – These tools are used to gather more detailed information.  Parents may be the ones to complete these forms or therapists may go through the questions with the parents during the evaluation.

3. Standardized Testing – Most therapists will also use a standardized test to assess your child’s development.  These standardized tests are administered and scored in a consistent manner by all therapists.  The results of the standardized tests show a relative degree of validity and reliability – which means that if others administer the same test to your child, they would get about the same score.  The scores gathered from these tests are based on score samples of typically developing peers.

So, what exactly are therapists looking for when they assess your child?  This all depends on their specialty area and your concerns.

Physical Therapy:  The PT (physical therapist) will look at your child’s ability to use their large muscle groups, aka “gross motor skills.”  They assess your child’s ability to move and explore their environment.  They also look at their balance and coordination, body awareness, range of motion, strength, endurance, etc.

Occupational Therapy:  The OT (occupational therapist) will assess your child’s small muscle groups, aka “fine motor skills.”  They will also look at your child’s sensory processing skills, motor coordination, visual and perceptual skills, self-help, feeding skills and handwriting.

Speech Therapy:  The SLP (speech-language pathologist) will assess your child’s ability to communicate.  They will look at your child’s understanding of language (receptive language skills), their ability to express themselves (expressive language skills) and how they produce specific sounds (articulation).  They SLP will also look at the way your child moves and coordinates the muscles in and around their mouth in order to produce sounds and chew and swallow food.

Developmental Therapy:  The DT (developmental specialist) will assess your child’s overall development. They also look at their social interactions, play skills, classroom interactions and cognitive skills.

After the evaluation is complete, the results will tell us which skills are missing and what, if any, further recommendations and referrals are needed.

If you have questions about the evaluation process or the results of the evaluation, please talk to your child’s therapist.  It’s important for you to understand exactly what is being assessed and what the results mean.

Now It’s Your Turn:  Has your child had a formal evaluation?  If so, what did your think about the evaluation process?