Encouraging Kids to Play on Their Belly

Lately, there has been lots of hype about putting babies on their belly during playtime. I am so glad for that, because it helps them to develop head, neck, trunk, and leg muscle strength. It is also a good position for visual development, digestion, and production of sounds. Babies who do not tolerate lying on their tummies are most likely going to be delayed with the gross motor skills of rolling and crawling. Whether the baby is placed on a "tummy time" mat or just over the parents lap, this is a good position!

But guess what...it is not just a position for babies! Children of all ages can benefit from lying on their belly while on the floor or a firm bed. A good time to encourage this could be as they are looking at a book, rolling trains on a track, playing video games or board games, or while watching TV. Many children will fatigue quickly because they don't have strong upper bodies, which can correlate to delayed coordination or poor stamina for handwriting and fine motor activities. What you want to see is that the child can prop up on their forearms with their elbows flexed and their head not sinking, and shoulders relaxed not hunched. Some children will roll to one side or just choose to sit up when this position becomes too difficult.

Some ideas to strengthen these muscles include:
1. Yoga
2. Animal imitations: snake, worm, alligator (lay down on belly and clap arms as if they are the teeth chomping down)
3. Wheelbarrow walk- for kids less strong, hold their hips instead of their feet
4. Push-ups
5. Army crawl (AKA commando crawl) through an obstacle course of pillows and under furniture

I have a fabric tunnel that my son and daughter love to crawl and army crawl through. Sometimes I put it next to the couch cushions and other pillows to set up a long obstacle course to climb through. Sometimes we go through it forward and other times backwards. Crawling backwards can really help with the trunk and arm strength too.

For kids who dislike this position, either have the sibling or yourself to get down on the floor to play with them. Often, a distraction may help them forget how much work it really is to play while lying on the belly!

Teaching Toddlers How to Play with Toys

Shouldn't all kids just know how to play? Not necessarily. Some kids can fiddle around with a toy and figure out what to do with it. Others learn by watching another child and then imitating what that other child did. For some children, especially those with developmental disabilities, they don't learn by either one of those ways. They must be taught, and even then the lessons need to be broken down into simple steps. These steps may need to be repeated an hour later or the next day. For children with muscle tone or orthopedic abnormalities, the difficulties in learning may be due to fatigue and mechanics. But eventually, with repetition and patience, the child can learn how to play.



Quite often when I am asked to "come look at a toddler" at work and give my advice to why this child is behind in his development or he has destructive behaviors such as breaking toys, throwing things, or tearing apart other household items, I realize that the child doesn't know how to play. So much of a typically developing toddler's time is spent in play. But some of the toddlers with a delay in development are running around wild, just sitting there doing nothing, watching TV, or "getting into trouble". If they do play it may be limited such as only playing with certain toys and being perseverative in the way they play. An example of perseverative or controlling play is when a child insists on stacking blocks and doing nothing else with the blocks. If someone tries to help them make a house or train with the blocks, they get upset. This is because they have such a limited repertoire of how to play. When some of these toddlers get bored with the same old toys or not knowing how to play, they may become destructive. These behaviors the toddler has would be diminished if he just knew how to play.

That is when I come in to the picture. This means I need to be an investigator and figure out why this toddler is acting up. Is he bad because he is evil? Most likely not. I find that very rarely is there not a reason for a behavior problem. Reasons include: seizures, developmental delays (especially language- receptive and expressive), food allergies, and plain ole' not knowing how to play with toys.



Before parents are able to say "Go play with your toys" to their toddler, there are some things to consider:

• What is the child's physcial and cognitive abilities? Figure out is it really reasonable or not to expect this child to do such a thing. Does the child have the manipulation skills, muscular endurance, and problem solving abilities to play with the toys that are there.
• Can the child make choices? If he can't make choices when you verbally ask a question such as "Do you want to play with the puzzles or the trains?", then he isn't going to say this to himself and go choose an activity unaided when you go ask him to play.
• Is he motivated to play with the toys he has? If he is 2 years old and still has baby toys as opposed to "big boy" toys, then he isn't likely to go play with the toys.
• How long of an attention span does this toddler have? Do the toys require a longer attention span than he has (e.g. game boards, intricate puzzles)?
• Is there some structure to how his toys are kept and organized? If the toys are just dumped and scattered around, some toddlers are too overwhelmed by this to figure out what to go play. However, if they had toys kept in containers, shelves, baskets, or a toy box they may be more likely to know which toy to play with, especially if the adult guides them to a certain container.
• Has the parents, caregivers, or other adults in the chld's life spent enough time getting down on the floor and playing with the child? If not, then why? If it is because the adults don't have time, then make it. If it is because the adults don't remember how to play, then go get one of the many books out there on toddler games and toddler activities and read it. Just think back to things you would have liked when you were young. For example, I always wanted a sit-n-spin (R) but never had one. I played on one at a friend's house when I had the chance. So, I bought one for my daughter when she was 2 1/2, and sure enough she loved it! She didn't play with it daily, but she did enjoyed it. Browse the toy catalogs or toy aisles at the store if you are unsure of what to play. Just have fun playing!

