1. “I Can Do It!”: Ways to Grow Your Child’s Independence NDSS Webinar Series Tuesday, April 29, 2014 Katie Bergeron Peglow, PT, MS COO of Adaptivemall.com

2. “I Can Do It!”: Ways to Grow Your Child’s Independence  Some of my First Memories include Down syndrome (DS).  My younger sister, Carrie Bergeron, was born with DS when I was 4 ½ years old.  She always strived to be independent like myself and our other two siblings.  Thankfully, Carrie has worked hard and has been blessed with abilities that allow her to be semi-independent at the age of 37.  Carrie is a self-advocate and national speaker/performer.  Our family created Adaptivemall.com & Special Tomato Brand Products.Adaptivemall.comSpecial Tomato Brand Products  The Story Behind the Brand The Story Behind the Brand April 29, 2014NDSS Webinar Series2

3. “I Can Do It!”: Ways to Grow Your Child’s Independence  Focusing on early developmental milestones in today’s presentation  Right amount of support  Not too much, just enough  Patience April 29, 2014NDSS Webinar Series3

4. “I Can Do It!”: Ways to Grow Your Child’s Independence  ROLLING  SEATING  CRAWLING & CREEPING  STANDING  WALKING  TRICYCLES & BICYCLES  BATHING  FINE MOTOR SKILLS April 29, 2014NDSS Webinar Series4

5. “I Can Do It!”: Ways to Grow Your Child’s Independence ROLLING  The Facts of Rolling…  Average Age for Children with Down Syndrome to Roll From Stomach to Back Independently = 6 months (1)  Average Age for Children with Down Syndrome to Roll From Back to Stomach Independently = 7 months (1) April 29, 2014NDSS Webinar Series5 (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.

6. “I Can Do It!”: Ways to Grow Your Child’s Independence ROLLING  What kind of products will help?  Use toys, stuffed animals, people to motivate the movement  Rolling from Stomach to Back  Happens first  Typically easier  Utilize gravity with the head  Rolling from Back to Stomach  Happens second  More difficult  Engaging the core and leg muscles against gravity April 29, 2014NDSS Webinar Series6 Photos courtesy of Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.

7. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  For Children with DS, sitting often looks like…  Wide base of support  C-curve to the spine  Forward head  “Hanging” on their joints April 29, 2014NDSS Webinar Series7

8. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  The Facts of Seating…  Average Age for Children with Down Syndrome to Sit Independently = 11 months (1)  Key Measurements  Hip Width  Thigh Depth  Foot to Knee Height  Bottom to Top of Head April 29, 2014NDSS Webinar Series8 Key Measurements (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. Graphics courtesy of Adaptivemall.comAdaptivemall.com

9. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  What kind of products will help?  Pre-sitting  Full support  Tilted seating surface  Gradually bring chair upright as head control improves April 29, 2014NDSS Webinar Series9 Photos courtesy of Adaptivemall.com & Bardum.noAdaptivemall.comBardum.no

10. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  What kind of products will help?  Upright Sitting  Pelvis needs a good foundation  Support for the feet  Footrest  Floor April 29, 2014NDSS Webinar Series10 Photos & Graphic courtesy of Adaptivemall.comAdaptivemall.com

11. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  What kind of products will help?  Active Sitting  Input from environment to know where their body is in space (proprioception)  “Fidgets” & “Movers” - Kore Stool  Curved bottom allows movement in all directions  3 different sizes of fixed seat heights – foot to knee height  Encourages anterior pelvic tilt April 29, 2014NDSS Webinar Series11 Photo courtesy of Adaptivemall.comAdaptivemall.com

12. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  What kind of products will help?  Active Sitting  Working the core muscles  Therapy Balls  Swings April 29, 2014NDSS Webinar Series12 Photos courtesy of noahsdad.com & dsamidlands.orgnoahsdad.comdsamidlands.org

