Sitting is The New Smoking: Get Up Off Your Seat!

By: Jenn Ripepi, MD, Choosy Pediatrician

You may have heard that "sitting is the new smoking" in the last few years. What is meant by this is that sitting for long periods is bad for our health in many ways. We are meant to move and do it frequently. So what does this mean for our children and their futures?

Sitting decreases our need to breathe deeply, to have our muscles contract and demand increased blood flow. That is the opposite of aerobic exercise. Aerobic exercise is the kind that improves your blood flow and helps to prevent plugged arteries. When we walk, run, swim, and bike or do other activities which get us to breathe harder and our hearts to pump faster, it helps to keep our arteries clear. When we sit we are not using our muscles and letting our blood vessels keep opened up as much as when we move. Over time, that that adds up.

Sit Up Straight

Teaching children to have good posture is important, especially in the pre-school years. Children grow at a rapid pace during their first four years of life and there is an increase in postural responses. It then regresses until adult postural reflexes are reached sometime between 7-10 years of age. So as professionals see it, the most “training”, or using correct sitting/standing positions in static posture and its dynamic reflexes occurs during the early pre-school years of life.

Our overall posture is affected by sitting for long periods. We tend to let our heads drop and that in turn leads our shoulders to hunch forward and our lower backs to curve forward. Our core muscles in our abdomen and lower back get weak. We end up with lower back problems and the whole host of other spinal problems like headaches. For our children who have developing skeletons this is a stress that may force their posture to be permanently impacted. That leads me to the next point.

Build Strong Bones

Strong bones are built not just from calcium and phosphorus but by being used. We have learned from the astronauts in space for long periods that their bone mass decreases when they are out of Earth's gravity. That led others to look at what happens here on the Earth's surface in a number of situations. People have more bone mass when they are physically working against gravity in what we refer to as weight-bearing exercise. That means walking, running, jumping, climbing---moving your body against the Earth's gravitational pull. If children are not moving, they are not building the strong bones to carry them through their lifetimes.

Muscles Matter

Muscles are meant to be used! Our bodies have been built for walking, running, climbing and jumping. If we don't use our muscles, they tend to become weak. Weak muscles can be built up but it takes a lot more work to build strong muscles when someone has not been used to using them. Ask anyone who has gone through physical therapy after an injury and a period of rest. They likely will tell you it was difficult to get started but got easier as their therapy progressed.

Get Moving!

You wouldn’t believe how often I heard in my practice as a pediatrician that kids are tired all the time! Then I'd ask what they "did" all day and they'd answer that they spent most of their time sitting! Not really "doing" anything! They were bored! Our minds need physical as well as mental stimulation. 

A few years ago I read a study about recess in schools and children's performance. Children who had recess with active free play did better in afternoon classes and with their behaviors than children who did not have that opportunity. Children are in classrooms for hours and are kept sitting for that time. They sit on the bus. They sit to do homework. Then many sit in front of a television or video games or other device when they get home. And don’t forget, when they are sitting, they should be at least practicing proper posture or they may have issues down the road.

What Can We Do As Child Advocates?

It is important to help young children learn that when their heart beats faster because they are moving, it is actually healthy and good for them. Help them identify if their heart is "resting," happy, or very happy based on sensing their heart rate. Continue to reinforce the idea of happy, healthy hearts for the entire family. Make everyone’s hearts happy in your family and engage in active movement together. 

At home, keep active not only to help your children but to help yourself. Less screen time and more active time as a family. If you and your children are watching a television show or engaging in technology of some kid, have frequent movement breaks to encourage blood flow and muscle use. 

Music is also a great tool to get our hearts beating. There are many different types of music that enable children to expand upon their listening horizons, imaginations and movements. Allow your children to listen to a variety of music and dance and sing along with them.

When you are on the go, free play outside stimulates big movements and strength and allows children to explore their surroundings. The fresh air and open spaces allow those big, deep breaths we need to keep up with our bodies' demand for oxygen. 

