Category Archives: physical therapy

The Cardboard Fairy Strikes Again

by Sue Lowenstein, MSPT, Physical Therapist 

Well, “The Cardboard Fairy” has done it again! She helped give another child at Easterseals a set of wings by putting her engineering skills and ingenuity to use!  This time, the Cardboard Fairy tackled the issue of a walker that needed some additional support.  

Let me back up a little for those of you that have not read our previous blogs (here, here and here) about the  “Cardboard Fairy.” Her real name is Dorothy Hess. Dorothy is a retired market researcher who volunteers for Easterseals in a very unique way. She uses heavy duty cardboard (sometimes referred to as “tri-wall”), along with various straps, glue, PVC pipe, clips, and whatever other materials might be necessary to create custom-made adaptive equipment.  

Now, let me introduce you to my student, Kayla. She is a sweet and social 4 year old girl who wears purple glasses and has a head full of curls and a smile that can light up a room. Kayla has been attending our approved private pre-school program in Levittown since September of 2020. When Kayla first started preschool, she needed a full wrap-around chest support, along with the sturdiness and width of a gait trainer, to walk. However, as time passed, she approached the point where she was outgrowing this gait trainer. While a larger sized gait trainer could have been ordered for Kayla, it would have been significantly larger and cumbersome. These gait trainers do not fold, which would make it very difficult for her parents to transport it from place to place.  

As her physical therapist, I was eager to help Kayla transition to a more traditional style and smaller walker (and one that is foldable!). However, Kayla was still reliant on the full back support that the gait trainer provided her. Many attempts to have Kayla walk in a traditional reverse walker without a back support were unsuccessful. Even though Kayla was strong and balanced enough to walk with this type of walker, she craved the back support that the Rifton gait trainer afforded her. But there were no reverse walkers available on the market that  came with larger back supports like the one that Kayla needed. 

So I tried my best to create a custom back support. I used pool noodles (PT’s and OT’s love these things), along with some extra cardboard, tape, and cable ties to try to create a custom back support that would be mounted a traditional reverse walker. However, it did not take long for the cardboard to bend and the tape to fall, resulting in an epic fail. 

I decided that this was a job for the Cardboard Fairy! With permission from Kayla’s family, and adhering to Easterseals’  COVID protocols, we were able to bring Dorothy in to sneak a peek at Kayla and my sad attempt at building a back support. Dorothy took some measurements, and left our school with the walker in her hand.  Just a few short days later, what to my wondering eyes appears on my phone but a video of a lightweight but sturdy back support designed to fit perfectly onto the reverse walker.  It is made out of the tri-wall I mentioned above.  It snaps easily into place onto the walker, and there are two additional straps to help it remain stable and in place for Kayla when walking. It can also easily be removed to allow the walker to be folded and transported by her caregivers. And to top it all off, Dorothy painted it purple to match the color of the walker and Kayla’s glasses!!! 

Kayla’s parents and Dorothy and I are thrilled to report that Kayla took to this back support and the walker very quickly, and she is now WALKING INDEPENDENTLY all around her home and in the hallways of her preschool. The Cardboard Fairy did it again…she gave another child a set of wings (this time in the form of a purple back support) so she could take off!!! Well done, Dorothy. Kayla…you keep on walking, girl!!!!  

Kayla using her adapted walker!

DIY Sensory Mat

by Rachel Meade

After discussing the sensory mat idea with our PT, I figured I could definitely make one.

Making one was very easy and could definitely have been less expensive then what I spent on making it. All the items could have been purchased from the $1 store except the mat.

With my sons sensory issues he likes and dislikes so many things, so this multi-experience mat is perfect. He thoroughly enjoys running his hands over each section and rubbing his feet on certain ones as well.

The pipe cleaners, which are soft but still a little prickly, are his favorite. He is very intrigued by the sandpaper. The rainbow robe is confusing to him because it is hard when you step on it but nice to rub. He loves the Brillo pads for his hands or feet and he likes to pick off the felt furniture dots.

This whole mat only took me about an hour to make once I collected all the items!!