13. “I Can Do It!”: Ways to Grow Your Child’s Independence SEATING  What kind of products will help?  Active Sitting  Using sitting in tasks  Use a bench with slight tilt forward  Grounding feet to floor  Active use of leg muscles  Engaging core muscles  Puzzles  Pieces on floor – reach down to get  Puzzle on table  Sit to stand to place the piece can be added to increase the difficulty level April 29, 2014NDSS Webinar Series13 Photo courtesy of www.assistireland.iewww.assistireland.ie

14. “I Can Do It!”: Ways to Grow Your Child’s Independence CRAWLING & CREEPING  The Facts of Crawling & Creeping…  Average Age for Children with Down Syndrome to Crawl Independently = 14 months (1)  Average Age for Children with Down Syndrome to Creep Independently = 17 months (1) April 29, 2014NDSS Webinar Series14 (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.

15. “I Can Do It!”: Ways to Grow Your Child’s Independence CRAWLING & CREEPING  What kind of products will help?  Use toys, stuffed animals, people to motivate the movement  Crawling is with the belly on the floor  Arm pulling and leg pushing  Start with both sides of the body doing the same thing at the same time  Work towards reciprocal movement (right side does the opposite of the left side)  Creeping is with the belly off the floor, also called quadruped  Arms & Legs are used  Strong core muscles are essential  Uses reciprocal movement April 29, 2014NDSS Webinar Series15 Photos courtesy of noahsdad.comnoahsdad.com

16. “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING  The Facts of Standing…  Average Age for Children with Down Syndrome to Pull-to-Stand Independently = 17 months (1)  Average Age for Children with Down Syndrome to Stand Independently = 21 months (1) April 29, 2014NDSS Webinar Series16 (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.

17. “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING  What kind of products will help?  Start with Supported Kneeling or Tall Kneeling  Increases the strength of the hip, leg and core muscles  Helps increase balance  Right & Left Legs are doing the same thing  Use your couch with cushions removed as a working surface April 29, 2014NDSS Webinar Series17 Photo courtesy of noahsdad.comnoahsdad.com

18. “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING  What kind of products will help?  Half-Kneeling  Precursor to Pulling To Stand  Legs are doing opposite motions April 29, 2014NDSS Webinar Series18 Photo courtesy of noahsdad.comnoahsdad.com

19. “I Can Do It!”: Ways to Grow Your Child’s Independence STANDING  What kind of products will help?  Pulling to Stand  Use benches, stable toys or furniture to encourage the movement  Standing Independently  Cruising April 29, 2014NDSS Webinar Series19 Photo courtesy of noahsdad.comnoahsdad.com

20. “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING  The Facts of Walking…  Average Age for Children with Down Syndrome to Walk Independently (at least 3 steps unsupported) = 26 months (1)  Key Measurements if adaptive equipment is needed  Floor to Elbow April 29, 2014NDSS Webinar Series20 Key Measurement (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. Graphic courtesy of Adaptivemall.comAdaptivemall.com

21. “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING  What kind of products will help?  Hypotonia makes this an extra difficult task  Going through the typical sequence of physical developmental milestones will help strengthen all of the muscles needed for walking  Children will most likely need a push toy to start April 29, 2014NDSS Webinar Series21 Photos courtesy of http://billandria. blogspot.com http://billandria. blogspot.com Photo courtesy of billandria.blogspot.combillandria.blogspot.com

22. “I Can Do It!”: Ways to Grow Your Child’s Independence WALKING  What kind of products will help?  Some may need support for longer  Walker – no positioning accessories  Gait trainer – positioning accessories added on as needed and taken away with progress April 29, 2014NDSS Webinar Series22 Photos courtesy of http://billandria. blogspot.com http://billandria. blogspot.com Photos courtesy of parentmap.com & confessionsofadownsyndromedaddy.comparentmap.comconfessionsofadownsyndromedaddy.com

23. “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES  The Facts of Tricycles & Bicycles…  Average Age for Children with Down Syndrome to Ride a Tricyle Independently (15 Feet) = 61 months (1)  What is the end goal? Independence!  Success  Fun  Next level challenge  Key Measurements if adaptive equipment is needed  Inseam April 29, 2014NDSS Webinar Series23 Key Measurement Graphic courtesy of Adaptivemall.comAdaptivemall.com (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House.