When children are required to sit in school, ask the teachers how they build movement into their lessons. Ask how recess is spent during inclement weather and advocate for active play indoors in a large open space when possible, if the students cannot go outside frequently. (You may be able to let the educators know that they'll have more alert and better behaved children when they allow recess.) 

Try to observe how long children sit when you are with them. A little activity break during homework time can help their concentration. Additionally, try to avoid the command to sit still except when it is really needed (like mealtimes, religious services, haircuts, etc). As we as a society begin to relearn that we are meant to move frequently, we can let our children lead us naturally in movement. All we have to do is follow their lead!

How do you help your children stay active and moving, rather than sitting all day? 

About the Author: I have been a pediatrician for over 25 years. My husband and I have been privileged to raise 4 bright and healthy children. I have tried to gather wisdom from the families I have been blessed to meet during my journey. I believe in practical and flexible parenting to help raise healthy adults. I love to garden, hike, travel and cook and I am looking forward to hearing from Choosy followers.

Balance and Strength - Critical Movement Skills of Infants

By: Steve Sanders, Author of “Moving Matters” and Professor at University of South Florida

When a new baby comes into the home parents naturally ask questions related to the physical development of their infant. Why should my baby be physically active? What types of and how much physical activity should I do with my baby? Infants go through the greatest rate of physical development during the first year of life, and being physically active every day is important for healthy growth and development.

During the first five years of life movement plays an important part in all of a child’s learning. Children learn about the world around them through movement. Those who are more efficient at moving are better able to explore and learn about their environment. Playing with and being physically active with an infant every day will help develop critical movement skills.

Infant Reflexes

When a child is born he does not know how to move and has to learn about and develop physical skills. Movement is first initiated through reflexes. From reflexes children learn to reach, grasp objects, pull and push, and move the head and other body parts. Each time a reflex moves infant muscles a message is sent to the brain and the brain sends messages back to the muscles. This initial process helps the infant to learn how the body can move.

Developing Balance and Strength 

At about 6-8 weeks of age emphasis on activity turns from reflexes to strengthening of muscles and development of balance. Parents should be encouraged to create a stimulating activity environment for their infant that includes a daily activity routine, space for movement, daily tummy time, and lots of appropriate equipment to manipulate.

The future development of all physical skills is based on early learning of balance skills. One of baby’s greatest accomplishments during first year is to stand up and walk. Although walking is all about having the strength and coordination to stand up and move the feet forward, the most important ingredient is balance. Balance comes from the vestibular system located in the inner ear. As fluid in the inner ear moves back and forth a signal is sent telling the brain where the head is and if it is upright. The brain then sends signals to the child’s eyes, muscles and bones to work together to make adjustments to keep the body balanced. The system helps the child to remain steady and upright.

Although muscular strength is not a physical skill, to develop physical skills an infant must develop muscular strength to move his body and body parts. Strengthening muscles does not happen overnight. For example, it typically takes about three months for an infant to have the strength to hold his head up on his own.

A great introductory balance and strength activity for infants is to use a large exercise ball or beach ball (about 24-30 inches in diameter). You can begin this activity at three to four months of age. Place the infant on his back or stomach on the ball. Hold infant with your hands around the child’s middle. Gently and slowly at first, rock back and forth, from side to side, and round and round. Start with slow and steady movements. Do two to three minutes at first, then increase time as baby gets older or increases interest. Learning balance does not happen overnight. The maturation of the balance process is not generally achieved by children until about age 12.

For more information reflexes, balance, and development of strength in infants please read Encouraging Physical Activity in Infants from Gryphon House Publishers.

About the Author: Steve is a professor at the University of South Florida where he is currently involved with the preparation of physical education teachers along with conducting research related to curriculum and instruction in early childhood physical activity.  His most recent project is the book series “Moving Matters” in which he outlines for parents of infants, toddlers, and preschoolers a variety of fun physical activity experiences to assist children in developing the needed physical skills to become physically active and healthy throughout life.   

Helping your Child Thrive at the Pool: It’s a Year-Round Event!