The Importance of Enthusiasm

by Jennifer Latt

This year has been unique for all of us in so many ways.  If I am being completely honest, I have to admit that when we were told we were moving towards doing virtual therapy this past spring, I thought “I can’t do it!”  I had no vision how this could take place and I doubted myself even more.  I have learned it takes a lot of planning and communication with the families.  When I work in the Easterseals building, it is pretty easy for me to roll in and get started with a session.  I have been working in the physical therapy department for years.  I have a plethora of ideas in my head that I can pull out for whatever I think we need to work on that day.  I know what the PT gym has in it, as far as things to play with and use, to help our children meet their sensory needs.  At first, I thought “how am I going to get all this information across to parents?”   I began to do my research on virtual sessions and then I needed to just buckle down and give it a shot.

My first plan of attack was to come up with what I wanted to accomplish with my session for a particular child.  Next, I would try to find pictures of the activities or I would actually have my son step in and I would take pictures of me helping him in different positions to show families what I was doing.  I would email these plans to the parents the night before so they could prep.  I also asked families to give me a list of items that they had at home, favorite toys, and even take a picture of their playroom so I knew what I could work with.

It has truly been a joy to be able to connect with families during this time.  I know that most people would not wish to be trapped at home trying to work and teach their kids and get their therapies in.  However, it has been so amazing for me to be able to connect with families and get the opportunity to see how they interact.  It has also been beneficial for families to get a greater understanding of what we do and why we do certain activities.

The one obvious down side of all of this for me has been the frustration of not being hands on with the children and not always being able to elicit the intended results.  Flexibility has been the key!  I want to applaud all the parents out there who have had to put their homes and their lives on display.  It is not easy trying to take over the role of therapist or teacher, and understand what we are asking you to do.  Know that from my point of view I think the families have been remarkable through all of this.  The most important thing I wanted to share is, that as parents, you need to allow yourselves to be silly during your sessions with your children.  I know that taking on the role of therapist can be intimidating and overwhelming with all of your other responsibilities. In my experience, I know that when I show some silliness, it makes for a much more productive and fun session for not only the child, but also myself. Some of my most fun sessions are often the most engaging and productive. So give yourself permission to not stress about doing it perfectly, and just enjoy this time as much as possible. Your energy sets the tone for your child.

I would like to give several life examples of how this could play out.  I coach high school basketball.  It is easy for me to order the girls around and tell them to run and do one activity after the other. If this was always my approach, they would quickly resent me.  Instead, I constantly cheer them on and offer positive reinforcement.  I run with them and do the activities too, so they know they are not alone.  I offer incentives.  For so many free throws made, I will make them brownies.  If a player really hustles during a game I will bring them a treat.

Both of my children started taking Suzuki piano at a very young age.  It was incredibly difficult and stressful to say the least, especially for my son.  He learns differently and memorizing very complex songs was at times an impossible task.  We did fight!  Yet, I knew this was good for him in so many ways.   I could have continued to fight or I could change my ways.  I came up with incentives.  I would cheer him on and hug him.  I would have incentive charts for so many repetitions of lines played.  I would have his figurines lined up on the piano and when he played through a required line we would play make believe with the figurines.

As parents, when you are asking your children to do activities for school or therapy, don’t be afraid to cheer and get silly and dance around, and make it fun.  Be willing to do the activities with your kids or do it first and then have them do it.   During music time, clap your hands and sing and dance with your kids. If you put on an exercise video, then put on a funny workout outfit and do it with your kid.  During PT for example, if your child has to kick a ball so many times, then when he is done lift him up and spin him around or give him hugs and tickle him so that he associates having fun during therapy.  If you are ever in the Easterseals building when I am doing therapies, you are likely to hear me singing bad renditions of made up songs about what we are doing in the moment.  I even like to break out with Queen’s ”I like to ride by bicycle” when working on riding a bike.  I promise, that we as therapists, are not going to laugh at your silliness during the sessions.  You and your child will feel much better and connected to each other when the task is fun and not just something to get done.  I know that this may all seem like common sense but often we get bogged down with just getting the task done or fitting as much as we can in our allotted times that we forget what it feels like to be a kid.