24. “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES  What kind of products will help?  Tricycles  Work on Reciprocal Motion  Muscle Strength  Social Skills  Many sizes available through adult sizes  Accessories available with some models if needed  Look for a wide turning radius to prevent tipping April 29, 2014NDSS Webinar Series24 Photos courtesy of Adaptivemall.comAdaptivemall.com

25. “I Can Do It!”: Ways to Grow Your Child’s Independence TRICYCLES & BICYCLES  What kind of products will help?  Bicycles  Work on Reciprocal Motion  Muscle Strength  Social Skills  Balance  Start with a balance bike to focus on balancing first  Progress to a bike with pedals April 29, 2014NDSS Webinar Series25 Photos courtesy of Adaptivemall.com & striderbikes.comAdaptivemall.comstriderbikes.com

26. “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING  The Facts of Sitting in the Bath…  Average Age for Children with Down Syndrome to Sit Independently = 11 months (1)  Sitting independently in the water takes on a whole new set of challenges  Key Measurements  Hip Width  Bottom to Top of Shoulders April 29, 2014NDSS Webinar Series26 Key Measurements (1) Winders, P.C. (1997). Gross motor skills in children with Down syndrome. Bethesda, MA: Woodbine House. Graphics courtesy of Adaptivemall.comAdaptivemall.com

27. “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING  What kind of products will help?  Sitting independently is one thing, sitting independently in water is another  Bouyancy  Slipperiness  “Dream Baby Deluxe Safety Infant Bath Seat”  Bar folds forward out of the way for easy transfers in and out  Suctions to floor of tub  Great kiddie pool option April 29, 2014NDSS Webinar Series27 Photo courtesy of myliddybug.blogspot.commyliddybug.blogspot.com

28. “I Can Do It!”: Ways to Grow Your Child’s Independence BATHING  What kind of products will help?  Similar support for older children  Holds trunk secure for safety while allowing sitting  Great kiddie pool options April 29, 2014NDSS Webinar Series28 Photos courtesy of Adaptivemall.comAdaptivemall.com

29. “I Can Do It!”: Ways to Grow Your Child’s Independence FINE MOTOR SKILLS  Many toys help with…  Strengthening of Hand Muscles  Finger Isolation  Muscle Control  Life Skill Development  Problem Solving  Color & Shape Recognition April 29, 2014NDSS Webinar Series29 Photos courtesy of differentlythesame.net, noahsdad.com & lovethatmax.comdifferentlythesame.netnoahsdad.comlovethatmax.com

30. “I Can Do It!”: Ways to Grow Your Child’s Independence GOAL = INDEPENDENCE  Find Key Motivators  Right Amount of Support  Practice  Patience  Challenge at the Next Level  Be Creative  Celebrate Successes  & Have Fun! April 29, 2014NDSS Webinar Series30 Photos courtesy of facebook.com/ActivateHerefacebook.com/ActivateHere

31. “I Can Do It!”: Ways to Grow Your Child’s Independence  Katie Bergeron Peglow, PT, MS  Pediatric Physical Therapist  COO of &  Email: katieb@bergeroncompanies.comkatieb@bergeroncompanies.com  Customer Service: 1-800-371-2778  International #: 1-315-429-7112  Fax #: 1-315-429-8862 April 29, 2014NDSS Webinar Series31 Q & A THANK YOU! Please understand that although I am a licensed physical therapist, I cannot act in the capacity of your professional therapist(s). An in-depth knowledge of your child’s medical condition and abilities are required to make any final product recommendations. Your therapist(s) is best qualified for this reason.