Remember that many kids need to be shown how to play. If you show them that a toy car doesn't just get rolled back and forth but can be crashing into blocks, racing off of a table or couch, and driving under furniture as you make car noises "beep, beep" then they may then have more ideas on how to play. For toddlers and other children who tend to be rigid and controlling in their play skills, you may only be able to show them one more way to use a doll, blocks, or cars. But if you show them one new way to play per week, then within a month, they learned 4 new ways to play with toys. Before you know it, the child will have many choices of what to play when Mom hollers out "Go play in your room!".

Imaginative Play

It is so cute to watch kids, especially toddlers and preschoolers use their imagination during play. As a therapist, I can often get little kids to do some amazing things with imaginative play, and the little ones don't even realize they are improving with their body strength, communication, sensory processing, or other areas of development. They just think they are playing. With imagination: ankle weights become "space boots", arms out to the side become "butterfly wings", and slithering on the belly turns one into a "sneaky snake". Even though as an occupational therapist, my main training is not in speech and language skills, I can really work on expressive and receptive language skills during imaginative play.



I have to hand it to my husband, he is actually better at imaginative play than I am. And that is saying something, because I love to play and act silly. Last year my daughter was really into the Peter Pan Disney movie. So, my husband went to a local party supply store and bought her a Peter Pan costume and some pirate accessories. My husband and then 4-year old daughter would play for up to 30 minutes as she acted out scenes from the movie. He even "threw her" onto the bed as if she was being shot out of the canon. She also jumped from the bed to his arms as she was "walking the plank". It was so cute. Now, I am sad that she isn't as into acting out stories. She is in kindergarten and is much more into playing with games, dolls, tea party, and her friends.



So, today I was watching my 15 month old son play with an unactivated cell phone as he said "hi". I was thinking, "yeah", I get to watch his imagination develop. He is at the age where it is just emerging. Let the fun begin!



At work, so often the toddlers I work with can't yet participate in imaginative play until we work on some underlying skills: joint attention, memory, following simple instructions, sensory processing, & imitating other peoples actions, sounds, or words. So often the attention and imitation are the two biggies we work on. I get so excited when I get to work on the high level skill of imagination! All of the sudden we can be clowns in the circus, cowboys on a horse, and any zoo animal we so desire to be! Sometimes it is even fun to make up an animal or thing that doesn't yet exist!

Well, I am off to go watch the ultimate imagination movie with my daughter and husband on the couch...Toy Story. From the opening scene of the boy playing with his toys to the way the creators of the movie have the toys come to life, this movie is full of imagination! It's been around for awhile, but we love it. We are ready for Toy Story 3 that is due out in 2010!

Playing with Toys: Stored Away or Setting Out?

Toys, toys, toys! As soon as you enter my home, you know children live here. Although the toys are placed neatly in containers, baskets, toy boxes, and shelves, they are still quite visible. I make sure my two children can reach the toys that are theirs. My 5 year old daughter's Barbies (R) and Polly Pockets (R) stay upstairs in her room because I don't want my 14 month old son to choke on the pieces. His toys are low to the ground or in baskets so that they are in reach.



So often when I go to a client's home, the toys are scattered throughout the home or they are put nicely in dark containers out of the child's reach. Now, there are times both of these situations could help a child. But sometimes, the child needs the opposite of what they have. If a child tends to fleet around from one activity to another seemingly like a tornado, then less toys within reach may be better. Also, help the child to clean up one activity before going to another when possible. I don't think the house has to stay spic-n-span all day, but too much stuff out on tables and the floor can overwhelm some children. On the other hand, a more passive child may need more toys setting out, because if not, he would just not play with the toys or think to request to play with them. This child may also need a little more help learning how to play with a toy. Although a one and two year old's attention span may not last through the evening news (30 minutes), many of them can play with the same toy for at least 5 minutes. Remember that a toddler's attention span is not super long, but consider the quality. When he played with the toy, was he focused on it or did he give up easily when not figuring it out? Did he play with the toy or did he just dump it on the floor? Look at the quality of play, not just the quantity of toys and how long he can sit still. Some kids may sit and play with a toy for 15 minutes but just perseverate on playing with it one way, such as rolling a car back and forth. Did the child also say "beep, beep", crash the cars, or drive the car under the table as if it were a long bridge? When possible, expand how long and the variety of ways a child can play with a toy. One way to help with this is to have a semi-organized play space that is not too over-whelming and not too under-whelming!