Little Steps Pediatric Therapy News

July 2019


July 18-20th - Wilmette Sidewalk Sale

Get out and enjoy the Summer....Grab the family and make your way to downtown Wilmette for the annual Summerfest & Sidewalk Sale! Three days of fun, shopping, food and more!!

Summer Groups and classes


WHO: Ages 5+.

**If you are unsure if your child will benefit from bike camp, they can schedule an evaluation with Jaime N.**

WHAT: To teach your kiddo how to ride a two-wheeled bike by themselves!

  • Bike safety
  • Balance and coordination of pedaling
  • GAMES and prizes!


  • July 15-19 - 3:30-4:30pm FULL, 4:30-5:30pm - **Limited Spots Available
  • August 12-16 - TBD

WHERE: Glenview clinic - parking lot behind the clinic/Marianos

HELD BY: Little Steps Team

Preschool Readiness Group - NEW SESSION starting JULY 12!! Spaces are limited...

WHAT: promotes early learning for children who have not yet met preschool age. The program tries to teach alongside the requirements elementary schools are most currently looking for. Our PRP works with various aspects that try to engage our children socially, intellectually, physically, and emotionally.

The program focuses on hands on activities so children can explore and learn in their environment to create curiosity and promote learning. Social interaction also creates a unique peer learning environment that encourages children to reach their highest potential. Activities are created alongside the children and their needs in order to reach achievement and ultimately academic success.

Our Preschool Readiness Program Practices:

  • Social Interaction
  • Peer Learning
  • Fine Motor Skills
  • Gross Motor Skills
  • Pre-writing Skills
  • Pre-language Skills
  • Pre-Reading Skills
  • Math, Science, and Reading integrated activities
  • Aid in transitioning from activity to activity
  • Creating a positive learning environment

WHEN & WHERE: Fridays, Glenview Clinic - 8 week program (7/12-9/6)

  • 9:30-10:30 - younger 2's
  • 10:30-12:00 - older 2's and 3's

HELD BY: Vanesa Corado, Lead Teacher & Spanish Interpreter/Translator. SLP and OT's assist with class as well





Therapeutic and Sports Focus Group @ Glenview Clinic

WHO: Age 5-7 year olds

WHAT: weekly afternoon group, in adjunct to their one-on-one sessions, to work on higher level balance, coordination, strength, and endurance exercises.

Billable by insurance! $20 to trial the class

WHEN: Thursdays 4:00-5:00pm,

HELD BY: Jaime Neidenbach, PT, DPT

Social Skills Camp @ Wilmette clinic

See flyer below for more Details:

*Billable by insurance

* Can do 1x/week if you would like

Big picture


"W" Sitting

By: Julie Hesch, PT, DPT

3 Reasons Why Children “W” Sit

Structural Abnormalities of the Hip

  • Can cause Femoral Anteversion, which is the inward twisting of the thigh bone (femur - the bone that is located between the hip and the knee). It causes the child's knees and feet to turn inward, or have what is also known as a "pigeon-toed" appearance.
Poor Balance or Core Weakness
  • W sitting widens the child's base of support while seated on the floor. This is used as a compensatory strategy for decreased abdominal/core strength, back extensor strength, and poor balance.
  • Crawling on hands and knees with legs outside of hips
  • kneeling with knees outside of hips
  • transition from hands and knees to sitting without moving through side sitting.
  • Frequently, a child realizes that this type of sitting takes less effort and achieves more stability, so it quickly becomes their go-to position.

Reasons Why “W” Sit is Dangerous:

Decreased Core Activation

  • The wide base of support decreases muscle activation needed to maintain upright sitting position.
  • Limits the child's need to shift weight from side to side during play resulting in decreased balance reactions

Poor Posture

  • W sitting can shift the pelvis posteriorly (backward) and hunching of the shoulders, which can cause slouching during sitting secondary to core/abdominal muscle weakness
Decreased Trunk Rotation:
  • Due to poor posture (slouching and hunching) it becomes more difficult to rotate your trunk and activate core/abdominal muscles appropriately. This results in muscle weakness secondary to decreased activation.
  • The inability to play utilizing trunk rotation can effect the body's ability to integrate left and right sides of the body leading to decreased coordination.

Delayed or impaired fine motor development

  • Decreased trunk rotation effects crossing midline
  • midline crossing and integrating left and right sides of the body during play directly effect fine motor development, such as transferring objects from one hand to another or buttoning up on a shirt.