I want to end with one of my favorite pictures of my son from when he was little.  He had just received this dress up outfit for his birthday.  The pure joy on his face at dressing up and being silly is priceless.  Try to embrace this kind of enthusiasm when you are working on tasks at home.  Don’t give up.  Learning to let yourself go and be silly takes time.  If you have a bad day and a session with your therapists or teachers doesn’t go as planned, forgive yourself and your child.  Every day is a new opportunity.

Measuring Accomplishments

by Susan Lowenstein, MSPT

Booker T. Washington, American author, orator, educator, and advisor to many presidents once said, “You measure the size of the accomplishment by the obstacles you have to overcome to reach your goals.” 

So, that being said…let me tell you about a little boy I know named Miles. He is a 6 year old that is currently a student of mine at Easterseals of Southeastern PA, Bucks County Division. I have had the pleasure of watching him fight to overcome obstacles for the past 9 months, but he has been fighting an uphill battle for all 72 months of his young life.

Miles attending virtual therapy!

OBSTACLE #1: Born 8 weeks early.

OBSTACLE #2: Shared birthday with his twin brother so he was already small for his gestational size.

OBSTACLE #3: Has a mutation on his COL2A1 gene that causes several types of skeletal dysplasia, and his is closest to what is called hypochondrogenesis.

OBSTACLES #4,5,6,7 and 8: Has spinal instability, ongoing joint issues, hearing loss, significant vision issues, and a floppy airway.  

OBSTACLE#9: Intubated at birth

OBSTACLE#10: Received a tracheostomy at 3 months of age

OBSTACLE#11: Transferred to the ICU at Nemours DuPont (an hour away from home!)

So… why am I sharing all of this with you? Well, this is just the beginning of Miles’s story. He may have encountered countless obstacles… but he continues face each one head on and works to overcome them.

So…let’s look at all that Miles has ACCOMPLISHED so far in his 6 years of life.  

ACCOMPLISHMENT #1: Became strong enough to be supported by a home ventilator and home nursing support to go home, just 6 days shy of his and twin brother George’s 1st birthday! 

ACCOMPLISHMENT #2: Learned to taste foods by mouth (even though he needed a g-tube for nutrition) during the first year of his life

ACCOMPLISHMENT #3: Used his hands to gesture and request for food like yogurt and applesauce during his first year of life

ACCOMPLISHMENT #4: Re-learned how to accept some food orally again after cleft palate split at 18 months of age.  

ACCOMPLISHMENT #5:  Started sprinting (practicing time off the ventilator) when he was around 3 years old. Now he is at the point where he can spend nearly all of his waking hours without the ventilator.

ACCOMPLISHMENT #6: Sat upright in a highly supportive activity chair at 2.5 years old (despite his large head and short arms and trunk)

ACCOMPLISHMENT #7: Sat upright on the floor without any back support while playing with toys and watching the classroom smart board or TV at home at 5 years old

ACCOMPLISHMENT #8: Transitions from lying down into sitting up all by himself at almost 6 years old

And…just in the time that it has taken me to put this blog together…Miles has accomplished yet another 2 more feats!!! He can now pull himself up into a supported standing position at his walker all by himself (that’s #9), and has gotten strong enough to crawl over to a large couch cushion and pull all of his body weight up onto it (that’s #10).

Every accomplishment that Miles has achieved is testimony to his resilience, his amazing family and his team of health care and educational professionals. Together, we continue to imagine what he CAN do, not what he CANNOT do.

When people ask me what I do for a living, I tell them that I am a pediatric PT that works with children with complex physical and medical needs. Frequently, I am asked, “ Doesn’t your work make you sad?”  But to the contrary, I find it wondrous to work with children like Miles who are able to overcome obstacles and accomplish so much more than some people may have ever thought would be possible.

Miles, thank you for being such a fighter. We at Easterseals are behind you 100%, and we will continue to watch you hurdle through more obstacles and accomplish so much more accomplish in your future!

Miles proudly displays a certificate of accomplishment