By: Dora Gosselin, PT, DPT, PCS, C/NDT

We are now a few weeks into fall. The leaves are changing, the temperatures are cooling and our family activities may change as we spend less time outdoors and more time indoors. Many health professionals encourage us to remain equally as active during winter months as we were in summer. During the month of October the American Physical Therapy Association recognizes the impact that physical therapists and physical therapist assistants make in restoring and improving motion in people's lives.

With these two “events” happening, I have been reflecting on what we did outdoors as a family this summer. We typically spend as much time as possible at the pool. As parents, pool safety is critically important, but there is another very significant part of pool culture – the play and social interaction that happens between children when they are in the water.

Now you may be asking “why are we talking about the pool in October? It basically does not exist in our life until mid-to-late May.” Here’s the answer: in the spirit of physical therapy month and summer 2016, let’s use the “off-season” to develop our children’s movement skills so they can get to the next section of the pool with their friends next summer!

For children to fully participate in the pool environment they must have the movement skills that allow them to be safe while keeping up with their age-matched peers. For children with sensorimotor or other disabilities, the pool may not be a refuge for endless play but rather a scary and isolating experience.

Our pool, like many others, is divided into sections. There is a shallow section that is lined with parents ready to leap into the water to save their precocious toddler; a deeper part, about five feet deep, that hosts the most diverse group of swimmers from very new swimmers keeping their head above water just enough to prevent a lifeguard from jumping in for the save to very skilled swim team members flipping and diving about; and lastly there is the diving well – the home of the diving boards – a spot that is reserved for the most highly skilled swimmers.

Many of you can relate to this description of a community pool. You can likely recall the swimming (movement) skills of children in each section of the pool. What I would like to call your attention to is the play and social interactions that happen in each section of the pool. The shallow end is generally filled with toddlers and kindergarten-aged children doing what they do – playing with plastic toys and dunking their face under to show their parent for the umpteenth time. Interactions between children in the shallow end are less; many children are very fulfilled with experiencing their own movement and there is less peer play here. In the deeper sections of the pool the social interaction and play is more variable and is a much more significant component of the pool experience. Children interact with one another with swimming races, using goggles to retrieve dive toys thrown by one another and of course the jumping and diving activities. They also just carry on conversation as they tread water or wait in line to go down the slide or off of the diving board. If children live in an area that has seasons, the skills they learn and practice during three months of the year may not carryover between seasons. For children who have a disability and need more practice swimming, seasons and lack of access to an outdoor pool are exponentially troublesome for skill carryover.

The most obvious solution here is to find a pool that your family can utilize all year round so that your child can practice and continue to develop skills over the “off-season.” If this resource is not available in your community or is cost prohibitive, here is a list of suggestions to get your little fish ready to swim and play next year:

• Get in the water as early as you can in the spring. Even swimming just a few times before pool season 2016 will give your child an advantage and a level of comfort when your community pool does open.
• Demonstrate for your child some strategies for peer play they can do in the pool. For example, for a rising kindergartner, the “hot skill” may be jumping in the pool in tandem with a friend or doing a handstand. Take on these skills outside of the pool to help your children develop the movement and play skills they need  to participate with their peers.

When you do finally get into the water for the first time in the spring, follow these tips to get your children acquainted with the water again:

• Swimming requires integration of the right and left sides of the body. This requires coordination as well as strength and endurance. Putting this all together is difficult. A great tool for lessening the task demands on your children is to use a simple kickboard. With the kickboard, children can practice using their legs symmetrically or they can hold the kickboard with one arm and practice coordinating three extremities. 
• Practice, practice, practice! Motor learning theory tells us that internal feedback is the most valuable tool for learning a skill. If your children are frustrated and scared as they practice swimming, it is impossible for them to learn from their own bodies what movements they need to do to attain and sustain swimming skills. You will be most helpful by identifying the components of movement your children do well by proposing something that they should practice. For example, “I love the way that you are kicking your feet fast. This time can you also try to keep your bottom up while you kick?” 