In-toeing gait pattern ("Pigeon-Toed")

  • "W" sitting results in increased hip internal rotation (turning in), decreased hip external rotation (turning out), and hip abductor weakness (muscles on the side of our hips that activate to keep our pelvis level)

"W" Sitting solutions:

Alternate Ways to Sit

  • tailor sit - "criss-cross" sitting
  • long sit - with legs extended straight in front of the child
  • side sitting - both legs positioned to either side of the body. One leg internally rotated and one leg externally rotated
  • tummy time
  • sitting on a chair with feet in contact with the floor.
Core Strengthening/leg strengthening and Hip Stretching
  • squatting, climbing, reaching in different directions while standing or sitting with legs in front of the child, swimming, etc.
  • yoga for kids
Repetition/verbal cues
  • remind the child to correct sitting position anytime you see it

Try singing this catchy song with your kiddos to avoid W sitting:

"Sit down, Let's begin. Leg's out straight then pull them in"

Repeat as needed.


Proprioception and its Effects

By: Allison Schmitt, OT student on clinical at Little Steps

What is proprioception?

Proprioception is our ability to sense where we are in relation to our environment and the position of our body and joints. Our proprioceptive sense allows us to produce precise and fluid movements without looking at our limbs, such as throwing a ball. Some examples of proprioception are knowing that our arms are above our head, whether we are standing on cement or grass, being able to touch our nose with our eyes closed, and balancing on one leg. We have receptors all over our body that detect proprioceptive input, but these receptors are most highly concentrated in our joints to help us sense the position of our joints.

What is proprioceptive input and what are the effects?

You may have heard proprioceptive input referred to as “deep pressure” or “prop input”. Proprioceptive input stimulates our receptors to give our body information about its position or orientation. It can also provide intense feedback that the body may be craving. Children who have difficulty processing proprioceptive input may present with decreased motor planning or body awareness. They may appear clumsy, enjoy crashing into things, be very active, or seek additional deep pressure input. Proprioceptive input can be very calming to children and help to organize and regulate their bodies. It can also improve focus and attention. The effects of proprioceptive input last for about 2 hours. The best results are seen when input is incorporated multiple times throughout the day.

Proprioception activities to do at home:

· Identifying body parts

· Squeezing between pillows

· Pushing or pulling heavy objects

· Climbing over obstacles

· Animal walks

· Giving a tight hug

· Squeezing a stress ball

· Yoga

WHO, WHAT,WHERE, WHY… WHEN should children be answering these questions?

By: Heidi Hansfield, MS, CCC-SLP

Asking and answering questions is an important part of conversational turn-taking, but this can be a difficult task for children with speech and language delays. There are many steps we go through (without even realizing it!) when we answer a question. We first must attend to the speaker in order to receive the question being asked. Next, we must process the question and form an answer. Finally, we must respond with the answer. When working with children who struggle in this area, it is important to start simple and gradually increase the complexity of questions being asked. The general milestones for mastering an understanding of wh-questions are as follows:

1-2 years:

· Answers simple “where” questions by pointing or looking in the appropriate place (e.g., “Where’s the doll?”)

· Answers “what’s this” questions to label familiar objects and pictures

2-3 years:

· Points to objects when asked a question regarding its function (e.g., “What do you wear on your head?”)

· Answers “what-doing” questions

· Responds to simple “what,” “where” and “who” questions about objects and people not present (e.g., “What did you eat for breakfast?,” “Where is your brother?,” “Who takes you to camp?”)

· Answers critical thinking questions (e.g., “What do you wear when it’s cold?”)

3-4 years:

· Answers more complex questions, such as “who,” “why,” “where,” and “how”

· Answers questions about functions of objects (“What are spoons for?,” “Why do we wear a coat?”)

4 years:

· Answers “when” questions

~Summer Activity~

Let’s go to the pool!

Now that summer is approaching, it’s finally time for some outdoor swimming! As you are preparing to go to the pool with your little one(s), use this opportunity to incorporate wh- questions.

  • Open your child’s drawer or closet, and ask “Where are your shorts?
  • Ask “what’s this?” to label the items you are bringing to the pool – sandals, hat, swimsuit, goggles, floaties, towel, etc
  • Lay out your pool gear, and ask your child to point to objects by function – “What do you put on your head?,” “What gets you dry when you come of the water?,” “What do we use to help us float in the pool?”
  • To increase the complexity, you can ask questions such as, “Why do we wear sunscreen at the pool?,” “Why do we need a towel?”
  • Later, review your pool outing by asking questions such as “What did you do at the pool?” and “Who did we see at the pool?”