Growth in one area of pool proficiency (movement or social) may spur growth in the other. If your child continues to be resistant to practice or is having difficulty attaining better skills, you can always focus on the social opportunities. Many pools have rules banning most flotation devices; however, some pool managers may be amendable to your child using a U.S. Coast Guard approved flotation device. Having the safety of a flotation device may provide your children with the confidence that they need to cross the lane line and explore the games and interactions that happen in the deep end.

In conclusion, the challenge of swimming demands integration of both sides of the brain and body in a coordinated and sustained way.. Hopefully this blog has reminded you that swimming has two parts – movement and social – and that both of these parts need to be practiced so that your children can thrive and participate safely at the pool. I also hope that it has allowed you to consider what your strategy will be for ensuring a positive 2016 pool season. Start thinking about your game plan now, not on May 1st!

About the Author: Dora Gosselin, PT, DPT, PCS, C/NDT enjoys her combined clinical and academic roles at Duke University. She is board certified in pediatrics and certified in Pediatric Neurodevelopmental Treatment. She has also completed her Advanced Baby training through the Neurodevelopmental Treatment Association. Dora's most meaningful professional accomplishments always occur when a family and child share joy when a new skill is acquired and when physical therapy students, in the clinic or the classroom, grow their passion and skills. Outside of physical therapy, Dora (and her husband, Ben) can usually be found watching their seven-year-old do some sort of performance in the living room.

Moving and Music: Essential For Child Development

By: Dr. Linda Carson

By age three, most children have acquired around 1,000 words. By the age of six, they have acquired nearly 10,000 words! This highlights the significant role we have during the first five years of life to lay the foundation for expanding vocabulary as well as using language for learning and communicating.

How can busy parents support and enhance this significant stage of child development? Probably the easiest way is to talk to children as much as possible. In the youngest toddlers, describe what they are doing as they explore and experiment. With preschool children, ask questions and have conversations about everything from what they might see in nature to their preferences for activities or foods. And be intentional about introducing new and unusual words so that your child’s vocabulary expands. Another very important but easy way to build vocabulary, and at the same time encourage a love of books, is bedtime reading.

While you are at it, add words to your playtime. Babies think and communicate with their bodies before they actually think with words, so your day to day playful interactions can be very meaningful for learning as well as for building bonds of trust and love. During early childhood, children learn a lot with their bodies and about their bodies. There are rich vocabulary words to be experienced by moving and exploring.

You can download this Healthy Vocabulary Framework chart of vocabulary words from Choosy Kids that can be used to mix and vary active learning experiences for young children. You can also listen to Choosy Kids song, I Am Moving I Am Learning, which incorporates words on the chart.

Combining music with deliberate movement has even greater impact on early learning. When young children hear music, they naturally respond by moving their bodies. Movement and music have been shown to influence and enhance the healthy development of the brains and bodies of young children. Music stimulates both sides of the brain. When childhood songs encourage movements that use both sides of the body and incorporate healthy messages, a powerful double whammy learning experience is taking place inside the child.

“Developmentally appropriate music activities involve the whole child-the child's desire for language, the body's urge to move, the brain's attention to patterns, the ear's lead in initiating communication, the voice's response to sounds, as well as the eye-hand coordination associated with playing musical instruments.” (Harman, M.A. Music and Movement - Instrumental in Language Development, http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?ArticleID=601).

So music and movement can not only build vocabulary and motor skills, they can also lay the very necessary foundation for school readiness and school success.

Choosy Kids is a company devoted to early learning through music and movement. Listen to samples of well-conceived, fun-filled songs that encourage active learning.

You can check out more blogs like this from a team of 51 other bloggers at the #Blogger52Project, brought to you by The Quinntessential Mommy.

About the Author: Linda Carson, Ed. D, is the founder and CEO of Choosy Kids, LLC, and the Ware Distinguished Professor Emerita at West Virginia University. An award winning, nationally recognized expert, Dr. Carson has devoted her career to promoting healthy preferences for young children and the adults who make decisions on their behalf. Click here to learn more about Linda.